advancing primary healthcare OUTREACH

IMPACTIssue 1, November 2015

health care where it’s needed most CONTENTS

FOREWORD CENTRAL FAR NORTH REGION

Page 04 Page 18 Page 30 Ann Maree Liddy Kilkivan Clinic Healthy Eating in Cape York Matthew Cooke Blackwater Mental Health Page 31 Page 05 Page 19 Provider Profile: Dr Rob Miller Kathy Brown Provider Profile: Dr Tommy Tran Happy Feet! Dr Bill Glasson Page 20 Page 32 Home Is Where the Heart Is Weipa Mental Health Service OUTREACH SERVICES Happy Kids in Gladstone Wujal Wujal Page 21 Page 33 The Whole Child, The Whole Family 7 Page 06 Healthy Hearing Outreach Services Page 07 Feature Article: Children Receive Much Needed ENT Surgery NORTH-WEST REGION ACKNOWLEDGEMENTS 11 Page 08 Page 22 Page 34 Health Care Where It’s Needed Most Sleep Well, Live Well Photo Acknowledgements Page 09 Page 23 Outreach by the Numbers Page 35 Outreach in the Gulf Thank you to our Outreach SOUTH-EAST REGION Western Corridor Mental Health Providers Page 24 Page 10 Heart of Outreach in the Great South-East Page 25 Page 11 Mending Hearts in the Gulf 15 Work it Out Telehealth in the North West Page 12 Team Approach Succeeds at Logan Clinic Provider Profile: Dr Christian Rowan NORTH REGION Page 13 Our Future, The Bigger Picture Page 26 TAIHS 24 SOUTH-WEST REGION Page 27 Mums and Bubs Page 14 Know Your Numbers Checking up in Cunnamulla Prep Screening in Clermont Page 15 Page 28 Provider Profile: Paula Hadgraft Pioneer Podiatry Page 16 Provider Profile: Dr Yong Tan 27 32 Supporting People through the Drought Page 29 Page 17 Andrew’s Story Spot On Vital Health HEAL

Main cover photo supplied by Suzanne McCorkell, SOUL Photographic Design Photo supplied by Coriena Ross, Leidana Photography 4 Outreach Impact Outreach Impact 5

FOREWORD

Kathy Brown Dr Bill Glasson

Queensland State Director, Department of Health Ophthalmologist, Outreach Provider

The Australian Government is committed to improving access There is a famous adage that medical outreach is about bringing to health services for people living in rural, regional and remote the services to the patient rather than the patients to the services. I Ann Maree Liddy Matthew Cooke Australia through a range of outreach programmes. More than truly believe in this as it delivers equity to all Australians - no matter $220 million has been invested over the last three years for the where they live across this far reaching country of ours. This also CEO, CheckUP CEO, QAIHC Rural Health Outreach Fund, Medical Outreach Indigenous Chronic allows the engagement of the local health professionals such as Disease Programme, Visiting Optometrist Scheme, and Healthy our doctors, nurses and allied health professionals who are integral Accessing quality health services is something that most The Declaration of Alma Ata (1978) reaffirmed…that health is a Ears - Better Hearing, Better Listening Programme. in providing outreach services to rural and regional Australia. Queenslanders take for granted. Many of us have access to a wide fundamental human right…and that the gross inequality of health range of health services within a five minute drive from home. between people within a country is unacceptable. These programmes provide funding to address a range of financial A major spin-off of such a model is that it allows us, as specialists disincentives incurred by health professionals in providing outreach and GPs, to train and better educate the local health professionals. But for many people, particularly those living in rural and remote QAIHC, working in partnership with CheckUP, delivers services. Commonwealth funded outreach programmes have This in turn allows these health professionals to manage far more areas, and for a large number of Aboriginal and Torres Strait Islander Commonwealth Government Outreach funded services to rural a multidisciplinary focus and participating health professionals complex conditions knowing that they have the support of the people, this is often not the case. Accessing specialised health and remote areas across . Our Regional Coordinators work in partnership with local health teams to identify and address specialists back in the major metropolitan city. Also, the social care typically involves a long drive to a coastal city or town, with work with Aboriginal Community Controlled Health Organisations service gaps. dislocation which patients incur when they have to be transported considerable time spent away from work, but more importantly, to build capacity within their Services, to identify service gaps in to a major city is very significant and comes at a huge cost to them time away from family and friends. their communities, and to provide improved access to existing and The Australian Government recognises the barriers that are faced and the system. new services. by people living outside of major cities and aims to provide health That is why I am delighted to be launching the inaugural Outreach care that is accessible, affordable and appropriate to their needs. I would like to thank all of my specialist and GP colleagues who magazine, Impact, which highlights how the Outreach program is Regional Coordinators, working collaboratively with these regional give their time to ensure that patients in rural and remote Australia helping tens of thousands of people throughout Queensland to teams, have facilitated strategies to target Aboriginal and Torres have access to high quality and affordable medical services. access quality health care closer to home. Strait Islander Queenslanders. Many of these patients present with complex health problems, and through building stronger This magazine showcases just some of the many services that are partnerships with service providers and mainstream organisations, being delivered across the six Outreach in Queensland, their health issues are addressed. The provision of quality health and is a tribute to the dedicated Outreach providers who travel the care in a culturally appropriate manner has been paramount in length and breadth of our large state to provide this much needed this. health care. Through ensuring a clear framework for service delivery, and Over the past twelve months almost 123,000 consultations have engaging with both the client and the community, the access to been delivered at 156 locations in Queensland through the services amongst Aboriginal and Torres Strait Islander patients Outreach program and 70% of these consultations were with has shown a marked increase on last year. For example, access Aboriginal and Torres Strait Islander people. to services through MOICDP funding was 78% at the end of June 2015; at the end of September it was 85%. To the Outreach health providers, and to the many health facilities hosting Outreach services across the state, a sincere thank you for The increased access to Outreach Services will contribute to this tremendous achievement. Thank you also to the Regional ‘closing the gap’ in health outcomes for Aboriginal and Torres Strait Coordinators and the CheckUP and QAIHC teams for their highly Islander Queenslanders – congratulations to the hard-working effective coordination of the Outreach program, and for compiling people who have made this happen, especially our QAIHC this first edition of Impact. Regional Coordinators. This is a magnificent outcome.

We hope that the articles in this magazine demonstrate to you how It is wonderful to read the positive stories from around the our Outreach program is making a positive impact on the health regions featured in this publication. I urge everyone – providers, of so many Queenslanders. Quality heath care should not just be facilities, Aboriginal Community Controlled Health Organisations, available for people in our coastal cities and towns, or to those coordinators and community – to continue to work together, who can afford it. We are delighted that our Outreach program and know, that through writing their own personal good news is helping to deliver quality health for all, in the parts of the state outcomes, they are contributing to the much bigger picture of where it’s needed most. removing inequalities in health care for everyone.

Photo supplied by Tonita Taylor Photography 6 Outreach Impact Outreach Impact 7

OUTREACH SERVICES

CheckUP, in partnership with the Queensland Aboriginal and Islander Health Council (QAIHC), is FEATURE ARTICLE: the jurisdictional fundholder for the Rural Health Outreach Fund (RHOF), the Medical Outreach Indigenous Chronic Disease Program (MOICDP), Healthy Ears – Better Hearing, Better Listening CHILDREN RECEIVE MUCH NEEDED ENT SURGERY Program, and the Visiting Optometrists Scheme (VOS) in Queensland. ON THE SUNSHINE COAST Collectively, these programs are known as Outreach Services.

CheckUP, in partnership with the The questionnaire asked: North Coast Aboriginal Corporation for Community Health (NCACCH) • What improvement have been and a private ear, nose and throat experienced by your child since (ENT) specialist, Dr David McIntosh, receiving the surgery? received additional Outreach funding from the Department of Health for • What does is mean to you/ ENT surgery for Aboriginal and Torres your family member to have Strait Islander children who would the opportunity to receive this otherwise be on a two to three year surgery? waiting list for much needed medical intervention. • How would it affect you/your family member if you had to wait The surgeries were undertaken at an extended period of time for the Noosa Hospital in June 2015, and the surgery? coordinated by NCACCH, who also

provide ear health screenings into The questionnaire revealed that Bubejah is all smiles after his ENT surgery schools. A total of 21 Aboriginal the early outcomes of the ENT and Torres Strait Islander children, surgery resulted in considerable aged between three and 19 improvements to the hearing, years of age received the surgery. speech, sleep patterns, breathing and behaviour of the children. On providing the ENT surgeries Dr McIntosh reflected that, “The surgery With funding provided by the AMAQ provides the children with a better Foundation, Dr David McIntosh, the Photo supplied by Suzanne McCorkell, SOUL Photographic Design chance of reaching their full potential.” Noosa Hospital and NACCH will again work with CheckUP in early 2016 to ural Health Outreach Fund (RHOF) to increase access to a range of health hearing health. The Program’s objectives Many parents of children receiving support more children through the services, including expanded primary are to increase access to multidisciplinary surgery on the day expressed their ENT surgical process. The aim of the Rural Health health for Aboriginal and Torres Strait care in primary health care settings and to gratitude for being able to access Nichole and Kim from North Coast AMS Outreach Fund is to improve health Islander people in the treatment and increase the range of services offered by the service and looked forward Routcomes for people living in regional, management of chronic disease. visiting health professionals to prevent, to seeing the positive results. rural and remote locations by supporting The Program focuses service delivery on detect and manage ear disease more My daughter is doing the delivery of outreach health activities. diabetes, cardiovascular disease, chronic effectively. Another mum noticed immediate really well. The service The Program focuses service delivery on respiratory disease, chronic renal (kidney) results following her daughter’s a range of chronic conditions; maternity disease, mental health and cancer. isiting Optometrist Scheme (VOS) surgery with improved verbal is amazing. It makes and paediatric health, eye health, support communication and listening. She for chronic disease management and ealthy Ears - Better The objective of the Visiting is also demonstrating more self- such a big difference women’s health. Hearing, Better Listening Optometrist Scheme is to confidence in school with her learning for families to be able Vimprove the eye health of people residing and interacting. edical Outreach Indigenous The aim of the Healthy Ears - in regional, rural and remote locations, to get the surgery when Chronic Disease Program HBetter Hearing, Better Listening Program including Aboriginal and Torres Strait To measure the impact and outcomes (MOICDP) is to increase access to a range of health Islander communities, by increasing of these surgeries the NCACCH Health it’s needed rather than services including expanded primary optometry services in areas of identified Workers administered post-operative spending three years on M health for Indigenous children and need and improving the coordination questionnaires to the parents or carers The aim of the Medical Outreach youth (up to 21 years) for the diagnosis, and integration of eye health services of the children who received the the wait list. Indigenous Chronic Disease Program is treatment and management of ear and and the quality of ongoing patient care. surgery. Dr McIntosh and Tameeka following surgery 8 Outreach Impact Outreach Impact 9

OUTREACH BY THE NUMBERS Statistics for the period July 2014 to June 2015

122,959occasions of service

156 12,962 locations in visits Queensland

145 84,997 Photo supplied by Suzanne McCorkell, SOUL Photographic Design health providers Aboriginal & Torres Strait Islander patients HEALTH CARE WHERE IT’S NEEDED MOST Central Region Agnes Water-Baralaba-Biggenden-Biloela-Blackwater-Boyne Island-Buderim--Calliope-Childers-Dallarnil- 70% 1,266 Eidsvold-Emerald-Fraser Coast-Gayndah-Gemfields-GinGin-Gladstone---Kilkivan-Maroochydore-Maryborough- of visits by allied services Monto-Mount Morgan-Mount Perry-Moura-Mundubbera-Nambour--Rolleston-Sapphire-Springsure-Sunshine Coast- health providers Tannum Sands-Taroom-Theodore-Tieri-Wandoan-Woorabinda-Wowan. Regional Coordinator - Anita Williams

Far North Region Atherton-Aurukun-Babinda-Badu Island-Bamaga-Boigu Island--Cardwell-Chillagoe-Coconut Island-Coen- 45% 21% Cooktown-Croydon-Darnley Island-Dauan Island-Edmonton-Einasleigh-Forsayth-Georgetown-Hammond Island-Hope Vale-Horn Island- of services are projected Injinoo-Innisfail-Kowanyama-Kubin Island-Laura-Lockhart River-Mabuiag Island-Mapoon-Mareeba-Mossman-Mossman Gorge-Mount specialist services increase in visits Garnet-Mt Surprise-Murray Island-Murray Upper-Napranum-Pormpuraaw-Ravenshoe-Saibai Island-St Paul’s Island-Stephens Island- in 2015-2016 Thursday Island-Tully-Warraber Island-Weipa-Wujal Wujal-Yam Island-Yarrabah-Yorke Island. Regional Coordinator - Moira Matic

North Region Airlie Beach-Ayr-Bowen-Cannonvale-Capella-Cardwell-Charters Towers-Clermont-Collinsville-Dysart-Garbutt-Glenden- Greenvale-Homehill-Hughenden-Ingham-Kennedy-Mackay-Magnetic Island-Middlemount-Moranbah-Nebo-Palm Island-Pentland- Proserpine-Ravenswood-Richmond-Sarina-. Regional Coordinator - Susan Dixon-Grover

North West Region Adels Grove-Alpha-Aramac-Barcaldine-Bedourie--Blackall-Boulia-Burketown-Camooweal-Cloncurry- Dajarra-Doomadgee-Gregory-Isisford-Julia Creek-Jundah-Karumba-Lawn Hill-Longreach-Mornington Island--- Normanton-Stonehenge-Tambo---Winton. Regional Coordinator - Jessica Silver

South East Region Acacia Ridge-Browns Plains-Burleigh Heads-Caboolture-Capalaba-Coolangatta-Deception Bay-Eagleby-Goodna- Goomeri-Inala-Ipswich-Laidley-Logan-Miami-Morayfield-Northgate-Oxenford-Sippy Downs-Stradbroke Island-Strathpine-Tin Can Bay- Woolloongabba-Wynnum. Regional Coordinator - Sarah Duke

South West Region Augathella-Boggabilla-Bollon-Charleville-Cherbourg-Chinchilla-Cunnamulla-Dalby-Dirranbandi-Eulo-Gatton- Goondiwindi-Gympie-Inglewood-Kingaroy-Miles-Millmerran-Mitchell-Mungundi-Murgon-Oakey-Quilpie-Roma-St George-Stanthorpe- Surat-Tara-Texas-Thallon-Thargomindah--Wallumbilla-Warwick-Wondai-Wyandra-Yowah. Regional Coordinator - Nigel Daisy

Photo supplied by Tonita Taylor Photography 10 Outreach Impact Outreach Impact 11

SOUTH EAST REGION WORK IT OUT

UIH’s Work It Out (WIO) program relaxation, exercise, managing fatigue, is a great example of how service medication use, and tools to manage coordination and integration is working frustration, pain and isolation related well in practice. The WIO team is an to their chronic disease. The exercise Iinter-professional team supporting program provides qualified exercise each client’s journey. Through Outreach professionals available to participants funding, CheckUP supports allied who are given the necessary tools health professionals who undertake needed to enjoy improved quality of life. one-on-one consultations with clients so they can achieve positive results. Evaluation of the program shows that participants improved their fitness test The Work it Out program was last results over the program’s duration and year’s recipient of the ‘National Lead all clients reported significant changes Photo supplied by IUIH Clinicians Group’ award for excellence in their social and emotional well-being. in the innovative implementation of clinical practice. The accolade was Using the IUIH model of care, the Institute awarded in the category of ‘Cultural is empowering communities in south-east Photo supplied by Coriena Ross, Leidana Photography Competency in Indigenous Care in Queensland to take responsibility for the the Management of Chronic Disease’ delivery of health services to Indigenous to the team who dedicate themselves Australians, by Indigenous Australians. In to improving the lives of Aboriginal this way, IUIH is not only helping to Close and Torres Strait Islander peoples. the Gap in life expectancy but is laying OUTREACH IN THE GREAT SOUTH-EAST the foundations for better education, The program was established by the IUIH real jobs in the real economy, and safer in response to the abnormally high rates communities. The Aboriginal and Torres Strait Islander population of south-east Queensland represents over one-third of of Indigenous people living with, or at risk Queensland’s total Indigenous population. It is also the fastest growing Aboriginal and Torres Strait Islander of chronic disease in south-east. When population in Australia and is forecast to double by 2031 to a population of over 133,000. patients attend their local Aboriginal Medical Service for a health check or to The accolade treat a chronic disease they are given the option of being referred to the program to was awarded in the ith these figures in mind, it Services (CCSS) and IUIH Connect. This health services. Outreach services have help manage their illness. As a result, the is not surprising that there means that clients have ready access to the been provided by IUIH to the Charleville and category of Cultural program has seen over 860 participants Photo supplied by IUIH is a strong focus on the care they need without financial burden. Western Areas Aboriginal and Torres Strait take part with outstanding outcomes. integration and coordination Islanders Community Health Services and Competency in

Wof allied health and specialist services in the The IUIH allied health team provide services in the Cunnamulla Aboriginal Corporation for The CEO of the IUIH, Adrian Carson, sees Indigenous Care in south-east region. an interdisciplinary model that focuses on the Health to deliver podiatry services. the program as an important component patient journey and community, including the Management of the strategic approach to closing The Institute for Urban Indigenous Health facilitating case conferences for client the gap on Indigenous life expectancy. (IUIH) receives funding through the management across disciplines to ensure of Chronic Disease

Outreach program to deliver allied health best practice in service delivery. Furthermore, “Work it Out is one of our flagship to the team services across 17 Aboriginal and Torres by integrating services, IUIH has managed to programs delivered by IUIH to our partner Strait Islander Community Controlled increase efficiencies, reduce duplication of who dedicate clinics across the south-east corner. Clinics in south-east Queensland. services and better meet the needs of clients Since its inception the program has from the Aboriginal and Torres Strait Islander themselves to gone from strength to strength with a The delivery of services within clinics enables community in south-east Queensland. significant increase in client participation improving the lives a ‘one-stop shop’ for clients with holistic and improved health outcomes.” support complementing other clinical The Institute’s coordinated and integrated of Aboriginal and

service delivery. It also enables integration model of service delivery has been recognised The WIO education program adopts with other services delivered in and through by the wider community controlled health Torres Strait Islander an extensive, structured curriculum clinics such as the aged care program, sector in Queensland, with requests from peoples. covering topics relating to nutrition, Photo supplied by IUIH Care Coordination and Supplementary other regions to deliver much-needed allied Photo supplied by IUIH 12 Outreach Impact Outreach Impact 13

TEAM APPROACH PROVIDER PROFILE: OUR FUTURE, DR CHRISTIAN SUCCEEDS AT ROWAN THE BIGGER

LOGAN CLINIC r Christian Rowan is an Addiction PICTURE Medicine Specialist and the Medical r Anjali Sainani is a psychiatrist who is providing Director of Addiction Sciences a visiting service at the Aboriginal and Queensland. As a former President he health and well-being of our communities in Dof the Australian Medical Association of the future lies within the hands of our children. Torres Strait Islander Community Health Service at their Logan clinic. Dr Sainani works with the Queensland and the Rural Doctors Association The delivery of paediatric services in the south- Dexisting Social Health team at the clinic and the case of Queensland, Dr Rowan has an strong east Queensland region is of upmost importance understanding of health and the challenges of toT ensure our children grow up healthy and strong. conferencing approach used by the entire team has assisted with the better integration and coordination of patient care. chronic disease management in Queensland. Dr Manjula Kannangara is a paediatrician who has been Being able to case conference high risk patients and Addiction Sciences practicing in this region for three years in Aboriginal their families has helped everyone at the Clinic to get Queensland and Torres Strait Islander Community Controlled Health on board and has resulted in some fantastic outcomes. provides outreach Services (ATSICHS). Dr Manjula takes a holistic approach services into to health care and works in conjunction with the allied One example of a highly successful outcome was a patient that Aboriginal health team across nine clinics. For the last two years was able to use art as a medium for expression. The process and Torres she also has been supervising a paediatric registrar was so successful that the patient recently showcased some Strait Islander who provides services between Inala Indigenous of their own art at the Logan clinic with support from the staff. Community Health Health Services () and ATSICHS. Services across five Dr Sainani firmly believes that it is the team based approach locations in south- Dr Manjula is passionate about delivering a to health care that is helping to ensure that visiting mental east Queensland family centred service and is able to achieve this health services are working well. under the by looking at and considering the big picture. Medical Outreach Indigenous “The whole family needs to be functioning well in order for Chronic Disease the child to grow, develop and thrive. Involving families, The process was so successful Program. These the allied health team, schools and other agencies that the patient showcased specialist through case conferencing and stakeholder meetings clinics assess helps to identify the needs of the child and their family some of their own art at the and treat a range of conditions including and assists me to get a better picture,” Dr Manjula said. chronic pain; prescription drug dependence; Logan clinic. heroin and marijuana dependence; alcohol “I work closely with the allied health team, especially abuse; smoking; and gambling addiction. the speech pathologists, occupational therapists and psychologists to help build the foundations Working closely with the allied health teams of the child’s learning and development. It is and the local GPs, the Addiction Sciences fundamental that each child is exposed to a healthy Queensland team are able to achieve some environment that encourages them to learn and thrive.” excellent outcomes for their patients. Ashley Wilkinson, IUIH occupational therapist, comments Dr Christian Rowan says, “A multidisciplinary that, “Having access to Dr Manjula’s notes through a focus and approach is essential in the shared medical record system is helpful in creating a management and treatment of complex chronic bigger picture before commencing therapy with a child.” pain problems as well the rehabilitation of people who have become dependent on drugs, “We’re able to work together as a team to ensure the best both illicit and medically prescribed. We have possible outcome for the child and their family. As an seen some excellent outcomes from the work occupational therapist, I am confident that my professional we have been undertaking with Aboriginal and opinion is well considered by Dr Manjula.” Torres Strait Islander communities in south-east Queensland.” Photo supplied by Coriena Ross, Leidana Photography Photo supplied by Suzanne McCorkell, SOUL Photographic Design 14 Outreach Impact Outreach Impact 15

SOUTH WEST REGION PROVIDER PROFILE: PAULA HADGRAFT n 2008, COAG agreed to six targets, 2012, Warwick State School since 2014 the period of attendance. Information one of which was to halve the gap in and this year at Newtown State School, regarding the child’s educational reading, writing and numeracy for targeting literacy and language learning challenges is sought from the teacher; Aboriginal and Torres Strait Islander for students in Prep to Year 3. The team this information helps the therapist Ichildren by 2018. Closing the Gap are constantly looking for new programs individualise the program. Following works on the foundations of respect and which encourage student engagement a session the therapist will assist the unity and acknowledges that, ‘it requires in the learning experience offered. teacher with classroom programming by intensive and sustained work‘ by all sectors providing ideas which can be incorporated of the community. Hadgraft Speech The barriers to Aboriginal education into the day-to-day curriculum. Pathology, in cooperation with CheckUP, often include teaching materials which have contributed to this process by have inappropriate context, where the Hadgraft Speech Pathology is hoping that establishing a school-based, Indigenous stories told do not relate to the lives this valuable approach will be used in specific speech pathology service; of the Aboriginal students. Hadgraft other regions to assist schools to close the focussing on the integration of the speech Speech Pathology will be discussing literacy and language gap for Aboriginal pathology service with the students, with school principals the possibility of and Torres Strait Islander children. parents, school and teachers. The service using technology to allow students to provides programs which address the take photos of their learning activity, literacy and language needs of students which can be incorporated into Photo supplied by Leonie Semmens referred by their parents or school teacher. language and literacy learning therapy.

The Australian Government, Closing On a day-to-day basis the speech the Gap document (July 2014), states, pathologist invites parents to become ‘there have been few improvements in involved in their child’s therapy program the proportion of Indigenous students by firstly discussing their child’s needs CHECKING UP IN CUNNAMULLA meeting the minimum national standard and if able, attending the therapy sessions

in reading across all age groups’. Hadgraft at the school. The speech pathologist Cunnamulla is a small town that lies on the Warrego River in south-west Queensland, 206 kilometres south of Speech Pathology has provided services encourages all parents to seek a 715 health check for their child prior to, or during Charleville and approximately 750 kilometres west of Brisbane. Cunnamulla is situated at the intersection of at Goondiwindi State School since the and the Balonne Highway. At the 2011 Census, the town had a population of 1,641 with approximately 34% of people identifying as Aboriginal or Torres Strait Islander.

unnamulla Aboriginal Corporation Roma based Vital Health provides a number for Health (CACH) recently of visiting allied health services including entered into a new collaborative dietetics, exercise physiology, occupational arrangement with the South West therapy, physiotherapy and speech CHospital and Health Service and Queensland pathology. Podiatry services are provided Country Practice in the provision of a much by the Institute for Urban Indigenous needed GP service for the town. The new GP Health (IUIH) and Jason Cripps Podiatry. service has increased the number of people who are regularly accessing health services Cunnamulla Aboriginal Corporation for Health in Cunnamulla and is a good indicator that is currently identifying other health services this service is valued by the community. such as ophthalmology and a local surgical service, that would benefit their community. Cunnamulla Aboriginal Corporation for Health is also supported through the In the meantime, the wide range of visiting provision of Outreach funded allied Outreach funded services are providing health services which visit Cunnamulla the Cunnamulla community with access to on a monthly basis and provide a multi- quality health care without the need to travel disciplinary approach to patient care. long distances from home.

Jacquie Graham from Hadgraft Speech Pathology with students from Newtown Sate School PhotosPhoto supplied by Shane Richards 16 Outreach Impact Outreach Impact 17

SUPPORTING PEOPLE THROUGH THE DROUGHT

o say that times are tough in The Charleville and Western Areas Speaking directly to the people south-west Queensland is an Aboriginal and Torres Strait Islanders living in these communities is the understatement. The current Community Health (CWAATSICH) is best way to discover what services drought is affecting 80% of one organisation delivering this much are most needed at this time. theT state and follows the previous needed support. CWAATSICH provides drought which lasted eight years. a wide range of allied health services The multiple allied health services But this time around many people in including podiatry, physiotherapy, provided by CWAATSICH results in rural and remote communities are exercise physiotherapy, speech and communities in the south-west region reporting that this is the worst drought occupational therapy, psychology, and having access to regular quality health in living memory. The difficulties audiology services to Aboriginal and care and reduces the stress on people experienced on the land has flow- Torres Strait Islander people living in who are too unwell to travel, or who on effects for the entire community Charleville, Roma, Quilpie and Mitchell. are doing it tough at this difficult time. in these drought affected areas. CWAATSICH develops new CWAATSICH CEO, Ms Sheryl Lawson, With times so incredibly tough, it’s vital service proposals, approved and sums up her service as, “A safe Photo supplied by Suzanne McCorkell, SOUL Photographic Design that people are supported as much funded by CheckUP’s Outreach and friendly environment for our as possible and one important way is program, based on the needs community where they can access up- through the provision of critical health and priorities identified through to-date services and information as services which address the physical extensive community consultations well as health education, to empower and emotional needs of people. throughout the south-west. the community to make informed SPOT ON VITAL HEALTH decisions regarding their health”. tilising the funding Speech Pathology Occupational provided by CheckUP, Therapy (SPOT) groups at key schools Vital Health has been able and kindergartens in the area. to increase the speech Upathology and occupational A group intervention has meant therapy services provided to areas that the clinicians are able to focus such as St George, Cherbourg, on combined speech pathology Cunnamulla and Charleville. and occupational therapy goals while providing more children with Three passionate health providers targeted intervention at the one time. have driven the success of these Outreach services – Emma Kay, When asked for an example of success, an occupational therapist, and Emma said, “Today two pre-Prep aged speech pathologists, Harriet children in our SPOT group were able Benham and Ella Worboys. to identify the first letter and sound in their name without any prompts! We The three clinicians have collaborated only began practising this in our last across professions to develop two group sessions.”

We have found this integrated approach to be a highly effective way to help children achieve developmentally appropriate goals.

Photo supplied by Leonie Semmens Photos supplied by Vital Health 18 Outreach Impact Outreach Impact 19

CENTRAL REGION PROVIDER PROFILE: DR TOMMY TRAN

The Outreach Regional Coordinator in , Anita Williams is delighted with the investment in her region which has resulted in 13,000 consultations provided to the community over the past 12 months.

ver the next 12 months, even more and more time in rural medicine. The Outreach more services will be delivered “I’ve really cut down on my private practice in rural and remote areas of time. I used to work there full-time but I’ve services delivered in Queensland with an emphasis dropped it down to about one and a half to Central Queensland Oon those conditions identified through two days a week and I hope to fill the rest of the local planning processes – diabetes, my time with my Outreach services,” he said. supplement the mental health, cardiovascular disease and chronic disease management. Dr Tran says the service has been welcomed local health services by the community. “In areas like Central that are available One of the health providers who will be Queensland where there are difficulties Photo supplied by Tonita Taylor Photography delivering health services in the Central accessing specialists, the local people are in my region and it Queensland region over the next 12 very appreciative of the services,” he said. months is paediatrician, Dr Tommy means less trips to Tran. Dr Tran began providing Outreach “I get a tremendous amount of job Brisbane for medical KILKIVAN OUTREACH CLINIC EMBRACED BY LOCALS services in 2014 and particularly enjoys satisfaction because a lot of people have travelling to smaller localities to deliver trouble accessing services and being able procedures that can health care. Dr Tran runs a private to provide services for the kids in their CheckUP, in partnership with Central Queensland, Wide Bay, Sunshine Coast PHN, has established the Kilkivan practice in Brisbane but is spending home town is really great.” now be delivered Outreach Clinic. locally. he Kilkivan Outreach Clinic has been embraced by the community. The clinic has Dr Zeeman really maintained the same staff of a General Practitioner, physiotherapist, podiatrist and counsellor since its establishment in 2013 ensuring continuity of care for patients. does go the extra

TheT GP, Dr Sandra Zeeman, visits Kilkivan for two days per fortnight and has established mile to make sure that a strong connection with her patients. Many patients have commented how much they I’ve understood her value the fact that Dr Zeeman drives over two hours each second Wednesday to spend two very busy and full days with the people of Kilkivan. Access to regular medical care diagnosis. Her calm from a GP and other health providers has given the community a boost and a reduction in travel for those who are unwell, elderly or simply busy with work and family commitments. and gentle manner, along with her medical The team continues to increase the efficiency and effectiveness of medical service for patients, particularly those at risk of poor health outcomes. The model is working well experience and for the Kilkivan community, due largely to the positive partnership between the health providers, CheckUP and the Primary Health Network. genuine care really sets her apart. BLACKWATER MENTAL HEALTH SERVICE A MODEL OF SUCCESS shley Withers visits the community of Blackwater through Ashley has an exemplary working relationship with the team from Lifestyle Training Therapy Solutions (LTTS) and the North Blackwater General Practice who have devised an “on the Outreach funding allocated by CheckUP. Ashley believes day waiting list” so if patients cancel their appointment with Ashley that by providing clients with a range of strategies that someone else is called which results in no wasted appointments. Aaim to reduce distress it allows them to enhance and promote their This model is working extremely well and means the Blackwater own emotional well-being. The visiting service is funded for one community is receiving a high quality service without the need for visit per month and is highly utilised. Patients from towns within long distance travel. a two hour radius of Blackwater are also accessing this service. Dr Tommy Tran 20 Outreach Impact Outreach Impact 21

HAPPY KIDS If a student cannot hear HOME IS WHERE THE properly in the classroom, IN GLADSTONE they cannot learn and will HEART IS not engage. Disengaged he students and teachers at students are more likely hulundu Wooribah Indigenous for treatment of complex cardiac issues. Rosella Park State School, Health Organisation ICOP was founded in 2007 and since then Gladstone are delighted to be to misbehave and cannot receives quarterly visits has grown from its initial 10 rural and receiving Outreach funded visits from the Indigenous remote communities to now covering fromT Marcelee Gellatly, from Lifestyle progress through school NCardiac Outreach Program (ICOP). 36 communities across Queensland. Therapies and Training Solutions, who at the same rate as other has been visiting the school every The visiting cardiac specialists from Rohan Corpus, state manager and creative fortnight since May 2015. To the students students. By providing this the Royal Brisbane and Women’s genius behind the program, will tell you and teachers at the school this service Hospital visit Gladstone as part that ICOP takes pride that their service has been invaluable. The teachers service, we are not only is based on inherent Aboriginal values- of the Outreach funded program. report that there have been significant providing great health respect, responsibility, relationship, improvements in the students to whom The ICOP team are helping to ensure the rights and reciprocity while prioritising Marcelee has been providing a service. care for the community, Indigenous community receive much a wellness approach to sickness and needed cardiac specific treatment, often engaging the patient in maintaining their A key focus for Marcelee has been a but we are also doing our own healthcare. saving patients the inconvenience of Fun with Food program with a class bit to ‘close the gap’ in having to travel to major centres for follow- of six young boys. All of the students up and certain investigations. The service presented with restricted diets as a result educational disparity as has been welcomed by both the Indigenous Thanks to the services of fussy food patterns or behaviour well. and non-Indigenous community. provided by CheckUP’s linked to their autism or other dietary issues. Marcelee has met with parents Photos supplied by Karen Mills One patient, who had not been seen by Outreach program, I was able and spent considerable time with the a specialist for five years, was re-engaged to be treated in my home town teacher and support teacher aide in by the Indigenous Cardiac Outreach the classroom offering strategies to Program, while another patient with without the inconvenience of assist these students in expanding HEALTHY HEARING ASSISTS serious cardiac issues was made aware travelling away. their repertoire of food choices. of the urgent need to be admitted to Royal Brisbane and Women’s Hospital In addition to this, she has modelled her EDUCATIONAL OUTCOMES intervention by working directly with the have so far participated in this program. students each visit. The improvement hrough the use of funding allocated The Aboriginal health worker travels in the students willingness to try new through the Outreach program, to the school with mobile hearing foods has been considerable, with both Healthy Ears – Better Hearing, Better equipment and undertakes screening the classroom staff and parents reporting Listening, Central Queensland RegionalT Aboriginal and Islander Community of all Indigenous children at the school. many positive stories. They have Screening is also available to non- attributed the boys’ improvement to the Controlled Health Organisation (CQRAICCHO) Indigenous children who have been efforts of Marcelee and the support they has taken on the challenge of screening identified as having possible hearing issues. have received as a result of this additional young people for hearing problems.

service for the school. The combined efforts of Aboriginal Health Students with hearing issues on the first Workers, Peter McIntosh and Cecelia screening are listed to be rescreened at a later We cannot thank you Cook (both trained as hearing health date. Students who are identified as having providers), has resulted in hundreds of hearing difficulties are then referred on to a enough for allowing us young people having their ears screened specialist service for further intervention . in schools throughout the district. this opportunity, and CQRAICCHO Program Coordinator, Melena feel very, very lucky to Both primary and secondary school McKeown comments that, “Not only does students have been able to access this the screening result in the early detection of have been involved in screening, and schools in Gladstone, Moura, hearing problems in Indigenous children, but Boyne Island, Tannum Sands, Ubobo, it also means better educational outcomes such a program. Blackwater, Emerald and Woorabinda for these children in the long term”. Photo supplied by ICOP Clinic in Gladstone Photo supplied by CQRAICCHO 22 Outreach Impact Outreach Impact 23

NORTH WEST REGION OUTREACH IN THE GULF

ach month a team from primary health care services from the The team works in partnership with Gidgee Healing in Mount Gidgee Healing Bus, their mobile health the Normanton Recovery Service, the Isa travel 500km north to van, based at the Normanton Recovery community, and other local and visiting Normanton, a small cattle town and Community Wellbeing Service. health providers to support an integrated Eof 1,100 people in the On each visit the health providers see and collaborative approach to improving region of north-west Queensland. approximately 50 Aboriginal and Torres health outcomes for the Aboriginal Strait Islander patients with a very low and Torres Strait Islander residents of The Gidgee team includes a GP, nurse non-attendance rate. This service has Normanton. and Aboriginal health worker who stay been operating for approximately 12 in Normanton for the week to deliver months and has been highly successful.

Photo supplied by Leonie Semmens SLEEP WELL, LIVE WELL

The benefits of coordinating health services is evident with the success of a new Outreach funded service provided by Queensland Sleep. We identified that there were an large number he service is delivered by Justin Craig, the Outreach clinic in Mount Isa, Queensland a sleep scientist, and was developed Sleep’s scientific staff also provide on-going of patients on Dr Kelly’s by the existing visiting respiratory equipment assessments and data downloads physician, Dr Wayne Kelly and which enable Dr Kelly to make immediate waiting list and that there OutreachT Regional Coordinator, Jess Silver. changes to a patient’s CPAP machine settings. were many patients with

Queensland Sleep performs home sleep Dr Kelly is also able to assess patients who sleep apnoea who would investigations which can assist in the diagnosis have been diagnosed with, or may be Gidgee Healing Bus Photo supplied by Gidgee Healing of a wide range of sleep disorders including suspected of suffering from a sleep disorder, benefit from seeing a simple snoring, Obstructive Sleep Apnoea, which may require a medical clearance. sleep scientist. REM Hypoventilation Syndrome, Overlap Syndrome and Restless Leg Syndrome. According to Dr Kelly, “The addition of WESTERN CORRIDOR Queensland Sleep’s service has meant that Positive Airway Pressure (PAP) studies are the clinic as a whole has been improved as also performed in Mount Isa with intensive since I am able to provide more one-on- MENTAL HEALTH SUPPORT follow-up and education provided by local one time with my patients I can provide technicians in consultation with Brisbane- education which helps with the patient’s ased at Winton, the Central West Consultant (CNC) accompanies the based scientific and medical staff. As part of compliance and the device’s effectiveness.” Rural and Remote Community consulting psychiatrist, Dr Richard Mental Health Service delivers Zimmerman, on monthly road trips much needed mental health and bimonthly flights to this region. Bsupport to people living in the Western The road trip usually covers 1,700km Corridor, which incorporates the over a period of five days. The CNC small, isolated communities is also accompanied on these trips by of Birdsville, Bedourie and Boulia. the Indigenous mental health worker.

Other than the local Primary Health The service offers interventions to people Care Centre, each community relies on with mental health issues, emotional and regular contact from nearby regional social issues as well as support to the wider centres for many health services. community including staff at the local The rural and remote Clinical Nurse Primary Health Centre. Photos supplied by Justin Craig Photo supplied by Jeff Maslen 24 Outreach Impact Outreach Impact 25

HEART OF AUSTRALIA eart of Australia is a program that embodies the most Heart of Australia founder, Dr innovative approach to frontline specialist medical Rolf Gomes, was the cardiologist service delivery in generations - helping people whose on-duty when Tiger visited the lives are impacted by the vast distances in Queensland. mobile truck service. In her no H nonsense style, Valda says, “Tiger Heart of Australia delivers fortnightly cardiac and respiratory didn’t do real good on the stress services to rural and remote communities across Queensland in a 25 machine.” Dr Gomes remembers metre long custom-designed clinic on wheels. The purpose-built, it this way, “The results of Tiger’s self-sufficient trailer provides two private clinic rooms, a testing on-board cardiac stress test room and a reception area. It is wheelchair accessible and fully air- were grossly abnormal. He was conditioned. The road train has travelled more than 72,000km in its literally a walking time bomb”. “Tiger” Flohr and his wife Valda first year, covering an area of more than 450,000 square kilometres. That was on a Friday and Dr Gomes told the Flohrs that CheckUP supports Heart of Australia by funding a he wanted Tiger admitted to hospital in Brisbane the cardiologist and sonographer to deliver much needed following Sunday for urgent treatment. On the Monday, cardiology services in the south-west and north-west regions. in a 90 minute procedure, Tiger had two surgical stents implanted and the next day he was cleared to head home. Photo supplied by Suzanne McCorkell, SOUL Photographic Design Just one example of the many people who have been He had just one week off work and now, he and Valda are well helped by the Heart of Australia service is “Tiger” Flohr. Tiger and truly back into the swing of things with family and friends was experiencing discomfort in his chest but he soldiered and their hobby farm, and are looking forward to lots more TELEHEALTH TO ENSURE on despite the pain. As so often happens, it was his wife, time together after reaching a 51 year milestone as life partners. MENDING HEARTS Valda, who made the move to “get things checked out”. Of Heart of Australia, they say, “Don’t miss it. It’s a terrific truck and CONTINUITY OF CARE IN Valda thought her husband might have been describing a terrific service”. When pressed for a message to others about his IN THE GULF a hernia pain, so she arranged for Tiger to see their GP. experience, Tiger says simply, “If something’s nagging at you in a THE NORTH WEST “I asked the doctor to check on things and I suggested health sense – don’t leave it too late to get help.” r Robert Justo, Director of Paediatric Cardiology at the that we should check on his ticker too,” says Valda. Lady Cilento Children’s Hospital, has been visiting Mt heckUP, in collaboration with Metro South Hospital Isa for the past 15 years providing expert paediatric and Health Service, are about to roll-out endocrinology cardiology advice and an echocardiography service. services to four communities in Central West Queensland. D CMount Isa, Birdsville, Bedourie and Boulia will be visited by This year he increased his service to incorporate communities in the North West region travelling to Doomadgee in May, Associate Professor Anthony Russell, Director of the Department and Mornington Island and Normanton in October with the of Diabetes and Endocrinology at the Princess Alexandra Hospital assistance of funding from CheckUP’s Outreach program. in Brisbane. Dr Russell will be delivering his service with the assistance of the Royal Flying Doctor Service on each occasion. In total, 20 patients were seen during these visits including some children with rheumatic or congenital heart disease Previously, Boulia has not received endocrinology services – before and after their heart surgery - and some children through CheckUP Outreach funding. The addition of this with heart murmurs had investigations undertaken. service is a result of the consultative process undertaken All of the children underwent an echocardiogram and important by the Regional Coordinators with the local community. education and advice was provided to the families and care givers. These visits by Dr Russell will complement the telehealth Many of the families had previously seen Dr Justo in Mt Isa service already established with the Princess Alexandra and were delighted that Dr Justo had come to see their Hospital by the Central West Hospital and Health Service. children the town where they live. This meant that the families didn’t have to pack up and leave their communities for their In addition, another member of Dr Russell’s team, Dr Anish Menon, child’s follow-up checkup, saving them a three day trip. also an Endocrinologist, will be visiting Longreach four times a year. Dr Menon is also the telehealth endocrinologist and his These Outreach clinics would not have been so successful without follow-up telehealth consultations will ensure continuity of care the support of the dedicated Indigenous Health Workers including for his patients. Rhonda Tim, Helen Burns, Belinda Johnson, Anne O’Keefe, Lila Cairns, Faye Aplin and Jocelyn Turner.

Photo supplied by Heart of Australia 26 Outreach Impact Outreach Impact 27

NORTH REGION MUMS AND BUBS KNOW YOUR NUMBERS

s part of National Stroke Week this year, ith a focus on well-coordinated, integrated care Collinsville nurse Angela Laskie from and services, TAIHS maintains a strong working the Mackay Hospital and Health Service partnership with the Townsville Hospital encouraged residents to be aware of their and Health Services (THHS) in the delivery Ahealth risk factors, live a healthier lifestyle, and to have Wof midwifery and child health services. TAIHS employs a their “numbers” checked. Angela Laskie was funded qualified midwife to coordinate the TAIHS Maternal and through the Outreach program to undertake this Child Health (MCH) program, known affectionately as the National Stroke Foundation activity in Collinsville which Mums and Bubs program. TAIHS’ role involves ensuring is one of many health programs that take a preventative quality, effectiveness and efficiency in service delivery to approach to health care through Outreach Services. ensure the best possible health outcomes for patients. Throughout the week, 37 Collinsville residents In addition, education provided by TAIHS increases the had their “Know Your Numbers” health checks Photo supplied by Martin Hodgson mothers’ knowledge and skills in baby care, self-care and completed and went in the draw to win a wearable parenting approaches aimed to eliminate risk factors fitness device that tracks steps, distance, calories THE TOWNSVILLE ABORIGINAL AND TORRES STRAIT associated with infant/child mortality such as low birth- burned, active minutes and sleep, and lights up to weights, pre-term births, poor nutrition, alcohol/tobacco/ show the wearer’s progress towards reaching a goal. ISLANDER HEALTH SERVICE substance misuse, and poor health status. The program also This was won by local resident, Terance Woodward. involves fathers in learning how to care for their children. he Townsville Aboriginal and Torres comprehensive and inclusive view of The TAIHS service footprint covers The “Know Your Numbers” health checks consists of Strait Islander Health Service health that this entails. This involves seeing Townsville and surrounding communities Based on TAIHS’ success as a leader in primary health care taking a blood pressure reading and the completion (TAIHS) aims to empower Aboriginal health as more than just physical well- with some programs extending north to in the region, TAIHS services also support early childhood of questions relating to lifestyle factors such as and Torres Strait Islander people to being; it acknowledges the significance Ingham, west to Hughenden and south milestones development, improving immunisation rates and smoking status and exercise, to help with the takeT control of their individual, family and of social, emotional and cultural factors as to Clermont and Mackay, inclusive of focusing on the treatment of infections and chronic illnesses identification of those people who are at increased community health, which encompasses determinants of overall health and well-being. Palm Island. TAIHS currently employs 183 in children. TAIHS’ multidisciplinary service model includes risk of stroke and other conditions such as diabetes. physical, social, emotional, cultural, spiritual persons with 76% identifying as Indigenous. access to a range of allied health services, and incorporates and economic well-being. Our community has The TAIHS health service delivery model clinic-based and home visiting services utilising patient- access to holistic primary health care which is incorporates a contemporary care paradigm TAIHS now provides Outreach funded centred education as a platform for assisting children to PREP SCREENING IN culturally appropriate and is underpinned by focused on health promotion, prevention clinics in Home Hill, Charters Towers have a better start in life. principles of collaboration and sustainability. and early intervention while ensuring a and Ingham with a focus on supporting suitably qualified and capable Indigenous Aboriginal and Torres Strait Islander people CLERMONT TAIHS is an AGPAL accredited, bulk-billing, workforce, a multidisciplinary team affected by, or at risk of developing, chronic primary health care service initiated and approach fostering family involvement illnesses to manage their conditions to n addition to a monthly CheckUP Outreach Hearing operated by the local Indigenous community. and access to holistic health care options. achieve the best possible health outcomes. Clinic, local registered nurse and audiometrist, It was established in 1974 to deliver holistic, Louise Cook, has successfully implemented comprehensive, and culturally appropriate There is strong evidence that Aboriginal Since the implementation of the TAIHS a Prep Hearing Screening Clinic in Clermont. integrated health care to the Indigenous and Community Controlled Health Services Outreach clinics, all sites have seen I wider communities of the Townsville region. (ACCHS) deliver a better range and quality significant numbers of patients through Annual school-based visits to the local primary of health services to Aboriginal and Torres their clinics and have had some wonderful schools have positively identified hearing concerns TAIHS provides an integrated primary health Strait Islander people, and that care is examples of people accessing culturally in some Prep students, which if left unattended care model in keeping with the philosophy more appropriate, efficient and effective appropriate services in their own town that can lead to learning and behavioural difficulties. of community control, together with the than mainstream health care and services. they otherwise would not have had accessed. All consenting Prep students are screened for hearing and ear issues. If results from any of the battery of tests fall outside set parameters, a referral letter is sent home to parents advising them of the need for a follow-up assessment with the GP.

Through this Outreach funding, 35 Prep students were screened for hearing issues at the school-based clinics last financial year with 10 requiring follow-up assessments. Photos supplied by TAIHS Photo supplied by TAIHS 28 Outreach Impact Outreach Impact 29

PIONEER PODIATRY PROVIDER MAKING A DIFFERENCE:

hil Marshman is ANDREW’S STORY a podiatrist who PROFILE: provides Outreach funded services to the Northern Area Primary Health Limited (NAPHL), formerly Ptowns of Bowen, Collinsville, DR YONG TAN Townsville Mackay Medicare Local, provide allied Moranbah, Clermont, Dysart and Middlemount. health Outreach services to Ayr, Bowen, Cardwell, Cannonvale, Charters Towers, Collinsville, Hughenden, r Yong Tan has been For Phil, the best thing Ingham, Proserpine, Richmond, Sarina and . providing Outreach about providing Outreach diabetes and services is meeting lots endocrinology services The following is one of many heart warming stories from the of amazing residents Dfor many years in Bowen and region, as told by Olivia Propsting, NAPHL Outreach provider. of the smaller outlying communities. It is also a privilege in the last two to three years for Phil to travel by car and see Queensland’s beautiful has expanded his services to landscapes, although avoiding unpredictable kangaroos is Andrew and his family include the Bidgerdii Community first met Andrew in May 2014 and he Despite these challenges Andrew one occupational hazard that Phil doesn’t particularly enjoy. Health Service in Rockhampton. made an instant impression on me. His continues to be as independent as possible,

big smile, positive attitude and friendly not wanting to be a burden on his family. Phil comments that, “My Outreach service means we can give I love the elevation Previously, Dr Tan provided a nature were something I really admired. Andrew lives with his wife and five people access to preventative medical care. For example, diabetes/endocrine service to the IAndrew is a 40 year old man who was children on a cattle station where he function of my new preventing people with diabetes from developing limb- Townsville Aboriginal and Islander diagnosed with Chronic Inflammatory participates fully in anything that he threatening conditions. Many residents wouldn’t be able to chair. For the first Health Service medical centre as Demyelinating Polyneuropathy when can, including mustering, working travel to receive this care, either due to the costs of travel, or well as the Diabetes and Endocrine Department at the he was 30 years old. This is a progressive in the yards and fixing fence lines. the lack of support to access transport. The Outreach service time in eight years I Townsville Hospital, in addition to his private practice. neurological condition affecting the legs also allows us to give specialist care for other foot and leg and arms. The pain that goes along with I started seeing Andrew after he was was able to make eye conditions, for people who would not normally want to travel.” it can be unbearable, however if you referred to me for a new power-drive contact with my wife ask him, he would tell you, “It’s nothing, wheelchair as his current one was old and Phil is particularly committed to continuing to provide some people have it much worse”. his needs were increasing. The process of high levels of specialist care to the outlying areas, and give her a kiss. I arranging a new chair was a lengthy one, and to continue to develop relationships with the Andrew lost function in his lower limbs due to distance and time restraints but was also taller than existing health providers in these communities. Patients who see me at my eight years ago so his main form of mobility after 9 months his chair arrived. I was so my youngest two Outreach clinics are usually the is his power-drive wheelchair. He is slowly excited for him to try the special functions Phil reflects that, “It takes a while to get street credibility in these losing sensation, strength and function of the new chair such as seat elevation and children! small communities! But once you do, it’s such a delight to add my people unlikely or unable to travel in his upper limbs, meaning everyday tilt-in-space so he can recline the chair and passion and experience for the benefit of these communities. It is tasks are becoming difficult for him. relieve pressure areas and have a nap. a great pleasure and privilege”. to larger city centres for such services, and therefore are more HEAL™ is a nationally accredited evidence-based program that is now being run by likely to fall through the gaps Northern Australia Primary Health Limited (NAPHL) exercise physiologists at all their by not accessing appropriate HEAL™ Outreach sites. health care. Outreach specialist EAL is a lifestyle modification based healthy lifestyle education class. The program that enables participants program assists people who are overweight services play an important role to develop lifelong healthy eating or obese with existing chronic disease, or at in bringing equity of health care and physical activity behaviours. risk of developing chronic disease, to improve HThe program consists of eight weekly group their health and well-being by providing to people from rural and remote education and exercise sessions as well as lifestyle education with a focus on improving individual consultation before and after the nutrition, physical activity and promoting self communities. program and at five and 12 month follow- management. Persons at risk of developing up consultations. Each week, participants , or with existing, diabetes, heart diseases or undertake one hour of supervised group- other conditions are examples of some of the based low to moderate intensity physical participants that are benefiting from HEAL. activity followed by a one hour group- Participating in the HEAL program Photo supplied by Tonita Taylor Photography 30 Outreach Impact Outreach Impact 31

FAR NORTH REGION PROVIDER PROFILE: DR ROB MILLER

r Rob Miller is a dermatologist who has been delivering services in Torres Strait for 14 years. One of the keystones of quality care is the ability to provide continuity of care. Dr DMiller comments that, “A continuous health service for 14 years by the same doctor has huge benefits to the quality of care for my patients. It has also allowed me HAPPY FEET! Photo supplied by Coriena Ross, Leidana Photography to provide education and local knowledge to transient ebbie Lewry is a podiatrist who has been staff and has given me the ability to provide input working in Indigenous health since March 2014 into long-term health care planning in the region”. and is currently looking after the Tablelands,

Yarrabah, Innisfail, Tully and Cardwell regions. HEALTHY EATING IN CAPE YORK Dr Miller laments that for many years patients living D in rural and remote locations, and Aboriginal and Debbie’s main aim is to help her patients in the prevention of foot rooke Searle is Apunipima Cape York Heath Council’s have joined forces on a number of initiatives to promote Torres Strait Islander communities have been under- issues through education and treatment and she works closely community dietitian servicing the remote Aboriginal healthy choices at the store including in-store cook- serviced when it comes to specialist medical support with health workers, practice nurses and the local GPs to help communities of Aurukun, Mapoon and Napranum. ups. Most recently, Aurukun has introduced the Healthy compared to their metropolitan counterparts. “One make this happen. Teaching patients how to care for their own feet Choice Reward Scheme that operates in a similar way we are assisting to address this imbalance is to and to help them formulate achievable plans for managing their BSpending a week in Aurukun once a fortnight, Brooke way to the fuel voucher scheme whereby if someone lifestyle, are critical to ensure success and improve their health. provides a range of services for the community. As well as buys $15 worth of fruit and vegetables they receive a

providing a clinical dietetic service within the clinic, Brooke voucher for $10 to spend on more fruit and vegetables. The funding provided through Outreach allows for a diverse can also be seen out and about providing home visits pool of health professionals to work collaboratively, with to families and visiting the Home and Community Care Of her work in Aurukun, Brooke said, “I see a lot of clients close involvement from diabetes educators and dietitians, Centre to review menus and support the cooks in using who have a chronic disease where diet plays such an to help prepare comprehensive care plans for the patients. healthy recipes for the residents that access that service. important role in the self-management of their condition.

Our team approach to nutrition care, means that we not This multidisciplinary approach has led to the early detection of Being part of Apunipima’s nutrition team means Brooke is only provide advice to individuals in the clinic, but we also some issues that have needed further investigation with good supported by community nutritionists and together they focus on making sure the healthy choice is an easy choice in outcomes . work across a variety of community settings include the the community. So when I discuss healthier options with a

school, child care and the local food store to make sure healthy client, I feel confident that these messages will be reinforced Debbie comments that, “I see a lot of patients who respond well choices are accessible and available to the local community. when they leave the clinic. The in-store cook-ups are a great to the right encouragement and have improved their health Having signed a Memorandum of Understanding (MOU) example of helping people to make the changes they need bring the specialist to the patient, which is what the status. They have now become fantastic community role models”. earlier this year, Island and Cape Stores and Apunipima to improve their health.” Rural Health Outreach Fund is helping to achieve”.

Dr Miller has literally hundreds of stories about patients who have been assisted through his Outreach service. From a 17 year old girl on an outer island in the Torres Strait whose treatment for lupus has completely transformed her personality and self-esteem, to a 55 year old diver crippled by psoriasis for years who was treated with advanced drugs on his home island. He has now resumed his diving job and is no longer reliant on social welfare.

Dr Miller estimates that by treating his patients locally it has saved thousands of dollars in travel and accommodation costs for patients. The savings in work time and family disruption are immeasurable.

Brooke Searle in Aurukun Debbie Lewry treating a patient 32 Outreach Impact Outreach Impact 33

THE WHOLE CHILD, THE WHOLE FAMILY

n the regional communities of her come to see the child at school or Atherton and Mareeba in Far North day care. This means attendance rates Queensland, children and families are often better, and children are more Photo supplied by Tonita Taylor Photography have experienced the benefits of settled and comfortable than when Icommunity-based occupational therapy travelling to a clinic for appointments. services with Crystel Poggioli from The Whole Child Therapy Services. Crystel says, “I find it extremely rewarding WEIPA MENTAL WUJAL WUJAL to work with the local Aboriginal Crystel is passionate about finding practical, communities. It is a privilege to be able ujal Wujal is an Aboriginal Shire Council located individual solutions to the daily challenges to step into a child and family’s real life, HEALTH SERVICE in the Bloomfield Valley inside the World Heritage children and families face, whether it and share with them the problems they Area some 170km to the north of Cairns and 70km be related to challenging behaviours, are facing on a daily basis. It is completely r Jan Steel has been providing a psychiatric south of Cooktown. Wujal Wujal covers an area of 64 developmental concerns, or helping to put heart warming to see them make service to Weipa since early 2011. Dr Steel visits Whectares. The present community of Wujal Wujal has existed on the pieces together in determining whether progress and gain confidence over time.” Weipa four times per year and has built a strong site for many hundreds of years and is set around the highly sacred a child has a more complex diagnosis. working relationship with the local Mental Health waterfalls of Wujal Wujal meaning “many falls” in local language. “For me the real breakthroughs are the DTeam, the Alcohol, Tobacco and Other Drugs (ATODS) team, With support from CheckUP Outreach little steps towards positive change the hospital doctors, and the local General Practitioners. The Wujal Wujal Primary Health Care Centre provides a suite of funding, Crystel has provided that work together over time, and I love regular Outreach funded medical, community and allied health occupational therapy services to the local empowering the family to take charge and The Weipa Clinic has been highly utilised with very services in partnership with other health and social service communities in liaison with the local bring about the changes they’d like to see”. few patients cancelling appointments, and there providers, including diabetes educators, podiatry, paediatricians, Aboriginal Health Services, Midin and have been some extremely positive outcomes. hearing health, speech pathologist, mental health, maternal Mulungu clinics. This has seen significant “A lot of the time with a family I’m listening This success has been made possible by the and child health, eye specialists, and endocrinologist specialists. breakthroughs for many families who to them, and trying to understand their hard work and collaboration of the entire team. have children with a range of challenges. background, their values and their This wide range of allied health and specialist services are provided For example, children are now able to rather than travelling to an urban area. preferences. Within that context I can Dr Steel reflects on a one particular patient’s journey, “With by Apunipima Cape York Health Council Aboriginal Corporation, receive multiple assessments to support then help a family to move, step-by-step, encouragement and support, her mood improved and she the Cairns and Hinterland Hospital and Health Service, Cape York complex diagnoses, such as autism, Families also enjoy seeing the occupational towards where they would like their life was able to avoid hospital admission. She is now doing well Guardian Pharmacy, Darben Medical (dermatology) and Rowan with the local occupational therapist, therapist in their own home, or having with their child to be.” and following her dream of retirement.” Churchill (optometry).

Wujal Wujal Falls Photo supplied by Tonita Taylor Photography 34 Outreach Impact 35

THANK YOU TO OUR OUTREACH PROVIDERS

CheckUP and QAIHC would like to thank all of the dedicated health providers and services for their hard work and commitment to providing better health for all.

A.J.S Medical Services Evolution Podiatry Porter Eye Care Addiction Sciences Queensland Eyedentity Optical Private Diabetes Education Akosile, Dr Oluwaseun Fitzpatrick Family Optometrists Queensland Sleep Disorder Unit Amanda Gale Physiotherapy & Wellbeing Fleury, Dr Aisling QUT Health Clinics - Optometry Apunipima Cape York Health Council FNQDocs Rachel Stone Podiatry Aboriginal Corporation Franz Felfer Optometrist Riga Medical Enterprise Aranha, Dr Algenes Gidgee Healing Ritchie and Associates - Psychologists Baralaba Private Clinic Glasson, Dr William RM Miller Medical Bernard Chin Medica Hadgraft Speech Pathology Rodwell, Dr Steven Bird, Dr Russell Hagne, Ingrid Rothsay, Deborah Bowler, Dr Simon Hagon, Jan Rowan Churchill Brian Todd Medica Heart of Australia Royal Flying Doctor Service of Australia Brisbane Bone & Joint Centre Hutton, Francisca Ruban, Dr Alan Brisbane Eye Clinic I G Brown Medical Rural and Remote Psychology Service Broadhurst, Dr Matthew IDEAS Van Rural Ultrasound Services Cairns and Hinterland Hospital & Health Ilka-Chittick, Lyndell Ryan, Dr Leo Service IWC S Kumar (Medical) Cairns Audiology Group Institute for Urban Indigenous Health Sainani, Dr Anjali CAM Barrett ISIS Psychology Services Samahl Investments Cape York Guardian Pharmacy Journeaux, Dr Simon Sangla, Dr Kunwarjit Central and North West Queensland Julian Boulnois Medical Shaker, Dr David Medicare Local Kannangara, Dr Manjula Sheehan, Barry Central Queensland Hospital & Health Kelly, Dr Wayne Singh, Adrian Service Klestov, Dr Klestov Sinha, Dr Ashim Central Queensland Medicare Local Leslie, Dr David Skiathitis, Dr Irene Central Queensland Regional Aboriginal and Lifestyle Therapies and Training Solutions Smallcombe, Dr Katherine Islander Community Controlled Organisation Likely, Dr Michael South West Hospital and Health Service Central West Hospital and Health Service Lisa Grice T/As Private Diabetes Education Spark, Jamie Children’s Health Queensland Hospital & Mackay Hospital and Health Service Stalewski Medical Health Service Malouf Medical Steel, Dr Jan PHOTO ACKNOWLEDGEMENTS Clarity Hearing Solutions Mamu Health Service Susan Pavey Collins, Dr Brett Mater Misericordiae Health Service Brisbane Sweet as Diabetes Solutions Compleat Nutrition McGlade, Dr Andrea Syed Cardiology Conway, Graeme Metro North Hospital and Health Service T R Porter Cooke, Dr Robert Michael Young Optometrists Taylor, Kent Thank you to the following photographers who kindly donated their stunning Cooper Smith Optometrists Moreton Eye Group The Optical Superstore Darwin photographs for this magazine: Cox, Dr John Mosby, Edward Theodore Medical Centre CQ EYE Mulungu Aboriginal Corporation Medical There4U CQ Physio Group Service Torres and Cape Hospital and Health Service • Tonita Taylor Photography - www.tonitataylor.com CR Schull Medical Naidoo, Dr Navin Townsville Aboriginal and Islander Health Cummings, Kirsty Natalie Loughman Occupational Therapy Service Danesi, Dr Christopher Nelson, Laura Townsville Hospital and Health Service • Suzanne McCorkell, SOUL Photographic Design - www.soulphotographics.com.au Darben Medical Norrie, Dr Mark Townsville-Mackay Medicare Local Hospital & Health Service North West Hospital and Health Service Tran, Dr Tommy • Coriena Ross, Leidana Photography Davies, Dr Llewelyn NQ Family Practice van der Westhuyzen, Dr Jasper Diabetes Care New Beginnings O’Brien Health Care Vital Health Diabetes Education Outreach Service Optical Lenses Whittaker, Dr Amy • Leonie Semmens Dobinson, Dr Katherine Ossulton Services Wide Bay Hospital and Health Service Dover, Dr Thomas Oxley Clinic William Boyd Medical • Karen Mills DPB O’Brien Medical Palm Island Community Company William Talbot Eye Care Dugdale, Dr Alan Panizza, Dr Fiona Wowan Dululu Community Volunteer Group Dyer, Dr John Parnell, Jaime Wuchopperen Health Service • Martin Hodgson Earlsay Peters, Lex YM & J Tan (Medical) Earnshaw, Dr William Peters, Dr Sandra Young, Joy • Jeff Maslan Edopt Pioneer Podiatry Zauner, Maria ENT Specialists Poggioli, Crystel Zeeman, Dr Sandra • Justin Craig Photo supplied by Tonita Taylor Photography

QAIHC CheckUP Level 2/55 Russell Street Level 2/55 Russell Street SOUTH BRISBANE Q 4101 SOUTH BRISBANE Q 4101 07 3328 8500 1800 339 237 [email protected] [email protected]

The Outreach program is made possible through funding from the Australian Department of Health.