Report of the 6th National Conference

Sustaining Environmental Health in Indigenous Communities

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John Carleton and Graham Locke, Queensland Department of Local Government, Planning, Sport and Recreation

Department of Local Government, Planning Sport and Recreation

“For people to enjoy and maintain a healthy living standard, it is essential that environmental health infrastructure, such as water supply, sewerage, waste management, drainage systems and sustainable services are adequate. Inadequate essential services in remote Aboriginal and Torres Strait Islander communities can underpin health status. It has been identified that the health status of Aboriginal and Torres Strait Islander people is well below that of the rest of us living in Australia.

Recognising that improving a community’s general health and wellbeing can result from effective and sustainable environmental health infrastructure, the Queensland Government established the Indigenous Environmental Health Infrastructure Program (IEHIP). The IEHIP encompasses infrastructure development and sustainability operations of essential environmental health infrastructure to 34 Queensland Aboriginal and Torres Strait Islander Councils.

Improving the capacity of the community to maintain essential services is a key outcome of the IEHIP. To this end, the program in its present form is making significant progress. Continued progress and improvements to sustaining environmental heath infrastructure will require ongoing cooperation among a broad range of stakeholders including all levels of government, the community and other stakeholders.

Key Words

Environmental Health Infrastructure
The essential infrastructure systems required for general health and wellbeing, such as water supply, sewerage, waste management, stormwater, roads and serviced lots.

Essential Service Officers (ESOs)
Council staff responsible for the operations and maintenance of essential services such as water, sewerage, waste management services.

Traditional Owners
People who, through membership in a descent group or clan, have responsibility for caring for particular country. Traditional Owners are authorised to speak for country and its heritage.

1. Introduction

In 1987, the Nganampa Health Council published an environmental health report called the 'UPK Report'. The report reached the conclusion that nine healthy living practices are necessary for
improved health in the Anangu Pitjantjatjara Lands. These healthy living practices are important to improving the health and wellbeing of all people living in Queensland.

The nine healthy living practices listed according to their likely importance to improving people's health status are:
  1. Washing people.
  2. Washing clothes/bedding.
  3. Removing waste.
  4. Improving nutrition.
  5. Reducing crowding
  6. Separating of dogs and children.
  7. Controlling dust.
  8. Temperature control.
  9. Reducing trauma (UPK Report 1987.)
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These healthy living practices are impacted on by the type and condition of environmental health infrastructure in a community. Likewise, they can be used to identify, plan and prioritise environmental health infrastructure projects and their sustainability.

A 2003 report by Queensland Health reported that the health of Queensland Aboriginal and Torres Strait Islander people remains substantially worse than any other section of the Queensland population. Examples of this disparity between Indigenous people and other Queenslanders are:
  • Gap in life expectancy is estimated to be 18-19 years less.
  • The age adjusted death rate is estimated to be over three times (3.2) greater.
  • Infant mortality rates are still unacceptably high, at two and a half times greater.
  • The estimated mortality rates for Queensland Aboriginal and Torres Strait Islander people in middle age (40-64 years) are among the highest recorded in the world.
  • Mortality rates in early middle age are estimated to be more than five times greater.
  • There has been little improvement in adult mortality over the last 20 years, and this lack of progress is virtually without precedent on a world scale. (Queensland Health, 2003)

The Australian Government Productivity Commission, through its Review of Government Service Provision, issued a report in July 2005 entitled ‘Overcoming Indigenous Disadvantage’, which identified relevant key indicators and strategic areas for action and included effective environmental health systems.

With regard to effective environmental health systems, the relevant indicators identified by the Productivity Commission review were:
  • Rates of diseases associated with poor environmental health (including water and food-borne diseases, trachoma, tuberculosis and rheumatic heart disease).
  • Access to clean water and functional sewerage.
  • Overcrowding in housing.

Each of the identified indicators is related to the type and condition of the environmental health infrastructure.

There is considerable evidence that the health and wellbeing of Indigenous people can be enhanced through:
  • A strategic and integrated approach to improving environmental health-related infrastructure and sustainable services.
  • Sustainable integrated models of funding addressing whole-oflife costs of infrastructure.
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2. Objectives

The primary objective for the IEHIP is to improve the health and wellbeing of Aboriginal and Torres Strait Islander communities by providing an integrated infrastructure development and sustainability program focused on whole of asset life infrastructure provision and management. Other specific objectives are:
  1. To improve Aboriginal and Torres Strait Islander environmental health infrastructure systems.
  2. To improve asset management.
  3. To provide technical training.
  4. To assist with legislative compliance.

Allied closely with these operation and maintenance objectives is the requirement to develop and sustain ongoing community employment, training and management capability. Facilitating improved employment, skills transfer and training outcomes will enhance a community’s capacity for the longer term.

3. Infrastructure Development and Sustainability

In 1995, the Queensland Government established what is now referred to as the Indigenous Environmental Health Infrastructure Program (IEHIP) to significantly improve the health and wellbeing of Queensland Aboriginal and Torres Strait Islander communities by improving environmental health infrastructure. Environmental health infrastructure is defined as:
  • Improvement and/or augmentation of water supply schemes including reticulation, metering, house connections or water treatment.
  • Improvement, augmentation and/or new reticulated sewerage systems or sewage treatment.
  • Improvement, relocation of old waste disposal sites or new waste disposal facilities including sealed, all-weather access to such facilities.
  • New fully serviced sub-division housing lots.
  • Sealing and drainage for internal community roads.
  • Improved stormwater drainage and surface infrastructure.
  • Preparation of community planning documentation (mapping, community plans, etc).

The IEHIP has its roots in the important ‘National Commitment to Improve Outcomes in the Delivery of Programs and Services for Aboriginal Peoples and Torres Strait Islanders’ which was endorsed by the Council of Australian Governments (COAG) on 7 December 1992.

In addition, the IEHIP seeks to address needs identified by Meeting Challenges Making Choices (COAG 2004), and Queensland Government priorities - improving health care, strengthening services to community, rowing a diverse economy and creating jobs through a continued commitment to assist Indigenous communities disadvantaged by location, size and a limited rate base.

Currently the IEHIP is divided into distinct implementation program models for infrastructure development and sustainability, located on mainland Queensland or in the Torres Strait (refer to the maps in Appendix 1).
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3.1 Infrastructure Development

Each of the infrastructure development program models employ similar elements for procedures and process for program governance, procurement of Project Managers and construction companies and collaboration with Councils, community and relevant stakeholders.

The IEHIP is managed in partnership with the Queensland and Australian Governments, Aboriginal and Torres Strait Islander Councils, communities and other related agencies.

In 2005 the Queensland Government provided $100 million to address environmental health infrastructure projects in Aboriginal communities on the mainland. This allocation was conditional on matching funding provided by the Australian Government, which to date has provided $30 million. Strategic program management is coordinated by the Queensland Government.

In Torres Strait, the Queensland and Australian Governments have been collaborating since 1998 with matched funding of $92.4 million delivered through the Major Infrastructure Program (MIP). The MIP funds are managed by an independent Fund Manager, and the management and reporting provides assurance that the funds are being appropriated in accordance with an agreement between the funding agencies. Strategic program management is coordinated by the Torres Strait Regional Authority.

3.2 Infrastructure Sustainability

The mainland sustainability program provides expert technical advice on water supply, sewerage and waste management infrastructure systems to 17 mainland Aboriginal Councils. Funding of this program has been provided by the Queensland Government. However, the mainland infrastructure development program has allocated approximately 15% of appropriated funds to support
sustainability activities.

A different program model is employed in the Torres Strait sustainability program, where the primary emphasis is on the provision of technical services and advice to the 17 Island Councils. The infrastructure is managed and operated by a team consisting of management and technical support from officers from the Island Coordinating Council (ICC) and the community provided Essential Service Officers to operate their infrastructure on a day-to-day basis. The program is managed by the ICC, with joint funding from the Queensland and Australian Governments.

Whilst slightly different program models are used in the implementation of sustainability activities, there are close similarities.

Technical Services and Advice
  1. Conduct site visits to each community to assess the operational status of the infrastructure systems. Provide technical services and/or advice to enhance the capacity and capability of the systems to sustainable levels of operations and maintenance.
  2. Maintain contact with the infrastructure staff.
  3. Assist in the development and improvement of an asset management culture for infrastructure systems within the Council and the community.
  4. Monitor legislative compliance to ensure that the infrastructure systems are being operated and maintained satisfactorily.
  5. Provide advice to the State and Council to help ensure that appropriate technology for the infrastructure systems is considered.

Training
  1. Prepare training needs analysis for the infrastructure staff and update as required.
  2. Facilitate a training program for the infrastructure staff.
  3. Develop orientation, technical training and support materials to strengthen existing knowledge and provide increased skills capacity.
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Consultation
  1. Carry out ongoing liaison with infrastructure staff, Council management and relevant stakeholders to encourage acceptance of the infrastructure staff role, facilitation of their responsibilities, and coordination of related projects.
  2. Provide information from time to time to update government agencies and other stakeholders on outcomes and status of infrastructure operations and maintenance.
  3. Support development of effective communication mechanisms for the infrastructure staff.
  4. Provide support and assistance for public awareness activities relating to sustainability of the infrastructure systems.

Other
  1. Other tasks to support sustainability of the environmental health infrastructure.

4. Supporting Infrastructure Development and Sustainability Operations

Effective infrastructure development and sustainable environmental health infrastructure requires acknowledgement and attention in the key areas of staff, consultation and communication, partnering and collaboration, and cultural heritage.

Essential Service Officers

Essential Service Officers (ESOs) are members of Council’s infrastructure or works teams. They are responsible for the sustainability of environmental health infrastructure. ESOs benefit from the IEHIP through technical advice and specialist training in water industry operations.

ESOs play a vital role in improving a community’s health and wellbeing. They often work closely with Environmental Health Workers and other professionals, who complement and support each other in their respective roles.

Consultation and Communication

Essential to the effectiveness of infrastructure development and sustainability is implementation of close consultation and communication among all parties involved. This ensures that a high level of service is provided at all times.

Consultation with the Council and the community requires development of an open, honest and proactive relationship. In addition to the formal decision-making process, it is also beneficial to engage others such as men's, women’s and other community groups and the general community, as the effectiveness of environmental health infrastructure affects all those in the communities in some way.

Community consultation also needs to recognise cultural differences between the communities and the interests of Native Title holders. This may require a flexible approach that can focus on multiple issues/interests, whilst respecting the various stakeholders and promoting communal values in achieving sustainable high standard community infrastructure.

An ongoing review of the consultation and collaboration strategy is integral to the sustainability of IEHIP projects.
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Partnering and Coordination

The IEHIP actively seeks partnering opportunities with other stakeholders with aligned objectives. The partnerships formed during program delivery have dramatically improved outcomes via many avenues, including pooling of funds, capacity-building in communities, and coordination of service delivery. Partnering arrangements employed have been with:
  • Queensland Department of Main Roads to jointly fund multiple roads and drainage projects.
  • Queensland Environment Protection Agency.
  • The Torres Strait Heavy Equipment Management and Training Program to deliver accredited training to over 100 civil earthmoving trainees.
  • The Island Coordinating Council Infrastructure Support Unit to deliver appropriate handover training and technical support to ensure ongoing infrastructure sustainability.
  • Local Councils to achieve local involvement in construction projects.

The cross-agency cooperation that has been achieved through these forums has meant that the infrastructure development and operational discussions are taken into consideration of each other, which results in sustainable infrastructure delivery.

Cultural Heritage

Maintaining heritage values and places is a vital part of the community’s ‘sense of place’, cultural identity and well-being. This is particularly true for Indigenous Australians, whose heritage creates and maintains links between ancestors, people and the land (Australian Heritage Commission, 2002).

In recognising the rights and interests of Indigenous peoples in their heritage, all parties concerned with identifying, conserving and managing this heritage should acknowledge, accept and act on the principles that Indigenous people:
  • Are the primary source of information on the value of their heritage and how this is best conserved.
  • Must have an active role in any Indigenous heritage planning process.
  • Must have input into primary decision-making in relation to Indigenous heritage, so they can continue to fulfil their obligations towards this heritage.
  • Must control intellectual property and other information relating specifically to their heritage, as this may be an integral aspect of its heritage value.

(Australian Heritage Commission, 2002)

The process of collaboration with Traditional Owners should be considered early in the development of project plans, as it can have an impact of the timely completion of the project.

The Queensland Aboriginal Cultural Heritage Act 2003 and the Torres Strait islander Cultural Heritage Act 2003 specifies that land users are to proactively assess cultural heritage issues prior to undertaking any land use activity, and to negotiate directly with Traditional Owners where cultural heritage is likely to be an issue.

The legislation also establishes a duty of care on all land users to take all reasonable and practical measures to ensure their activities do not harm cultural heritage. In addition, guidance and tools to help assess and manage cultural heritage are provided, with assistance also provided by other State agencies such as the Queensland Department of Natural Resources and Water and the Environmental Protection Agency.

There is recognition that Aboriginal and Torres Strait Islander cultural heritage begins by identifying the Traditional Owners to the area, which in the first instance is the registered Native Title Party for the
area. If there are no registered Traditional Owners of the area, one should engage the person or other Indigenous persons with an interest in an area in accordance with the local tradition or custom, as being responsible for the area.
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Other cultural heritage matters to consider are:
  • Cultural heritage monitors.
  • Logistics of collaboration with Traditional Owners.
  • Cultural heritage management plans.

Cultural heritage monitors can be an invaluable source of assistance to ensuring that projects are successfully completed. Cultural heritage monitors provide assistance in the identification of culturally significant values and places.

The cultural heritage legislation specifies that a cultural heritage management plan is required when an Environmental Impact Statement is specified. Taking a proactive approach to the preparation of a cultural heritage management plan provides a number of beneficial outputs, including early engagement of the community, open communication, identification and resolution of issues, opportunities for employment and training, and a more effectively implemented project.

5. Significant Sustainability Outcomes

Some significant IEHIP sustainability outcomes are:
  • Community Infrastructure Audit - A comprehensive audit has been carried out on the mainland Aboriginal community infrastructure, operations and staff capacity. The audit has identified the current state of the infrastructure, and provided training needs analysis. Ongoing technical assistance and an appropriate site-specific training program is being implemented.

The audit identified a large range of issues, from simple items which can be rectified by a change of work practices, to a requirement for new infrastructure. Identified issues were assessed according to criteria of public health, occupational health and safety and compliance. The audits provide a valuable management tool for current and future operational activities, plan future infrastructure, and assist in making appropriate financial decisions.
  • Water Demand Management Project - A pilot water demand management project is currently being implemented in the Northern Peninsula Area of Cape York. The pilot project seeks to determine an appropriate delivery methodology, actions and evaluate outcomes of water demand management prior to commencement in the other Aboriginal communities.

The project is using the community-based social marketing (CBSM) approach to bring about behavioural change. When water demand management principles are communicated using a CBSM approach, priorities of different users are considered to ensure that water supplies are used wisely in the public interest.
  • Asset Management System – A comprehensive asset management system has been implemented in the Torres Strait sustainability program. The program provides accurate, reliable information on the water service infrastructure located throughout the 17 Island Councils.
  • Staff Capacity Building Program – A comprehensive skills enhancement program designed to increase the capacity of infrastructure officers to obtain nationally-recognised competency in water industry operations has been implemented in the Torres Strait Island sustainability program. This assists in giving operators a higher degree of ownership for the valuable work that they perform.
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6. Community Benefits

Outcomes delivered by IEHIP are consistent with relevant policy objectives and priorities of both the Queensland and Australian governments. This includes the whole-of-government approach, where all three levels of Government continue to successfully work together. Likewise, IEHIP has demonstrated flexibility, accountability and leadership, and has continued implementation of the broad Government policy objectives of shared responsibility and partnership.

IEHIP has achieved outstanding impacts on the health and wellbeing of Aboriginal and Torres Strait Islanders. Furthermore, IEHIP has provided multiple flow-on benefits to community capacity building and economic development, by providing employment, training and the necessary skills for community members to enable them to have the capacity and confidence to undertake future activities.

7. Conclusion

The Queensland and Australian Governments have made a substantial investment in environmental health infrastructure in Queensland. It is therefore important to allocate resources for the
future to optimize the life cycle of the infrastructure, and to provide the service levels that the communities require.

The provision of essential environmental health infrastructure and ongoing support for high quality sustainability services assists to maximise the use and lifespan of the infrastructure in Aboriginal and Torres Strait Islander communities, and helps to mitigate the risk of continued community exposure to unacceptable health and environmental hazards.

Continued progress and improvements to environmental heath infrastructure will require ongoing cooperation among the broad range of stakeholders, including all levels of government, the community and other stakeholders.

The scope and methodology of the IEHIP can be replicated in other communities. However, it may require adjustments to account for site-specific conditions, infrastructure and staffing considerations.

References

Australian Heritage Commission (2002). Ask First: A guide to respecting Indigenous heritage places and values. National Capital Printing, Canberra

Council of Australian Governments (2004). Meeting Challenges Making Choices.

Nganampa Health Council (1987). UPK Report.

Queensland Health (2003). Health of Queensland’s Aborigines and Torres Strait Islanders. www.health.qld.gov.au/publications/corporate/sr1/summary.asp

SCRGSP (Steering Committee for the Review of Government Service Provision) (2005), Overcoming Indigenous Disadvantage: Key Indicators 2005, Productivity Commission, Canberra. www.pc.gov.au/gsp

Appendix 1 - Map of Indigenous Comunities - Mainland Quensland

Map of Indigenous Communities – Torres Strait Queensland

Questions

Douglas Passi, Mer Island - “Regarding your waste management program - I know some community members support you there because the environment we are keeping is too small to support rubbish. I have a problem with quarantine to recycle. I am very frustrated with the health of my children. Promotion at school. It has been going on for nearly a year - getting waste recycled and coming
up from the Torres Strait to Cairns. Is there any infrastructure planning that can sort this issue”?
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John Carleton - “I appreciate that and for those of you not familiar with the area, Torres Strait has a significant issue re quarantine zones. In order to move things in or out of the zones we have to comply with AQIS (the customs people). I appreciate that it is a very frustrating experience from a strategic and operational point of view. However, the Major Infrastructure Program that is currently in the Torres Strait has a regional waste management strategy, which looks from a strategic point of view at how we are going to deal with waste. We have a secondary project which we are in the process of doing with EPA on Warraber Island, which is looking at some operational things dealing with recycling and so on. Another project we are about to implement in the Torres Strait looks a little bit further at how we are going to try to access some of the issues we have, particularly with the Quarantine relationships. We need to get AQIS and Australian Customs on board in order to mitigate this. We can’t give you the outcome on that, but we would like to resolve some of these problems right now. It could be that we find other innovative ways to deal with the waste on site where it is, or try to develop some system that Customs will accept on how we can move it through the zones to Cairns or some area of recycling. It is being looked at, and all I can really say is that we are conscious of these issues we have with State government and also particularly with the TSRA. It is a significant issue. We talk about it every time we have management meetings, and this is discussed with them every week. We also talk about waste. I hope I can give you some comfort that we are trying to address it. Thanks”.

Steven of Yarrabah - “You were talking about working in partnership with ICC and TSRA. I just want to know, for mainland communities who are you going to work in partnership with? Would it be our
respective councils, or what”?

John Carleton - “Our partnership arrangements when we do capital works, operations and maintenance are directly in partnership with local governments and mainland communities. We are wanting to extend it further to the community itself, but our key partner from the local government area are local councils. In Torres Strait we deal only with ICC, and the local government in the Torres Strait. ICC just talks on behalf of councils in the Torres Strait. On the mainland it is with the council itself”.

Steven of Yarrabah - “You must be taking into account that a lot of mainland communities are in transitional stages - we need clear directions”.

Graham Lock - “Regarding amalgamations, we are in the dark about exactly what is going to happen, too”.

John Carleton - “We appreciate your comment. To give you an example, we did an audit on the mainland. One part looked specifically at the service officers at the infrastructure level or operations, but it also identified particular management issues happening within the councils - dealing with financial management from an infrastructure point of view. This is where we are working with the other branches in state government to get capacity building occurring in the different communities as they go through their transitional periods. We can provide them with training and assistance from a financial management point of view about what is asset management and what is infrastructure. We are trying to do our component of that governance aspect”.

For Further Information

John Carleton

PO Box 15031, City East, Brisbane, Qld 4002

Ph: 07 3225 2348 Email: john.carleton@dlgpsr.qld.gov.au
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