Report of the 6th National Conference

A Model for the Delivery of Environmental Health Services on a Regional Basis

Page last updated: 07 July 2008

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Raymond Christophers, Nirrumbuk Aboriginal Corporation; Louie Bin Maarus, Regional EHW; Phillip Augustine, Regional EHW Kullarri Region EH Services, Nirrumbuk Aboriginal Corporation; Gerhard Ehlers, Townsville Shire Council Raymond Christophers

“First of all we would like to acknowledge the traditional owners of this country, and we thank you very much for your welcome. Before I start I would like to take the opportunity to present a bit about the Nirrumbuk Aboriginal Corporation.

Nirrumbuk Aboriginal Corporation is a service provider and is a full corporation. We don’t work for the government, though we do contracts for the government. As you may have heard, our leader says that we have to be mainstream, so what Nirrumbuk Aboriginal Corporation has done has been to try and go in that direction.

There are four major communities and 82 outstations (area of 56,000 sq klms) in the Kimberleys.

Some of our stakeholders include the communities, Broome Shire Council, Nirrumbuk employees and Office of Aboriginal Health.

I can’t agree with some things said this morning about monitoring and reporting, because we have done the labouring bit. However, you can only do the labouring bit so far, and I think that education is the way to go - the more people are educated, the quicker our job will be.

What Are Part of Our Services?

  • Monitoring and reporting on EH matters.
  • Minor repairs involving water/wastewater.
  • Dog Health Program.
  • Pest Control Program (Mosquito Control).
  • Assist with community projects/education.
  • EH-related community cleanups.
  • Pre-cyclone season cleanups are a big one for us.
  • Training and development is always what we do.
  • Maintaining plant and equipment.
  • We assist in the education as part of our role.

How We Do It?

We try to employ a person from the community, who is chosen by the community:
  • We employ one AEHW in each major community, and we work with that person, giving him full support.
  • We employ a three-man regional crew.
  • Work is flexible - planned six months in advance.
  • Planning meetings involve all stakeholders.
  • All our staff are trained in Certificate 3 (even myself, who was originally trained as a butcher - so I had to learn that one).
  • All staff are trained to Certificate 3 level in Aboriginal Environmental Health”.
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Phillip Augustine

“I would like to acknowledge the traditional owners of this country and thank you for having us here.

Most of Our Job Is


  • Monitoring - checking on ponds, a contract to maintain overgrowth and check fences, etc. In one of the communities during a heavy season, the rain cut underneath the fence and made a tunnel. Kids got underneath, were chasing ducks into the ponds, and a small toddler got into the water. A day later it showed up in schools that a few of the kids were affected by the water. What we are doing is interacting with health clinics and schools to keep in touch in order to maintain a good standard of health.
  • Reporting – as a regional team we look at water sampling. There are cases in clinics where kids suffer from diarrhoea, and one case showed e-coli. We came across two cases of kids with Giardia, so we had to go to schools and talk about germs.
  • Pest control – also EHWs are trained in pesticides in the spraying of cockroaches, dogs and mosquitoes in households. In households we encourage people to empty dog bowls, for example. We encourage them to follow normal safety precautions and the use of cockroach barriers, and how birds and animals can be affected by cockroach spray indirectly.
  • Community projects.
  • We file weekly timesheets to the office in Broome”.

Louie Bin Maarus

“Good morning. I come from north of Broome. I would like to acknowledge the traditional owners for giving me the opportunity to speak on their land
I do the regional crew of three boys:
  • Run the heavy machinery (950 cat) used in the program.
  • We visit all 82 outstations at least twice a year around the Broome area.
  • The four major communities are visited twice a year with assistance from the local AEHW.
  • The major part of regional crew time is spent on
- EH-related cleanups.
- Pre and after cyclone cleanups.
- Dog Health Program.
- Travelling – eg, 500 klms a day to reach a community.
- Gidanka community is a big community of 600-700 people.
- We also work closely with other teams such as tips”.

Gerhard Ehlers

“I had the great privilege of working with Nirrumbuk Aboriginal Corporation for a year and a half. I would like to take this opportunity to acknowledge the traditional owners of the area. I was funded by the Office Aboriginal Health, but was stationed in the shire who gave me administration and office support.
My role was mainly that of a liaison person between the various stakeholders such as government departments providing legislative and technical advice/service of:
  • Water sampling.
  • Disease investigation.
  • Food premises inspections.
  • Management of pest/vector control programmes.
  • Processes applications for effluent disposal systems.
  • Assesses community layout plans.
  • Education and training programmes for community and AEHWs (education is a passion of mine, as I believe education is the way to improving things long-time).
  • Funded by the Office of Aboriginal Health.
  • Administration/office provided by the Shire Council.
  • EHO focuses on the 2004 survey findings of the Environmental
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Health Needs of Indigenous Communities in WA survey. Out of that came some core EH issues that needed to be focused on, such as the inadequacies of the smaller outstations. This is where the Nirrumbuk model really came in, as it also serviced the outstations on an area of 56,000 sqm, which is a huge area. A lot of the government funding and programs focused on the large communities and neglected the smaller outstations, where Nirrumbuk filled that gap. One example I can give is when that survey was conducted there were no dog programs in 60% of the communities, and during the program we found that 74% of households actually had dogs, so you can imagine the health impact. With Nirrumbuk coming on board and the model they used, there is now 100% dog health programs in all communities, including the outstations.

One of the advantages for me working with Nirrumbuk was that it gave me credibility and acceptance into the communities in a much shorter space of time. We did all our planning together and worked as one, to the extent that I felt I was part of Nirrumbuk. Again it was also the access to local historical knowledge and other things””

Raymond Christophers

“We are required to give a quarterly financial report and half-yearly service report:
  • Six months’ forward planning with our stakeholders.
  • Communities are informed prior to regional EHW crew visits.
  • We bring the EHWs into Broome and hold a planning meeting and go through allocation sheets to get a summary of data of what our core jobs are for the next six months. Many guys don’t see themselves as pencil pushers, but this has let us know how much time we are spending on certain programs, and helps us plan better. We can service the communities far better now, and determine what’s important at what time of the year.
  • Referring to diagram - here is the summary sheet, which provides a good overview from which we can plan, and covers all the bases in the contract.

Management Information

  • Three-monthly detailed plans for AEHWs and RC.
  • Weekly allocation sheets completed.
  • Information from allocation sheets tallied cumulatively.
  • Summary % for each crew produced.
  • Data used to fine-tune service delivery.

Program Strengths

In the past the service delivery was better for the workers - structure is to fulfil the contract:
  • Central Management
- Removes politics from service delivery.
- Ensures a uniform standard of services.
  • Program is self-contained for
- Staff – none have left (they are all good men).
- Equipment – we are applying all the time for equipment.
- Maintenance – we are learning as we go with maintenance
schedules.
  • Everyone knows what is happening, and when.
  • Delivery can be integrated with other programs for synergies.
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I manage two programs - NS team to outstations. The team comprised six originally, but we joined with another team. The new team members are learning, so we are now covering the areas better with cross-training of both teams.

Program Weaknesses –

  • Program continuity under threat from.
- Changing government policies.
- Relatively short expiry dates.
  • Uncertainty over the future CDEP funds – this is a big one for me, as I have been a chair for this. I’ve talked to ICC and it looks like the money that’s there will only help me to prop up service men, but not the EHWs – may not be CDEP-subsidised in the future.
  • No provision for depreciation of capital items - if you are running a real business you need to be able to do that, and we need to continue to work on this to get it - our machine is a $300K value machine. Gone are the days of pick and shovel, and we need to have this sort of machinery.
  • Program focuses ‘outside of fence’ – the education part of getting back inside the house and educating people about the small things. The speaker this morning had a good point about the small stuff like leaking taps.

Conclusions

  • Well-trained staff is a most important asset, and it is important to me to make sure that they get the support.
  • Refresher training courses are important.
  • Model delivers an efficient service.
  • Model delivers a cost-effective service.
  • Our model can be copied or expanded anywhere.

Our recommendation to government is for government to combine Environmental and Municipal Services under the health umbrella. Their core business is housing, not health, and CHIP funding should go to health which would protect EHW funding. We are happy to talk to anyone about this program and provide advice to help others set one up for a small fee, of course. Thank you”.

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