Radio Interview - Indigenous Health and Hygiene in Remote WA Community

As you've heard on the news and on AM this morning, it's been slammed by various people in the Labor Party, including the Shadow Minister for Indigenous Affairs, Kim Carr, and also the State MP, Linda Burney. But it's been embraced by Mulan community elders and apparently been supported by the West Australian Labor Government, which will undertake to closely monitor the children's health in this little community, particularly the eye disease, trachoma.

Joining me on the line this morning is the President of the Australian Medical Association, the Federal President, Doctor Bill Glasson. Bill Glasson, good morning and welcome.

BILL GLASSON: Sally, good morning to you.

LOANE: You're an ophthalmologist and you've worked in many Aboriginal communities, what do you think of the idea?

GLASSON: I think people must understand that a lot of what we need to deliver in health, not only in relation to eye diseases but a whole range of diseases, relate to the environmental health that indigenous patients or indigenous people find themselves in, and that's really poor housing, poor water, poor sanitation across the board - things like washing your hands, cleaning your teeth, et cetera - and how the importance of that will have an impact ultimately on your general health across the board.

But I suppose the real issue here is that many of the indigenous communities and many of the indigenous children have parents that never have had the appropriate model.

They've never been brought up with the normal sort of ways where your mother will say: "Listen, clean your teeth because the health of your teeth is important. And: "Wash your hands, Johnny," or whatever.

And so if the parents have never been taught that it's very hard for them to teach the children, and therefore it's important that this is built around education. In other words the carrot, not the stick - to be honest with you - and I think it's important to get involved with these communities, identify the people in communities who are actually making a difference. And as I move around indigenous communities there are people on the ground who really are making a huge difference with very simple things like, as we've just talked about, why it's important to clean your teeth, wash your hands, et cetera.

I was up in the Tiwi Islands a few months back and I saw a person up there who really was not only feeding these children a good, healthy diet but while she was feeding them this indigenous lady was teaching them about manners, about saying thank you, about why it was important to wash your hands, clean your teeth, et cetera. So it's all about education and if you do it that way, Sally, I think we can get a positive outcome.

LOANE: Yes. The trachoma, explain that, because some people have rubbished the idea of washing the children's faces a couple of times a day. Can that help in stopping trachoma?

GLASSON: Very much so. Basically the biggest impact on treating trachoma is not drugs, the biggest impact is clean water, washing your hands, and keeping the flies off you basically, because it's one of those diseases that it's a recurrent infective process that goes on that ends up scarring the eye, and so it's basic hygiene that makes the biggest difference. But if you've got no clean water and you've got no flushing toilet and you've got nowhere to wash your hands, per se, then it's very hard to use those principles.

So we're saying that you need to get out there and make sure that there is fresh water, make sure there's an appropriate place for kids to have a bath, and things like a swimming pool we keep talking about. It may seem silly, but a swimming pool in a community can make a huge difference to things like trachoma and a whole range of skin diseases as well.

LOANE: I don't know if you know this Mulan community. Amanda Vanstone was asked about the availability of fresh water in this community. But that would have to be the number one point. If you've got to have kids keeping clean you've got to have an adequate supply of water.

GLASSON: Sally, you're absolutely right. If you've got fresh water and plenty of it, it probably has the biggest impact on health across the board. As I said, it comes down to the basics of health. We're not talking about sort of high level diseases here, these are fairly basic diseases that you and I don't think about because we're in a situation where we do have plenty of fresh water. We are taught the normal sort of habits of washing our hands and cleaning our teeth, et cetera, et cetera, and the importance of that.

But these little kids don't have the normal family sort of structure to actually educate them, and so this is about educating these kids. Not only educate the kids, you have to educate the parents, teaching the parents why it's important to do X, Y and Z and really engaging these communities at a very basic level.

So I think that's why we've got to go to community by community and decide what do we need to do in this community, to not only decrease trachoma but a whole range of diseases, and it may be something as simple as putting in a fresh water supply or putting in a swimming pool or whatever. But do it community by community.

LOANE: Bill Glasson, can it work if there is a bit of stick there too: you will get X it you do this?

GLASSON: I think it's a level of community control. In other words, with those people in the senior ranks of the community that's OK, but don't use the stick on the family units, because I don't believe it will necessarily work. I believe if you say to the community leaders: "Listen, if you do X, Y and Z then you'll get extra money or extra sort of resources in whatever way, so be it." But I think when you're talking about individual families and these little kids and mums and dads who really have had no education, or very little, and don't know what's normal and abnormal and, really, have never been taught the importance of why it's good to wash your hands or why it's important to wash your teeth.

So I think that be careful of using the stick. I think that we should engage in these communities and make sure we sort of educate them and say why it's so important and then as we get less trachoma, less disease, they become part of the solution, they feel we're doing good things here and support these communities, as I said.

LOANE: I thought the irony when I first looked at this story was that they're getting petrol bowsers, or the government will install petrol bowsers, and yet petrol sniffing is such a shocking curse in these communities.

GLASSON: It is, Sally, and again you've got to look at why that is, and it's because you have a whole group of young kids who basically have got nothing to do. So we've got to make sure we develop programs out there, develop appropriate sports so they get activities to do - that might be teach them how to swim, play Aussie Rules, or play whatever sport - and so you've got to get involved with these kids.

Again, if the kids have got a full tummy with nice food then they'll go to school. They'll say: "Listen, we'll come and we'll play sport." We've got to make it exciting, we've got to make the kids want to come in and do it.

In fact, I was at a little community school, believe it or not, down in Canberra the other day, Sally, and this little school deals with very deprived children - a lot of those indigenous, by the way - and a part of the program now is they take them to a swimming pool. Well, you'd swear these little kids - a lot of them five, six, seven, eight - had won the Gold Lotto because for a lot of them it was the first time they'd ever been to a swimming pool - and this was in Canberra, by the way.

But because of that these kids now want to come to school because they know that they can go and have a swim. But while they're at school those teachers teach them why it's important to clean your teeth, and they give them breakfast and they teach them why the manners are important, to say thank you and pass things, et cetera. So they're actually educating these kids in the broader sense. As well as the three Rs you teach them why it's important how to sort of socially communicate, I suppose.

We've got a lot of work to do here, but it's very basic work and it takes a lot of effort and it takes a lot of, I suppose, resources directed appropriately, directed at programs that are working and then you can build on those programs into the broader communities.

LOANE: All right. Bill Glasson, thank you.

GLASSON: Sally, thanks very much indeed.

LOANE: There's the Federal President of the Australian Medical Association, Doctor Bill Glasson, who is, as I mentioned before, an ophthalmologist, Queensland based, and has worked in many, many Aboriginal communities over the years.

Ends/…