Indigenous Environmental Health: Report of the Fifth National Conference 2004
Delys Brady, Manager, Corporate Planning and Risk Management, Hunter New England Area Health Service, New South Wales
Nell Angus, Community Dietician/Project Officer, Wor-Ra-Kee Project, Hunter New England Area Health Service, New South Wales
Nell AngusWe would first like to acknowledge the traditional owners on whose land we are gathered today. Delys and I will be speaking about Wor-Ra-Kee, the Karuah Family Nutrition and School Access Project. Wor-Ra-Kee, from the traditional Kuttang language, means ‘to see’.
Karuah is a small, beautiful township situated on the Hunter River, a 45 minute drive north of Newcastle. The Karuah Aboriginal community is an urbanised group of about 200 people, in approximately 60 homes on a former mission. They have a community hall, playground, workshop, Lands Council office, and an Aboriginal Corporation office where outreach medical clinics are held.
Food choices in the community tend to be mainly westernised, although some of the Elders have talked about eating river worms, goanna, pipis and snake. The locals report that access to varied, affordable food is limited by lack of transport to travel to the shops and of money to spend there.
Our decision to work with the Karuah community and focus on nutrition, Aboriginal families and school achievement was supported by our research. Firstly, during a consultation for the Hunter Aboriginal Health Plan, local community members indicated they wanted better attendance at school by their children, and improved general health and wellbeing in the community. Secondly, more formal research showed that Indigenous students tend to be lower educational achievers, and that poor nutrition affects absenteeism, concentration and learning at school. It also impacts on health status, weight and oral health.
The Hunter Aboriginal Health Partnership between Hunter Health and Awabakal Aboriginal Medical Service applied successfully for funding through the Australian Government Department of Health and Ageing’s National Child Nutrition Program (aligned to the National Indigenous English Literacy and Numeracy Strategy). Hunter Health and the Families First Initiative also provided financial and in-kind support.
The next step was to get others interested in working with the Hunter Aboriginal Health Partnership and Karuah community, not only to assist with implementation, but also for sustainability and evaluation. The project received guidance, support and sponsorship from:
- Karuah’s Aboriginal community, Local Aboriginal Land Council, Public School and Kamarah Aboriginal Corporation
- Warlga Ngurra Women’s and Children’s Refuge
- Families First Initiative
- National Heart Foundation
- New South Wales Department of Sport and Recreation
- Hunter Health’s Community Nutrition Unit, Health Child and Family Health and Birrali Aboriginal Birthing Service.
In helping each child start to uncover his or her own potential, the aim was supported by the objectives of:
- achieving good school attendance and concentration through regular access to nutritious food, awareness in the community of the link between healthy eating and doing well at school, and building healthy nutrition practices and knowledge in the community
- overcoming child health, hearing and nutrition problems by improving the assessment of children’s growth and health, and strengthening involvement of other services and sponsors.
What we didTo achieve the project’s stated objectives we ran:
- a breakfast club with community workers five days a week during school terms for 18 months from February 2003 where between 10 and 35 kids were offered a variety of healthy food choices each day (the Red Cross provided valuable advice)
- an Arvo Club twice a week after-school during school terms for 15 months
- a Homework Club for one term in 2004 at the request of the children; prior to the project, a homework club had operated every Monday from Karuah Primary School
- Growth Assessment Training that provided basic skills for 10 Aboriginal health workers from across the Hunter in measuring children’s growth, interpreting results and understanding factors affecting children’s growth. Modified from the Northern Territory’s Area Health Service Growth Assessment and Action Plan and funded by Families First Initiative, a three-day workshop was conducted with Hunter Child and Family Health. Health promotion information was provided in course kits, and links were encouraged with mainstream and Aboriginal service providers through provision of two directories.
BenefitsThe project benefited the children involved, schooling in Karuah, and the community as a whole.
ChildrenBenefits to the children included:
- Opportunities to prepare simple recipes at Arvo Club, as well as grow and taste some different foods. Wor-Ra-Kee was given two garden beds in the Karuah community garden project.
- A focus on traditional art and craft in the Arvo Club using the Traditional Games booklet, from the Department of Tourism, Sport and Recreation web site, that drew on Indigenous history while using modern equipment.
- A place to meet in the morning at Brekkie Club.
- Almost one-on-one assistance at Homework Club.
SchoolingBenefits to schooling in Karuah included:
- An evaluation conducted with the school revealed that absenteeism was significantly reduced and suspension days were almost halved. Teachers noted that the children seemed more attentive in class and that disciplinary action seemed not to escalate to suspension as often as it had in the past.
- Teachers also commented that the children seemed to like going to school and learned better in class.
CommunityBenefits to the Karuah community include:
- Working with the community to renovate and furnish the hall improved their facility, and established rapport and built relationships and trust between the project and community members.
- Parents were pleased to see something positive for the kids—some assisted with Arvo and Homework Clubs.
- Aboriginal workers employed from the community participated in child protection and food safety training, and had discussions about communicating with children, thereby providing qualifications and skills for later jobs.
- The project provided information on food, health and links to learning.
- Other services established a Koori Women’s Group, with informal conversations about cooking, food and grocery shopping, and art and craft activity.
- The project provided a conduit for involving the Port Stephens Families First Aboriginal Worker and the child support worker from Warlga Ngurra Women’s and Children’s Refuge in the Arvo and Homework Clubs.
- An Arvo Club Cookbook of children’s art and recipes was produced.
Other achievementsAs well as the planned achievements within the Karuah community, other spin-offs from the project included:
- Sponsorship from the National Health Foundation and the federal Department of Tourism, Sport and Recreation provided team shirts for project workers and the steering committee; and Kid’s Packs of tee-shirt, drink bottle and an Arvo Club Cookbook.
- Two newsletters were produced and distributed to each household.
- A Hunter Version of Eating Well for You and Your Baby was modified, with kind permission from the Queensland Indigenous Infant Project at Inala, to include pictures of Hunter Aboriginal families.
- Participation in 2003 NAIDOC Week festivities at Karuah.
- An end-of-project party during 2004 NAIDOC Week with races, balloon sculpting, kite flying, prizes, and, of course, eating!
Delys Brady Lessons learnedWhile successful in many aspects, those of you who have implemented a project from scratch would know that things don’t always run smoothly. So, we had to try and reduce potential problems with attention to the following:
- Involvement with the Aboriginal community, essential from the beginning, can be influenced by:
- a history of individual experiences with the organisation/service we represent, especially where those experiences were not always good
- community members may regard us/our organisation/services as authority figures and be wary of us, especially in the beginning
- a history of unsustained project work may mean the project is not the community’s highest priority.
- Community participation is about engaging, involving and empowering as many people as possible. Some pitfalls to be aware of are:
- communities are built on relationships and it takes time to work these out
- politics within the community are sometimes hidden to outsiders
- generating willingness to take on responsibilities is a major challenge and can be impossible in some areas.
- Good planning is essential from the start but flexibility, patience and eternal optimism are also essential for success. For this project, we initially experienced some logistical problems in maintaining a profile when the program only ran during school terms, and the project officer and managers were based 40 minutes from the community. So, we altered our original plan, extended the project officer’s hours so she became more of a presence in the community and ran a few programs during school holidays.
- Realistically estimate time requirements, and while difficult initially, remember:
- it takes time to establish relationships in Aboriginal communities
- non-recurrent projects have a limited life and a lot needs to be achieved in a tight timeframe
- delays can have a ‘domino effect’ in the community.
- Our advice is to estimate the paid hours needed and then double it, at least.
- Establish the boundaries early, especially when time is limited. Stay focused, clearly state what can and cannot be done within the funding and activity of the project and avoid non-project issues, which can have hidden agendas. Our project officer had to assess every issue brought to her and, if appropriate, refer it to someone else.
- Cultural awareness or competence is especially important when working directly with Aboriginal communities. It is essential to acknowledge the different perceptions of the world that you, as a project worker, have compared to someone who has lived in the community all their life and perhaps rarely travelled beyond it. Fundamental to acceptance is respect, understanding and communication without judgement. It is about respecting and valuing everyone’s view. It can sometimes take years for Aboriginal people to be fully accepted in Aboriginal communities and usually longer for non-Aboriginal people.
- Aim as high as you can and provide as much training and up-skilling as your project will allow. We provided accredited training in child protection and food handling for our workers that equipped them to use safe practice in the project and in future jobs.
- Remember to allow for delays and mistakes, communicate effectively about the project and avoid ‘shooting the worker’.
- Getting the team right is probably the element that can make or break a project. The terrific people we were very fortunate to have committed to the project were:
- our very dedicated Project Officer/Nutritionist and heart of the project, Nell Angus
- our great Aboriginal health workers, Vanessa Saunders, Sharon McGregor and Joanne Simms
- our Families First helpers and funder, Lisa Brown, Michelle Jensen and Teresa Findlay-Barnes
- our Warlga Ngurra supporter, Tamara Ridgeway
- our Growth and Assessment Trainer, Eileen Guest.
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So where to from here?Several ongoing activities have stemmed from the project:
- We are still seeking recurrent funding to sustain the Breakfast Club.
- The Arvo and Homework Clubs continue with Families First Aboriginal workers, encouraging community participation.
- Publications continue to be distributed.
- The project has become linked with the chronic care project in Karuah community.
FinallyWe are very grateful for our funding: we achieved a lot with a little. But Aboriginal communities need projects funded for longer periods to develop trust, and get the ongoing involvement of the community to sustain the project. Tailored approaches are needed, especially those involving the beautiful Aboriginal children. They are, after all, the future of the community. We need to do as much as we can to help them realise their potential. That is our message today.
Wor-Ra-Kee: helping the beautiful Aboriginal children of Karuah ‘to see’ a better future.
For further information
Corporate Planning and Risk Management,
Hunter New England Area Health Service, New South Wales
Locked Bag No 1,
New Lambton, New South Wales, 2305
Phone: 02 4985 5908
Fax: 02 4921 4833
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