Indigenous Environmental Health: Report of the Fifth National Conference 2004
National Public Health Partnership and the enHealth Council
Michael Jackson, Chair, enHealth Council
Conferences such as this give environmental health practitioners at all levels, from all over Australia, the opportunity to talk together, and that is a very rich opportunity. Delegates can network, find out what works and what doesn’t, share ideas and stories, and adapt solutions to their own local context. It is my hope that you go home from this conference inspired about the work we do and the ways in which we can improve Aboriginal environmental health.
In improving Aboriginal environmental health in Australia there are really three spheres of action: government, non-government and the community, and it is up to all of us to do our bit and work together. This year’s conference theme ‘Today, Tomorrow - Together’ gives us an opportunity to reflect on how we can do things better together.
In the government sphere, the enHealth Council has a number of working groups. The NIEHF is one of those and there are several others that address issues such as water, air, toxicology and contaminated sites. The enHealth Council consists of the Directors of Environmental Health from every state and territory. It also includes representation from the Australian Government Department of Health and Ageing, the Australian Institute for Environmental Health, the Public Health Association of Australia, the Australian Consumers’ Association, the Standing Committee on Aboriginal and Torres Strait Islander Health, and the Department of Environment and Heritage. Recently, representatives of local government, who are very important in terms of delivering improvements in environmental health at the local level, have also joined the Council.
The tasks of the enHealth Council are to act as the peak environmental health advisory committee to government, providing leadership in environmental health across the board in Australia; to forge partnerships with key players; to drive implementation of the National Environmental Health Strategy; and to develop and coordinate national environmental health advice.
The strength of the enHealth Council is the expertise, commitment and passion of its members. There is contribution not only from the directors and the people on the Council, but from within the governments that are represented. The members provide a very important conduit to the enHealth Council and to government. The role of the NIEHF is to provide policy advice to the Council and to comment on relevant strategies from an Indigenous standpoint.
The National Public Health Partnership comprises Directors of Public Health from throughout Australia and New Zealand. It looks at the broader picture of public health issues in Australia and reports directly to the Australian Health Ministers Advisory Council. The Standing Committee for Aboriginal and Torres Strait Islander Health also reports to that Council. The enHealth Council reports to the National Public Health Partnership along with other specialist groups, such as the Strategic Inter-Governmental Nutrition Alliance (SIGNAL)1 (about nutrition) and the Communicable Diseases Network Australia (CDNA)2 (about communicable diseases).
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The Chair of the NIEHF now sits on the enHealth Council. That was an important step so there is now no gap: members of each working party are on the Council, just as members of the enHealth Council and CDNA sit directly on the Partnership.
The important thing about this arrangement is that there is a conduit. There is a pathway that allows the NIEHF, through the enHealth Council, to go up to the Partnership and to Ministers, and that is our opportunity to raise the profile of Indigenous environmental health and the needs of Aboriginal communities.
What is it that we can and can’t do? We can identify where national approaches are needed and do something about it; we can develop national policies, guidelines and models; we can conduct specific projects—and we have done that in response to the recommendations of previous conferences; and we can provide a communication pathway to health Ministers. I have to say that I think we need to do more of that. We need to further lift the profile of Indigenous environmental health issues before our health Ministers. We can share information, skills, experience, expertise and we can advocate in a number of different forums. What we can’t do is guarantee funding; we can’t take action without working in consultation and collaboration; and we can’t deal with issues that are outside our terms of reference.
I want to acknowledge the challenges you face in delivering environmental health at the coalface. I’ve been to a number of communities in Western Australia and I recognise the situation with which many of you are faced. These communities are isolated both geographically and professionally. You are on your own to a large degree, with limited support, and there are often questions about the status of our workforce in Indigenous communities. There is poor infrastructure and competing demands. Where do you start dealing with the all the issues that confront you on a day-to-day basis? There are inadequate pay structures for many of our community workers and not enough hands on deck. There is inadequate funding for resources and equipment. I would challenge people in the broader community to go to an isolated community and live without a water authority, a local government that collects the rubbish, and all the other resources we’ve come to expect.
The value of investing in environmental health has been recognised in a number of different places. In the report of the Western Australian Government Task Force on Aboriginal Social Justice there is a key quote we have used many times. It is:
The greatest improvement in environmental health conditions, particularly in remote communities must be treated as the single highest priority for Government programs. Some of the most basic improvements that we can make in Aboriginal health are through improvements in environmental health programs. 3
Some of our achievements include an increase in the number of Indigenous environmental health workers. We are better at sharing and building on lessons learned. There is a greater awareness of the issues within governments at all levels from local through to federal. We have improved the training of environmental health officers, particularly the opportunities for environmental health workers to progress to becoming environmental health officers, and I acknowledge the Batchelor Institute and the New South Wales Training Scheme. Promotion of the importance of the work of environmental health officers has also improved through initiatives such as production of the video My Job that came out of a recommendation of a previous conference.
The Standing Committee for Aboriginal and Torres Strait Islander Health has recently issued the Cultural Respect Framework for Aboriginal and Torres Strait Islanders; and the National Public Health Partnership has produced Public Health Laws of Relevance to Rural and Remote Aboriginal and Torres Strait Islander Communities. Our enHealth Council water-working group, in conjunction with the Bureau of Rural Sciences, has done some work on rural and remote water supplies; a report has been developed and is about to be released. A review of the National Environmental Health Strategy has been completed over the last couple of days. Indigenous environmental health is one of the key priorities in that strategy.
A recent review of Indigenous environmental health workers has specifically addressed identification and funding of positions. We would like to see a paid Aboriginal environmental health worker position in every community. We have made some improvement in the consistency of education and training across jurisdictions and are looking for improvement in employment and career paths. We need to develop award wages rather than relying on the Community Development Education Program (CDEP). That is something about which we need to advocate at all levels in order to redress the current inequality.
One of the issues of workforce support that has been identified is the value of web sites, particularly for our officers working in isolated locations. There are some good web sites provided through the University of Western Sydney, Peter Stephenson’s work, 4 Edith Cowan University and the enHealth Council.
The report, Accountability in Indigenous Environmental Health Services, produced by the Australian Government Department of Health and Ageing, 2002 is very useful.5 It looks at structures that deliver Indigenous environmental health services in different states and territories and analyses what is working and what is not.
What is the way forward? There is indeed much work to be done and we won’t be resting until we have made an even greater impression. Environmental health is the cornerstone of health improvement. If we can improve environmental health on the ground and fix the issues in environmental health we can reduce a lot of the impact on hospitals and clinics. We need to work together. Indigenous environmental health is a key priority for the enHealth Council and the National Public Health Partnership.
For further information
Chair, enHealth Council,
Department of Health Western Australia
189 Royal Street, East Perth,
Western Australia, 6004
Phone: 08 9222 2223
Fax: 08 9222 4049
1. See <www.nphp.gov.au/workprog/signal/>.
2. See <http:/www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strategcommunic-index.htm>
3. Western Australian Government Task Force on Aboriginal Social Justice, Western Australian Government, Perth.
4. Stephenson, P 2002, The Double Bind and the Double Burden: Implications for the Professional Education and Practice of Indigenous Environmental Health Practitioners, University of Technology, Sydney.
5. Australian Government Department of Health and Ageing, 2002, Accountability in Indigenous Environmental Health Services.