My name's Shelly Kneebone, I'm a Ngarinyin woman from this area. I am the CEO of the Derby Aboriginal Health Service, where we're sitting here today conducting this interview.
What are the biggest challenges in delivering remote health services
Continuity of care definitely for our clients, getting access to specialist services is some of the biggest challenges within our AMS. We are one of the largest geographic services in the AMS in the WA, probably one of the largest in the Kimberley. Getting our clients from remote communities that you know, potentially is an it's an 8 hour trip just to Derby, 2 hour trip to Broome, which is the regional centre to get things like lung screening is a three day journey for most people. And then it's the price of accommodation.
The Patient Assisted Travel Scheme doesn't necessarily cover all the expenses of what it is to, to get these services. But a lot of people don't want to leave country for a long period of time either. And they're in services where they don't feel culturally secure, don't necessarily have a relationship with specialists. A lot of times we have to fly them to Perth. If we can't get them into the CT scan in Broome, then it, it requires a, a trip to Perth and then, you know, someone has to look after them Perth and there's accommodation.
So a CT Scan potentially could take a week if we can't get them into Broom and it's an emergent service. So yeah, my role is to make sure that people get access to everything that they need through the health sector.
How do you provide support getting mob to their appointments
Most of our people don't have access to transport or they don't even own a vehicle. We have dedicated drivers within the town that get them to their appointments. We will get them up, put them on the bus if we need to, you know. So transport's essential. Also, they need someone that understands the process that they're going through. A lot of them English, second language, not really understanding the processes. They do get quite, quite off putting if they're going into something that they don't understand. So it's quite nice to have an Aboriginal Health Worker Practitioner or a GP or a registered nurse that will walk through that journey with them.
Why is the mobile screening service important
We are so, you know, grateful to have the Heart of Australia truck here for us that that offers such a unique ability for our people to get CT scanning in a culturally safe environment with our staff that could walk through the journey with them. But not only that, we have support people on board now that should their results come back where they need ongoing treatment, we have people in the clinic that can help them go through that process, navigate oncology appointments. And this is something that a lot of them wouldn't have if we didn't have Heart of Australia with the mobile CT scanner.
The response from the town's been absolutely amazing and so very grateful. The team from Heart Australia have been absolutely brilliant to work with. We've done a lot of consultation over the last year about how we're going to run the service, how we're going to set it up, how it's going to be culturally safe.
So yeah, it's been, it's been an amazing journey so far.
Wy was co-designing the mobile screening service important
Too often programmes are developed in areas that don't understand the cultural nuances of working with Aboriginal people. No, every Aboriginal group has different cultural nuances. Not none of us are exactly the same. Yes we do have common themes but place based co-design, you know, it's been signed off under the Closing the Gap National Agreement where Government have said that they will work with us because we quite often have the answers to how we need to solve our problems for our own people. Yes, it doesn't happen overnight. It is a long journey, You know, change takes time. It's it's not a 12 month thing.
It's we have our answers, we have our ways of doing things and quite often, you know, getting someone to an appointment is not as simple as sending out a text saying this is your appointment time, please arrive. There are so many factors of why someone can't attend an appointment. They may be in Sorry time, they may not have accommodation, they may be carers for children. So we need to be able to build in factors that give everybody every opportunity to attend these appointments.
So co-design, that's essential. We have certainly the answers and the processes around how we can best get people to these these appointments.
What have you learned that would help other services
It's been a long journey from when we first heard about Heart of Australia and teaming up with NACCHO, who were very excited. I think have that conversation with Heart of Australia. Keep the dialogue open. To be honest, I think we've had a fairly seamless journey with Heart of Australia. It's, it's, it's not being difficult. There's been, it's, it's been quite seamless. Just communication, communicate, let them know what does and doesn't work for your community so that they're coming in knowing and fully prepared for what works and doesn't work in your community. They are very adaptable to work around our needs and lots of forward planning.
That would be my take to people wanting to take on Heart of Australia.If you don't take it on, you're absolutely crazy.
The exciting thing with Heart of Australia is that there is the ability to grow this service into other in specialised areas such as audio, audiology, cardiology, you know, these are more like essential services for our mob. Why wouldn't you do it? You know, you've it'd be a really missed opportunity if they didn't take up the offer from Heart Australia.
What has community response been to the mobile screening service
The community are absolutely like over the moon; Facebook posts, we've, we have a Facebook page that we put stuff on feedback in the supermarket, even from the local hospital. We have done a lot of comms around Heart of Australia coming into Derby and the the community, to sum it up in one world, I just word is just absolutely grateful.
It's a good feeling knowing that you can deliver a service to people. One, it's essential, 2, it's easier access and three, it's culturally appropriate. Yeah
She explains how through the National Lung Cancer Screening Program, mobile lung cancer screening is making it easier for people to get a CT scan while ensuring cultural safety.