Tip:
Highlight text to annotate it
X
WOMAN: You've got a little thing of hair just curled there.
No, they said they're happy with it.
(Growls)
Predominantly, we're involved in screening for hepatitis B.
For all clients at risk of hepatitis B, we will take a blood sample from them
to check what their immune status is
and to see whether they've been exposed to hepatitis B.
Then we will offer immunisation for them. That's our main role.
If somebody is testing positive for hepatitis B,
then we'll give information
about where they are in their journey of hepatitis B.
We can also be involved in treatment,
although that's fairly new for us as a ***-health department
because we're not a liver clinic.
Our main role at the moment
is around monitoring and supporting people with hep B.
When those very close-fitting lycra outfits arrived at our service,
I thought, 'Nobody is ever gonna want to get in those!'
But it's funny, people elbow each other
out of the way to get in an STI outfit.
I think it's because, for one,
here in our service, we really love our work.
We're prepared to do anything
that will catch a little bit of attention.
You get in the outfits, walk out under the trees,
everyone in the whole building is looking at us and having a laugh,
and if you can have a bit of a laugh,
that's a great way to start conversations.
There are always issues of shame and fear around most infections,
particularly within *** health,
because of a lack of knowledge within community.
Often people are feeling so bad - 'I've got this virus, it's within me' -
how that makes them feel about themselves.
The characters were very much developed
in a partnership with the Queensland Aboriginal and Islander Health Council,
QAIHC,
the 2 Spirits Aboriginal and Torres Strait Islander program
with Healthy Communities
here in Queensland and Queensland Health.
It was a collaboration that brought the suits,
but the Condoman comic book and character was developed
from Aboriginal-community engagement and community leadership.
All cultures see the importance of arts and culture
to communicate health-promotion ideas.
We look to involve a range of different ways,
whether it's music or theatre, to communicate health-promotion messages
and engage with people.
It's quite boring if it's just medical information.
For us, it's around education,
to try and break down the barriers so people access services,
so they'll go to their GP and ask for screening, maybe around hepatitis B
or other infections, like *** and syphilis and ***-health infections.
Our job within health care is to make sure that we're warm, welcoming,
accepting and also provide up-to-date, good information.
The nice thing about those outfits,
even though I'm a little bit uncertain about hep B being shown with other STIs,
acute hep B in adults is sexually transmitted,
and chronic hepatitis B, I like to think of
as more of a family and a community issue.
I don't want to get stigma in there.
But it's nice to see hep B in there with the other STIs,
out and about and having fun.
It's a way to normalise the conversations about chronic hep B.
- Hello, Bart. How are you today? - Good, thanks.
We saw you a couple of weeks ago and had a heap of blood tests done...
BART: Yes.
..to see if anything came out.
What's come out is that
you've got some abnormalities
on your liver tests.
OK.
One of them is that,
you know we were going to test for all the hepatitises,
the inflammation-of-the-liver tests?
- Yes. - One of them has come back positive.
It looks like you've got hepatitis B.
Do you know anything about hepatitis B at all?
No, not at all.
You really don't know.
Do you know if any friends, relatives have hepatitis B?
We don't at the moment have a current prevalence figure
for hep B in the Torres Strait.
What we know is that in the mid-'80s, before the introduction of vaccination,
about 11% of children and antenatal women
had chronic hepatitis B.
With the study that we did recently,
we identified somewhere between 200 and 300 people in the region
who have chronic hepatitis B.
That's probably approximately 3% of the population.
We're doing further work to get a true prevalence figure.
Hi. My name is Nicky Newley-Guivarra.
I'm a descendant of the Wuthathi people in Shelburne Bay
and also Darnley Island in the Torres Strait.
I went to university and studied fine arts.
That's where everything started happening, was with the art,
because I used it like therapy.
Every time I sat down and painted,
I was thinking about my life and the next steps I needed to make.
Hepatitis Australia was offering grants
to work more effectively in Aboriginal and Torres Strait Islander communities,
so we applied for one.
What we applied for was to go far north
and do some education around hepatitis B.
In the far north, hepatitis B is more prominent
in Aboriginal and Torres Strait Islander communities.
What is hepatitis, where is your liver, what it does, how do you catch hep B.
I'm up in Thursday Island for three days to cover the whole community
about viral hepatitis B.
When I go into Aboriginal communities,
I work closely with the Indigenous ***-health workers.
I like to make sure that they're upskilled with viral hepatitis as well.
I offer an info session. It goes for about an hour.
It's giving them all the information they need as health workers
to be able to work more effectively with the community.
The community workshops are different
to me coming in and upskilling health workers.
It's more of a laid-back environment for them
to be able to have some awareness about hepatitis B.
It's basic awareness.
But the key point I want to get across to community
is the importance of treatment and management of hep B.
I talk about the importance of vaccination in their community,
make sure that they're vaccinated,
the importance of knowing about transmission if you're not vaccinated
and the importance of monitoring.
If they're living with hepatitis B,
it's really important that they come into their local health service
and be monitored.
I thought, 'Why not use art as a medium to educate people?'
That's where it all started.
Now I think that we've worked in about 60 to 70 Aboriginal communities
throughout Queensland.
When I come in to educate,
I like to try and lessen that stigma, lessen the shame.
By them having a role model in the community
that can get up and talk about it and also open up and say,
'I've lived with hepatitis...'
I can associate some of the symptoms with how I felt.
I always come back to, 'When I had it, this is how I felt.'
I always say that once I was cleared from hepatitis,
my quality of life is a hundred per cent.
Me getting out into the Aboriginal communities
and doing what I do, it's passion.
I've got a strong passion towards
making sure that people know about viral hepatitis.
Once you've lived with viral hepatitis,
you do know the importance of knowledge around it.
I measure the success of this work through evaluations.
Every workshop that I deliver, I evaluate.
I also get the knowledge at the start of the workshop,
what their knowledge is around viral hepatitis,
by a series of simple questions.
They're just basic, five questions.
Most of the time they'll go, 'I don't know.'
Then you lessen their anxiety about that
and say, 'It's OK. If you don't know, just put "I don't know."'
That way, I know where I'm starting at.
At the end of the presentation that I deliver,
I give them the same five questions.
That tells me whether they've got that knowledge.
PHOTOGRAPHER: And another one.
Thank you, boys.
At the beginning I noticed no-one really knew what hep B was.
By the end of the workshop they do, so I'm happy with that outcome.
What we want to investigate is to see if the infection is such
that we need to treat it.
There is a treatment for it.
It's a long course of tablets.
The whole process of compliance
is education of the patient to understand the importance
of taking their medication.
That's a long process
that requires appropriate and adequate staffing
to have the time to do that with patients,
and not only the clinical, front-line staff
looking at acute illness as well as chronic, but the education component
and the education staff within the district.
Don't be too worried about this. If you do get worried, I'm here all the time.
Just come to the centre and ask to see me.
They'll either say, 'John can see you soon,' or it might be tomorrow.
- Is that OK? - Yeah, that's fine, Doctor.
- OK. Thank you. - Thank you.
It's a little bit easier to talk about hepatitis B
now that there's a national strategy.
It gives a bit of direction, a mandate, really,
for starting to talk with communities about it.
For hepatitis B, in all levels of community,
it tends to be a pretty new discussion.
It tends to be a new discussion for health workers, for nurses,
for doctors, for clinical management as well as for people in the street.
In that regard, it's quite simple because it's new for everybody
and everybody is learning together.
I'm still learning as well.
One of the things that was really clear
was also that the staff didn't actually feel confident
that they knew enough about hepatitis B.
I think this is a very important issue to address.
I know that in the Torres Strait there are also many other health issues
that people are dealing with.
It's one of many conditions.
But I think hepatitis B has been a neglected disease to some extent.
I think it's up to us to catch up with the new developments that have occurred.
Many clinicians, when they studied medicine and for many years,
there wasn't that much you could do for hepatitis B.
Now there's an increasing body of knowledge
about things that we can and should be doing.
It's time that we actually took that on board and did it.
Captions by CSI Australia