Albury Wodonga Aboriginal Health Service
Albury Wodonga Aboriginal Health Service (AWAHS) is an Aboriginal owned and managed community health service in Albury Wodonga.
The health service provides the MCCC Registrar with a unique opportunity to pursue a career in Aboriginal Health and to develop skills and understanding around the effective delivery of initiatives that improve primary healthcare outcomes for Aboriginal communities.
AWAHS provides a diverse range of services to meet its community’s health needs, not only in a clinical sense, but on a cultural and social level as well.
Planning and lobbying for the establishment of AWAHS spans more than thirty years. The Aboriginal community of the Albury Wodonga region, made up of over 50 different language groups, recognised the need for a health service to effectively address the needs of local Aboriginal people.
A partnership between Mungabareena Aboriginal Corporation, Wandoo Aboriginal Corporation and Woomera Aboriginal Corporation produced the Koori Cross Border Health Plan in 2001. As a result, AWAHS was incorporated in September 2003 and the Health Service commenced full operational service in June 2005 from a rental premises in central Albury. In 2007 a joint venture between the Office of Aboriginal and Torres Strait Islander Health (OATSIH) and NSW Health saw AWAHS receive funding to build a purpose built health facility. AWAHS officially opened its new building in August 2009.
Today AWAHS succeeds in meeting its vision statement to:
“…. provide and improve health outcomes for our local Aboriginal community with a range of culturally appropriate, flexible, reliable, professional and viable health and wellbeing services, to strengthen, nurture, enhance and maintain the overall quality of life of our community members.” Source: AWAHS website.
From its beginning with one general practitioner and a couple of administration staff, the service now includes a full time health clinic and general practice, staffed by GP’s, Registrars and Nursing Practitioners. Aboriginal Health Workers provide a specialist range of health services including midwifery, child and family health and chronic disease management.
MEETING NEEDS OF COMMUNITY
The Department of the Prime Minister and Cabinet (2017) Closing the Gap Prime Minister’s report 2017, acknowledges “..the importance of Aboriginal and Torres Strait Islander leadership and stewardship in pursuit of sustainable solutions” for bridging the gap between the quality of life for indigenous and non-indigenous Australians. (1).
As a “leader and steward”, this Aboriginal community owned health service aims to provide services to best “Strengthen, nurture, enhance and maintain the overall quality of life of our community members”.
AWAHS takes a holistic approach and recognises its community’s preference to seek health care options from a service that recognises not only their health needs, but their cultural needs as well.
Aboriginal Health Workers, counsellors and outreach workers provide services across a diverse range of programs including social and emotional wellbeing programs, alcohol & other drug counselling, dental health and transport.
Programs provided by the service include: parents groups, youth groups, housing support, legal advice, Elders bingo, Friday night gigs, TAFE liaison, women’s health, healing arts program, health & fitness, kinder oral health, baby bundles project, sister girls young women support, mum’s & bubs and Koori Kindermanna Preschool.
AWAHS also has a group room for functions, programs and events and runs a Men’s Shed program with powered workshop space, meeting space and kitchen and BBQ facilities.
When asked how the service manages to meet community needs, CEO David Noonan says it’s all about listening. Listening to community, listening to the Board as community members and listening to staff.
“…. it is consultation and really keeping an ear on what is happening in the community and trying to get a greater understanding of community needs from a number of different perspectives”. said David Noonan – CEO
Listening to community and understanding the perspective of community members has facilitated the growth of the organisation which also offers access to allied health services in podiatry, diabetes education, dietetics, speech pathology, occupational therapy, psychology and social work.
The organisation commenced its GP Training role with Bogong Regional Training Network and continues the relationship as a GP Registrar training provider with MCCC.
“We created a relationship with Bogong at the time because our principal GP was Dr Gordon Taylor. He was on the Board of Bogong. …. he helped to create that relationship and move the service from being a service that had one GP, to one that included registrars and training.” said David Noonan – CEO
AWAHS has grown significantly over time and prioritises GP Supervisor training and provision of training for GP Registrars as an important corner stone to its delivery of quality health services.
MCCC works in collaboration with Aboriginal health organisations to develop and deliver meaningful initiatives that improve primary healthcare outcomes for Aboriginal communities.
AWAHS partners with MCCC and supports the provision of MCCC Cultural Training and the MCCC Aboriginal and Torres Strait Islander Health Curriculum.
“It’s again a relationship we have built up. It’s a reciprocal relationship with them that allows us to get the best from each other. It’s a shared relationship which is great.” said David Noonan – CEO
ADVOCACY, RELATIONSHIPS, OPPORTUNITIES
In addition to health service provision, a broad role for the organisation is to advocate for its community.
To facilitate relationships and function as effective advocates, AWAHS strategy is to participate on Boards and Committees of various service provider groups on a local, state and national level. Some of the organisations AWAHS has representation on include Diabetes Australia, National Cancer Council Service, Building Strong Foundations NSW Committee and Murray Primary Health Network Indigenous Advisory Council.
“We explore how, through funding options and through our contacts with funding bodies – whether they be State, Commonwealth or a number of others – how we can best position ourselves to get access to funding to provide those services as well as to take up opportunities for people to access services available in the broader community”. David Noonan CEO
The CEO and AWAHS Community Board take advantage of opportunities that will advance the service by being visible to funding bodies, government strategists and policy makers, partners and various other stakeholders. By having representation on such organisations, AWAHS ensures its participation in policy development and decision making on how health services are developed and provided to the Aboriginal Community.
“David, … has always got his mind open to what opportunities we can take to help the community.” said Sharryn Ward, Practice Manager
AWAHS General Practice Clinic runs five days per week and is serviced by four General Practitioners, Nursing staff, Aboriginal Health Workers and support staff.
The service has had a long history of providing registrar training. Dr Gordon Taylor (RACGP, ACRRM) a past practitioner with the service, was one of the original AWAHS medical team and a member of the Board of Bogong GP Training.
Currently Dr Patrick Giddings and Dr Tess Goodwin share service provision with General Practitioner and Registrar Supervisor for MCCC, Dr Asm Asaduzzaman (a past AWAHS Registrar) and MCCC GP Registrar Dr Dr Katherine Kucfir.
DR ASM ASADUZZAMAN
Dr Asaduzzaman has been with the service for six years. Dr Asaduzzaman moved to Australia in 2004 working at La Trobe Regional Hospital and Box Hill Hospital, completing his AMC and gaining experience in emergency medicine. He joined the Bogong training program, completing the rural training pathway in North East Victoria.
“I love this place. I love what I do here. I started GP Training in 2010 with Bogong and came here in 2011, for a six month extended skill position…. during that time I got my Fellowship…. I stayed. I meant to go back to Melbourne after I finished my training … and I’m still here.” said Dr Asm Asaduzzaman – GP Supervisor
Dr Assaduzzaman also describes the organisations effectiveness as having its basis in a successful team approach, with good relationships between clinicians, support workers, administration and management, to meet the varied and often complex aspects of patient care and health service provision. When asked what really inspires him, Dr Assaduzzaman acknowledges his feeling of achievement in:
“ helping in some small way …… the community look after their own health”. said Dr Asm Asaduzzaman – GP Supervisor
With the availability of specifically trained staff in medical, nursing, maternity, child health, chronic disease management, social and emotional well-being, counselling, drug and alcohol support and allied health services, the General Practitioner is able to utilise these services for the patient and can offer a “one stop shop”.
“AWAHS offers ….. a different kind of service. Most of the services I can offer are here. …
I don’t have to send the patient to other places.” said Dr Assaduzzaman.
Provision of these services in one location enhances flexibility, monitoring, follow up and connectedness to optimise positive outcomes for the patient/family/group in health terms, but also improves social and cultural outcomes as well.
Working in Aboriginal Health GP Clinicians are exposed to diversity across clinical, cultural and social platforms. Clinical diversity with presentations across the whole health spectrum, cultural diversity being aware of history, place, belonging and cultural pride and social diversity by becoming part of the AWAHS Community with family connectedness, community support and shared experiences.
“..not only the extension skills, we have diversity – I say to the registrar – if you want real diversity, come to AWAHS. We have – we can give you the diversity.” said Dr Asm Asaduzzaman – GP Supervisor
DR KATHERINE KUCFIR
GPT3 Registrar, Dr Katherine Kucfir, completed her medical training in Poland, arrived in Australia and worked in Melbourne at Eastern Health. Taking the opportunity to experience various aspects of medicine, Katherine completed a range of rotations and worked in emergency medicine in Melbourne. Having a family with small children, Katherine chose to relocate to a more rural setting and has found “none of her family is keen on going back”.
Hearing “rave reviews” about AWAHS on the GP Registrar grapevine, Katherine chose AWAHS and commenced her extended skills post in 2017.
In describing highlights of working at AWAHS, Katherine identified the team spirit, the level of professionalism of the staff in dealing with often complex or emergency presentations and the support provided on both a formal and informal level.
“It is the team spirit …… you see it from day one when there is always someone at your side if you need it.
Even just to discuss things”. said Dr Katherine Kucfir – GPT3
Unlike most mainstream general practices, AWAHS has a flexible appointment schedule suited to meet the needs of the community. Thirty minute appointments are available and encouraged to accommodate complex issues and provide the time and capacity to cover an issue in depth and as necessary, arrange further consultations or refer on to other services provided by the centre.
“You can actually discuss things in depth with the patients and there are a lot of issues I don’t think they would be able to talk about in another practice … there is not time for that.
Lots of things surface only in the half hour consultations.” said Dr Katherine Kucfir
MCCC values its relationships with Aboriginal health organisations and works closely with these partners to deliver opportunities for registrars to gain experience in the provision appropriate health delivery systems.
The benefits and opportunities for the Registrar in completing an extended skills or advanced training post with an Aboriginal Health Service lies in the range of clinical skills they acquire and in the professional skills and understanding that develops from working in a multidisciplinary team of Aboriginal health workers who understand Aboriginal health in the context of Aboriginal culture.
GPT Registrar, Dr Katherine Kucfir explains that working as part of the team at AWAHS means you are in an environment where the patients feel comfortable and you can effectively provide a treatment plan for them, tailored to their needs that may not be met in mainstream health provision.
David Noonan explained that the community often chose to come to AWAHS before they go anywhere else. Consequently, the clinic staff needed to be aware and resourced appropriately as occasionally quite complex and sometimes critical presentations occur.
“… the community often chooses to come here before they go anywhere else. So we often get emergency medicine things coming through. We have had people have a heart attack – and come here before they go to hospital. We have had a baby born in our treatment room because the person chose to come here first before they got shipped off to the hospital. … sometimes we have to do things that in a general practice sense you probably don’t get a lot of opportunity to do.” said David Noonan – CEO
Doctors Asaduzzaman and Kucfir described cases that were wide ranging in their clinical diversity, recognising that in General Practice you never know what is going to walk in the door, but in an Aboriginal Health Service, where community members feel more comfortable with the service rather than hospital, what walks through the door could turn out to be “quite unusual or critical and turn into emergency medicine quite quickly”.
Dr Kucfir, appreciates working as part of the team at AWAHS where services are delivered with cultural sensitivity by professionals of both Aboriginal and non Aboriginal backgrounds.
“We have the team of Aboriginal staff supporting our patients so they are not concerned about stigma, about judgement, about the non-sensitive dealing with their issues”. said Dr Katherine Kucfir, GPT3
SHARRYN WARD – PRACTICE MANAGER
Practice Manager, Sharryn Ward has been with the service for five years. She describes the fact that community members can attend and have their needs covered “under one roof” means better health outcomes because they are supported in an environment where they have connection and belong.
“The people that come here …… feel that their cultural needs are being met in a way that they would not get in any other service. They know that the minute they walk through the door they will see ….. somebody they know. They know that they are understood. I think that that is one of the big things for this service, that the community feels safe within it. They see that cultural safety as really important for them.” said Sharryn Ward – Practice Manager
A CAREER IN ABORIGINAL HEALTH IS A GREAT OPPORTUNITY
The strategy of providing GP Registrar training in a culturally appropriate setting, within a multidisciplinary health team, meets the objective to provide AWAHS with an effective and sustainable medical work force that will provide quality and culturally appropriate health care to the community.
“We want our registrars to consider, at some point down the track, a career in Aboriginal Health. Because it is a career opportunity for people. And whether they stay here in Albury Wodonga – which often we love them to …… or whether they go anywhere else across the country, having had an opportunity to experience working in Aboriginal Health means often, people will go back to that.” said David Noonan – CEO
GENERAL PRACTICE DELIVERY IS ONLY PART OF THE PICTURE
As an Aboriginal owned and managed health service, AWAHS has acted for and on behalf of its community, addressing the needs of its community by developing a diverse range of specific, targeted services to improve health outcomes on a clinical, cultural and social level. The MCCC GP Registrar on becoming part of this health team, is provided valuable opportunities to develop clinical and professional skills to provide culturally appropriate, quality health care.
As CEO of the organisation, David Noonan invites trainee Registrars to “come and see what it is like!” and emphasises that a career in Aboriginal health is a great opportunity on many levels.
(1) Department of the Prime Minister and Cabinet (2017) Closing the Gap Prime Minister’s report 2017. Canberra: Department of the Prime Minister and Cabinet.