Friday, 18 October 2013
A project to improve the renal health of people in WA's Eastern Goldfields has resulted in new shops, vegetable gardens, music and visual arts projects - as well as better health.
The Western Desert Kidney Health Project (WDKHP) is an innovative project that grew out of the Aboriginal community in the Eastern Goldfields, and their desperation to do something to stem the tide of kidney disease and diabetes that was ripping apart their community.
Associate Professor and medical practitioner Christine Jeffries-Stokes and renal physician Dr Steve Wright have worked with chief investigator Annette Stokes, an award-winning medical researcher, on the project, out of the Kalgoorlie office of the Rural Clinical School of WA.
For the past three years a mobile team lead by Ms Stokes and made up of Aboriginal health workers, medical students, paediatric registrars, volunteer researchers and community artists have spent a few weeks a year in each of 10 communities in the region, with the aim of reducing renal disease and diabetes by at least 20 per cent.
They have offered health assessments, looking for the risk factors for kidney disease and diabetes, immediately referring people with abnormal results for counselling, treatment or further investigation.
"At the same time, we teach people about diabetes and renal disease and how they can be prevented or at least minimised," Dr Jeffries-Stokes said. "The artists work with the communities, especially the children, to translate the health messages into appropriate and engaging forms.
"Not only does this help the message to get out and to be understood, but it has resulted in some lovely outcomes for the communities, including artistic and performance skills, pride and kudos.
"We also have a community development arm to help communities to find ways to make positive change," she said.
Rates of kidney disease and diabetes escalated with urbanisation and change to a western style diet and lifestyle in the communities in the Western Desert. Bush tucker disappeared and fresh fruit and vegetables were scarce but packaged foods and high sugar drinks became more easily available.
"The health assessments have resulted in more than 50 per cent of people being referred for further investigation or treatment," Dr Jeffries-Stokes said. "About 40 per cent of people have signs of early kidney disease, including a significant number of children, some as young as two.
"More than 50 per cent of people are overweight or show signs of nutrition-related diseases such as diabetes, high cholesterol or anaemia. In some communities this is as high as 70 per cent.
Rather than just treat the disease, the project set to work to treat the cause. With encouragement and help from WDKHP, changes in the communities have been made so that people have more access to fresh and healthy food.
Laverton has a shop after three years without one. Leonora also has a shop with good food and a hydroponic vegetable-growing project. Norseman School won a Stephanie Alexander kitchen garden grant.
Kurrawang, Coonana and Tjuntjuntjarra schools all have vegetable gardens, the Menzies community has planted fruit trees in the park and Mulga Queen is working towards a fruit tree windbreak for their community.
"After the arts project in Laverton this year, all the children in the community returned to school. Before this, there was a very high level of non-attendance," Dr Jeffries-Stokes said.
One of the art projects was a sand animation, using traditional sand drawing to teach the health message. The children in each community made the animations, wrote the story that went with it, edited and photographed each project, with the help of an animation artist, Steve Aiton. Norseman School used their sand animation as part of their successful application for a kitchen garden grant.
The sand animations are being used by students at Latrobe University as part of a course in health promotion and cultural difference.
"Our team were authors for two editorials in the Australian and New Zealand Journal of Public Health (ANZJPH): one on the difficulties of evaluating Aboriginal health projects, and another comparing scenarios of inequity in the Western Desert and South Africa's Limpopo region," Dr Jeffries-Stokes said.
"A century ago, south of the Limpopo River, mining companies bought large tracts of land from poverty-stricken farmers. Black tribal groups were dispersed and malaria was widespread. Public health campaigns distributed mosquito nets and subsidised quinine tablets," she said.
"Mining has had a similar outcome here for the Aboriginal communities."
The editorial in the ANZJPH last year said governments needed to ensure access to affordable fresh fruit and vegetables.
"They also need to take action against the purveyors of junk food - just as they took action against the malaria-carrying mosquito."
Dr Jeffries-Stokes said the three years of field work would be complete in November. The team then has funding for a further 12 months to analyse and write up their data and to put together an exhibition of art works from the project.
"The project has been more successful than we had dreamed, with extraordinary benefits in community empowerment and the production of such beautiful artworks that tell important stories and have a reach far beyond the communities that created them," Dr Jeffries-Stokes said.
The Western Desert Kidney Health Program has many partners and supporters including the Rural Clinical School of WA, Bega Garnbiringu Health Services, the State and Federal Governments, bhpbilliton Nicklewest, LotteryWest, and Healthway.
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