Extended care

Two RNs and one midwife describe their roles in Closing the Gap. 

After moving from a hospital-based nursing career to the community-controlled health services, registered nurse Nola White was part of a two-person team that set up a centre in Inala.

White joined Dr Noel Hayman in setting up the Inala Indigenous Health Service after consultation with the Aboriginal community and Elders revealed the desire for a nurse to be a part of the team.

“There wasn’t anything specifically for Indigenous health so the aim when Dr Hayman and I started was just to target Aboriginal and Torres Strait Islander people and it’s just been so successful,” White says.

The service has expanded from only a dozen patients coming through the door in the beginning to more than 70 a day at present, and it now includes a team of 50.

The success has led to the centre securing enough funding to bring health specialists into the community, including a cardiologist, ophthalmologist, endocrinologist, paediatrician, hepatitis C doctor and psychiatric registrar. The need for these was established after White and the team saw that patients with chronic diseases lacked access to specialists in hospitals.

When clients were referred to the hospital system, it was noted that they often weren’t turning up, seriously affecting their health. This was for a range of reasons, including transport, literacy levels and family and monetary problems, White explains.

“Their health wasn’t really looked after,” she says.

White says the program has been successful; all of the specialist clinics have an attendance rate of almost 100 per cent. And for even more outreach, a specialist team of nurses and doctors is taken out to the remote rural community of Cunnamulla once a month.

“In the years that I’ve been here in this service I can see people’s health improving,” she says. “They’re seeking treatment earlier. With our health team, we’ve been able to bring the service to the people and to me that’s been helping to close the gap.”

Rhodanthe Lipsett, midwife

PHOTO CREDIT: Michelle McAulay

At 91, Rhodanthe Lipsett is still dedicating her time to maternal and infant health.

Having devoting over half a century to her work, Lipsett was awarded an honorary doctorate from the University of Canberra and continues to work to improve infant health through a trust set up in her name.

The Rhodanthe Lipsett Trust provides grants to Indigenous students to complete their midwifery studies. The hope is that these future midwives will take their education and new-found skills back to their communities to care for pregnant Indigenous women in a way that is best suited to them.

“[Graduates] could take their new skills into their communities, marrying them with their culture and then involve their mothers in the best possible way – and that’s beginning to happen,” Lipsett says. “That’s going to make all the difference in the world because if they can do that then they get the best co-operation with the mothers.”

The realisation of the need for more Indigenous midwives came from conversations Lipsett had with Indigenous health workers at the Australian College of Midwives’ biennial conferences.

She says it came out “loud and clear” that the most good could be done by helping student midwives qualify.

Midwives and the community at large have gotten behind the scholarship program; funds have already reached the $100,000 mark. One midwife even cycled right around Australia raising money.

A percentage of the proceeds from every copy sold of Baby Care, a book penned by Lipsett, also goes into the trust.

“People see this as a real way of helping to Close the Gap,” Lipsett says.

The first half-dozen scholarships were awarded in 2012; another six were given out last year. One student living south of Alice Springs used hers to purchase a much-needed laptop.

Lipsett’s first experience with the need for a tailored approach to care came from her midwifery training at Broken Hill, when the typical procedures were left aside for a 16-year-old Indigenous girl in advanced labour, in favour of what the senior supervising sister believed to be the best approach at the time.

When the sister asked her what she learned that day, Lipsett answered, “I guess what I learned today, sister, was there’s no one right way.”

“[The sister] said, ‘Don’t ever forget it.’ And I never did,” Lipsett says.

Raelene Ward, registered nurse

Raelene Ward is bringing her knowledge from her role as a registered nurse and work on a suicide prevention project to research that she is undertaking at the University of Southern Queensland.

“I had been in community control and nursing for a long time and you feel there comes a time in your life where you can’t contribute anymore and research is another direction that I have chosen to help my people and communities,” Ward says.

The aim is to better understand suicide within Aboriginal communities in the south-western part of Queensland and across Toowoomba and Darling Downs.

“I would like to understand what suicide means to Aboriginal people,” Ward says, adding the project is about understanding the historical and contemporary perspectives of each community.

She says suicide is an immense problem for Indigenous people and self-harm in these communities is complicated by factors such as trans-generational transmissions of violence, de-colonisation and racism.

Previously, Ward co-ordinated a suicide prevention project, working across four Queensland communities. The work focused on knowledge sharing and establishing health education tools to engage communities on a long-term basis, allowing them to become resilient.

It was established that the services were difficult to get to and racism and discrimination were regularly experienced when they were accessed.

Ward was born in Cunnamulla. Her interest in suicide came from being exposed to communities where living standards and other factors are different to the wider population, which has implications for mental and general health.

She is also working on projects in the areas of men’s mental health and suicide prevention in younger Indigenous people.

For her work, Ward received Suicide Prevention Australia’s 2009 ‘LIFE Award’ in the Indigenous category.

Ward has previously worked as a registered nurse within the community control sector. Her role focused on the closing the gap in immunisations and ensuring that Indigenous people had better access to specialist services.

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