10th May 2013

Health, education, community-control: Donna Ah Chee in Lowitja Institute newsletter

Congress CEO’s Guest Editorial in the April–May 2013 edition of Wangka Pulka, the Lowitja Institute newsletter.

I am fortunate to have been appointed recently as the Chief Executive Officer of the Central Australian Aboriginal Congress Aboriginal Corporation (Congress), which is one of the oldest and probably the largest Aboriginal health services in Australia. Congress is a great organisation that has a long and proud history of providing comprehensive primary health care services to the Aboriginal community of Alice Springs.

As a Bundjalung woman I grew up on the far north coast of New South Wales and have lived in Alice Springs since 1987, where I am married to a Southern Arrernte Yankuntjarra man. I have three children: a 22-year-old studying Commerce at the University of Adelaide (UofA) and playing AFL football for South Adelaide; a 20-year-old daughter doing Medicine at UofA; and an 18-year-old daughter who has recently started a Human Movement course at the University of South Australia. I have been committed to eradicating the educational disadvantage afflicting our people all of my life, both in my work and in my own family, as I think education is the key pathway to achieving control over your destiny, and to meaningful employment, health and wellbeing.

My own educational career did not happen quite as smoothly as that of my children. Although I finished school after completing Year 10, I was lucky enough to get back into formal education in my early twenties at Tranby College in Sydney where I completed my equivalent of Year 12. I then went to work for government in a role that had me assisting the development of Aboriginal child care services across remote NSW.

From there I moved to Alice Springs where I married and worked my way up until in 1995 I was appointed CEO of the Institute for Aboriginal Development (IAD) – an Aboriginal community controlled adult education provider. As part of this process I also completed a postgraduate degree in management through La Trobe University. After successfully achieving a key goal of gaining more than $2 million to build new premises for IAD (following a long political struggle), I decided it was time for a change and accepted a job as the branch manager of Congress Alukura in 1999. The next year I was appointed Deputy CEO of Congress, a position I held until 2011 when I left to become the CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO).

This opportunity to be CEO of Congress has come at a time when I am ready for the challenge. Although national policy is vital and an important part of health improvement, my year at NACCHO helped me to understand that it is the concrete example of a well-functioning community controlled health service that will have more impact on changing policy and improving the health of our people. The truth is in the doing. I also believe that with the right investment in evidence- based programs and services, especially in the early childhood area, we will be able to continue the improvements in health that are now well established in the Northern Territory to continue – and this is a really worthwhile goal.

There are many exciting developments happening at Congress. Firstly, the organisation now has a new constitution and, as part of this, it has (probably) become the first Aboriginal community controlled health service in Australia to include three non-member Director positions on its Board. These positions are in addition to the six Board members elected by the community from the membership at the Annual General Meeting. The three non-member Directors will be Aboriginal people with specific expertise in primary health care, governance and administration and finance. This, along with a range of other changes, has greatly strengthened the corporate governance of the organisation.

In addition to ensuring that Congress continues to provide high-quality primary health care services – in areas such as acute care, chronic disease management, pharmacy services, child health, women’s health, male health, dental, social and emotional wellbeing and other areas – we are also focusing on some key strategic areas.

The first and most important of these is early childhood. We now know that if children lack emotional self-regulation and impulse control by age four, there is a high risk that this inability will turn into a lifelong disability. Early childhood development is the key to the primary prevention of addictions to sugar, fat, alcohol and other drugs, and mental health conditions such as depression with its links to suicide. A positive early childhood is also linked to an active healthy lifestyle and the prevention of obesity, diabetes, heart disease and other chronic conditions. Parents need to get the maximum support possible to be able to respond well to their children’s needs and to know how to stimulate their development to the maximum level possible. This is a key part of the program logic of the Nurse Family Partnership Program that Congress has been providing for the last three years.

However, in addition to supporting parents in their homes we also need to be able to offer children additional care, support and stimulation in educational day care facilities – which are not the same as child care centres. It is very clear from the available research that this combination of programs can have a major positive impact on early childhood development in spite of an adverse social environment. It can be the key difference in terms of children being able to enter school with the capabilities and capacity to learn and do well – as opposed to the current reality where too many of our children are entering school with little or no chance of succeeding.

A second key issue that must be better addressed is that of alcohol. Again, there is a great need for evidence-based policy and research, and evaluation of all initiatives, if we are to make progress on key policies such as an alcohol floor price, reduced take- away trading hours and effective treatment services. There has been a lot of media coverage on this issue of late, which is a welcome development, but we are still a long way from implementing evidence-based policies.

The need to build the evidence base in Aboriginal health, and ensure that we are implementing the best possible services and programs, was a major reason why Congress became a founding member of the inaugural Cooperative Research Centre (CRC) for Aboriginal and Tropical Health back in 1997. We realised we needed to build more effective partnerships with researchers in the areas that really matter to Aboriginal health improvement: areas such as health system research; the development of core primary health care services and core indicators; chronic disease management; continuous quality improvement; and the social determinants of health. These are all areas that the successive CRCs have helped us to address.

However, now more than ever we need to strengthen the focus on evidence and evaluation, using the key partnerships that have developed since 1997 with researchers all over Australia. There is the continued and real risk that Aboriginal health policy will once again be reduced to slogans and ideologies and not evidence. Here in the NT this is what has happened to alcohol policy, where proper use of data and evidence has been jettisoned for opportunistic and populist appeals to the lowest common denominator in the electorate.

It is vital that, in a climate of scarce government resources, every dollar spent is spent in ways that maximise efficiency. This requires an even stronger focus on a national Aboriginal controlled health research institute, and this is why Congress is strongly behind the continued need for the Lowitja Institute. We also believe that it cannot be left to beg for private sector or philanthropic funds alone. Rather, it is a core responsibility of government to ensure that there is a viable, national research institute for Aboriginal and Torres Strait Islander health.

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