General Practitioner, VIC
Viral Hepatitis: ‘Elimination Starts with the Community'
Plenary session #5 was an inspiring reminder not to forget the people who are at the centre of why we do what we do.
Rhondda Lewis, viral hepatitis health practitioner with Cairns Sexual Health Service and Yvonne Drazic started the session, speaking about their involvement with the Cairns Hepatitis Action Team (CHAT). CHAT was established in 2013 by peers to empower patients to be the lobbyists and agents of change in the area of viral hepatitis.
Through Asset Based Community Development, focusing on peers’ strengths and abilities to explore the community’s needs and visions for the future, the group has been very successful in organising many large events and contributing to the goal of having Cairns “Hep C free by 2020”.
They have tried to avoid using the word “problem” when referring to viral hepatitis to reduce further potential for stigma and discrimination. Instead, they focus on resilience, peer support, learning from others and increasing confidence to empower and promote real engagement to improve health efficacy. They are rightly proud of CHAT reflecting Ottawa Charter principles in a real world setting. (1)
See Rhondda and Yvonne's presentation here.
A/Prof Phillip J Mills, Kulkulgal Tribal Elder of Zenadth Kes and Associate professor with the Australia Institute of Tropical Health and Medicine (JCU) followed with a talk rallying us to press for policy change when it comes to how we manage the Aboriginal and Torres Strait Islander population who are affected by viral hepatitis. He made excellent points that we should ensure that our services are culturally appropriate and consider the whole journey for the patient and the impact of various social determinants of health, rather than managing the disease in isolation. He challenged us to consider that the language we use can come across as demeaning and damage the therapeutic relationship, thus affecting engagement in care.
Lastly, Melanie Walker, the CEO of the Australian Injecting and Illicit Drug Users League (AIVL) presented 3 case studies demonstrating the impact Hepatitis C can have on families. She also pointed out to us that while 29,160 people with hepatitis C were cured in 2016, 5,900 new infections occurred over the same time period.
If we want to reach the target of elimination of Hepatitis C by 2030, prevention and harm reduction need to be our focus, as well as considering how to assist those who are less well connected to the health care system to access treatment.
Melanie discussed some of the barriers being no Needle and Syringe programs (NSP) in prisons, no formal recognition or funding of peer workers, punitive measures targeting people who inject drugs (PWID), stigma and reduced access to health services in regional Australia.
In addressing these issues, AIVL’s work over 2017-2018 will focus on enhancing NSP service outcomes, building capacity amongst peer educators and other health professionals, improving Hep C outcomes for people exiting custodial care to improve transition to primary care, developing resources directed at harm reduction in the ATSI and CALD communities, creating a new website and continuing to write national policy papers to improve health outcomes in PWID.
These impressive goals have the potential to make real improvements to the health and well-being of the lives of PWID, as well as contributing substantially towards Australia’s elimination target.
See Melanie's presentation here.
1. Lewis, RM, Drazic Y, Engaging community: The Cairns Hepatitis Action Team – paths to patient involvement, Journal of Virus Eradication Vol3, sup 2, August 2017