They're dedicated, they care and they need help!

The reports from Cambodia, Indonesia, Lao, Sri Lanka, Thailand and Vietnam all told similar sad stories - high numbers of HBV/HCV and low priority response from government.

Patients on incomes less than US$1,000 expected to pay US$14,000 for treatment!

Despite the odds, these doctors have in the past 12mths introduced new programs and are constantly advocating for greater recognition and increased funding to prevent the rise of viral hep.

Their stories may have been sad, but their drive and positive attitudes were inspiring. 

AIVL has found a novel approach to engage the Indigenous population of Australia.

The project, Dulangirr Gubbynidgel (New Beginnings) have released a Hepatitis C peer education kit, develolped by Aboriginal people who use illicit drugs, some of whom have HepC and those at risk.

Included in the kit are games, exercises and information.

The message is in the name, HepC isn't necessarily 'the end', but could be an opportunity to make changes and get people thinking about their health and to "start looking after themselves"

The Transmission Risks Game asks players to place cards where they believe they should go.                                                                                       Is the behaviour/activity:                             

HIGH RISK?                                                                                                                                                                                                        MEDIUM TO LOW RISK?                                                                                                                                                                                        VERY LOW RISK?                                                                                                                                                                                         EXTREMELY LOW RISK?                                                                                                                                                                                      NO RISK?

Aimee Capper reports that the knowledge gained has reduced the amount of bed linen going up in flames, as the card game showed that sheets were a 'no risk' route of transmission!

Despite the cracks caused by the 2010 earthquake, the Christchurch HepC Community Clinic continued to operate. Then came 2011 and it all came tumbling down – literally.

BUT the Clinic continued to operate, moving first to Receptionist Mickey’s home, then a Portaroom and then to an industrial area.

The Clinic became a lifeline, providing vital and practical support to their clients.

The earth may have separated, but not the clinic and their clients.

Today, they have a new and stable home and play a major role in the provision of HepC care and are a shining example of what can be achieved against the odds.

Kelly Barclay told us that unlike Australia, there are a large number of undetected HCV sufferers in the NZ community, so the decision was made not to wait, but to 'take it out there'.

In an 18mth pilot program a Community Nurse will provide assessments, fibroscans, education and discuss treatment options in 2 pilot sites.

This pilot will potentially remove one of the major barriers to addressing HCV, as the nurse will be located in the Community thereby increasing the number of access points to information and or treatment.

It's hoped that the opportunity to access information and support will result in earlier lifestyle changes and increased uptake rates in monitoring and or treatment.

Sounds like a positive approach and we look forward to hearing about it's success rate.

Well done Kiwis!

Prof Paul Ward asked if 'trust' was an integral part of our practice and if we had considered the impact on treatment outcomes for our patients. He graphically (with humourous dipictions) described the differing perceptions of a variety of cohorts, including CALD, MSM, Sex Workers and Indigenous patients and how trust is essential to ensure adherence to care plans.

There are many different concepts of trust, but essentially the need to trust is due to lack of knowledge i.e. you have to rely on the clinician, and in trusting there is an element of risk, as you have to assume the clinician has the level of appropriate knowledge and also has your best interests at heart.

There also needs to be trust in the system and for a patient this trust is usually formed at the point of access, therefore, the person who has initial contact can influence the level of trust - begs the question, are we providing an appropriate level of training for our frontline staff?

For a patient, once a trusting relationship has been formed, they can 'move on' and concentrate on their journey and not on the driver.

Fortuitously, a survey has shown that 62% of the Australian population trust their doctors, but only 2.2% trust their politician.