Miwatj Health Clinic
Miwatj Health clients outside the Nhulunbuy clinic
Miwatj Ear clininc at a remote homeland centre
Miwatj Health Operational Areas
Provision of Clinical Services
Aboriginal health worker checking blood pressure at the
Nhulunbuy clinic
Miwatj Health provides clinical services by doctors, nurses and Aboriginal Health Workers at its clinic in Nhulunbuy, and visiting clinical services to those nearby communities and homeland centres on the Gove Peninsula which do not have their own clinical services. This comprises a wide range of professional services including diagnosis of illness, treating acute trauma (every day), carrying out full adult and child health checks, ante-natal and post-natal care, providing medications, developing chronic disease care plans, undertaking brief interventions, transporting patients for further radiological investigations, and so on.
In its clinical services, Miwatj Health must balance the need to provide acute care for short-term medical problems with the need to take a long term preventive approach to chronic disease and child health. In past years Miwatj Health focused almost exclusively on acute care. Now, however, we are gradually moving to place a stronger emphasis on longer term care planning and a more strategic approach to the best practice provision of health care. This is a central goal of our Continuous Quality Improvement processes, and we are making major progress in this. However, current funding from the Commonwealth Government does not allow us to provide a full range of acute care services at the same time as providing a full range of longer term care planning services. Hence we must prioritise our service delivery, which inevitably means some people miss out.
Public Health Programs
Public health programs are those which impact on the health of a group or population (compared to those clinical services which just provide medical treatment to individuals).
GP employed by Miwatj Health at an ear clinic
Miwatj Health is conscious that clinical services alone cannot bring about long-term improvements in the health status of a population. Just as the underlying basis of good health among non-Aboriginal Australians is an effective public health system – providing clean water and effective sewage systems, ensuring access to healthy food, and so on - so the health problems of Aboriginal people in the Miwatj region have their origin in poor public health facilities which facilitate unhealthy lifestyles. For that reason, Miwatj Health is taking a higher profile in such areas as nutrition, tobacco control and other issues which affect the health of a whole population.
To this end Miwatj Health has created a Public Health programs division separate from its clinical services division. Public health programs in the four key areas of nutrition, tobacco control, ear health and eye health will be implemented in communities across the region. These programs will usually operate outside the clinic, on the ground in communities, and will include strong education and health promotion components.
Raypirri Rom group planning session
Emotional & Social Wellbeing Programs
The Raypirri Rom program aims to reduce violence and the harm caused by substance abuse using traditional practices and forms of authority. The Raypirri Rom workers are quite literally peacemakers in their communities.
Raypirri Rom first started at Miwatj Health in the early 1990s, following a report by Mr Djerrkura (deceased). His vision was of Yolngu communities taking responsibility for their own problems, by reinforcing the customary law which has been in Yolngu culture since our ancestors.
Rapirri Rom project staff are based on the ground, in communities. Their work does not stop at 5pm but often goes all night – they must deal with the problems at the time they arise.
During the day shift the Raypirri team have a daily routine of completing their specific roles that were given to each individual e.g. data collection, attendance (hrs of work) and taking care of the workers emotional needs. Once this is complete, a team meeting is held to discuss work for the day. This may include:
- follow up work on Raypirri clients
- visits to our service providers and other agencies
- organise committee meetings fortnightly
- study for our Cert III training in Community Services and Family Wellbeing
- doing reflective writing in the group diary
Night shift work involves:
- being available for community members in need of assistance in domestic violence situations
- settling down drunken family members
- sending kids home once the oval lights have been turned off
- constant communication with Night Patrol via radio (also have access to police frequency)
- follow up work
- following through with referrals by agencies
Miwatj believes that supporting Yolngu living on country
is an important part of successful health outcomes
The Raypirri team is supported by a strong and outspoken committee, consisting of members from Yirrkala, Gunyangara and Galuru communities. The committee meets every 2 weeks along with the Raypirri team, and are very enthusiastic about creating their own practice / reflective frameworks. We all use Yolngu language, along with other methods, to allow both Yolngu and Balanda to have a clear understanding of our work.
Advocacy, Policy and Planning
Since its inception Miwatj Health has always seen that advocacy is one of its core functions. Advocacy which points out the vital role of community controlled health organisations, and which aims at ensuring an adequate level of primary health care provision, is an essential part of our activities. We have recently appointed an experienced Policy and Planning Officer to guide our work, to design programs, to prepare submissions, and liaise with governments and community bodies.
Governance & Management; Business Services, Finance & Administration
Miwatj Health has recently reviewed its administration, finance and support services areas to ensure that Miwatj Health’s administrative and finance systems are able to effectively support its primary operations.
Miwatj staff use up to date database management systems
To this end we have recently reviewed all our policies and procedures, created the position of Business Services Manager tasked, among other things, with monitoring compliance to ensure all allowable Medicare income is claimed and with identifying possible new sources of funding in the private sector. This will ensure that Miwatj is focused on maximising the efficiency of its financial operations including ensuring all possible sources of independent revenue are claimed and/or identified. Particular emphasis is placed on ensuring that Miwatj Health is able to monitor and maximise the take-up of new Enhanced Primary Care (EPC) Medicare items.
A planned improvement in Miwatj Health’s information systems will also help to ensure the correct processing, tracking and receipt of all Medicare items. New monthly reporting processes are also being implemented to enable monitoring of actual versus expected income and expenditure and timely follow-ups.