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Fitzroy Crossing is more than 2500km to the north of Perth on the Fitzroy River in the tropical Kimberley region and is roughly half way along the bitumen road linking Broome and Halls Creek. Local roads are unsealed and there are very few safe stopping points. For local people an expensive daily bus service ($135 one way to Broome in 2012) provides the only non-private transport and the small airfield does not provide a practical transport alternative. During the wet season, roads are frequently flooded, preventing access into and out of Fitzroy Crossing and local unsealed roads are often washed out. About 3000 people live in Fitzroy Crossing and the Fitzroy Valley, an area almost the same as that of Tasmania.
A comprehensive community consultation showed that the local community wanted a holistic, culturally appropriate health promotion service that included respect for Aboriginal law, culture, spirit and land, which focused on disease prevention and health promotion. This consultation resulted in the establishment of Nindilingarri Cultural Health Service (known locally as NCHS) in 1995 as an Aboriginal Community Controlled Health Organisation.
Nindilingarri provides the management of a comprehensive health promotion program, an accredited twenty-four bed residential aged care hostel, a home and community care program and a home dialysis facility where family members can support renal patients to home-dialyse in safety. It is co-located and in formal partnership with the Western Australian State Government’s Western Australian Country Health Service (WACHS) and Kimberley Population Health Unit (KPHU).
The evaluation reports on five of the eight Nindilingarri health promotion programs (the remaining having either been newly established or recently evaluated). These programs are:
The series of reports in the evaluation are prefaced by an introduction to the Fitzroy Valley and its peoples. Each of the program reports stand alone but, read as a series, show the integrated nature of this set of health promotion programs. They also show the difference that health promotion workers can make to the health and wellbeing of the people they serve when they engage best-practice approaches to their work. Outcomes are achieved despite the constraints of limited resources and the remote location.
The Nindilingarri health promotion teams clearly focus on addressing the burden of ill-health being experienced by the peoples of the Fitzroy Valley. The commitment of all staff to working with the aspirations of Aboriginal people in the valley results in health promotion projects that seek to address risk factors for ill-health. With family and community groups, health promotion teams develop client-centred goals and collaborate with other local agencies to empower the community to maintain healthy environments and lifestyles. In so doing, the Nindilingarri Cultural Health Service team is able to deliver a truly appropriate set of services to the community that it seeks to serve.
Priscilla Robinson, Bill Genat, Penny Smith
The University of Melbourne, La Trobe University