HepatitisWA Newsletter December 2018

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Newsletter

Issue 23 | December 2018

dispensing the cure | P.8 OUT & ABOUT | P.16


Newsletter Editor Eliana Ennis Graphic Artist Eliana Ennis Board of Management Executive Members Chairperson Ursula Swan Treasurer David Wilding Secretary Justin Kwok Non Executive Members Dr Aesen Thambiran Carol Houghton Louise Southalan Nicole Jolly Pramod Kapoor Patron Dr Charles Watson CEO Brent Bell Postal Address PO Box 67 Francis Street Northbridge, WA 6865 Information & Support Line Monday - Friday 9am - 5pm (08) 9328 8538 Metro 1800 800 070 Country

COVER PHOTO

CREDIT

Office 134 Aberdeen Street Northbridge, WA 6003 Telephone: (08) 9227 9802 Fax: (08) 9227 6545 Web: www.hepatitiswa.com.au Proof Reading Brent Bell Sally Rowell Email the Editor resources@hepatitiswa.com.au

PHOTO BY ETHAN ROBERTSON HepatitisWA acknowledges Aboriginal people as the traditional owners and custodians of our HepatitisWA (Inc). lands and water. HepatitisWA is a community based organisation which provides a range services to the HepatitisWA recognises andofacknowledges community in response tocarers viralwhen hepatitis, the rights of their clients and particularly hepatitis accessing our services.B and C. Please contact us for more information, or make an appointment to stop by and talk with an appropriate member of our staff.

istockphoto.com.au/@ethanrobertson

Opinions published in the HepatitisWA Newsletter are not necessarily those of the editor or of HepatitisWA (Inc). Information in this newsletter is not intended to take the place of medical advice from your GP or specialist. You should always get appropriate medical advice on your particular needs or circumstances. *Disclaimer: The copyright of external articles published in this newsletter remain with the original authors and publishers, unless otherwise stated.


APRIL 2018 DECEMBER

CONTENTS

10

14

16

PERSONAL PERSPECTIVE

COMMUNITY NEWS

PROMOTIONS

10 Super Easy...Just a Tablet a Day

04 Letter from the Editor

05 Join us in the Social Media World

22 Meet the Team

An interview with a female client receiving hep C treatment through the Deen Clinic

FEATURES 06 Introducing HepatitisWA New CEO

Interview with Brent Bell

08 Dispensing the Cure

Chat with Pooja Maru

12 Giving GP’s a Helping Hand with the Cure

Interview with Annette Fraser, GP Liaison Nurse Project

14 Coping with Christmas

Written by Eliana Ennis

Introducing Amanda, our busy B

Connect with HepatitisWA on Facebook and Twitter today.

07 Deen Clinic

HEALTH & LIFESTYLE

15 Thank You Volunteers

16 Out & About Help your kids stay active this

19 Happy Holidays! Office Closing hours

24 ‘My Promise to Myself’ Hep C Cure Campaign

Summer. Written by Live Lighter

18 Recipe: Beef Kofta with Tzatziki

Recipe by Live Lighter

PEER BASED HARM REDUCTION WA’S DOMAIN 20 A Year in Review

Learn about the different projects that PBHRWA have run this year

15 And the Winner is...

stay

connected www.hepatitiswa.com.au

www.facebook.com/HepWA

www.twitter.com/HepatitisWA

HepatitisWA Newsletter // Dec 2018

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LETTER FROM THE EDITOR It’s amazing to think we are almost at the end of 2018 and what a year it has been! All the newsletter editions have been a joy to put together and have flown off the shelf. Thanks for the ongoing support for reading our content and sharing the latest findings for viral hepatitis in your world. The HepatitisWA newsletter would not exist without its readers so thank you! We take this opportunity to introduce our new CEO Brent Bell and welcome him to the team. Learn more about his career in an interview on page 10. The collection of stories and interviews in this edition are a testament to the wonderful work going on to eradicate viral hepatitis by 2030. Since there has been a decline in uptake for the new hepatitis C treatments since it was first made available on the PBS in March 2016, we thought in this edition, it was important to highlight the two areas where improvements can be made to help those living with hepatitis C access treatment. We note that there needs to be more GPs prescribing the hepatitis C cure and more pharmacies dispensing the treatment. To help our readers understand these hurdles we have had the privilege to interview Pooja Maru, pharmacist and an owner at Craven’s Pharmacy (page 8). Craven’s Pharmacy was one of the first pharmacies in WA to dispense the hep C treatment. We also introduce our latest HepatitisWA project the GP Liaison Nurse project, run by Annette Fraser. Her work focuses on supporting GPs who are not yet aware they can treat their patients living with hepatitis C. (page 12) One of our favourite stories to share is those of people who get cured from hepatitis C so we hope you enjoy our inspiring personal perspective in this edition (page 10). There is still a way to go to remove the stigma associated with hepatitis C. We also celebrate winning the WA Health Excellent Awards 2018 along with a number of partners. The collaboration project improved access to treatment in prisons. As the year comes to a close, we recognize that the festive season is a time of celebration for many people though, it can also be a difficult time for some. Therefore, we hope you enjoy our tips on how to cope this Christmas. (page 14) There is a lot more to discover in this edition but we thought it best to leave some surprises… Merry Christmas and a Happy New Year.

Eliana Ennis Editor 4

HepatitisWA Newsletter // Dec 2018


join us in the social media world.... Keep up-to-date on: Latest news Events Resources & Publications Campaigns while connecting with our community

F i n d u s o n w w w. fa c e b o o k . c o m : H e pat i t i s WA

F i n d u s o n w w w.t w i t t e r . c o m : @ H e pat i t i s WA

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introducing... hepatitisWA’s

new CEO brent bell Brent bell joined the hepatitiswa team in September 2018 and we thought our hepatitiswa newsletter readers would like to learn a little more about our new leader.

What drew you to apply for the role of CEO at HepatitisWA? My interest in the health sector started in the Defence Force when I was part of the emergency medical team. I have since continued my passion for health care and a strong sense of community throughout my career in both government and the private sector. Therefore, when I saw the opportunity to lead a service in the not-forprofit sector, it seemed a perfect combination of my passions.

What do you hope to achieve in this role? What I hope to achieve is to lead HepatitisWA into a strong and secure future within the health sector. I would like to be able to expand the footprint that we have further into the health sector and beyond.

What are your current goals? My initial goal is to learn everything I can about the Sexual Health and Blood-Borne sector, 6

HepatitisWA Newsletter // Dec 2018

and ensure that everyone in the sector and partner sectors are aware of the great work that HepatitisWA do. Another goal is to expand our health promotion initiatives further into the social media space to reach the general public.

What experience do you bring to the role as CEO? My leadership position in the Australian Defence Force allowed me to develop my skills by encouraging and supporting a team to achieve strategic outcomes. Next, my role in the Mental Health Sector as an Organisational Change Manager enabled me to further develop skills and knowledge in strategic planning, goal setting and motivating teams. My last role was as the Operations Manager of a large scale multi-site medical service contract. I have worked in a variety of settings, which has broadened my scope of experience by leading, working with and serving people. Over the last 10 years, I have also been a part of several key working groups such as the WA Health Workforce Strategy Committee, WA Health Clinical Service Redesign Group, and the WA Offender Recidivism Committee. I have also


FEATURE been part of the WA White Ribbon Committee. In addition to a Bachelor’s Degree in Psychology, I have completed courses in the Kouzes and Posner 5 stages Leadership Model, qualified trainer in “Belbin Team Profiles” to identify team member strengths and build team outcomes, and the Studer Group “HighMiddleLow” Staff Development Model. I have had the opportunity to work in range of settings that have allowed me to engage with very different groups of people, and understand the needs of the workforce and consumers.

Are there any initiatives that you have already implemented at HepatitisWA that you are excited about? We have already commenced initiatives that extend our presence on social media platforms. This is exciting because it has the potential to

“I have worked in a variety of settings, which has broadened my scope of experience by leading, working with and serving people.” increase our level of engagement with people who might not be aware of our services. There are many other initiatives that are currently in development.

When you’re not at work, what do you like doing? I spend my time away from work with my family and love going to the beach. While at the beach, I enjoy stand up paddle boarding. Keeping active is important to me so I am trying to get to the gym more often too. At home I also enjoy listening to music, cooking, and having a cold beer or glass of wine.

HepatitisWA’s Deen Clinic is open for hepatitis C treatments. confidential service, available to anyone living with hep c

Make an appointment on (08) 9227 9800. Our services include: Hepatitis C testing | Hepatitis C treatment | Support | Referrals

HepatitisWA Newsletter // Dec 2018

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Dispensing the cure hepatitiswa had the honour of interviewing pooja maru to share craven’s pharmacy’s story of how they started dispensing the new hep c cure. What is your role at Craven’s Pharmacy? I’m one of the owners and pharmacists at Craven’s Pharmacy.

When did Craven’s pharmacy first start dispensing the treatment? We started dispensing it before it became PBS listed. We did some for the private patients at Royal Perth hospital who were not covered by Medicare. They were part of a study and the drug company paid for the treatment to be dispensed. That was four years ago. So once it became listed on the PBS we already had an idea of what was involved to dispense the treatment so it was easy to transition into it. Craven’s Pharmacy is different to most because we have a Nurse Practitioner who can prescribe hep C treatment too. 8

HepatitisWA 2018 HepatitisWANewsletter Newsletter////April Dec 2018

That was really how we first got involved with prescribing and dispensing the hepatitis C treatment.

How difficult was it to transition into providing this life saving treatment to patients? Dispensing the treatment was not a problem at all, I think it’s like any other script. The issue comes with the price to dispense and this is often what most pharmacies worry about when they are deciding to dispense the treatment.

What do you think is the main reason pharmacies are hesitant to dispense the hep C treatment? There are lots of things a pharmacist will think about before deciding to dispense the hep C treatment. I believe the biggest barrier is the cost. The average script costs around $20-30 while the hep C treatments are about $15,000 a script (It was $26,000 per script when it was first released). As you can imagine that is


FEATURE a huge cost compared to a usual script. I think that certainly impacts the decision to dispense or not, as it will hugely impact cashflow. Sometimes the total daily order we would make will be less than $1,000. The bottom line is, you need to be doing a substantial volume of hepatitis C treatments per month to make it viable. The sad thing is, however, sometimes I will get calls from HepatitisWA saying a client was refused treatment at a pharmacy. Once you understand the cost risk for the pharmacy you can see why someone may choose not to dispense. However, ethically we have to make sure that we pass a patient onto someone who can dispense the hep C treatment. Last year we had a male patient who came all the way from Midland to the Perth CBD and he had gone to 5 different pharmacies that said they could not treat him. He finally came to us and we ordered it for him. However, he had had a gap of 10 days between treatment. He had been persistent and kept trying to find a pharmacy to treat but there will be a lot of people that would give up in the process. It’s a long journey for a patient to even decide to begin treatment so to refuse them when they handover the script could really affect their journey to the cure. As a pharmacist, I’m ok with pharmacies refusing to dispense the prescription. However they should be referring the patient onto a pharmacy that can provide the treatment. Taking on this financial risk can also be a positive thing too. Any patient standing in front of you in your pharmacy is a potential customer so providing them with this service could be the beginning of a long-term relationship and repeated business. That’s our motto here at Craven’s, every patient that comes in is a potential new customer for a long period.

Having a Nurse Practitioner in house, do you find that you get a lot of ‘walk ins’ for hep C testing? Yes, we are working hard to promote our services here with posters outside and inside the pharmacy. Since we have the Nurse Practitioner it enables us to not only test but treat patients and once they have used the service we find that they recommend their friends too!

Also, often this virus effects a cohort of people that miss out and are disadvantaged so it feels good to make a difference. Whether they are homeless or dealing with mental health problems getting cured is a big win! It makes their day, it makes their life! So much money goes into diabetes and cardiovascular disease but this impacts people as well. Therefore, it’s great to know that the government has decided it’s worth doing something about.

What would you say to a pharmacy considering dispensing the hep C treatment? Speak to a pharmacist who is already dispensing the treatment just to make sure you are up to date with all the latest research and the type of conversations you need to have with your wholesaler, and accountant (claiming your tax on time) and making sure that you are dispensing it at the right time. For a pharmacy, that has never dispensed the treatments before they will need to play catch up and read up about it. They can get in touch with the drug reps for resources that they can give to the patients including booklets and easy to use treatment drug dose boxes. We have run into cash flow issues because of hep C. Either Medicare wouldn’t pay us on time or we dispensed it at the end of the month so didn’t have enough money to pay the suppliers. Therefore deciding to dispense is something that the pharmacy owner needs to be actively involved in. This can be difficult if the owner isn’t an employee pharmacist however, either way it needs to be discussed.

Anything else you would like to add? I think we need to raise awareness of importance of finishing the therapy. If a pharmacy can’t dispense it, refer them on to a pharmacy that does. We want to ensure that all patients finish the treatment for optimal outcomes.

What is the best thing about dispensing the treatment to patients? For us, it’s something that’s a cure. When our Nurse Practitioner tells me that we’ve done a blood test and there is no detectable rate of the virus in the blood you can say, ‘Wow, we have made a difference!’ I love seeing the look on a patient’s face when they are told that they have been cured. You can also quite comfortably tell them there is a 95% cure rate. That’s what drives us. We want the same thing as HepatitisWA, viral hepatitis eradication by 2030. We get to take part in seeing a virus be eradicated and that is exciting.

contact Craven’s Pharmacy today phone | 08 9325 4375 | 08 9325 7708 address | 2/553 Hay Street, Perth 6000 website | www.perthpharmacy.com.au email | cravenspharmacy@gmail.com

HepatitisWA 2018 HepatitisWANewsletter Newsletter////April Dec 2018

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Super easy... just a tablet a day When were you first diagnosed with hep C? I went to donate blood in December 2017 and after about 10 days I got a letter to say to ring the blood bank and I went in to see the doctor and they said ‘Are you aware you have hep C?’ And I said, ‘Nah I didn’t know!’

How did you feel when you found out about the diagnosis? It was surprising because I suppose I don’t feel like I fit into the normal realms of how you would usually contract it – injecting drugs. I couldn’t quite figure out how I got it but one thought was about 30 years ago I’d helped out with first aid for contact sports like rugby and since it was before the days of wearing gloves and covering up cuts when dealing with other people’s blood I may have had an open cut that got into contact with someone else’s infected blood. But how I got it, I’m not exactly sure, I suppose that was the hardest thing about the diagnosis. The main promos you see about hep C are centred around injecting drug users and because I don’t do that I never suspected I’d get it.

When you first found out about the news did you tell your friends and family? No, because we are all of the same vintage and since there is such a strong association with injecting drug use I didn’t want to have to explain that’s not how I got it.

What would you say is your main reservation for not telling them? The stigma associated with hep C. Even though I had a mate that only 3 years ago passed away from hep c liver failure. Not even then did a lot of our friend group know that he passed because of hep C. But I know he would have contracted it from his wild teenage years. He didn’t know and just started feeling a bit run down one day and then he got super sick. That was before the new treatments though.

What do you think needs to change to allow people to talk more openly about living with hepatitis C? I think letting the community know that there are a LOT of different ways you can get it is a really important message. And that it only takes one time of getting in contact with infected blood that can leave you at risk. It could be by a blood transfusion (of infected blood), backyard tattoos, sharing nail clippers, toothbrushes or shavers of an infected person not to 10

HepatitisWA Newsletter // Dec 2018

mention injecting drugs. You might not even know that you are passing it on to loved ones through sharing something simple like a toothbrush if you don’t know you have it! I think talking about living with hep C can cloud the fact that you’ve been cured. People don’t focus on the fact that you’re cured, they just focus on the fact that you did have the virus. That’s the part they will remember apart from the message you’re trying to get across. That’s why I don’t talk about it anyway…

How was the process of getting on the treatment? Super Easy!

If you had the opportunity to talk to someone considering the treatment what would you say? It’s easy as. To a large extent, it’s just taking a tablet 1-3 times a day for 8-12 weeks! You have to have a blood test but you already have to do that for a lot of things in life so what’s another blood test? It’s not a big deal!

Did you have any reservations about getting on the treatment? No way, why would you have reservations to get rid of a disease? Easy choice!

What’s it been like getting treated through the Deen Clinic? It’s been great! Everyone is very accommodating. Once I got the letter from the blood bank I went to my GP and he said ‘Go to the Deen Clinic’ and I came here and started treatment. It has been great because everyone knows exactly what’s needed for treatment, it all happens here. For someone in my circumstance once I found out about the diagnosis, I saw my doctor and got on treatment within about 10 days. It was so fast and that was a big part because of the service available at the Deen Clinic!

Did your GP give you contact information about the Deen Clinic? He just told me about HepatitisWA and the Deen Clinic and I gave you guys a call. Easy. Just needed to pick up the phone!

What was it like accessing the medication through a pharmacy? This was tricky. What I did find was the number of pharmacies that provide the treatment in Perth is limited. It was helpful to use the HepatitisWA pharmacy list on the website. The list includes pharmacies that do dispense the medication. That way I just found the pharmacy that was closest to my house and went there to access the medication. Once that was sorted, I just needed to call the pharmacy for my repeat prescription and they’d call me the next day to say it was ready to collect.


PERSONAL PERSPECTIVE

“The main promos you see about hep C are centred around injecting drug users and because I don’t do that I never suspected I’d get it.”

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giving gp’s a helping hand with the cure

resources to GPs so they feel confident in treating their patients with the relatively new Direct Acting Antiviral (DAA) drugs. Some aren’t yet aware they can treat their patients without needing to refer them to a specialist. Are you enjoying the role? Absolutely loving it! Enjoying talking to people from all walks of life. I am learning every day and I love sharing this information. What is the purpose behind this new GP Liaison Nurse Project? Historically, GPs have referred patients with hepatitis C to a specialist for treatment. Sometimes, due to this, they would be on a wait list for a lengthy period and have to travel to the city for treatment. Now, since GPs are able to prescribe the treatment there’s fewer reasons why patients can’t be treated closer to home. That way they are being treated by someone they are familiar with.

What is your role at HepatitisWA? It’s a new role, the GP Liaison Nurse project. This type of project is the first of its kind for Australia. My role is targeted to help doctors and health providers who are treating or starting to treat patients with hepatitis C. When the new treatments, the direct acting antivirals first became available onto the PBS back in March 2016 the uptake was excellent. However, in the last 12 months there has been a gradual decline in uptake of the treatments. We are hoping to boost the numbers of people who are accessing the treatments by providing information and 12

HepatitisWA Newsletter // Dec 2018

What have been the most common concerns from GPs who are hesitant to prescribe? They have often never treated patients who are living with hep C. Therefore, they may not be familiar with the DAA treatments available. There is a great app created by HEP Drug Interactions by the University of Liverpool ‘Liverpool HEP iChart’ where you can type in your patients known medication, both prescribed, over the counter, herbal and illicit and the app tells you if there is any drug interactions with the new DAAs.. Utilising this information will help make sure there aren’t any issues with treatment. GESA and ASHM have also created excellent algorithms to guide GPs and Nurse Practitioners undertaking a pretreatment assessment in order to decide what is the best treatment drug and how to monitor for viral response to treatment. What’s their response once they discover that they can treat patients? The common response is ‘WOW! That’s exciting!’


FEATURE We’ve seen great support in the community. Some doctors who are managing their own patients with the hepatitis C virus (HCV) offer to help mentor other doctors in their practice. This occurred just recently when we received a referral to the Deen Clinic from a doctor who worked in a practice where another GP was very confident and competent in managing HCV cases. GPs are helping other doctors grow their skill set which is really great for the patients and the community. What advice would you give to a GP that is thinking about prescribing? If they haven’t prescribed before, there is a great resource called ‘The Remote Consultation Request for initiation of Hepatitis C Treatment.’ It’s a great learning tool and gives you great tips on what to test for. This can be downloaded from the GESA website and some practices are including it in the practice software. There have been a lot of people diagnosed with hep C on a positive antibody result but in reality, 25% of people who test positive can actually clear the HCV themselves. So, there is a need to test those clients that they’ve got on their books, by undertaking a look back on their client list to determine ‘who has been diagnosed with hep C?’ Based on an antibody test and then retest those for a HCV PCR, genotype and a quantitative HCV RNA level. The HCV genotype is required by the PBS criteria to help treat the patient with the correct medication. How can HepatitisWA help GPs who would like to learn more about the hep C treatments? There are a couple of e-learning tools that would be great to do if you’re a GP and want to refresh your understanding of HCV and to learn more about prescribing the treatments. These include the Edith Cowan University E-Learning Hepatitis C course – it is free and the NP WISE E-learning NP WISE MEDICINE Managing Hepatitis C in Primary Care. The e-learning can go towards GPs annual personal development too!

Is there anything else you would like to add? My project is a free service to help, and support GPs new to managing patients with a diagnosis of Hepatitis C. When they find out it’s free they get really excited. They are often used to drug representatives, contacting them but this role is just here to help. It’s not a money-making scheme, as an organisation we want to achieve the World Health Organisations goal of eradicating hepatitis C by 2030. According to the research, Australia is definitely on track to reach this goal! Since the treatments are on the PBS now, it’s cheap to get treated and cured! For so long this virus was considered a death sentence, but now it doesn’t have to be. It’s amazing to help people change their lives and be free from hep C!

want to learn more? visit these websites for helpful resources and e-learning Liverpool hep ichart app https://www.hep-druginteractions.org/ gesa resources - ‘The remote consultation request for initiation of hep c treatment’ form http://www.gesa.org.au/resources/ hepatitis-c-treatment/ Edith Cowan University E-Learning Hepatitis C course https://www.ecu.edu.au/schools/medicaland-health-sciences/our-research/systemsand-intervention-research-centre-forhealth/projects/hepatitis-b-and-c-onlinetraining-programs HEPATITISWA website http://www.hepatitiswa.com.au/

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FEATURE

The HepatitisWA staff have come together to share their top tips to help you cope this Christmas. We understand that for many people this is a joyous season, however, we also know that for some it can be a stressful time. Therefore, we hope these tips help you to ride through the crazy festive season!

Be organised Don’t leave everything to the last minute. Start planning early. If you’re buying gifts don’t leave the shopping to the last minute.

Gift budget Be realistic about what you can afford and what you can’t – don’t put pressure on yourself to buy expensive gifts. Most people would love to spend time with you rather than receive gifts. Make yourself a list of the people you plan to buy gifts for and ideas of presents to help you stick with your chosen budget. Secret Santa is a great way for large groups of friends or family to avoid putting yourself in debt – it means you only have to buy one present rather than multitudes.

Family time Managing family expectation at this time can be difficult if you have many family members to visit on Christmas Day. Communicate your plans to loved ones early so everyone is on the same page. Don’t forget too, it’s just one day! So you can arrange family events on other days too! If you don’t get on with family members don’t put yourself in situations where you are going to be in their company for any length of time.

Take care of yourself Enjoy the opportunity to have some down time and relax. If you’re tired why not have a nap! It’s also very important in this season to drink enough water and eat healthy. In celebration seasons it’s easy to get carried away eating food high in sugar and fat, not to mention, going overboard with your alcohol intake. Even though it’s a time to celebrate and rejoice, make sure to take care of your body.

True meaning Focusing on the joy and values of Christmas make the whole event less stressful. Whether it’s a special spiritual time for you or represents time with your family and human connection let these be the driving force of the whole experience. Thinking about the true meaning of Christmas makes putting up Christmas trees and lights fun instead of stressful.

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HepatitisWA Newsletter // Dec 2018


FEATURE

And the winner is...

At the WA Health Excellent Awards 2018 on Thursday 8th November HepatitisWA along with Sexual Health and Blood-borne Virus program, Public and Aboriginal Health, Department of Health and Department of Justice; South Metropolitan Health Service; North Metropolitan Health Service; East Metropolitan Health Service; WA Country Health Service was nominated and won the Overcoming Inequities Award for ‘Improving access to hepatitis C treatment in WA prisons’. Not only did the project win this award, we also won the overall prize ‘Director General’s Award.’ Receiving these awards is an amazing achievement and demonstrates the excellent work being done to increase the access to hepatitis C treatments in prisons. Sally Rowell, HepatitisWA’s Community Services Manager represented the organisation on the night of the awards and her smile tells it all!

Improving access to hepatitis C treatment in WA prisons The partnership led by the Communicable Disease Control Directorate has improved access to hepatitis C treatment for prisoners across WA.

(From the left) Sally Rowell (HepatitisWA), Jude Bevan (Health Department), Janice Hare (Department of Justice), Joy Rowland (Department of Justice) and Peta Williams (South Metro Health Services)

Custodial settings provide a unique opportunity to provide health care to vulnerable people who may not otherwise have access to services. However there were significant structural barriers to treatment for those living with hepatitis C in prison. GP prescribing for prisoners is not allowed under Medicare and the Pharmaceutical Benefits Scheme despite curative treatment options for hepatitis C having been available to prescribe since March 2016. The collaboration improved access to treatment based on local service design. This has decreased the prevalence of hepatitis C in prison from 16.9 per cent in June 2016 to 12 per cent in June 2018.

Director general’s Award The Director General’s Award is the most outstanding entry chosen from the eight category award winners that embodies the commitment, professionalism and teamwork of the WA health system.

A very big

THANK YOU

to all our amazing volunteers!

Thanks to your help at community events and in our NSP we are able to educate many in WA about harm reduction and viral hepatitis.

Information sourced from the WA Health Excellence Awards 18 program pg. 20, 31

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Fun family outdoor activities:

OUT & ABOUT

Family picnics Swimming Day trips Walk the dog Check out the neighbourhood facilities Family bike rides

Children who are physically active from an early age are likely to continue to be active throughout their lifetime, ultimately improving their health Regular physical activity throughout life is likely to result in a healthy mind and body with physical and academic benefits. Both structured and unstructured activities help children develop physical, mental and social skills as well as fundamental motor skills (known commonly as coordination). Spending family time together is a great and simple way for parents and carers to role model healthy lifestyle habits, and there’s plenty of fun ways families can be active together! Use this article to gather ideas on ways to get active through family activities away from the home.

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HepatitisWA Newsletter // Dec 2018

Source: Adapted with permission from LiveLighter. LiveLighterÂŽ State of Western Australia 2018: www.livelighter.com.au


HEALTH & LIFESTYLE

Fun family outdoor activities Family picnics - Use some of your home cooked meals and snacks and have a picnic at a favourite family spot.

Swimming - Swimming is a great family activity, hit the pool or head to the beach. Perhaps you could take some sports gear and have a game of cricket, or grip ball on the sand.

Day tripS - There are lots of free or low cost places to visit in WA. Family trips together could be to a park, the beach, off bush walking, to a local playground or lake. Even visiting the zoo will keep your family moving!

Walk the doG - Get out and about with the family dog. See more of you neighbourhood on foot and discover what you’ve been missing in the car, even discover neighbourhood facilities you could access as a family.

Check out the neighbourhood facilitieS - Parks, playgrounds, and sports courts (basketball, tennis, ovals etc.) are often closer than you think. They offer spaces for a broad range of family activities including games, walks, picnics and use of equipment. Schedule some family time to access these free local facilities.

Family bike rideS - Taking the family out for a bike ride is a great way to get out and explore your city. Many cities and councils publish a list of bike paths in the local area on their website.

Too busy? Set aside time to get out as a family. Great ways to fit in some active family time together outdoors include; watch one less TV show; use travelling time; or drop into open spaces or playgrounds on the way home from school. When together, try out and share new equipment such as skateboards, bicycles, and rollerblades.

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HEALTH & LIFESTYLE

BEEF KOFTA WITH TZATZIKI Ingredients: 2 cloves garlic, peeled 2 cups mint leaves 1 cup low-fat Greek yoghurt 1 Lebanese cucumber, grated and

2 tsp ground coriander 1 tsp ground cinnamon 1 brown onion, peeled and quartered 1/2 cup flat-leaf parsley

2 tomatoes, cut into 1cm dice 1 red capsicum, cut into 1cm dice 2 spring onions (including green tops), sliced

squeezed of extra moisture 400g lean beef mince 2 tsp ground cumin

pepper, to taste 2 Lebanese cucumbers, extra, cut into 1cm dice

4 wholemeal or whole grain wraps

method: Finely chop garlic and mint or place them into the bowl of a food processor and process until finely chopped. Transfer 1/3 of garlic and mint mixture to a small bowl and mix with grated cucumber and yoghurt to make tzatziki. Set aside. Add onion and parsley to garlic and mint mixture and chop or process finely then combine with mince, spices and season with pepper. Use clean hands to divide into 8 portions, shape each into a 12cm long sausage and place on skewers. Spray a barbeque, chargrill or griddle with oil and heat on high. Cook kofta for 8 minutes or until cooked through, turning every few minutes. In a medium sized bowl, combine cucumber, tomatoes, capsicum and spring onion. To serve, divide Lebanese bread, salad and tzatziki on plates and add 2 kofta skewers to each. 18

HepatitisWA Newsletter // Dec 2018

Source: LiveLighter ÂŽ State of Western Australia 2013. Reproduced with permission. For more healthy recipes and tips visit www.livelighter.com.au


SEASONS GREETINGS FROM ALL OF US AT

our office will be closed from 24th december (midday) - 2nd january


What outreach services does Peer Based Harm Reduction WA offer? Our Outreach service ‘home-delivers’ NSEP in the Perth Metro and South West region to people whose circumstances make access to services difficult, and also supplies Harm Reduction Packs to homeless and street-present people via foot-patrols in the inner city and Fremantle.

peer based harm reduction WA: a year in review

The Outreach Youth Officer engages younger consumers and partners with Passages, DAYS, and other youth services.

Peer Based Harm Reduction WA has once again had a busy and productive 12 months. We have continued to grow the way we provide services to people who inject drugs, and how we support the international goal of hepatitis C elimination by 2030.

What were the main achievements of the Needle and Syringe Exchange in the past year? From July 2017 to June 2018, Peer Based Harm Reduction WA distributed 1,940,000 pieces of sterile injecting equipment and had more than 18,000 consumer interactions. During this period, Peer Based Harm Reduction WA expanded Injection Infection week into a month long health promotion activity. During injection infection month the number of consumers requesting extra free equipment and the reported re-use of equipment declined over the four-week period as shown in this bar graph.

OPAM recruits, trains, and supports our consumers to be volunteer peer-educators in the community. In the past 12 months the peer-educators provided over 4,000 education sessions, witnessed almost 200 overdoses and administered naloxone almost 70 times. The Peer Naloxone Project continues to educate consumers to recognise and respond to an overdose, including how to administer naloxone and provides life-saving naloxone kits. This year Outreach has expanded further with the addition of the Stirling Empowerment Project, a team of three workers who engage with vulnerable people, including those from multicultural backgrounds, to improve access to mental health, alcohol and other drug services in the Stirling region.

Number of consumers stating their reuse of equipment across all PBHRWA sites by week, March 2018 150 100

98 77

50

44

39

3

4

0 1

2 Number stated “Yes”

This year also saw the introduction of harm reduction packs to better meet the needs of local street based and Aboriginal consumers. Forty-six percent of harm reduction packs are distributed to Aboriginal consumers who receive one pack per occasion of service. As a result of the significant level of engagement with Aboriginal consumers through the introduction of harm reduction packs, Peer Based Harm Reduction WA were the recipients of a WA AOD Excellence Award in the Aboriginal category. 20

HepatitisWA Newsletter // Dec 2018

Tell us about your new ‘safe space’ poster? The ‘safe space’ poster has been developed in collaboration with people who use alcohol and other


PEER BASED HARM REDUCTION WA’S DOMAIN drugs. There was an extensive consultation process in order to ensure the community considered this resource appropriate. During the consultation process, all consumers interviewed reported facing stigma, discrimination and judgement from service providers, including those from the health and social support sectors. This poster is designed to indicate to consumers that the service and/or staff member displaying the poster is non-judgmental and respectful towards all people, including those who use alcohol and other drugs. As always, feel free to contact Peer Based Harm Reduction WA for more information about successfully engaging with people who use alcohol and other drugs. If you would like to order copies of the safe spaces poster for display in your service or organisation, please contact Ruth Wernham, Health Promotion Officer on email: healthpromotion@harmreductionwa. org or phone: (08) 9325 8387

What has been happening in the Health Clinic in the past 12 months? A keen focus was to provide an Outreach based clinic for consumers and their networks, in their own homes. This approach was thought to be the most effective way that we can increase BBV screening and treatment uptake in the community. We have introduced the hepatitis C (HCV) Case Management Worker to the team at Peer Based Harm Reduction WA. The role of the HCV Case Management Worker is to provide support to consumers who commence HCV treatment. Consumers are engaged in an outreach capacity, routinely contacted and, if required, transported to and from our clinic.

What can we expect from Peer Based Harm Reduction WA in the near future? Peer Based Harm Reduction WA will be conducting an initial 12-month pilot hepatitis C Peer Education project aimed at increasing the uptake of hepatitis C treatment in the injecting drug user community in the Perth Metropolitan area. The hepatitis C Peer Education project will assist in the dissemination and uptake of hepatitis C treatment information and resources specifically for people who inject drugs. The program will recruit and train peers in hepatitis C and harm reduction strategies, including hepatitis C transmission, testing and treatment, and these peers will then work in the community to deliver this information to their networks of other drug users. This project will use one of our existing models, but modified to focus on BBV transmission, testing and treatment, with a particular focus on education and information around the new hepatitis C treatments. HepatitisWA Newsletter // Dec 2018

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Hepatitis Organisations have adapted our program for their organisation which is a great compliment.

Is there anything else you would like to share about your work with Hepatitis B? I think it is really important to keep hepatitis B on the radar as there are approximately 237,000 people living with hepatitis B in Australia and currently there is no cure.

introducing... Amanda Our Busy B! What is your role at HepatitisWA? I coordinate the Hepatitis B Multicultural Program at HepatitisWA.

How long have you been involved in the hepatitis B project? I developed this program when I first started at HepatitisWA 4.5 years ago.

What has been some of the projects highlights for 2018? Presenting at the Hepatitis Symposium in Melbourne for all Hepatitis organisations throughout Australia was a big highlight. It was a great opportunity to showcase the WA hepatitis B program. Three other state 22

HepatitisWA Newsletter // Dec 2018

when you’re not at work, what do you love doing? I love my Harley Motorcycle and am a member of the Swan River Chapter HOG club. I hold an officer position as the Ladies of Harley Officer and Road Captain. There’s nothing better than going away for a weekend with friends on the bikes.


MEET THE TEAM

hepatitis b project 2018 overview Health Ambassador reach

TAFE

ISHAR Multicultural Women’s Centre

South & North Metro (AMEP)

ERC

Edmund Rice Centre

68% female

cravens Pharmacy

communicare

32% male

62%

Asian

22%

Sub-Saharan African

15%

Middle Eastern

WLH

navitas

1%

Other

William Langford House

mercycare centacare

Multicultural futures

Education January- NOVEMBER 2018

67 Education Sessions Healthy Life 24 Liver workshops 1488 people reached intend 100% ofto people get tested

testing clinic 138 asian 42 Middle east 25 Sub-saharan african 9 other

76% 24%

12 clinics 215 tested

76% female 24% male

53% vaccine offered 7% positive diagnosis 32% natural immunity 8% vaccine immunity HepatitisWA Newsletter // Dec 2018

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my promise to myself this year is to...

get rid of

hep C! need help to access treatments?

call our helpline on 9328 8538 visit our website hepatitiswa.com.au


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