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Hepatitis

Community News Spring 2005

Hep C & Prisons • New National Hepatitis C Strategy

Letter to the Editor Hello there, I am writing to send you a poem, and if you use it all well and good. It relates to life, addiction and the struggle incurred by combination therapy, which I have recently finished to excellent effect. The Hepatitis C Council of South Australia provides information, education and support to the hepatitis C community and those at risk. Street: Mail: Phone: Freecall: Fax: Web: Email:

3 Hackney Road, Hackney PO Box 782, Kent Town SA 5071 (08) 8362 8443 1800 021 133 (08) 8362 8559 www.hepccouncilsa.asn.au admin@hepccouncilsa.asn.au

STAFF Manager: Danny Gallant Metropolitan Educator/Acting Info and Support Line Coordinator: Deborah Warneke-Arnold Info and Support Line Volunteers: Fred Lyn Joan Steve Liz Will

The Hepatitis C Community News is well-formatted and quite pleasant on the eye. The cover of the Winter 2005 edition is particularly bright and positive. The truth always seems to be invariably harsh and it is as though the cover informs the viewer that we as individuals are able to create our own, more positive, yet still very real, truths. Maybe my poem is too heavy for your publication, and I fully understand if it is not what you require. Artists and poets are accustomed to rejection but I personally find other people’s rejection of who I am more than happy with being, is of absolutely no consequence. One person’s trash is another one’s treasure, etc. I have enclosed a stamped, self-addressed envelope for your convenience. If you choose to utilise it, like a literary caped crusader, my words shall fly through the air faster than the speed it would take me to walk to Hackney. It is also great to see Indigenous Australians get a guernsey in the piece, too. Thank you for your time.

Metropolitan Educator (Community Programs): Sharon Drage

Alan P. Kelly

Rural Education and Support Officer: Leslie Wightman

Editor’s Note: see pages 4-5 for Alan’s work

Getting It Together Program: Gary Clarke Michelle Morrison

Contents

Information and Resource Coordinator: Cecilia Lim Resource Volunteers: Claire Lyn Gail Maggie John Phil Senior Administration Officer: Lynn Newman Administration Officer: Megan Collier Publications Officer: James Morrison Librarian: Joy Sims BOARD Chairperson: Leslie Dunbar Vice Chairperson: Peter Underwood Secretary: Fred Robertson Treasurer: Barbara Williams Senior Staff Representative: Danny Gallant Ordinary Members: Catherine Ferguson Helen Ingham Fiona Bellizzi Marian Rich Barry Horwood Dean Wilkins

Useful Contacts & Community Links Hepatitis C Council of SA Provides information, education, support to the hepatitis C community and those at risk. The Council provides information and education sessions, as well as free written information. The Calming the C Support Group is also run by the Council. Call the Council’s Hep C Info and Support Line for information on (08) 8362 8443 or, for rural callers, 1800 02 11 33 (freecall). Partners of Prisoners (POP) Facilitates access to and delivery of relevant support services and programs which promote the health, wellbeing and family life of partners of prisoners who are at risk of hepatitis C, HIV/AIDS or are people living with hepatitis C or HIV. (08) 8210 0809

SAVIVE Provides peer-based support, information and user education, and is a Clean Needle Program outlet. (08) 8334 1699 Hepatitis Helpline This hotline operated by Drug and Alcohol Services South Australia provides 24-hour information, counselling, referral and support. Freecall: 1800 621 780 The Adelaide Dental Hospital has a specially-funded clinic where people with hepatitis C who also have a Health Care Card can recieve priority dental care. Call the Hepatitis C Council for a referral on (08) 8362 8443.

Aboriginal Drug and Alcohol Council of SA (ADAC) Ensures the development of effective programs to reduce harm related to substance misuse in Aboriginal communities. (08) 8362 0395 AIDS Council of SA (ACSA) Aims to improve the health and wellbeing of gay/homosexually active men, people who inject drugs, sex workers and people living with HIV/AIDS in order to contribute to the overall wellbeing of the community. (08) 8334 1611 SA Sex Industry Network (SA-SIN) Promotes the health, rights and wellbeing of sex workers. (08) 8334 1666

MOSAIC Has Moved Relationships Australia’s MOSAIC program has moved to 55 Hutt St, Adelaide. The new contact numbers are: Phone: (08) 8223 4566 • Fax: (08) 8232 2898

Clean Needle Programs To find out about programs operating in South Australia, contact the Alcohol and Drug Information Service. 1300 131 340 Nunkuwarrin Yunti A health service for Aboriginal and Torres Strait Islander people. (08) 8223 5011

Relationships Australia (SA) Provides support, education, information and referral for people affected by hepatitis C through the MOSAIC and P.E.A.C.E. services. MOSAIC is for anyone whose life is affected by hepatitis C, and P.E.A.C.E. is for people from culturally and linguistically diverse backgrounds.

New National Hepatitis C Strategy 1 The Second National Strategy Launch 2 The Strategy in a Nutshell Focus on Prisons 3 CNPs in Prison 4 An Insider’s View 6 From Schools to Prisons 7 A Failure of Care Community Updates 2 Riverland Awareness 8 Croc Festival 2005 9 Q&A 9 Brief News 10 In Our Library 11 Getting It Together Network 12 Council News Disclaimer: Views expressed in this newsletter are not necessarily those of the Hepatitis C Council of South Australia Inc. Information contained in this newsletter is not intended to take the place of medical advice given by your doctor or specialist. We welcome contributions from Council members and the general public.

“Increasing Access” Improving access to knowledge, prevention, resources and treatment Monday 20 to Wednesday 22 February 2006 Sydney Abstract Deadline Friday 11 November 2005 Earlybird Deadline Thursday 22 December 2005 Online registration will be available in October For further information Visit www.hepatitis.org.au Contact us on conferenceinfo@hepatitis.org.au or +61 2 8204 0770

People with hepatitis C may no longer need to have liver biopsies in the future in order to qualify for treatment. Federal Health Minister, Tony Abbott revealed this on 1 July, at the launch of the National Hepatitis C Strategy 2005-2008.

A centrepiece is the $1.8 million to be given to the states to improve surveillance of hepatitis C. This new state funding is in addition to the more than $40 million a year the government already spends to combat the disease.

The Federal Government, he said, has asked the Pharmaceutical Benefits Advisory Committee (PBAC) to review the requirement of a liver biopsy as a criterion for hepatitis C treatment.

Mr Abbott noted that with nearly 250,000 Australians living with hepatitis C, it is now the “most common reason for Australians to need liver transplants,” and there was still much to be done. He said the new strategy builds on the acknowledged strengths of the first strategy, under which new hepatitis C notifications dropped from 19,487 in 2000 to 14,499 in 2003.

The PBAC assesses the listing of medicines on the Pharmaceutical Benefits Scheme (PBS), the program intended to ensure that all Australian residents have access to necessary and lifesaving medicines at an affordable price. Mr Abbott said the Strategy aimed to reduce new cases of hepatitis C and ensure better treatment for people infected by the virus. It sets out a significant push towards treatment, monitoring and teaching the public about hepatitis C.

Among those present at the Strategy launch were Stuart Loveday, President of the Australian Hepatitis Council, Annie Madden, Executive Officer of Australian Injecting and Illicit Drug Users League, and Bob Batey from the John Hunter Hospital.

Mr Abbott thanked Professor Bob Batey and his committee for their work in drawing up the Second National Strategy and said the government would now work with Professor Batey and the committee to devise a new public awareness campaign targeted towards at-risk groups. The campaign will start next year.

community news

Second National Hepatitis C Strategy Launched

Both Mr Loveday and Ms Madden welcomed the new Strategy. However, said Mr Loveday, the moves needed to be backed up with action. “Without a concrete and achievable plan of action, this strategy will remain simply a policy document,” he said. In a media release, Ms Madden described the new strategy as “comprehensive” but said that ultimately, the strategy would be truly successful only if there was sufficient funding. She called on the Federal Government to ensure adequate future funding to make the promise of this strategy a reality for people affected by hepatitis C.

Cartoon: James Morrison

Hepatitis C Community News Spring 2005 •

community news

The Second Hep C Strategy in a Nutshell Prevention, treatment and surveillance. constrained by eligibility criteria, lack These three key areas are the focus of of knowledge of recent improvements the Second Hepatitis C Strategy. in outcomes, limited resources in remote areas and cultural barriers, In the foreword to the Strategy amongst other things. document, Federal Health Minister Tony Abbott said with 16,000 new Top on the action list for this area is infections occurring every year, the the development of an implementation current hepatitis C situation in Australia plan for the National Hepatitis C should be considered an epidemic. Testing Policy. The Strategy listed 23 priority action areas for prevention including: education through increasing public knowledge of hepatitis C and its prevention, access to clean injecting equipment through needle and drug substitution programs, investigation into strategies to prevent injecting drug use and support for health professionals and peer-based drug user organisations. The Strategy identified testing as the primary tool for diagnosing and assessing progress for people with chronic hepatitis C. It recognises the importance of that first contact as the event which shapes how people with hepatitis C understand their infection. The Strategy points out that only 1% of people living with hepatitis C are accessing treatment, as access is

The Strategy said improved surveillance mechanisms are needed for more information on the prevalence and incidence of hepatitis C in the general population. The Strategy is intended to work in complement with other health strategies, especially the National HIV/ AIDS Strategy 2005-2008, the National Sexually Transmissible Infections (STIs) Strategy 2005-2008 and the National Aboriginal and Torres Strait Islander Sexual Health and Blood Borne Virus Strategy 2005-2008. A copy of the National Hepatitis C Strategy 2005-2008 is available at the Hepatitis C Council of SA library. It is also available online at www.health. gov.au/internet/wcms/publishing.nsf/ Content/phd-hepc-strategy-0508-cnt. htm

Another TV Blooper The episode of House MD broadcast on Network Ten on 28 September 2005 featured a central storyline involving a patient displaying symptoms of hepatitis C. As the plot developed, a number of inaccurate statements were made about the nature of hepatitis C infections. One character (playing a doctor) stated that contracting hepatitis C “�� involves the exchange of bodily fluids”. Hepatitis C can only be contracted when infected blood enters the bloodstream of another person.�� A number of characters also implied that hepatitis C is a ‘homo’ or gay disease. In fact, sexuality is irrelevant to risk. Hepatitis C is usually contracted through sharing injecting Hepatitis C Community News • Spring 2005

equipment, non-sterile tattooing or body-piercing, or by people who had blood transfusions before proper testing was available. The Hepatitis C Council of SA has contacted Ten, asking them to include a corrective information bulletin before a future episode, and also The Advertiser, to publicise and correct the misinformation. Other state and territory hepatitis C bodies around Australia are also contacting their local media for the same reason.

Riverland Awareness The Riverland community recently indicated a strong interest in understanding more about hepatitis C and its impact on individuals, families and communities. Around 40 workers and community members attended a collaborative presentation which was designed to bring people up to date with current information on hepatitis C and related issues. The workshop was jointly organised by Leslie Wightman, the Hepatitis Council of SA’s rural education officer; Anne Bourne, Relationships Australia MOSAIC Counselling’s clinical practice leader; and Margaret Blake, team leader of Relationships Australia’s Berri office. All were delighted with the attendance. The presentation, entitled What’s New with Hep C, included presentations by Leslie and Anne, as well as Robyn Gilligan, the Flinders Medical Centre HIV and Viral Hepatitis nurse; Sue Gore, the Riverland Regional Health Service’s infection control coordinator; and Gary Clarke, the HCCSA’s community speaker. Thank you to Peggy Ball of the Riverland Regional Health Service, Helen of the Getting It Together/ Rural Hepatitis C Network, the Berri Relationships Australia team (Margaret, Stefan, Trish and Kylie), and to each of the speakers for their roles in making this a successful community event. Leslie Wightman MOSAIC, a confidential and free service provided by Relationships Australia for people affected by hepatitis C or HIV, is now available through the Relationships Australia office in the Riverland. For more details, please contact the Berri office on (08) 8582 4122.

Editorial: Need for Clean Needle Programs in Prisons Hepatitis C in prisons was in the news again recently with the screening of a segment on the ABC’s 7:30 Report focussing on the spread of the virus in prison populations. This followed a front page article in Just Us (a publication circulated amongst prison inmates around Australia) calling for action to reduce the spread of hepatitis C among prisoners. In a recent report described by The Lancet as “one of the most important documents on prison health ever published”, the World Health Organisation (WHO) brought together a wealth of evidence which showed that

taken to make prisons drug-free, drugs are still finding their way into prisons, and will continue to do so. On the ‘outside’, the use of illicit drugs is against the law, just as it is in prisons. However, on the outside, users have access to clean needle programs (CNPs), which not only provide new syringes, but also other equipment essential to making the process of injecting safe, and thus reducing the risk of transmission of blood-borne viruses between users. Clean needle programs, or needle exchange programs as they are referred to in other states, have been extremely effective

Focus on PRISONS

public health strategy? One of the most common argument against CNPs in prisons is the risk to the safety of prisoners and prison officers, as syringes could be used as a weapon. Another reason is that the introduction of such programs amounts to a tacit endorsement of drug use. While we recognise the safety concerns associated with a needle and syringe program in prisons, these are not insurmountable. As pointed out by Hepatitis C Council of SA Manager, Danny Gallant, “Excellent models can be found overseas where governments have worked with prison officer unions, local communities and prisoners themselves to find workable solutions to potential problems.”

Image: James Morrison

Australia was a world leader in coming up with the first hepatitis C strategy but has fallen behind other countries in responding to the spread of the virus in prisons. It’s time for us to catch up. SA could take the lead in piloting a prison needle exchange program. It is in everybody’s interest to reduce the spread of hepatitis C in prison populations because ultimately prisoners will return to live within the community.

infectious disease transmission in prisons could be prevented and even reversed by simple, safe, and cheap harm-reduction strategies. It has been estimated that a third of Australia’s 23,000 prisoners are infected with hepatitis C. Researchers at the University of Adelaide have reported that 60% of women and 40% of men in South Australian prisons have documented evidence of hepatitis C infection. Compare this with the estimated 1% infection rate in the general population. Hepatitis C continues to spread at an alarming rate in prisons because injecting drug use, although illegal, continues to occur in gaol. Whatever measures have been

in reducing the transmission of hepatitis C, B and HIV. Financially, CNPs have reduced healthcare costs to the taxpayer by reducing the spread of these viruses, and also preventing re-infection or superinfection (contracting another genotype of hepatitis C). CNPs are viewed as a public health measure on the outside, and a very successful one at that. Prisons are bound by a duty of care to their inmates to provide adequate health services. Prisoners have as much right to safety and good health as everyone else. Why then are prisons in Australia continuing to avoid introducing such a demonstrably successful

The WHO report – Status Paper on Prisons, Drugs and Harm Reduction – is available online at http://www.euro.sho.int/ document/e85877.pdf SA Auditor-General Ken MacPherson said that he believes prisoners contracting communicable diseases like hepatitis and HIV/AIDS in gaol could sue. He said that if there is a known risk and those in authority do not address that, “there is a breach of the relevant duty of care ... In my opinion, this is a matter that should be accorded appropriate attention in State custodial institutions to mitigate and manage the risks that are involved.” Hepatitis C Community News Spring 2005 •

Focus on PRISONS

An Insider’s View Releasing Old Gifts How many junkies does it take to change a light-globe? None. They can get what needs doing done in the dark. Obviously, I will never write jokes for Letterman—in fact, the preceding words are more a reflection of how I once existed, which is a joke in itself. Something profound happened to me during the 48-week course of hepatitis C combination therapy. I am told that responses to this course vary in accordance with each person’s chemical make-up, but for me it felt as though I was going cold turkey from heroin for a substantial portion of the time. The sensations weren’t quite as intense as that, but the myriad of side-effects were significant and continuous enough to have me questioning past lifestyle choices. The treatment was a success and, all going well, the hepatitis C virus will be absent from my bloodstream forever (or at least as long as I live). I haven’t been a deadbeat all my life. All the while, there has existed a parallel realm in which art has

been both my solace and an almost primal driving force. As an addict, I have let many artistic opportunities slip through my fingers. Now I am a survivor who no longer takes drugs and, all of a sudden, there is an accumulation of relatively decent artwork that hasn’t been sold on the cheap to feed my once insatiable veins. I’m back at university (mature age) and writing all manner of fact or fiction at so prodigious a rate that Peter Carey had better watch out! Perhaps I’m getting ahead of myself with that last comment. The Booker Prize may be out of my league, though my constant literary inundations to editors have seen them responding with recent rejection slips containing comments like, “…just missed the cut!” and, “…please keep sending!”. I especially enjoy the way they punctuate their kind negations with exclamation points! An Adelaide art gallery has sent me a contract for my first one-person show. This isn’t the first contract that I’ve been offered, but it is the first to which I am going to commit. Now all I need to do is wait for my release from prison.

Editor’s Note: The Hepatitis C Community News was recently contacted by Alan Kelly (see Letter to the Editor) with his story and some of his artwork. We are pleased to present some aspects of his outlook and experience with hepatitis C and the prison environment. Alan’s art is also featured on this issue’s cover. Hepatitis C Community News • Spring 2005

All words and art © Alan P. Kelly 2005

Live to Fight With each fresh sunrise I will not concede defeat Though soldiers thin and many expectations Are now mud upon my feet. Some call my battle illness Others name it a disease and while people sleep Contented in their beds I rally Troops in dreams and the only way these dreams Shall be dispersed is when the chariot I wear as flesh no longer carries my mortality.

Hepatitis C Community News Spring 2005 •

Focus on PRISONS

Forty-three years working with adolescents in schools prepared John Gladwell for his current position as a Health Promotions Officer for Prisons in the Department of Correctional Services. “When I first walked into a prison, it felt just like being in a high school at lunch time,” he said. “In prisons, as in schools, there are groupings formed out of ethnic, cultural and other affinities, and there are others who are on the outer. Among the main objectives of prisons are containment and limitation of activities—not too dissimilar to schools which, in many ways, are also custodial environments for a part of a child’s life. “A lot of the adults in prison are locked into adolescent ways of thinking and behaving, showing the impulsiveness and antiauthoritarianism of adolescence. “I started my working life as a classroom subject teacher but then worked as student counsellor for thirty years. This involved communicating and working with people personally in a direct way – very transferable to a prison context and the Correctional system. “For most people, including myself before I actually entered the prisons, the impressions we get of prison are from images we see on television, and that can be very misleading. Prisons are just places with people who are confined and have to conform to set rules. They are also places committed to duty of care, and minimisation

Hepatitis C Community News • Spring 2005

From Schools to Prisons: John Gladwell of harm to those they look after.”

have access to needles.

One worrying issue for John is widespread hepatitis C in prisons. “The incidence of hep C in prisons is way out of proportion compared to the general population. This is for all prisons in Australia, not just SA,” he said. “Everything points to unsafe injection practices as the major cause of this unsatisfactory situation.

“I’d feel more concerned about being attacked by a used needle than by a clean one,” he said. “Besides, there’s a strong body of evidence to indicate that those fears are unfounded. This evidence is from countries—mainly European—which have introduced safe needle exchange programs in their prisons. It is also strongly supported by reports in 2005 from both the WHO and the Government of Canada.” . The Second National Hepatitis C Strategy launched recently gives John a glimmer of hope as it is “very comprehensive”. Many of the new strategy’s recommendations already form the focus of his work. However, John felt that the strategy significantly underestimates the funding problems on the ground.

“Amphetamine is the current drug of choice. It is so readily available and can be taken in so many forms including injecting. So long as prisoners can get hold of it, there’s no way to control it. This is despite constant and diligent efforts to prevent drug contraband entering the prisons. And there’s no needle exchange program to deal with this problem. Currently none of the prison systems in Australia is prepared to commence safe needle exchange programs.” John acknowledged that there are concerns among custodial officers that needle exchange programs could endanger them, as prisoners would be in possession of needles which could be used to harm the officers. However, he pointed out that the reality is that prisoners clearly already

“The new Hep C Strategy is about raising awareness and increasing surveillance to reduce access to contraband drugs in prisons. However, prisoners have lots of time on their hands to work out ways of maintaining their habits in prison. If they feel the cravings coming on, they will find ways to satisfy them. “My work in Health Promotion is about improving their

A Failure of Care: Dean’s Story lives in prison. How do you make sure that prisoners can live as healthy human beings and not feel like caged animals? There’s very little funding to support all of that.” He said that there’s a need for more discussion between Federal and State authorities to work out details so that funds can be specifically allocated for programs and continuing state funding of federally seeded programs is ensured. On a more practical level, John says what he can do is to maintain a health promotion strategy to raise awareness. “We try to reinforce the message to prisoners that they don’t have to have hep C if they take precautions, and if they do get it, they can opt for treatment,” he said. “The message is, if you don’t seek treatment you are allowing yourself to slowly deteriorate with a disease that could destroy your liver. My job is to influence—not only the prisoners but also those who look after them. Many of the staff perceive the situation differently because they see it as something that threatens their own well-being. “Although ours is a very drugdependent society, people still view certain kinds of drug-taking differently from alcohol, tobacco or caffeine, which have become socially acceptable. It’s hard to change those views.” John described his efforts as perhaps “whistling in the wind”, but he said, “It’s worth making a try. To do nothing only allows our prisons to become the unhealthy places of our nightmares.” John Gladwell’s position is Health Promotions Officer, Custodial Services Unit, Department for Correctional Services. He has been in this job since May 2005.

Dean Wilkins is a long-time member of the Hepatitis C Council of SA. His is a classic story of how the prison system failed in providing a safe environment for its residents. Dean is one of the fortunate ones for whom hepatitis C therapy worked. A year after he started treatment he was told his treatment had been successful.

Mick: Dean’s reaction was to buy heroin off another prisoner.

Below is his story, as told to Mick Bunworth of the ABC’s 7:30 Report.

Dean: There’re many different symptoms with hepatitis C, such as brain fog, lack of concentration, flu-like symptoms, lethargy and fatigue. So for me, the prognosis was that I just would have just got worse and worse as the years went on and, if I was unlucky, I might have had liver cancer or cirrhosis. It’s the Department of Correctional Services or the State Government or Federal Government—there’s a duty of care by the Department of Corrections to look after the health of prisoners while they’re in custody, and they need to look at ways of preventing transmission rates within prisons.

Dean: I was quite conscious about not sharing needles with other people, about hepatitis B and other possibilities of other diseases that I might have got sharing needles. So I was quite aware about that. Mick: It’s been 20 years since Dean … last injected heroin. He knew the risks of transmittable disease, so Dean always used clean equipment and refused to share syringes with others. That is, until he went to prison for breaking and entering.

Dean: I was only going to snort it or smoke it and at the last minute I decided to ask someone for a syringe. Mick: In 1990, seven years after leaving prison, Dean was diagnosed with hepatitis C.

Dean: That’s the point where I put myself most at risk in my time of using, because previously I had been quite aware of using my own syringes and my own equipment and that. So this time, I just didn’t have the opportunity to get a new syringe or anything like that. Mick: Dean initially kicked his addiction, avoiding the heroin readily available in prison. He remained clean for the first two years of his sentence, but with a year to go, his spirits took a dive. Dean: I was in there for about 1820 months, and I applied for parole and I was knocked back for parole and I thought I was quite a good candidate for parole because it was my first time in. I didn’t get into any trouble in prison.

For more information on Partners of Prisoners (POP), see page 12.

Hepatitis C Community News Spring 2005 •

community news

Rocking Out at Croc Festival 2005 Rural and remote areas of Australia are the beneficiaries of an innovative series of youth festivals promoting reconciliation, community, education, health, sport and the arts. The Croc Festival program is intended to inspire young Indigenous and non-Indigenous students to attend

of SA’s Rural Education Project was invited to attend.

school more regularly, lead healthy lifestyles free of alcohol and drugs, and to work together to improve their knowledge, skills and selfesteem. Croc Festival began in 1998 in Weipa, Queensland. From there it has grown so that there are now events held in each state and territory across the country. Port Augusta hosted the first South Australian event in 2004. It attracted over 9,000 people, including students from almost 60 regional schools. This September it returned. The Hepatitis C Council

If you found yourself in Port Augusta around Croc Festival time, you would have been unable to escape the fact that something special was happening for young people. Parts of the school and TAFE ovals were taken over by a small tent city. One huge area was designed to sleep hundreds of young people. Another housed a gigantic stage for student performances. There were numerous other tents and structures housing interactive displays. HCCSA’s educators, Leslie Wightman and Sharon Drage, and Anita Drage, our work experience student from Para Hills High School, attended the Croc Festival. They were located in the Health Expo tent, which this year ran with the theme ‘Get Ur Body In2 Gear’. HCCSA’s stall theme was ‘Paintwork and Protection’,

From Croc Festival 2005: HCCSA’s free tattoos (top right, below) were extremely popular with participants, between their turns on the stomach-churning slingshot (right) and the dizzying rock-climbing tower (above).

Hepatitis C Community News • Spring 2005

and promoted messages relating to safe body art. Following a short presentation, health expo participants were invited into the HCCSA’s makeshift ‘parlour’ for a brief discussion while being temporarily tattooed. Approximately 900 young people were engaged with HCCSA staff over the two days of the festival, along with approximately 100 community members. The SA Premier, the Hon Mike Rann, and other important dignitaries also visited the HCCSA stall. We’d like to extend our thanks to the Health Expo organisers, in particular Angela Russell and Damian Coulthard. A big thanks must also go to the medical students and Pika Wiya workers who assisted in the tattoo parlour, and to Anita for her dedicated work experience effort. Leslie Wightman

Brief News

Contact: I had surgery recently, and they did a test for hepatitis C, which came up positive. I also went through the treatment. The antibodies were positive with a 3.6. What does the 3.6 mean? I have been clear of the virus for 3 years after the treatment. I am going to my gastro next week to get another test.

Catholic Mass leads to Hep C and HIV Concerns

Q&A Info Line: I have not heard of antibody results given with numbers before. Antibody results are positive or negative.

I am very pleased your treatment was successful in clearing the virus. When a person has been exposed to hepatitis C they develop antibodies. The antibody test is the first-line screening for hepatitis C, but is not evidence of current infection. The PCR test is used to detect the presence of hep C virus: in other words, to detect current infection. Results of PCR tests are given as detected or undetected. When a person clears hep C, either through treatment, or naturally in the first 6-12 months after infection, their PCR test result will be ‘undetected’ (i.e. no virus was detected). The antibody test will still be positive, but it’s only a marker of past exposure. It would be useful to know the exact name of the test you had. It can also be of benefit to you to have copies of your test results so that you can keep your own records. As you are going to the gastro next week this may be a good time to ask for copies of your results. I hope this is of assistance to you. I will be pleased to continue communication with you regarding this issue, or any other questions you may have.

The Catholic Diocese of Austin, Texas is investigating a priest who called 15 children to come forward during Mass so that he could prick them with an unsterilised pin. Reverend Arthur Michalka, 78, intended to demonstrate the pain of crucifixion. “I was trying to teach them that suffering is part of life,” he said. Though no-one involved in the service seemed to think anything untoward had taken place, the mother of one of the children was horrified when she found out what had happened, and claims her daughter bled when pricked. “Apparently our father has lost his mind,” she said. Local health authorities are now conducting confidential interviews to determine whether there is a need for follow-up hepatitis and HIV blood tests. Dr Ed Sherwood, the local district health authority, noted that the risk was “real but quite small”, but would have been much higher if adults had been pricked with the same pin, given that they are much more likely to have engaged in at-risk behaviour.

this might result in more effective treatment of Australians with hep C. More than half are infected with genotype 1 of the virus. Improving treatments and increasing their availability was named as a key priority in the Second National Hepatitis C Strategy launched in July.

The Power of Soy

community news

Q&A

Consuming miso soup and other soy foods may reduce the risk of hepatocellular carcinoma (HCC), according to a study published in the 1 June issue of the International Journal of Cancer. Hepatitis C and B infection are major risk factors for developing HCC. Subjects who ate miso soup or tofu more than five times a week had a 50% lower risk of HCC than those who ate soy foods no more than once per week. The study was adjusted for hep C and B infection, and was conducted in Japan. The lower HCC risk associated with higher soy consumption “may reflect a counteracting effect of isoflavones on oestrogen and testosterone levels that reduces HCC risk,” the investigating team suggest. The article can be found at: www3. interscience.wiley.com/cgi-bin/ fulltext/109884331/HTMLSTART

Hep C Treatment Time May Be Halved in Europe

New Study on Hep C Mortality

A committee of the European Medicines Agency has recommended the approval of a shorter, 24-week course of weight-based PEG-INTRON combination therapy for patients with genotype-1 hepatitis C and low viral load. This is intended for those who achieve a virological response within four weeks of commencing treatment. If final approval is given, it will apply only within the European Union. No change has yet been made to the Australian Product Information. If such a change were to take place,

A new study by the Australian Institute of Health and Welfare in cooperation with the South Australian Department of Health is to investigate the level and patterns of mortality among South Australian cases of hepatitis C. It’s hoped that the study will show whether hepatits C cases have higher general or cause-specific mortality rates than among the general community. If this is so, it should also show which causes of death are happening in excess. The study should be complete by June 2006. Hepatitis C Community News Spring 2005 •

community news

In Our Library The HCCSA Library has a range of magazines, articles, videos, CDs, tapes and multimedia resources available at 3 Hackney Rd, Hackney. The library also provides free internet access.

Online Hep C Self-Education Course If you find talking to somebody about your hepatitis C condition too confronting – even over the phone – you can now learn more about hep C privately online. HCV Advocate, the team behind hcvadvocate.org have recently introduced an online self-paced patient education course allowing people living with hepatitis C to learn more about their illness. The patient education course consists of a series of slides with text and audio narration. If you do not have access to speakers then the audio text is also written on the slides. There is currently one module on “Basic Overview of Hepatitis C”, with more to follow in the future.

are a requirement for accessing treatment in the USA but not in Australia due to the recent changes in eligibility criteria. Some of the statistics and historical facts are also skewed towards an American audience.

As well as raising awareness of this important public health issue, the booklet also aims to reduce the misinformation and stigma associated with hepatitis C. The booklet contains information on transmission, testing, prevention and support. It will be distributed across Australia to multicultural organisations and hepatitis C agencies.

For those who are comfortable on the Internet, this is a very useful source of information. Apart from being an interactive educational tool, the personalised certificate you receive at the end is quite impressive and makes it an enjoyable one-hour lesson!

The national distribution of the resource follows an awarenessraising program for health workers. This concentrated on increasing their multicultural knowledge and their awareness of the issues faced by people from culturally and linguistically diverse backgrounds in relation to health care and hepatitis C.

To access this site, go to: www/hepeducate.org/pe_test/ pe_course_list.php or go to the homepage (www.hepeducate. org) and follow the link to Patient Education.

An order form for the booklet is available from MHAHS on (02) 9515 5030. The booklet will also soon be available at www. multiculturalhivhepc.net.au

Multicultural Resources A new hepatitis C resource is now available in 15 languages. It was developed by the Multicultural HIV/AIDS and Hepatitis C Service (MHAHS) to raise awareness of hepatitis C among people from culturally and linguistically diverse backgrounds in Australia.

The module contains accurate information and statistics and is easy to navigate. The only requirement is that users register their names and passwords. This will also allow them to receive free regular updates from the HCV Advocate website.

Entitled Hepatitis C is Everybody’s Business, and funded by the Australian Government Department of Health and Ageing, the 12-page booklet is available in 15 languages: Arabic, Bosnian, Chinese, Croatian, English, Greek, Indonesian, Italian, Khmer (Cambodian), Korean, Macedonian, Portuguese, Spanish, Thai and Vietnamese.

It is worthwhile remembering that information is based on the USA and there are some details that do not apply to Australia. For example, elevated ALTs

The booklet is for anyone who wants to know about hepatitis C, including people who may have had a risk factor, or their families and friends.

Hepatitis C Community News 10 • Spring 2005

This website also has a number of other hepatitis C resources available in 18 different languages.

Rural Network/ Getting It Together Update Hi there again, folks. Well, it’s mid-October and it looks as though spring will finally shake off the winter blues and usher in another Adelaide summer at last. We GITs are busy gearing up for the second of our GIT Network Weekends, to be held here at the Hepatitis C Council. We and Leslie have been frantically organising everything and we have put together what should be an interesting and exciting program for all involved. People will be attending from the Riverland, Waikerie, Hills Mallee and Mid Northern health regions. This second weekend will include a community speaker from the HCCSA, along with speakers from the Health Consumer Alliance, MOSAIC and the Royal Adelaide Hospital. The first GIT Network meeting was held on the weekend of 2224 July. We were all a bit nervous but everything went really well. It didn’t take long for the whole thing to take on a life of its own. All the work and preparation paid off, we had a great time, and everyone came away stimulated and keen to build on what we had achieved so far. The core group of participants are a great bunch of enthusiastic and talented people and by the time Sunday afternoon came around it was sad to see them all head off into the sunset. By the time you read this we will be reflecting on our efforts with an eye to the third weekend in February 2006. Thanks again to all those involved in the project, including

our steering committee, those wonderful HCCSA people Deborah and Danny for their great presentations at the first weekend, to the other participants and all those that helped to make this whole thing possible. The GIT Team will keep you updated in future newsletters. If you would like further information about the Getting It Together Network, please call Gary or Michelle at the Hepatitis C Council of SA on 1800 021 133. Regards, Gary Clarke & Michelle Morrison

Reaching Out Parks Community Information Day Our free temporary tattoos were a magnet to visitors young and old at the Parks Community Information Day in October. Visitors had to read an information sheet and answer a question. Young ones merely had to ask. After a slow start, word of mouth about our “tadoos” brought throngs of young visitors with parents in tow. There was also a lot of interest from other service providers in our publications. All in all, a good day.

community news

Getting It Together

About GIT Living in a rural location? Want an opportunity to meet and communicate with other people affected by hepatitis C? The Getting It Together Network (GIT) might be just the thing for you! GIT aims to: • Give a voice to people affected by hepatitis C • Encourage and support the sharing of stories and experiences • Offer the opportunity to develop new skills and build networks • Provide wider access to current information and services Find out more: contact Gary, Michelle or Leslie at the Hepatitis C Council of SA on 1800 021 133 or (08) 8362 8443, or email leslie. wightman@hepccouncilsa.asn.au

Interested in Community Representation and Health Advocacy? The Hepatitis C Council and the Health Consumers Alliance are currently working together to develop a training opportunity for people interested in community representation and advocacy. We would like to bring together people who have considerable experience in the area, as well as those who would like to become more involved in promoting a community voice. For more information on this project, look for the flyer inserted in this issue of the News. Take the opportunity to have a say about what you would like included in the training.

Hepatitis C Community News Spring 2005 • 11

community news

Council News Vietnam Veteran’s Day Vietnam Veterans Day on 21 August provided another opportunity for the Hepatitis C Council to reach out to the community. The Council’s stall at the Day’s Health Expo attracted nearly 70 people, with many people disclosing that they were affected by hepatitis C. The atmosphere was fantastic. We had a spritely older gentleman in front of the stall who danced most of the day. I wish I had his energy!

A huge thanks to Lyn, Steve and David, who were kept busy providing hepatitis C info and applying free fake tattoos. We look forward to being part of the 40-year anniversary to be held next year, and will also be there on King William St to cheer the marchers before they arrive at the parade grounds. Deborah Warneke-Arnold

A Visit to the Sobering Up Unit In August, the Hepatitis C Council of SA made another contribution of pre-loved clothing to the Mission Australia Sobering Up Unit in Hindmarsh. This centre runs various services for young people who are homeless or at risk of being homeless, and face issues with alcohol and illicit drug use. The fantastic mosaic program run by HCCSA’s Sharon Drage, our Community Programs Metropolitan Educator, was conducted with young people at the Hindmarsh Centre. When people attend Hindmarsh, they often benefit from a new set of clothes, which is why we were prompted to make our donations. By the time we visited, we had a car boot full of clothes. These were received by the appreciative Mel Castle, one of the Mission Australia youth workers. HCCSA volunteers Fred, John and Maggie, together with then-Information and Resource Coordinator Elissa Mortimer, had a tour to better understand the amazing service that the workers there provide. HCCSA and the Hindmarsh Sobering-Up Unit intend to work together to provide more support and information to young people who are living with, or at risk of, hepatitis C. We’d like to offer sincere thanks to the HCCSA volunteers who coordinated this initiative, and especially to everyone who contributed clothes. Elissa Mortimer

Hepatitis C Community News 12 • Spring 2005

Corporate Challenge As part of a new initiative focussed on team building and lifting the profile of the Hepatitis C Council, staff, volunteers and board members of the council are participating in the 2005 Adelaide Corporate Challenge. We missed out on a spot in the lawn bowls competition so we instead opted for volleyball as our chosen activity. Judging by the results of our first game, the ‘Hep Cats’ are in for a successful season. Although, technically, we did not win (notice the emphasis on technically), we were all winners as we learnt about team spirit, the joy of participation, and the actual rules of the game. In the first round we took on the Telstra ‘Get Spiked’ team, who were tough opponents to draw in the first round. With most of our experience limited to playing at high school, it took us a little while to warm up, but once we got going, we impressed the opposition (and ourselves!) with a fine display of skill and enthusiasm. We have no doubt (well, only a little doubt) that as the 9-week season progresses, we will have notched up a few wins of our own and will have done the Hep C Council proud. Leslie Wightman

3 Hackney Road, Hackney PO Box 782, Kent Town SA 5071 (08) 8362 8443 1800 021 133 (08) 8362 8559 www.hepccouncilsa.asn.au admin@hepccouncilsa.asn.au

STAFF Manager: Danny Gallant Metropolitan Educator/Acting Info and Support Line Coordinator: Deborah Warneke-Arnold Info and Support Line Volunteers: Fred Lyn Joan Steve Liz Will

Metropolitan Educator (Community Programs): Sharon Drage

Alan P. Kelly

Rural Education and Support Officer: Leslie Wightman

Editor’s Note: see pages 4-5 for Alan’s work

Getting It Together Program: Gary Clarke Michelle Morrison

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MOSAIC Has Moved Relationships Australia’s MOSAIC program has moved to 55 Hutt St, Adelaide. The new contact numbers are: Phone: (08) 8223 4566 • Fax: (08) 8232 2898

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Community News Spring 2005

Hep C & Prisons • New National Hepatitis C Strategy