#60 HepSA Community News by Hepatitis SA

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#60 • June 2013

FibroScanning • Sex Work & Safety Working with Migrant Communities • The Real Thing

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The best contribution pr inted in each issue of the Hepatitis SA Comm unity News will receive a $25 shopping vouche r. Write to us about anythi ng to do with the magazine, Hepatitis SA , your personal experienc es living with hepatitis, or living well ideas. Email us at editor@hepa titissa.asn.au

Hepatitis SA provides free information and education on viral hepatitis, and support to people living with viral hepatitis. Street: Mail: Phone: Fax: Web: Email:

3 Hackney Road, Hackney PO Box 782, Kent Town SA 5071 (08) 8362 8443 1300 437 222 (08) 8362 8559 www.hepsa.asn.au admin@hepsa.asn.au

Hepatitis SA Free education sessions, printed information, telephone information and support’, referrals, clean needle program and library. (08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au

STAFF

Hepatitis SA Helpline

Executive Officer: Kerry Paterson

1300 437 222 (cost ofa local call)

Administration: Megan Collier Kam Richter Information & Support Coordinator: Deborah Warneke-Arnold Information and Support Line Volunteers: Debra Fred Janette Karan Louise Michele Will Education Coordinator: Tess Opie Educators: Nicole Taylor Michelle Spudic (Rural) Imogen Dayman

Cover photo by Ralf Heß [flickr.com/photos/waelder1], used under a Creative Commons license Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@hepatitissa.asn.au. Editor: James Morrison Non-staff Contributor: Danella Smith

Health Promotion Officer: Shannon Wright

Contents

Information and Resources Volunteers: Dayna Deo Amita Karen Menuka Phil

1 News

Publications Officer: James Morrison

Probing with FMC’s FibroScan

Information and Resources Officer: Rose Magdalene

Let’s Get Quizzical

ICT Support Officer: Bryan Soh-Lim

Closing the Gap

Librarian: Joy Sims

Northern ‘One-Stop Shop’

Peer Education Coordinator: Maggie McCabe

Sex Work & Safety

Peer Education Coordinator Support: Bill Gaston

A Secret in the Family

Peer Educator Mentor: Fred Robertson

What’s On/Q&A

Cutting Through Challenges

The Real thing

In Our Library

Peer Educators: Dean Karan

Penni

Will

BOARD Chairperson: Arieta Papadelos

insert photo from stories here

1300 224 636 www.beyondlbue.org.au insert photo from stories here

Ordinary Members: Gillian Bridgen Carol Holly

Catherine Ferguson Jeff Stewart

insert photo from stories here

Disclaimer: Views expressed in this newsletter are not necessarily those of Hepatitis SA. 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 Hepatitis SA members and the general public. Department for Health and Ageing, SA Health has contributed funds towards this program.

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Clean Needle Programs in SA For locations call the Alcohol and Drug Information Service. 1300 131 340

Secretary: Lindsay Krassnitzer

Senior Staff Representative: Kerry Paterson

(08) 8334 1611 www.acsa.org.au beyondblue Mental health information line

Vice-Chairperson: Lisa Carter

Treasurer: Darrien Bromley

Call Hepatitis SA on 1300 437 222 for a referral. AIDS Council SA Peak HIV/AIDS body in South Australia.

Hepatitis B Coordinator Elaine Lloyd Information and Resources Coordinator: Cecilia Lim

Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

headspace Mental health issues are common. Find information, support & help at your lcoal headspace centre

P.E.A.C.E. HIV and hepatitis education and support for people from non-English speaking backgrounds.

1800 650 890 www.headspace.org.au

(08) 8245 8100

Lifeline National, 24 hour telephone counselling service.

Positive Life Services and support for HIV positive people – including treatments information and peer activities.

13 11 14 (cost of a local call) www.lifeline.org.au

(08) 8293 3700 www.hivsa.org.au

Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers.

SA Sex Industry Network Promotes the health, rights and wellbeing of sex workers.

13 14 65

(08) 8351 7626

MOSAIC Counselling service For anyone whose life is affected by hepatitis.

SAVIVE Clean needle program and peerbased support information and education for people who use drugs.

(08) 8223 4566

(08) 8334 1699

Nunkuwarrin Yunti A city-based Aboriginal-controlled health service with clean needle program and liver clinic.

The Second Story Free, confidential health service for youth aged 12 to 25.

(08) 8406 1600

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100

Hepatitis C Community nurses Care and assistance, education, streamline referrals, patient support, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for appointment.

Community Access & Services SA (a service of the Vietnamese Community in Australia, SA Chapter) Alcohol and drug education; clean needle program for the Vietnamese and other communities.

Central & North:

(08) 8447 8821

Rosalie - 0466 777 876 rosalie.altus@fmc.sa.gov.au Emma - 0466 777 873

Margery - 0423 782 415 margery.milner@health.sa.gov.au Debbie - 0401 717 971 deborah.perks@health.sa.gov.au Jeff - 0401 717 953 jeffrey.stewart@health.sa. gov.au Trish - 0413 285 476 South:

Are you interested in volunteering with Hepatitis SA? Give us a call on 08 8362 8443 or drop us a line at admin@hepatitissa.asn.au. We rely on volunteers for many of our vital services.

News 3D Printer photo CC Andy Dingley [http://commons.wikimedia.org/wiki/User:Andy_Dingley]

Police officer compensated for hep C A South Australian Police officer who contracted hepatitis C during a fight with a drunken suspect has won a 9-year battle for worker’s compensation. The state’s Workers Compensation Tribunal has found SA Police must pay for the officer’s physical and psychological suffering Deputy President Judge Peter McCusker ruled medical evidence proved the officer, known as ‘P’, contracted the virus while on duty in 1988. “I find the worker suffered injury in the nature of Hepatitis C and subsequent fatigue, irritable bowel syndrome and psychological disability... in the course of employment,” he said. “The worker has been thereby incapacitated.”

A 3D printer works by creating an object from particles of the chosen material— plastic, metal, or even cells—one layer at a time, and fusing them together.

In 2004, P was unable to continue working due to treatment for the virus. From: Adelaide Now – 24/04/2013

Support system doubles the life of donor livers Donated livers can now be kept healthy for at least a day thanks to a device that keeps the organ ticking over as if still inside the body. The technology could more than double the availability of livers for transplant. In the US and Europe, 2000 donor livers are discarded annually because they deteriorate in transit, damaged by the ice packs and solutions that, for the past 40 years, have been the usual way to preserve them. And whereas most livers become unusable after about 14 hours, the new device keeps them functioning and in perfect condition for at least 24 hours. The device has a pump mimicking the heart, an oxygenator mimicking the lungs, and tubes to supply blood and nutrients. An automated master console controls the fluid pressure and levels of oxygen, carbon dioxide and sugar in the blood, making the device easy for non-specialist medical staff to use.

As well as buying precious time to use the organ, the device will enable surgeons to test a liver’s condition before deciding whether to use it. The device will also allow the use of fatty livers that have so far been rejected because they do not respond well to freezing. Two people have received livers kept alive using the device. Both were treated at King’s College Hospital, London, in February, and are among 20 people taking part in a pilot trial From: New Scientist – 23/3/2013

Printing livers Lab-grown livers have come a step closer to reality thanks to a 3D printer loaded with cells. Created by Organovo in San Diego, California, future versions of the system could produce chunks of liver for transplant. The mini-livers that Organovo made are just 0.5mm deep and 4mm across, but can perform most functions of the real thing. To create them, a printer builds up about 20 layers of hepatocytes and stellate

cells (two major types of liver cell). Crucially, it also adds cells from the lining of blood vessels. The cells come from spare tissue removed in operations and biopsies. Existing liver assays, based on single or double layers of cells, only last two days and don’t have the same range of functions as the microdiscs. The realistic structure and functioning of the mini-livers make them good predictors of the toxicity of drugs and other substances. They produce albumin, the liver protein that bulks up blood and ferries hormones, salts and drugs throughout the body. They also make cholesterol, which carries fat in the bloodstream, and produce major detoxification enzymes, called cytochrome P450s, that metabolise drugs in the liver. Organovo’s ultimate goal is to create human-sized structures suitable for transplant; the big hurdle is being able to print larger branched networks of blood vessels to nourish such an organ. From: New Scientist Online – 23/4/2013

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

News From the Community

Probing FibroScan welcomed at FMC

Above: Rachel Wundke scans Michael’s liver Opposite: The FMC FibroScan

linders Medical Centre (FMC) recently welcomed a clinical FibroScan machine, which can determine the extent of liver damage, and many are thrilled. The $100,000 secondhand machine was fully funded by FMC volunteers, and was first used in the liver clinic on 9 May. A group of eight liver nurses completed one full day of training to establish an understanding of how the machine functions. Chronic liver disease nurse Rachel Wundke explains the FibroScan machine is “perfect to help determine

Hepatitis C”, and its arrival has been an exciting time for the FMC.

is quicker, dramatically less intrusive, and with fewer risks involved.

The FibroScan process resembles an ultrasound, and it determines the extent of fibrosis through a measure of liver stiffness.

However, as Ms Wundke explains, biopsies will still have their place in the process, particularly for alcohol-related liver damage, or in cases where results on the scan are unclear.

FMC currently run Thursday afternoon clinics where patients attend a 10-minute FibroScan appointment to determine the overall health of their liver. For some patients, the scan may be able to rule out biopsies. Compared to these, a scan

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

“One of the men I scanned yesterday—the result wasn’t clear, so he will still need a biopsy,” Ms Wundke said. “[The FibroScan] will detect fibrosis and cirrhosis, and can test if we need to act urgently or not.”

From the Community News What is FibroScan? Chronic liver disease nurse Rachel Wundke explains the FibroScan machine is “perfect to help determine Hepatitis C”, and its arrival has been an exciting time for the FMC.

In South Australia, the FMC and the Royal Adelaide Hospital are the only hospitals with a FibroScan. The FMC’s scanner is a more advanced version, as it has an additional ‘XL’ probe. An XL probe is necessary for obese patients, as it recognises body fat around a patient’s stomach, and still allows for an accurate reading.

FibroScan tests are becoming a standard monitoring tool for hepatitis C and liver damage. Having a series of FibroScan tests over time can show an increase, decrease or stability in liver fibrosis.

Ms Wundke hopes the scanner will speed up the whole process of determining a patient’s liver damage, and ultimately put an end to patient waiting lists. “Our patients don’t have to wait anymore,” she says.

During the procedure, the patient lies on his or her back, right arm raised behind the head. The measurement is made on the right lobe of the liver by using a dedicated probe with a vibrating system. There are no specific adverse effects. However, FibroScan is not recommended for patients who are pregnant.

Michael, 63, has lived with hepatitis C for most of his adult life, and was Ms Wundke’s fifth patient to be scanned. He was thrilled by the new machine and his very quick 10-minute appointment.

Danella Smith

“This is a massive breakthrough for people like me who are living with it [Hepatitis C],” he said. “I think it is great to see advancements like this. It makes it a lot easier for us.” Ms Wundke says she believes all big hospitals in South Australia will gain access to a FibroScan in the near future.

FibroScan is a noninvasive method of assessing liver scarring, termed fibrosis. It is a new ultrasound-based technology, like that used to monitor the health of unborn babies in pregnant women. Performed at the bedside in the clinic, a mechanical pulse is generated at the skin surface by a probe. This pulse is propagated through the liver. The velocity of the wave is measured by ultrasound. The speed of this wave correlates with the “stiffness” of the liver, which in turn reflects the degree of fibrosis: generally, the stiffer the liver, the greater the degree of fibrosis.

The result is given as a specific score in kilopascals (KPa), a measure of pressure, and this score is the median score from at least 10 readings. In viral hepatitis a score of less than 7 means no or insignificant liver fibrosis; a score of more than 12.5 KPa indicates severe fibrosis or cirrhosis; and the results between this suggest moderate fibrosis.

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

From the Community

Let’s Get Quizzical

Alyona Haines / Hepatitis SA

James Morrison / Hepatitis SA

Alyona Haines / Hepatitis SA

Hepatitis SA Quiz Night a great success

Jo Sloan handing over the cheque to Kerry Paterson, Hepatitis SA’s EO TOP: The Hepatitis SA table claims a prize LEFT: Happy quizzers

quiz night organised by community members has raised over $3,800 for Hepatitis SA. Jo Sloan and her friends Natalie, Amanda and Susan pulled off a successful event which filled 13 tables with quiz night enthusiasts, including Hepatitis SA staff members, their family and friends. For Jo, whose husband recently received a shock diagnosis of hepatitis C, it was a very personal experience. Reflecting on the night, she said she thought the night went amazingly well. “It is always a gamble running a fundraiser, but my faith in the people of Adelaide was not misplaced,” she said.

“Looking around the room as I wandered through, I saw so many people laughing and enjoying themselves and I knew it was going to be a success. The girls and I look forward to hosting another event for Hepatitis SA next year, and we hope it will be as successful as this one was.” The quiz night had eight rounds of questions on hepatitis C, Australia, geography, sport, history, general knowledge, entertainment, and music. There were also questions on celebrities, logos and riddles. Each table also had to do a treasure hunt for random items. In between rounds, there were raffles, auctions, and a hepatitis

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

C information session presented by Hepatitis SA educator Imogen Dayman. Kath, a hepatitis C positive speaker, spoke about her experience with the disease. “The speakers were amazing,” Jo said, “especially Kath, who I feel really made people aware and more understanding of hepatitis C.” The final scores were very close. The winning table received a hamper of fine foods and wine, while the table with the lowest score got a set of wooden spoons. Everyone else left with small gifts from many different sponsors. All in all it was a night full of fun and laugher, and all for a good cause.

Around the Community

Closing the Gap Day O’liver gets on his bike

The event on 21 March was hosted by Nunkuwarrin Yunti as part of national awareness campaign focusing on Aboriginal health. The aim was to promote health services available to indigenous people, as well as provide useful

information to the community. Despite a small turnout, the event was a success as the relaxed atmosphere allowed community and health workers to exchange contacts and information and spend more time with clients, providing a more personal experience.

Fred Robertson / Hepatitis SA

epatitis SA mascot O’liver had a great time pumping out smoothies on a bicycle at the Closing the Gap day in Elizabeth recently.

Hepatitis SA peer educators handed out information packs and balloons.

Northern ‘One-Stop Shop’ Introducing the Elizabeth GP Plus pathology services for all the necessary blood tests are also available. Hepatitis SA runs a Calming the C support group there each month: see p11 for dates and times. Dental services for those struggling with dental issues due to their hepatitis are available from the Health Centre, and clients can also receive Hepatitis

A and B vaccinations on site. Centre Manager Wendy Sutton said the Elizabeth GP Plus is one of SA Health’s best one-stop-shop health care centres. “Our centre offers a broad range of services aimed at helping people to take control of their health and stay out of hospitals,” she said. “We encourage people with chronic illnesses to use this ser-

vice, as it is specifically designed for them. Having all these health services in one place reduces the need to travel to multiple locations, and provides ongoing quality care.” Most services at the Elizabeth GP Plus Health Care Centre require an appointment; some require a GP referral, but there are also some walk-in services. If you wish to see the hepatitis nurses you may self-refer by calling the nurses directly. For contact numbers see the back of this magazine.

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

Imogen Dayman / Hepatitis SA

eople with hepatitis B or C living in the northern suburbs can access hepatitis-related services at the Elizabeth GP Plus Health Care Centre. Specialist hepatitis nurses are available for regular appointments, and

Safer Communities

Sex Work & Safety Decriminalising sex work for a safer state Jane Watsername is a South Australian sex worker and writer. She states that “Because I’m a whore I risk discrimination and harassment, so I lead a double life. Because I’m a whore I am a criminal under South Australian law, and so I hide my identity.” Here she discusses the imminent potential for legalising sex work in SA, which Hepatitis SA supports and which we want to see happen so that the lives of every South Australian can be made safer from the dangers of blood-borne viruses like hepatitis B and C. Jane blogs at becauseimawhore.com.

here is a new bill before parliament which seeks to decriminalise sex work in South Australia. The ‘Statutes Amendment (Decriminalisation of Sex Work) Bill 2013’ was introduced to the House of Representatives by Labor MP Steph Key on the 16 May this year, and unlike the previous bill, I am thrilled with this one. This is a really big deal. Perhaps sex workers in South Australia will finally be able to work with dignity, choice and legal protection; perhaps our laws will be featured in PowerPoint presentations in conferences everywhere; perhaps

Photo © Decriminalise Sex Work in South Australia [www.facebook.com/decriminalisesa]

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all the work of South Australian sex worker activists past and present will have positive outcomes for sex workers here and internationally. This bill offers pure decriminalisation—with the exception of the clause that states sex workers and clients must be over 18—and also features the important addition of amendments to the Anti-Discrimination Act and Spent Conviction Act, which will make it illegal to discriminate against a sex worker and mean existing sex work convictions would be wiped from our records.

Decriminalisation basically means that all the offences related to sex work will be deleted from the law, and no new special laws will be added, allowing sex workers, sex work businesses and the industry to be governed by all the laws and regulations that govern every other citizen, worker, business and industry in the State. Under a decriminalised model, police would be there to protect us, not bust us, and we would be able to access all the protections that other workers can access. Decriminalisation will ensure that sex workers are not subject to special laws that were often made for political, not pragmatic, reasons. Rather, decriminalisation means sex workers are covered by the same sophisticated protections and regulations as other workers, rules which are reviewed and updated regularly (such as industrial relations and OH&S regulations). This bill will mean that no sex worker is a criminal. It means that all sex workers should be able to call police without fear. It means that potential offenders think twice before committing crimes against sex workers. It means sex workers have access to OH&S standards. It means sex workers are less isolated and will have fewer barriers to accessing assistance and health care, including hepatitis treatment, when they need it. It means sex workers can put safe work practices before police evasion tactics. It means sex industry businesses can be more open about their business activities and provide more specific tools and resources to assist sex workers and clients stay safe, as can organisations like Hepatitis SA. It means sex workers can be clearer with potential clients and employers about their boundaries. It means sex workers who have criminal records will no longer need to worry that this will affect them in finding work outside the industry. It means sex workers do not have to worry about getting a criminal record or having negative contact with police. It means that instead of sex workers

breaking the law, it will be the people who discriminate against us who are breaking the law—a massive shift, and I can only imagine the long-term impacts of this on the self-esteem of sex workers. Decriminalisation is best for everyone. There are some brothel owners and employers who would have preferred there to be tighter controls on sex workers and businesses so as to limit competition and to maximise the power they can have over workers, but ultimately the day-to-day work lives will not change for people in the sex industry (or outside it), except that where we need assistance we will have places to get it. Decriminalisation is not a magic wand, and will not solve all our problems, but it levels the playing field. It gives us somewhere to start. It gives us the right to fight for our rights. Decriminalisation is what sex workers around the world have been demanding for decades. New South Wales and New Zealand have already decriminalised sex work, and have reported successes for the health and safety of sex workers, and maybe South Australia will be the third place in the world to give sex workers equal rights. The current bill will be voted on following its second reading on the 20 June. If the vote is successful the bill will go to committee stage, where amendments can be put forward before it gets voted on a second time. If passed by the Lower House, the bill then needs to be passed (by a similar process) in the Upper House. But now we need your help. South Australia was once considered a world leader in progressive law reform, but this is no longer the case. Our leaders are scared of controversy; they are scared that you won’t vote for them if they support these laws. If we are going to get this bill passed, we need you to tell your local MP that you support us, you support decriminalisation, and you want them to support this bill.

Please consider supporting us by signing the petition at www.gopetition.com/petitions/ decriminalise-sex-work.html, and by writing to or meeting with your local MP. Other ways to support this cause are featured at www. facebook.com/decriminalisesa (you don’t need to have a Facebook account to make use of the page and its resorces). This is not just an issue for sex workers past and present and in the future—and our friends and families—it is an issue for all South Australians who care about equity and social justice. Please get behind us. We can’t do this alone! Jane Watsername Steph Key’s bill can be read online at tinyurl.com/sasexwork.

Call Us! For free, confidential information and support on viral hepatitis call:

1300 437 222

CNP Hepatitis SA

Monday - Friday 9am - 5pm Full range of syringes and needles. Water and filters also available for sale.

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

Cover Story

A Secret in the Family What happens when your father has been keeping his hep C secret, and then his liver fails?

ealing with a family illness is a very stressful time, and can potentially be detrimental to many aspects of your life. But following that little light you look to in times of despair, which I call hope, is often all you need to stay strong and get through. My dad is living with hepatitis C-related liver cirrhosis, and so my family have recently been through many ups and downs. So far, 2013 has been a particularly horrible year for Dad, and it all began when he started taking the combination treatment of interferon and ribavirin in December 2012. Dad had a bad reaction to the medication, and was rushed to intensive care at a nearby hospital on 15 January, as his kidneys and liver were failing. Until this all happened, most of the family didn’t know the extent of his illness. It wasn’t until a couple of weeks into his taking the medication that Dad explained to me that he was very exhausted, and that he had to take 12 tablets a day and inject himself once a week. He did not, however, tell me he had hep C. Still, to this day, the words have never come out of his mouth and I have found out through doctors. I would have to put the reason he has never told me down to the fact he is ashamed—as there is such a negative stigma surrounding Hep C—and that he didn’t want to scare me. Dad is a very proud man, and I

believe his outlook says that there is no room for illness in his life.

finally discharged from hospital after nearly five long weeks.

Dad spent four days in intensive care and, was then moved into a Hepatobiliary and Colorectal ward. He caught golden staph while in hospital, and had to take a rather large course of antibiotics. Despite this, Dad was still doing well, and the doctors were expecting he could come home on Friday, 8 February.

Luckily for me, the week after Dad came home was my 21st birthday. It was so special having him there for it, considering how sick he was, and everything he had been through.

On the Thursday, though, Dad was taken back into intensive care, as he had suffered from an internal bleed and collapsed on the hospital floor. The doctors explained that he experienced a bleed from his oesophageal varices due to portal hypertension. From my understanding, this means that because of the extent of damage to his liver, it could not cope with the amount of blood trying to filter through it. The pressure in the veins became too much, and they ultimately burst. The doctors performed an endoscopy, and placed rubber bands around the areas the oesophagus was bleeding from. Dad recovered quite well from this procedure, and was taken off sedation 24 hours later. He was very confused at first, and said some very weird stuff. The doctors had warned us about this confusion, which is often a symptom of liver failure. But he recovered quickly from this phase, and was

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

The hospital wanted Dad to go back in for a week to undergo a number of tests which have to be completed in order to become a candidate on the liver transplant list. As he hates hospitals so much, he told them he was not going to stay there, but would come in for whatever tests they needed done at any time. He was very adamant that he was not going to need a liver transplant, and the reason the doctors were doing these tests was in case things became dramatically worse. I think the idea of a transplant terrified him. Fortunately, after he completed the tests and met with the transplant psychologists and social workers, he was okay with the idea. After six weeks of being home, Dad had what the doctors described as a ‘torrential bleed’ on 28 March. It happened at our house, and I found him on the bathroom floor sitting in a huge pile of blood, slowly losing consciousness. I immediately called for an ambulance and the man on the phone told me I had to try and keep him awake and conscious.

That day will never leave my memory. They took him to a different hospital this time, since it was closer and he needed blood as soon as possible. I went to the hospital and was able to quickly see Dad before they performed an endoscopy to determine where he was bleeding from. By then they had given him a blood transfusion and he was quite stable. I told him that I loved him and that he had to stay strong for the family.

said they had expected him to wake up after two or three days, and an MRI and ECG scan revealed there was little brain activity.

15 units of blood transfused. The next day they took him back to the hospital he was originally in, as they were more advanced in terms of liver specialists. The bleeding finally stopped and they performed what is called a TIPS (transjugular intrahepatic portosystemic shunt) procedure. This involves entering through a vein in the neck, and going through to the liver where a small shunt is placed in order to bypass the blood. Dad remained in a coma for two weeks after they had performed the procedure and taken him off sedation. Sometimes he opened his eyes and looked around, but was still essentially ‘asleep’. The doctors

Photo CC S B Rosencrans [flickr.com/photos/starlen/384448979]

Thankfully, an ambulance came within five minutes and took over. The crew cut off his clothes, put an oxygen mask over his face, and rushed him to the nearest hospital.

They were not sure whether it was permanent brain damage or a result of the unfiltered blood going to the brain and carrying toxins such as ammonia. They decided to perform the TIPS procedure again to make the shunt in Dad’s liver smaller. This would allow 30% of the blood to filter through the liver, but 70% still would be bypassed. They also put Dad on a liver dialysis machine, which was only the second time they have used the machine in that hospital.

Overnight, he had two more huge bleeds and the doctors could not determine where it was coming from. The doctors said he had lost a third of his blood and had

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

Cover Story - A Secret in the Family After all of this, they told us they were not pleased with Dad’s progress and were expecting him to be much more alert. He was awake but extremely confused and weak. Dad spent five weeks in intensive care and was only recently taken back into the Hepatobiliary and Colorectal ward. He is now awake and conscious, but still extremely confused. He does not talk much and when he does it is hard to understand. I showed him a photo of himself the other day, and I said, “Do you know who that is?” He looked at the photo for a while and shook his head. I said, “That’s you, Dad!” He continued to look at the photo with a very confused look on his face and said, “Me? Is it really?” The doctors are still unsure whether Dad has permanent brain

damage from a loss of oxygen through the massive bleeds, or if he is suffering from a condition called hepatic encephalopathy, where the brain functioning is altered as a result of the liver no longer being able to get rid of toxins.

There is talk of performing another TIPS procedure and completely removing the shunt so that 100% of the blood is filtered. However, by doing this the chances of having another massive bleed are high.

The doctors have said that if this is the case, he is in it very deeply and they have never seen it to this extent before.

It’s now just a matter of waiting until Dad’s condition is known. This is very hard, but staying strong and positive—not only for my sake but for my family’s and, most importantly, for Dad’s sake—is is crucial.

Despite this, Dad is slowly getting physically stronger. He is improving every day. The shunt in his liver is not designed to be a long-term solution and the doctors have said the only ‘cure’ for him will be a new liver. However, the doctors will not put him on the transplant list at this stage because his body is too weak, and if his brain is not fully functioning then he most likely would not accept a new liver.

Hepatitis C is a condition with which some people can live with their whole lives and never really see the possible effects. Unfortunately for my dad, he has seen the full extent of the effects and knows all too well how serious and debilitating it can be. So does the rest of my family. Danella Smith

The Hepatitis C Treatment Outcome Study

investigators will have access to your email address. You have the right to withdraw from the research at any time, and without penalty.

ou are invited to take part in a study designed to determine some of the physical, psychological, and social factors associated with hepatitis C treatment outcomes.

Previous research has indicated that certain physical and psychological profiles predict better treatment outcomes across a range of medical conditions. However, little is known of how these factors predict treatment outcomes in hepatitis C. The primary objective of this research is to increase understanding of individual profiles that are associated with better hepatitis C treatment outcomes. We are asking individuals who are over the age of 18 years, who have access to the internet and a current email address, and who are preparing for hepatitis C treatment, to complete two confidential online surveys.

The first survey must be completed prior to the commencement of treatment and the second at a designated milestone during treatment. The first survey should take 35-40 minutes to complete, whilst the second survey can be completed in 5-10 minutes. Participation in this research is voluntary and any information you provide is completely confidential. Your email address and responses to the survey are not linked to any information that could personally identify you. Only the principal

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

At regular intervals, result summaries and other relevant hepatitis C based education and information will be posted on our website blog page. This information may be useful for individuals preparing for and undergoing treatment for hepatitis C. We value your privacy and right to have your information treated in the strictest confidence. Questions or Concerns About This Research? Any questions regarding this study can be directed to the principal investigator and PhD student researcher, Mr Simon Langston at slangsto@bond.edu.au. See more information or join the study at hepcstudy.hsstechnology. bond.edu.au.

What’s On Hepatitis C peer educators available to provide information and support to clients at the following services:

• Information and support in a conidential, friendly environment • Speak to others who have had treatment • Partners, family and friends welcome

Now meeting at HACKNEY and ELIZABETH Meet us fortnightly on Tuesdays, 12.30pm-2.30pm at Hepatitis SA, 3 Hackney Rd, Hackney Live in the Northern Suburbs? Can’t make it to Hackney? Come to

CALMING the C in the NORTH Every fourth Friday of the month 1–3 PM Room C20, GP Plus Elizabeth 16 Playford Blvd, Elizabeth light lunch provided

For information, phone 8362 8443

2013 Dates Tuesday, 8 January

Tuesday, 22 January

Tuesday, 23 July Tuesday, 6 August

Tuesday, 5 February Tuesday, 19 February

Tuesday, 9 July

Tuesday, 5 March Tuesday, 19 March

Tuesday, 3 September Tuesday, 17 September

Tuesday, 2 April Tuesday, 16 April Tuesday, 30 April

Tuesday, 1 October Tuesday, 15 October Tuesday, 29 October

Tuesday, 14 May Tuesday, 28 May

Tuesday, 12 November Tuesday, 26 November

Tuesday, 11 June Tuesday, 25 June

Tuesday, 10 December

Tuesday, 20 August

CALMING THE C IN THE NORTH Friday, 25 January

Friday, 28 June

Friday, 22 February

Friday, July 26

Friday, 22 March

Friday, August 23

Friday, 26 April

Friday, September 27

Friday, 24 May

Friday, October 25

Photo © S.Allen

Affected by hepatitis C?

Warinilla Outpatients Hepatitis C Treatment Clinic 92 Osmond Tce, Norwood Tuesdays fortnightly 2–5pm Upcoming dates: Jul: 2, 16 & 30 Aug: 13 & 27 Sep: 10 & 24 Oct: 8 & 22 Nov: 5 & 9 Dec: 3 & 17 Southern DASSA 82 Beach Rd, Christies Beach Monday monthly 9am–12pm Upcoming dates: Jul: 22 Aug: 9 Sep: 16 Oct: 14 Nov: 11 Northern DASSA 22 Langford Dr, Elizabeth Thursday fortnighty 10am–12pm Upcoming dates: Jul: 11 & 25 Aug: 22 Sep: 5 & 19 Oct: 17 & 31 Nov: 14 & 28 Dec: 12 Byron Place (New Roads Program) 61 - 67 Byron Pl, Hindmarsh Wednesday weekly 9am–12pm

Hutt Street Centre 258 Hutt St, Adelaide Wednesday Weekly 9am–12pm

Hep C online health course 6 week course via internet, chat (text) & self-paced modules. louisa@hepvic.org.au Tel: 1800 703 003 Limited Resources, Unlimited Ideas: conference for workers and clinicians in the alcohol and drug sector Brisbane , 17-18 July Presented by Lives Lived Well www.winterschool.info Applied Suicide Intervention Skills Training (ASIST) Salvation Army Activity Room, Byron St, Glenelg 9am–5pm, 30-31 July Cost: $330 Introduction to working with individuals with selfdestructive behaviour Presented by Safe in Oz Cost: $395 • Uniting Care Wesley Port Augusta, 8.45am–4pm, 16-17 Aug • Grow SA, 1/35 Brighton Rd, Hove 8.45am–4pm, 19-20 Sep Information & registration: safeinoz@wideband.net.au or 0433 085 367

Now That’s a Good Question! Hepatitis SA workers get asked all sorts of questions about hepatitis. Here’s one of them... Q: I have had treatment for hep C, and I have cleared the virus. Am I now immune to hepatitis C? A: Treatment does not protect Even if you have cleared one you from being reinfected strain of hep C, you can still with hepatitis C, even if you catch another. It is also possible have cleared the virus through to be living with more than treatment. one genotype simultaneously, There are a number of different which can make it much harder types (known as genotypes) of to treat your hepatitis C.  hepatitis C virus (HCV).

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

Working with Communities

Cutting Through the Challenges A

vina, Christina, Esther and Monu were out of school for only a week but they returned armed with gifts for their classmates - and a slide show on viral hepatitis which they had put together themselves. The four Year 10 Paralowie R-12 students’ work experience at Hepatitis SA was a creative scheme dreamt up by Migrant Resource Centre SA (MRCSA) worker, Gauri Giri, as a way to raise awareness about hepatitis through meeting the needs of people from migrant communities. Like many of their classmates, the four girls, from Bhutanese and Burmese backgrounds, were finding it hard to get employers to take them on for work experience. They were delighted to spend an activities-packed week speaking with educators and support workers, and helping to make badges and pack resources. During the week one of their tasks was to prepare a small slide show on hepatitis to present to their class. They also selected some “educational gifts” for their friends – badges, pencils, bookmarks, mouse mats and a couple of booklets. Motivated by what they’d learnt during the week, Avina and Monu, the Bhutanese girls, asked for booklets to distribute to their community during a coming festival; and Christina and Esther would like to get one of the booklets translated into their Chin language.

Gauri had expected that the students “will learn about hepatitis and healthy living, and will spread the information to their peers” and she was right. Viral hepatitis is an issue among immigrants especially for people coming from regions of high prevalence, but getting the hepatitis message to communities is a challenge not just because of language barriers. Hepatitis ranks low on the priorities of people settling into a new country. More urgent needs like learning a new language, finding work and housing, adjusting to new food, and adapting to unfamiliar education and health systems, take precedence over liver health. Viral hepatitis education needs to be integrated into other activities that help to meet these other valid, immediate needs. “When it comes to migrants, simply helping them with their hepatitis related problems is not always enough,” said Sharna Ciotti, Team Leader at Relationship Australia SA’s PEACE Multicultural Services (PEACE). “They face many more challenges than the average Australian. “PEACE spends a lot of time helping people fill out forms, find places to live, enrol their children in school and so on, before they can help with hepatitis. “People need to be in the right mental space before they can start

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

Cecilia Lim / Hepatitis SA

Services find innovative, relevant ways to work with migrant communities

treatment and PEACE works with people holistically rather than focussing on one issue and not the others.” Services like PEACE, MRCSA, Community Access and Support SA (CASSA) of the Vietnamese Community in Australia SA (VCASA), and Hepatitis SA have, independently and collaboratively, been intensifying efforts to raise awareness about viral hepatitis among migrant communities. Most of the work is done in partnership with community members, and made as relevant as possible to the target community. The MRC’s healthy eating program is one example. Gauri works with refugees, raising awareness about viral hepatitis through healthy eating and education. She believes that her community – the Bhutanese Nepalese community – is at risk of hepatitis B and hepatitis C and knowledge about these two diseases is very important. Four years ago, Gauri worked with Hepatitis SA on the New Country New Food project which introduced new refugees to various aspects of food in their new country. “For people coming from a refugee camp where food was minimal and cooking appliances basic, shopping in

supermarkets and cooking with modern appliances was extremely daunting,” she said. The project took participants on shopping trips to show them where they could buy familiar food, how to make healthier food choices and how to cook with modern appliances. It also gave participants information about viral hepatitis and liver health focussing on the importance of the liver to overall health. New Country New Food was relevant to participants because it was built around the immediate need of food, and the message was framed in an overall health context. The project was a success and Gauri continues to run a similar food and health education program for newly arrived refugees at the MRC. “The program teaches people that culturally important foods, like lentils and rice, should remain in their diet, but with a few additions of fruits and vegetables to make it healthier,” she said. “Trying new things, like new types of foods and cooking techniques, is also encouraged. However, it is always important to ask which foods are healthy and which are not, before making them regular items in a diet.”

Christina, Esther, Avina and Monu preparing a presentation for their classmates on hepatitis B and C.

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

Working with Communities As part of the program, information sessions about hepatitis B and C are frequently held for participants. “In refugee camps, there wasn’t much information about viral hepatitis. Because of myths, there is stigma associated with hepatitis within the Nepalese Bhutanese community, and within families,” Gauri said. “Many people with hepatitis B or C are viewed as contagious and are discriminated against and isolated. This deters people from finding out their hepatitis status.” She said when people learn the facts about transmission and prevention, they feel a lot safer and that reduces stigma and discrimination. Discrimination due to fear of contagion, is also an issue highlighted by Sharna. She said lack of information in the communities can lead to alienation and discrimination, which can seriously damage a person’s self-esteem and willingness to get tested and treated. While PEACE works with people on a one-on-one basis, it also provides training on use of interpreter services and work with communities as a whole. “The main issue PEACE has found is the lack of contextual understanding,” said Sharna. “Often interpreters do not convey the information properly. A lot of the information given is along highly sensitive, medical lines, and there are often many miscommunications. “Some interpreters don’t have any knowledge of hepatitis B or C, so it can be hard for them to translate things accurately. “Often due to cultural reasons people don’t feel comfortable translating certain things, such as unprotected sex or condom use. And sometimes, there just aren’t any translations for certain words, and people get mixed messages.” By providing training both for interpreters and service providers who use interpreters, PEACE hopes to reduce the misunderstandings and mixed messages that occur in translation. At the community level, PEACE is currently working with CASSA,

Hepatitis SA, the South East Asian Women’s Association and the Pooraka Vietnamese Church to develop and distribute a poster to encourage members of the Vietnamese community to get tested or vaccinated for hepatitis B. The poster launch will be accompanied by an information session and the poster will be distributed to restaurants in the western suburbs where there is a high proportion of Vietnamese residents. The poster project rests on the involvement of key community members amongst whom are workers from CASSA. CASSA, the welfare arm of VCASA, is an important link to the Vietnamese community for mainstream services. It has been facilitating hepatitisrelated education in the Vietnamese community for many years. Most of the education and information is provided through information sessions to the support groups which CASSA runs for users and family members. Sessions include practical ones like how to care for your liver and eat well on a low budget presented by Hepatitis SA educator, Nicole, last year. CASSA also worked with Hepatitis SA to organise a hepatitis B forum for the Vietnamese community. The organisers took advantage of an existing seniors group which met regularly and the forum was attended by about 100 people.. Tapping into existing networks and resources, is also the key to two projects which PEACE is currently developing for the South Sudanese community. In the first project two South Sudanese students at UniSA are working together to develop an animation to explain the four stages of hepatitis B progression. The animation will use culturally familiar metaphors to represent the interactions between the hepatitis B virus, the body’s immune system and the liver. This project was started as a response to the fact that hepatitis B related liver disease and liver cancer develop sooner in Africans than in the general community. There are

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

also many instances of late diagnoses in the African community. In the second Sudanese project PEACE recruited three interns from Relationships Australia’s Community Services Certificate IV program to disseminate hepatitis B information to their communities and to conduct a forum-style presentation for parents of a Sudanese ethnic school. The interns will later follow up with forum participants to assess the effectiveness of the project. PEACE has also taken advantage of “existing strong community links” and conducted an informal needs assessment with the Afghani community. The study involved 52 people and results will be released shortly. Both PEACE and Hepatitis SA are also working on projects to provide hepatitis B information to the Chinese community. PEACE will be organising an information session for young people and their parents at the Overseas Chinese Association. Hepatitis SA is following up on last year’s successful My Precious Liver project with information sessions for parents at the Chinese School of South Australia and the CASA Chinese Ethnic School. The sessions are presented with a liver nurse from the Queen Elizabeth Hospital. Meanwhile, the MRC has started a program placing volunteers at Hepatitis SA on a 6-month rotation. The aim of this program is to allow participants to experience an Australian workplace, learn about hepatitis and spread the information to their families and communities. Along the way, they also get to practise their English. The three diligent, friendly Bhutanese volunteers working in the Hepatitis SA resource room have provided much needed help but most importantly, their presence provides an opportunity for them to learn about viral hepatitis and for Hepatitis SA workers to learn about their culture. A classic win-win situation. - Alyona Haines and Cecilia Lim

The Real Thing $10,000 prize for a powerful message

The campaign offers a $10,000 prize for the most creative short film, incorporating the 1969 rock hit‘The Real Thing’, by Russell Morris, which best symbolises positive action in the fight against hepatitis C. The campaign targets a younger audience and plans to inform younger generations to get the message out. Morris, who is proud to be campaign ambassador for the competition, says that the best videos will be about “seeing the real person, not the hepatitis C Infection, and seeing a future free from hepatitis C, as well as talking to a doctor about treatment options.” “I have seen first-hand the impact of hepatitis C,” Morris says, “ and let

me tell you, it’s not pretty. The real thing and the right thing for anyone concerned about hepatitis C is to see a doctor or seek more information about new treatment options which offer a real opportunity to cure hepatitis C. “A lot of people put [hep C] down as being a junkies’ disease, Because of this, people are ashamed to come forward and seek help, but it is curable.”

Russell Morris

Hepatitis SA Executive Officer Kerry Paterson says the campaign hopes to get the community thinking about this serious public health issue. “People do not understand the basics about blood-to-blood transmission and are fearful about being infected,” she says.

Remember: The only time an individual living with hepatitis C is legally required to disclose their status is when they are applying for a job with the defence forces, donating blood, are a medical worker who undertakes exposure prone procedures or when asked on life insurance documentation.

Another cause of discrimination is a result of the association between hepatitis C and an illegal behaviour. “The main way hepatitis C is transmitted in Australia is by unsterile injecting drug use practices,” says Kerry. “Injecting drugs is an illegal behaviour and there are many associated negative stereotypes around this in the community.”

To see the finalists in the video competition, and to vote for the winner, visit the website at www. seetherealthing.com.au. Danella Smith

M. Spudic / Hepatitis SA

epatitis Australia has called on creative filmmakers to voice a number of important messages in a bid to challenge social stigma and discrimination related to hepatitis C. The ‘See the Real Thing’ campaign aims to create awareness of this chronic condition within the community, and to remove negative stigma about hepatitis C by showing the impact it has on many lives.

Rural Promotion

worse by the closeness of small communities, and people are more wary of accessing health services for fear of their hepatitis C status being disclosed.

advertising campaign to promote hepatitis C treatment awareness and Hepatitis SA services to people in country areas.

Because of this and the scarcity of services, people with hepatitis C in rural areas feel isolated and have less access to information and support.

To address this imbalance, Hepatitis SA is embarking on a radio

Anecdotal reports from rural workers indicate that country people think hepatitis C occurs less in rural areas. This may be because hepatitis C in rural areas is more “hidden”. The problem of stigma is made

If you live in the country, listen out for the hepatitis C service announcements and tell us what you think. You can email your feedback to michelle@hepatitissa.asn.au or call us on 1300 437 222.

ountry people are underrepresented in those accessing Hepatitis SA’s information and support services. Rural people make up 23% of the South Australian population, but only 19% of our clients come from country areas.

JUNE 2013 • HEPATITIS SA COMMUNITY NEWS •

In Our Library Review High Sobriety: my year without booze by Jill Stark Call No: 2.1 STA 141 By day Jill Stark was health journalist for The Age, specialising in alcohol and drug issues. By night and on weekends, she drank herself silly at marathon parties, surrendering her Sunday mornings to hangovers. In 2008, her series ‘Alcohol Timebomb’ won the National Drug and Alcohol Award for excellence in media reporting. At the 2010 Christmas staff party, she won the inaugural Jill Stark Drinking Award, bestowed on her for “recording the least amount of time between partying and turning up to work”. Like most of her peers, Jill Stark’s life was inextricably linked with alcohol. It was the lubricant which made social interactions easier and fun. What made her different was her decision to abstain from alcohol for a year—and write a book about it. In High Sobriety, the reader is taken through the 12 alcohol-free months a chapter a month. We follow Jill as she filled her reclaimed hours with activities that she’d now found time for: running, singing and dating while sober. The effect of her abstinence on her social life was discussed at length: Somebody said her book about not drinking should be titled “My Year With No Mates”. After months of not drinking, she was able to

work out exactly when the party starts to go awry and she should leave.

as a journalist, a writer or a footy fan. I stayed sober for more than a year and I was still all of those things.”

The narrative however, does not merely tell the personal story. It is filled with information about alcohol’s place in Australian culture including sports, celebrations and sex. She also wrote about alcohol’s effects on the brain and towards the end of the book described her brain scan to assess the effects of 22 years of drinking. High Sobriety is for people who are considering giving up

One group highly recommended by the author is the online movement Hello Sunday Morning started by young Queenslander Chris Raine. Check them out at hellosundaymorning.org.

alcohol but are afraid of losing their social life. Jill Stark put it simply at the end, “I don’t need a beer in my hand to be accepted

High Sobriety is available at the Hepatitis SA library. Call 8362 8443 or email librarian@ hepatitissa.asn.au, to ask about borrowing. Cecilia Lim

Recent Acquisitions Have You Had a Serious Health Incident? Don’t risk depression and anxiety Beyondblue, Melbourne, 2013 In our library: 4.3 BEY 79

HCV Advocate, San Francisco, 2013 Online link provided in catalogue Hepatitis C: Information for people with bleeding disorders Haemophilia Foundation Australia, Melbourne, 2007 In our library: 1.3 HFA 11

Restoring the Balance: The effect of arts participation on wellbeing and health Voluntary Arts UK, Edinburgh, (2013) In our library: 5.7 DEV 28 Infectious Disease Virtual Congress (12 YouTube videos) IDCareLive , Needham MA, 2013 Online link provided in catalogue

Hepatology: A clinical textbook 2013 (4th ed) Flying Publishers, Cologne, GM, 2013 Online link provided in catalogue

• HEPATITIS SA COMMUNITY NEWS • JUNE 2013

Sunshine Hormone, Vitamin D May Offer Hope for Treating Liver Fibrosis Salk Institute, La Jolla CA, 2013 In our library: 3.2 SAL 14 Mother’s Day in the Shadow of Hepatitis C

Stigma and Discrimination around HIV and HCV in Healthcare Settings: Research report Aust Society for HIV Medicine (ASHM), Sydney 2012 In our library: 6.2 ASH 5 Effects of Maternal Screening and Universal Immunization to Prevent Mother-to-Infant Transmission of HBV Gastroenterology, (Elsevier) Philadelphia, 2012 In our library: 7.1 CHE 13

Useful Services & Contacts

WIN!

Hepatitis SA provides free information and education on viral hepatitis, and support to people living with viral hepatitis. Street: Mail: Phone: Fax: Web: Email:

3 Hackney Road, Hackney PO Box 782, Kent Town SA 5071 (08) 8362 8443 1300 437 222 (08) 8362 8559 www.hepsa.asn.au admin@hepsa.asn.au

Hepatitis SA Free education sessions, printed information, telephone information and support’, referrals, clean needle program and library. (08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au

STAFF

Hepatitis SA Helpline

Executive Officer: Kerry Paterson

1300 437 222 (cost ofa local call)

Health Promotion Officer: Shannon Wright

Contents

Information and Resources Volunteers: Dayna Deo Amita Karen Menuka Phil

1 News

Publications Officer: James Morrison

Probing with FMC’s FibroScan

Information and Resources Officer: Rose Magdalene

Let’s Get Quizzical

ICT Support Officer: Bryan Soh-Lim

Closing the Gap

Librarian: Joy Sims

Northern ‘One-Stop Shop’

Peer Education Coordinator: Maggie McCabe

Sex Work & Safety

Peer Education Coordinator Support: Bill Gaston

A Secret in the Family

Peer Educator Mentor: Fred Robertson

What’s On/Q&A

Cutting Through Challenges

The Real thing

In Our Library

Peer Educators: Dean Karan

Penni

Will

BOARD Chairperson: Arieta Papadelos

insert photo from stories here

1300 224 636 www.beyondlbue.org.au insert photo from stories here

Ordinary Members: Gillian Bridgen Carol Holly

Catherine Ferguson Jeff Stewart

insert photo from stories here

..?

Clean Needle Programs in SA For locations call the Alcohol and Drug Information Service. 1300 131 340

Secretary: Lindsay Krassnitzer

Senior Staff Representative: Kerry Paterson

(08) 8334 1611 www.acsa.org.au beyondblue Mental health information line

Vice-Chairperson: Lisa Carter

Treasurer: Darrien Bromley

Call Hepatitis SA on 1300 437 222 for a referral. AIDS Council SA Peak HIV/AIDS body in South Australia.

Hepatitis B Coordinator Elaine Lloyd Information and Resources Coordinator: Cecilia Lim

Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

headspace Mental health issues are common. Find information, support & help at your lcoal headspace centre

P.E.A.C.E. HIV and hepatitis education and support for people from non-English speaking backgrounds.

1800 650 890 www.headspace.org.au

(08) 8245 8100

Lifeline National, 24 hour telephone counselling service.

Positive Life Services and support for HIV positive people – including treatments information and peer activities.

13 11 14 (cost of a local call) www.lifeline.org.au

(08) 8293 3700 www.hivsa.org.au

Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers.

SA Sex Industry Network Promotes the health, rights and wellbeing of sex workers.

13 14 65

(08) 8351 7626

MOSAIC Counselling service For anyone whose life is affected by hepatitis.

SAVIVE Clean needle program and peerbased support information and education for people who use drugs.

(08) 8223 4566

(08) 8334 1699

Nunkuwarrin Yunti A city-based Aboriginal-controlled health service with clean needle program and liver clinic.

The Second Story Free, confidential health service for youth aged 12 to 25.

(08) 8406 1600

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100

Hepatitis C Community nurses Care and assistance, education, streamline referrals, patient support, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for appointment.

Community Access & Services SA (a service of the Vietnamese Community in Australia, SA Chapter) Alcohol and drug education; clean needle program for the Vietnamese and other communities.

Central & North:

(08) 8447 8821

Rosalie - 0466 777 876 rosalie.altus@fmc.sa.gov.au Emma - 0466 777 873

Margery - 0423 782 415 margery.milner@health.sa.gov.au Debbie - 0401 717 971 deborah.perks@health.sa.gov.au Jeff - 0401 717 953 jeffrey.stewart@health.sa. gov.au Trish - 0413 285 476 South:

Are you interested in volunteering with Hepatitis SA? Give us a call on 08 8362 8443 or drop us a line at admin@hepatitissa.asn.au. We rely on volunteers for many of our vital services.

Community News

PLUS

#60 • June 2013

FibroScanning • Sex Work & Safety Working with Migrant Communities • The Real Thing

FREE! Please take one