June Good Liver:Good Liver 13/06/13 2:46 PM Page 1
The Newsletter of Hepatitis Victoria
June 2013
Good Liver Aboriginal and Torres Strait Islander edition
Responding to hepatitis B in the Torres Strait
Hepatitis B in Aboriginal and Torres Strait Islander people
Research shows that the Torres Strait has the highest notifications of chronic hep B in Queensland.
Finding ways to access diagnosis and treatment for hep B for Aboriginal and Torres Strait Islander people.
World Hepatitis Day 2013 Find out what we have planned for World Hepatitis Day 2013. The Street Shot exhibition will feature once again.
June Good Liver:Good Liver 13/06/13 2:46 PM Page 2
Contents
Contact and postal address:
Staff contacts:
Hepatitis Victoria
Melanie Eagle
Suite 5, 200 Sydney Road, Brunswick, Victoria. 3056
CEO Telephone: 9385 9102 melanie@hepvic.org.au
Telephone: (03) 9380 4644 Facsimile: (03) 9380 4688
Garry Irving Programs and Operations Manager Telephone: 9385 9109 garryi@hepvic.org.au
Email: admin@hepvic.org.au Website: www.hepvic.org.au
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From the desk of the Chief Executive Officer.
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In the news
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Aboriginal Program Update Getting the viral hepatitis message out to Aboriginal communities.
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HepatitisInfoline
1800 703 003
Amy Kirwan Prison Project Officer Telephone: 9385 9108 amy@hepvic.org.au
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Felicity Omar Aboriginal Educator Telephone: 9385 9108 felicity@hepvic.org.au
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W I N
E
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Good Liver is produced by Hepatitis Victoria, with support from the Victorian Government. The opinions and language expressed in this magazine are not necessarily those of Hepatitis Victoria or the Department of Health. Images are used for illustrative purposes only and have no connection to hepatitis.
Reader response Your comments or experiences in regard to any articles in the Good Liver are welcome. Call, write or email: alicia@hepvic.org.au
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Hepatitis B in Aboriginal and Torres Strait Islander peoples Increasing the access to diagnosis and treatment for hepatitis B.
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Eye on Portland A look at the Dhauwurd-Wurrung Elderly and Community Health Service.
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World Hepatitis Day 2013 What’s in development for World Hepatitis Day in 2013.
Garry Sattell T
Responding to hepatitis in the Torres Strait Research shows that the Torres Strait has the highest per capita notifications of chronic hepatitis B in Queensland.
Young People’s Program Coordinator Telephone: 9385 9111 isabella@hepvic.org.au Young People’s Project Officer and Development Coordinator Telephone: 9385 9105 kristy@hepvic.org.au
Hep B... it’s everyone’s business Hepatitis Victoria has a new resource.
Isabella Natale
Kristy Garner
Personal story AJ found himself on a personal journey of discovery about his body, society and hepatitis.
Lisa Nulty Office Coodinator Telephone: 9380 4644 admin@hepvic.org.au
Communiqué
Community Participation Program Coordinator Telephone: 9385 9110 garry@hepvic.org.au
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Alicia Lowndes
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Hepatitis B Positive Speakers. Moving In: new staff
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Young blood
Marketing, Communications and Online Services Coordinator Telephone: 9385 9107 alicia@hepvic.org.au
On the road with the Three Wise Monkeys
Hepatitis C peer education program
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Liver clinics list Contacts
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Communiqué From the desk of the Chief Executive Officer
These alarming statistics are explored in different ways in articles that follow. Some are also summarised here:
Aboriginal and Torres Strait Islander people and hepatitis B There are an estimated 30,000 Aboriginal and/or Torres Strait Islander people living
I
with chronic hepatitis B.
People with viral hepatitis, along with those
people represent only 2% of the Australian
at risk, by and large come from marginalised
population, but it is estimated that around
groups within our community. Once living
10% are living with chronic hepatitis B
nclusion is critical to all that we do at Hepatitis Victoria.
with the condition their marginalisation and sense of being excluded is often compounded.
Aboriginal and/or Torres Strait Islander
Prevalence of chronic hepatitis B among Aboriginal and/or Torres Strait Islanders is
Hence the need to put inclusion front and
2% in urban areas and 8% in rural areas.
centre of what we do. And respect. At the
Remote Aboriginal Communities are likely
same time we must challenge stigma and
to have higher prevalence rates and higher
discrimination and its devastating affect on
rates of liver cancer.
the ability of people to receive the treatment they deserve.
Aboriginal and/or Torres Strait Islander pregnant women have a 4.7% higher
This edition of Good Liver focuses on the
prevalence of hepatitis B surface antigen
Aboriginal and Torres Strait Islander
compared to 1.16% in non-Indigenous
community.
women.
This makes sense with NAIDOC week coming up in July to celebrate the history, culture and achievements of Aboriginal and
Aboriginal and Torres Strait Islanders and hepatitis C
Torres Strait Islander peoples. This follows closely behind National Reconciliation Week and other events such as the anniversary of 1967 referendum to recognise Aboriginal and Torres Strait Islander peoples, and the 1992
It is estimated that 22,000 Aboriginal and/or Torres Strait Islander people have been exposed to the hepatitis C virus and 16,000 are living with chronic hepatitis C.
Mabo High Court decision leading to land
Aboriginal and/or Torres Strait Islander
rights (see ‘In the News’ over the page).
people make up 8.3% of the Australian
It makes even more sense when we consider
population living with hepatitis C.
Earlier this year Hepatitis Victoria formally committed to developing a Reconciliation Action Plan. The Statement of Commitment acknowledges that viral hepatitis disproportionately affects Aboriginal and Torres Strait Islander people and that it is vital for us to work effectively with these communities to achieve our strategic objectives. A working group within Hepatitis Victoria was formed and a stakeholder meeting in April saw the development of our draft Reconciliation Action Plan. Following consultation with staff, Board members, and other stakeholders and Reconciliation Australia, the final plan is due to be released during NAIDOC week. As said earlier, inclusive practice is central to all we do. So it extends beyond particular population groups. It is an attitude of mind, which at times we all need a reminder about. One aspect of working at Hepatitis Victoria which I can be sure will keep me on my toes, and remembering about why I front up at the office, is the regular contact with our various volunteers and contributors. Contact with those who contribute to our organisation in a voluntary way is also one of the most fun aspects of work. These are the people who choose to lend us a hand without it being part of their formal job. Be they people who come and share their experiences at education sessions, people who gather to mail out this Good Liver so you can read it, our Board members, and the many others who brighten our days. So we decided to do something about that this year. For the first time we held a ‘Cheers Volunteers’ function during National Volunteer Week in mid May to formally recognise the contribution of our volunteers. We also nominated one of our volunteers along with our staff member who coordinates the volunteers for awards. (Further detail again ‘In the News’ over the page). This is just one small way in which we can include those who are important to our work in what we do.
the disproportionate health burden suffered
Prevalence of hepatitis C in Aboriginal
by Aboriginal and Torres Strait Islander
and/or Torres Strait Islander people is
peoples both generally, and specifically in
estimated to be three times as many
relation to viral hepatitis.
as the non-Indigenous population.
While Aboriginal and Torres Strait Islander
Aboriginal and/or Torres Strait Islanders
people represent only 2% of the Australian
who are injecting drug users have
population they make up 8.3% of the
higher rates of hepatitis C, as they are
Australian population living with chronic
significantly over represented in the
Warm regards,
hepatitis C and 10% of those living with
prison population.
Melanie Eagle
chronic hepatitis B.
CEO
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In the news
Passing of Yunapingu
A reception was held on 15 May 2013, and the Minister presented
Hepatitis Victoria would like express our sadness in the passing
a number of outstanding achievement awards to individuals and
of Yunapingu, Yothu Yindi frontman, who sadly passed away on
teams from Victorian health services, charity and non-government
2 June 2013. Yunapingu was a leader in Australia’s reconciliation
organisations.
journey, bringing Aboriginal issues to the larger stage and sharing
Hepatitis Victoria was pleased to nominate Graeme Ashton
his culture.
(Volunteer) and Garry Sattell (Community Participation Coordinator) for the 2013 awards.
NAIDOC Week – 7 to 14 July 2013 National Aborigines and Islanders Day Observance Committee (NAIDOC) Week celebrations are held across Australia each July
Garry Sattell (left) and Graeme Ashton
to celebrate the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. NAIDOC is celebrated not only in Indigenous communities, but by Australians from all walks of life. The week is a great opportunity to participate in a range of activities and to support your local Aboriginal and Torres Strait Islander community. There are a number of events planned for NAIDOC week and you can find all the details on www.naidoc.org.au The theme for NAIDOC Week 2013 is:
We value the vision: Yirrkala Bark Petitions 1963 The theme celebrates the 50th anniversary of the presentation
Graeme has contributed to the work of Hepatitis Victoria over the
of the Yirrkala Bark Petitions to the Federal Parliament. The
past 12 months, going above and beyond in all aspects of his
petitions were the first traditional documents recognised by
volunteering. He brings a positive, enthusiastic and good-humoured
the Commonwealth Parliament and helped shape the nation’s
presence to the office, undertaking tasks with admirable patience
acknowledgment of Aboriginal people and their land rights.
and good grace. We are extremely grateful and lucky to have
National Reconciliation Week – Building on the Past
Graeme as part of our team.
Celebrated across Australia each year between 27 May and 3 June,
Garry Sattell was nominated for the Victorian Disability Sector
National Reconciliation Week commemorates two significant milestones in the reconciliation journey:
Awards, for his significant expansion of support activities for people
May 27 marks the anniversary of Australia’s most successful referendum. The 1967 referendum saw over 90% of Australians vote to give the Commonwealth the power to make laws for Aboriginal and Torres Strait Islander peoples and recognise them in the national census. On 3 June, 1992, the High Court of Australia delivered its landmark Mabo decision, which legally recognised that Aboriginal and Torres Strait Islander peoples have a special relationship to the land and paved the way for land rights called Native Title.
living with viral hepatitis. He has worked to encourage individuals and groups to participate more actively with their health and wellbeing, providing a range of opportunities for people to seek support and to support others in the community. Some of his achievements include implementing and coordinating the Hepatitis Infoline and the introduction of peer support and health coaching. Following the awards ceremony, Hepatitis Victoria held a special event ‘Cheers Volunteers’ to thank all our supporters who have given up their time to help continue our work. Throughout 2013 we will be celebrating our 21st year of operation by highlighting the work of our volunteers and supporters.
National Volunteer Week – Volunteer Awards
We would like to take this opportunity to thank and congratulate
National Volunteer Week took place between 13 and 19 May this
Graeme and Garry, along with the numerous others who make our
year, celebrating Australia’s six million volunteers. As part of the
work possible.
celebrations the Victorian Minister for Health presented awards to the committed and dedicated volunteers in Victoria's health and wellbeing sector.
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Hepatitis C treatment outcome studycall for participants Are you about to undertake hepatitis C treatment? The Bond University in Queensland is looking for individuals over 18 to complete their survey as part of The Hepatitis C Treatment Outcome Study. Participants are being sought from Australia and other countries.
Rose said that one of the worst parts about having the virus is the stigma and assumptions associated with it. “A lot of people know they have it but they don’t seek treatment because they’re scared of discrimination. It’s been referred to as the silent epidemic, people are unaware they’re risking chronic liver disease”. Rose has kindly offered to get involved if people from the Dandenong Ranges want to establish a support group. If you are interested you can email Rose at rose.coulter@hotmail.com.
The study is designed to determine the physical, psychological and social factors associated with hepatitis C treatment outcomes. The primary objective of this research is to increase the understanding of individual profiles that are associated with better hepatitis C treatment outcomes. 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 and the second survey can be completed in 5 –10 minutes. Information provided is completely confidential and you have the right to withdraw from the study at any time. For more information on the study or to participate visit: www.hepcstudy.hsstechnology.bond.edu.au
Source: Ranges Trader Mail, 2013
HIV Drug combo shows promise in hepatitis B. (An extract from MedPage, Michael Smith, North American Correspondent) An article on the MedPage website has reported that a recent study has revealed a drug combination widely used in HIV treatment could suppress hepatitis B (HBV) in patients whose immune systems tolerate the virus. According to Edward Gane, MD, of Auckland City Hospital, after four years, 76% of patients taking tenofovir and emtricitabine had suppressed the virus, with no resistance and a good safety profile. Patients in the ‘immune-tolerant’ stage of HBV have high viral loads
Financial pressures on hepatitis C patients relieved – as featured in Ranges Trader Mail, 2013
and no significant immune response. Current guidelines do not
Hepatitis C treatment, boceprevir, was officially subsidised under
Gane said it's still not clear whether those guidelines should be
Australia’s Pharmaceutical Benefits Scheme (PBS) on 1 April, 2013
altered despite his findings, and urged that long-term prospective
and people can now access their treatment at a cheaper cost.
studies be conducted to see if the suppression of viral load reduces
A person with long-term hepatitis C and Belgrave resident, Rose
recommend treatment, although previous studies have shown that tenofovir can suppress the virus.
complications such as cirrhosis and liver cancer.
Coulter, has come out in support for the new subsidies saying the
The researchers enrolled 126 HBV patients with HBV viral loads of
announcement will make a huge impact on patients. “I’m very
at least 1.7 x 107 IU per mL of blood and normal levels of alanine
relieved that the progress has been made,” Ms Coulter said.
aminotransferase.
“This is really great news.” Ms Coulter was diagnosed with hepatitis C in 1990 when she was 32 years old as part of a blood test and believes she contracted the virus through a blood transfusion as a child. “Sometimes people don’t know they’ve got it until they’re diagnosed with end stage liver cancer,” she said. “It’s a really serious virus and having easier, financially achievable treatments means more people can clear it.” Hepatitis C virus recently overtook HIV/ AIDS as Australia’s leading cause of viral death and though there is no vaccine available currently, hepatitis C is a curable illness. Rose encouraged anyone who was concerned to get tested for the virus and to plan for their treatment, especially with the cheaper treatments available. “With these treatments, they now take around half the time,” she said.
They were randomly assigned to daily tenofovir and a placebo or tenofovir and emtricitabine. The primary endpoint was the proportion of patients who reached a viral load of less than 69 IU per mL, and secondary endpoints included loss of the HBV e antigen (HBeAg) and the development of antibodies to the antigen (HBeAg seroconversion). A substantial number of people reached the primary endpoint - 35 of 64 in the tenofovir arm and 47 of 62 in the combination arm, and even among those with continuing viremia, there were no resistance mutations, Gane reported. More details about the study and findings are available from the MedPage website: www.medpage.com Source: By MedPage Today, April 27, 2013
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Aboriginal Program at Hepatitis Victoria Getting the viral hepatitis message out into the community
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he Aboriginal Program works with a wide range of Aboriginal and community organisations to disseminate viral hepatitis prevention and management messages. We work with Aboriginal communities throughout the State, as well as with Aboriginal prisoners and workers in the justice system. We also provide support and training to workers in the field. Over the past few months we have been busy working on a number of projects. Work is underway with Ilbijerri Theatre Company, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Department of Health and the Department of Justice on this year’s Body Armour theatre production. Body Armour has been specifically designed for high school audiences, to raise awareness of hepatitis C in the Aboriginal community and beyond. Another exciting project is the pilot education program for Aboriginal women prisoners. The program was held at the Dame Phyllis Frost Centre in partnership with Victorian
Hepatitis Victoria’s Board of Directors - Aboriginal representative Hepatitis Victoria is overseen by a Board of Directors. We are very fortunate to have members who have been co-opted to represent the interests of culturally diverse people and community organisations. This includes our Aboriginal peoples representative Ron Briggs. Ron Briggs currently works as the Koori Counsellor and Liaison Coordinator at Children's Protection Society, and is a Board member of VAHS (Victorian Aboriginal Health Service). Ron is a highly regarded men's health worker in the Aboriginal community and has spent many years promoting health education, and advocating for treatment services based in Aboriginal Community Health. He was also one of the first people at the Victorian Aboriginal Health Service to undergo treatment for hepatitis C.
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Aboriginal Health Service and Wulumperi (Melbourne Sexual Health Centre). The program delivered information sessions on viral hepatitis and treatment, blood borne viruses, sexually transmitted diseases, diabetes, reproductive health and general health and wellbeing. The program was held over seven weeks and we had around 10 to 15 Aboriginal women attending the sessions each week. The women were engaged and asked lots of questions in these sessions. Due to the interest from the women and success of the pilot program we will be holding another program later in the year. Our hepatitis B awareness program ‘Yarning about hep B’, funded by a small grant from Hepatitis Australia, is also underway. We have partnered with the VACCHO to run six forums on raising awareness of hepatitis B. Two of these forums will be held in metropolitan areas and four in the regions. The forums are for health workers and focus on the four issues around hepatitis B: B Active,
B Tested, B Vaccinated and B Well. There are an estimated 30,000 Aboriginal and/or Torres Strait Islander people living with chronic hepatitis B. In 2011 the highest rate of acquisition was in the 30 to 39 year age group and the most prevalent area for diagnosis of newly acquired hepatitis B was in regional areas. Work is continuing on a “Mind the Gap” program to deliver two workshops for young people in Loddon Mallee region. I have also recently taken part in the Share the Spirit Festival, assisting VACCHO with the ‘Goanna Survey’ and participating at an education stall at the ‘Sista’s Day Out’ event in Ringwood, with around 100 community members visiting the stall. I look forward to continuing our work over the coming months and developing further partnerships with other Aboriginal organisations and communities
Felicity Omar Aboriginal Educator
Ron draws on his personal experience in his work to advise and assist others to manage their condition, demonstrating effective peer support and chronic disease self management principles. Alongside VAHS, Ron was instrumental in the recent development of the DVD 'Yarning Ron Briggs, Nicky Newly-Guivarra about Hep C'. He is also the 2012 recipient and Peter Waples-Crowe of the Mark Farmer Award from Hepatitis Victoria recognising both his commitment, and Peter and Ron delivered a session based on active engagement within the community to the 'Yarning about Hep C' DVD. The session support people living with viral hepatitis. was very well received and the two were Public Health Association inundated with further interest and questions of Australia Conference afterwards. Peter also chaired a panel The National Social Inclusion and Complex session on Aboriginal and Torres Strait Needs Conference was held in Canberra on Islander services, covering partnerships April 15–16, 2013. and successful models for health and Hepatitis Victoria and the Victorian Aboriginal engagement. Community Controlled Health Organisation (VACCHO) were represented by Ron Briggs and Peter Waples-Crowe (a former Hepatitis Victoria board member).
The two day program was attended by a number of key organisations including Red Cross and St Vincent de Paul.
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A journey of discovery A personal story about living with hepatitis C
AJ is an Aboriginal man in his 40’s. He first discovered he had hepatitis C in his early 20’s as part of a routine health check. What happened next was a journey of discovery – about his body, society and hepatitis. “I got hepatitis when I was 15 from a tattoo.
“I found it hard to get information. There was
young to care about being healthy, it just
no counselling or support available - people
wasn’t a priority.”
just didn’t talk about it. You were segregated from the community and discriminated against as a druggie – even by friends and family”. AJ sought out a lot of information about hepatitis C on his own.
AJ has had a history of drug and alcohol use, but nowadays lives a healthy lifestyle, cooking for himself, moderating his alcohol intake and he has been drug free for ten years. “Don’t be scared to learn about yourself. Find
Back in those days tattoos were a popular
“Things are changing and there is a lot more
the right information and a good doctor who
thing to do and I went with a group of mates
information around, but there is still a lot of
can support you. Hepatitis is not a death
to a tattoo parlour. Hepatitis just wasn’t an
shame and many people don’t seek help or
sentence and you are no longer excluded
issue then.”
treatment because of it”.
from society”.
Later in his 20s AJ found out he had hepatitis C. “There was no information around and I got a lot of mixed messages. Some doctors told me it was like AIDS and I was going to die, others said there was no treatment and some knew nothing about it at all”.
AJ has a low viral load and is still
and a e ic d n u ja d e c I experien thought t s ju le p o e p lack of energy ddict I was a drug a
considering treatment for himself.
So does AJ regret his tattoo?
“I am waiting for the treatment options to
“No I don’t. It was the only one I ever got and
improve, there are a lot of side affects, but
I guess I learnt my lesson not to have any
the medications are getting better all the
more. It’s a part of my history.”
time.” “At the time I didn’t have any symptoms, later I experienced jaundice and a lack of energy people just thought I was a drug addict”.
Hepatitis Victoria would like to thank AJ for AJ is working on his diet and a healthy
sharing his story.
lifestyle to make sure he is in the best condition for treatment.
AJ went to various GPs and found one that offered him a message of hope and the information he needed to manage his condition.
$50 offer Good Liver offers readers the chance to tell their own story about living with viral hepatitis. We have $50 for each story that is published in Good Liver. If you have a story you would like to share please contact us. Stories can be confidential and your identity will be protected.
“In my youth I just wasn’t in a position to be healthy. I had no support, no money and at times was homeless. It’s hard when you are
You can email your story or we can interview you to help craft your piece. Submissions should be 600 words and be supplied as an MS Word document. Include your contact details. Contact Alicia Lowndes to share your story Email: alicia@hepvic.org.au Visit the personal stories page on our website to read about other people’s journey. www.hepvic.org.au/personal_stories
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A
boriginal and/or Torres Strait Islander peoples have a higher incidence of chronic liver disease and liver cancer caused by hepatitis B (hep B).
• In Australia 210,000 people are living with hep B.
• 16% of chronic hep B infections are in Aboriginal and/or Torres Strait Islander people.
• Up to 26% of Aboriginal and/or Torres Strait Islander people have been exposed to hep B.
Hepatitis treatment
Hep B: It’s everyone’s business
Hep B... It’s Everyone’s Business brochure and poster available from Hepatitis Victoria. *Hepatitis Victoria acknowledges the grant from Hepatitis Australia that enabled the production of the Hep B... it’s everyone’s business brochure and poster as part of the ‘Yarning about hep B’ Program.
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• Treatment does not cure hep B. • Treatment is given to prevent further liver damage.
• Most people will be treated with
tablets which are well tolerated, with few side effects.
• Treatment can last for many years, life-long for some.
• Treatment is provided by liver specialists.
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Protect yourself Using condoms every time you have sex is the best way to prevent hepatitis B (hep B) and other sexually transmissible infections. If you inject drugs, use a new fit for every hit and don’t share any of the equipment.
Maintain a healthy diet
• Limit your fat intake. • Limit salt intake. • Eat more fruits, veggies and whole grains.
Reduce your alcohol intake For healthy men and women, drinking no more than two standard drinks on any day reduces your risk of harm from alcohol-related disease or injury over a lifetime.
Quit smoking Smoking damages your health and can cause liver damage.
Exercise Activity is good for you and your liver – join in an activity that both you and your family enjoy.
B tested Testing for hep B requires a quick and easy blood test. You can be tested at your local health service. The tests can determine:
• If you have been vaccinated. • If you have acute (short term) or chronic (long term) hep B.
• Which stage of chronic (long term) hep B you might be in. Your doctor or Aboriginal Health Worker can help explain the results of your tests. This could be a good time to get the rest of your family tested and vaccinated.
B well To manage your hepatitis you can aim to:
• Keep to your medication schedule, as directed by your doctor.
• Reduce or stop alcohol use. • Manage stress through meditation, yoga, or massage.
• Use complementary therapies with the help of a qualified health professional.
• Maintain active family, social and cultural connections.
• Exercise and drink lots of water. Enjoying a healthy diet can help to:
• Give your body the nutrients
B vaccinated All babies are offered hep B vaccinations at birth (since 2000). Vaccination for hep A and hep B is recommended for all people with hep C. Hep B vaccination involves 3 injections:
needed to maintain liver health.
• Maintain a healthy body weight. • Relieve symptoms of hepatitis, such as nausea and tiredness.
• Reduce the risk of many other health problems, such as heart disease and some cancers. Source: News.com
B Active
Now, in 1 month, and 6 months after the first injection. All Aboriginal and Torres Strait Islander peoples are encouraged to get vaccinated. Especially: • People living with HIV or hepatitis C.
• People who inject drugs. • People who live in the same house as someone living with hep B.
Vaccinations are available at your local Aboriginal Health Service.
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In 2011 a study was under– taken to investigate how health service providers in the Torres Strait are responding to chronic hepatitis B. The study resulted in a report titled A Situational Analysis of Chronic Hepatitis B in the Torres Strait. This article provides an insight into some of the key findings and recommendations arising from the study.
T
he World Health Organisation estimate that around 2 billion people worldwide have been infected with hepatitis B, with 350 million people living with chronic infection and an estimated 600,000 people dying of hepatitis B related-liver disease each year. In Australia, it has been estimated that while 2.5% of the population identify as Aboriginal and Torres Strait Islanders these communities comprise 10% of the population in Australia infected with chronic hepatitis B. Data is available showing that the Torres Strait region has the highest per capita notifications of chronic hepatitis B in Queensland, with other research highlighting the disproportionate impact that chronic hepatitis B has on Indigenous people, particularly in remote communities. In this study, we interviewed sixty-one people providing health services to the Torres Strait including health workers, registered nurses, medical practitioners, and public health and clinical specialists to find out how health services responded to chronic hepatitis B. The Torres Strait Islands lie between Cape York on the Australian mainland and Papua New Guinea. There are 274 islands, of which 17 are inhabited with the northern islands of Boigu, Dauan and Saibai being located within five kilometres of the Papua New Guinea mainland. The dispossession and alienation from traditional lands experienced by mainland Aboriginal people did not occur to the same extent in the Torres Strait, and to a certain degree the Islanders have retained their language, customs and cultural practice.
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Responding to hepatitis B in the Torres Strait We nab them and let them go The health services in the Torres Strait are provided by Queensland Health with fifteen Primary Health Care Centres located on islands throughout the region and the Thursday Island Primary Health Care Centre providing administrative and management
one clinician as ‘fragmented’. This fragmentation included a lack of agreed and coordinated pathways for responding to the infection. This ranged from the point of screening through to when a person could access clinical treatment for the infection.
support for outer island services. Cairns Base Hospital, located 850 km away from Thursday Island is the main referral hospital and the nearest specialist centre for chronic viral hepatitis.
“Everyone knows there’s a lot of hepatitis B but no-one was doing anything much about it, mainly because no-one was sure what would be useful to do.” (Medical Practitioner)
Hepatitis B was acknowledged as a health priority primarily by people providing health An inadequate health service response to services across the Torres Strait, and for chronic hepatitis B in the Torres Strait was noted by several participants and described by people working on specific islands. Most
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An effective public health response to chronic hepatitis B in the Torres Strait needs to include:
• Health services, health workers and a
community that recognises hepatitis B as a health issue affecting people within their communities.
• Developing health service responses that look at hepatitis B as a chronic disease requiring lifelong monitoring, rather than a sexually transmitted infection.
• Resources providing information for people with chronic hepatitis B in culturally appropriate ways that help people with chronic hepatitis B understand the infection, and how they as individuals, and their families, can respond effectively.
• A clear and agreed clinical pathway
describing activity from screening and diagnosis through to the clinical management of the infection including regular monitoring of the infection and referral pathways.
Photo © Mark Roy participants noted that other chronic diseases such as diabetes, rheumatic heart disease, sexually transmitted infections, hypertension, tuberculosis and malaria were important.
People in the Torres Strait are screened and
“There are so much more other things that are affecting people’s lifespan... lifestyle issues, diabetes, premature ischemic heart disease; these are the things that are knocking people off.” (Medical Practitioner)
Manager noted that for people diagnosed with
There were a range of non-clinical health priorities that were also identified. These include: the reality and logistics of living on small islands; the impact of access to schoolbased education affecting knowledge of the body and health promotion principles; the lack of employment opportunities and inadequate income; housing; high rates of obesity in a location where fresh fruit and vegetables are costly; few options for exercise, and dental problems.
like fish.
diagnosed for hepatitis B through a health program called the Adult Health Check and the Sexual Health Check. One Health Service chronic hepatitis B, the lack of a clinical pathway to guide health care workers in their response to chronic hepatitis B meant that we nab them, and then we let them go, just
Some health care workers reflected on their lack of knowledge about hepatitis B with one Health Worker asking,” I didn’t know there
Essential to the development of an effective and sustainable response to chronic hepatitis B in the Torres Strait is the existence of a skilled workforce. There were significant gaps at all levels of the workforce in the Torres Strait in current understandings about chronic hepatitis B, particularly related to clinical management. This report recommends establishing a team consisting of a clinical nurse consultant and health worker located at the Thursday Island Primary Health Care Centre. The role of this project will be to develop an agreed model of care or clinical pathway, provide education to people with chronic hepatitis B, health service providers and the community, and link mainland specialist services with primary health care services on the Torres Strait.
was treatment. Can it help them?” Other elementary questions noted by participants
A full copy of the report is available from
included asking if there were differences
www.latrobe.edu.au
between hepatitis B and hepatitis C, and if
Jack Wallace
there were differences between the term
Research Fellow, Australian Research Centre in Sex, Health and Society
‘carrier’ and ‘chronic.’
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Hepatitis B in Aboriginal and Torres Strait Islander people
A
boriginal and Torres Strait Islander people experience a disproportionate health burden arising from chronic viral hepatitis when compared with nonIndigenous Australians. This is true for both hepatitis B and hepatitis C, but exists in an even more disproportionate manner for hepatitis B
A higher prevalence of chronic hepatitis B (CHB) among Aboriginal and Torres Strait Islander people has been noted for nearly 50 years (1). According to the 2011 Census, Aboriginal and Torres Strait Islander people represent 2.6% of the Australian population, but have been estimated to represent 10% of Australians living with CHB (2). In addition to a higher prevalence of CHB, Aboriginal and Torres Strait Islander people are also at higher risk of newly acquired (acute) hepatitis B – with approximately 3 to 5 times the incidence of infection of nonIndigenous Australians (3). This makes Indigenous Australians a priority population for vaccination against hepatitis B, a fact recognised in the most recent edition of the Australian Immunisation Handbook 2013 (4).
treatment for hepatitis B contributes to rapidly rising incidence of liver cancer – now the fastest increasing cause of cancer deaths in Australia (9, 10). Although available data is limited, treatment coverage is likely to be even lower among Aboriginal and Torres Strait Islander people, particularly those in remote areas, far from hospital-based specialist clinics where they can access treatment (11, 12). The need to increase access to diagnosis and treatment for hepatitis B is mandated in several recent national policy and strategy documents (7, 13, 14). A key requirement for this to occur is removing barriers to care, especially for those unable to access specialist services.
The burden of liver diseases, including hepatitis B and hepatitis C, in Aboriginal and Torres Strait Islander Australians is considerable, and has been estimated to be responsible for approximately 11% of the life expectancy gap between Indigenous and non-Indigenous Australians attributable to chronic disease (5). Aboriginal and Torres Strait Islander people are also more likely to develop liver cancer than non-Indigenous Australians (6).
To this end, mandatory liver biopsy prior to treatment of CHB was removed in 2011. In addition, the Commonwealth Government has funded the development of a national hepatitis B curriculum for general practitioners and nurses, including advanced training to enable GPs to prescribe antiviral therapy.
In addition to vaccination to prevent hepatitis B infection in those susceptible, Aboriginal and Torres Strait Islander people are a priority population identified in the National Hepatitis B Strategy for diagnosis and management of CHB infection (7). However in Australia it is estimated that nearly half of those living with CHB remain undiagnosed (2), and less than 3% of people living with CHB are currently receiving antiviral treatment (8).
Unfortunately regulatory change is lagging behind the delivery of this training – threatening disengagement of the doctors who have completed the education and other requirements and are ready to prescribe these medications. This delay will be measured in an increased burden on the hospital system, and more importantly, in lives lost due to inability to access appropriate care in the community.
This lack of appropriate diagnosis and
Aboriginal and Torres Strait Islander people
12
experience higher cancer incidence and mortality than do non-Indigenous Australians, including screen-detectable and potentially preventable cancers such as liver cancer due to hepatitis B (6, 15). By supporting the delivery of culturally appropriate information and care through Aboriginal Community Controlled Health Services, including community engagement and education for health care providers, we can improve outcomes for Indigenous people living with CHB.
Jennifer MacLachlan and Benjamin Cowie WHO Regional Reference Laboratory for Hepatitis B, Victorian Infectious Diseases Reference Laboratory
References 1. Blumberg BS, Alter HJ, Visnich S. A "New" Antigen In Leukemia Sera. Jama. 1965;191:541-6. 2. MacLachlan JH, Allard N, Towell V, Cowie BC. The burden of chronic hepatitis B virus infection in Australia, 2011. Aust NZ J Public Health. 2013:online. 3. Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander people: Surveillance and Evaluation Report 2012. Sydney: The Kirby Institute, The University of New South Wales, 2012. 4. The Australian Immunisation Handbook. 10th ed: ATAGI, NHMRC, Department of Health and Ageing, Australian Government; 2013.
June Good Liver:Good Liver 13/06/13 2:46 PM Page 13
Eye on Portland Dhauwurd-Wurrung Elderly and Community Health Services
5. Contribution of chronic disease to the gap in adult mortality between Aboriginal and Torres Strait Islander and other Australians. Canberra: Australian Institute of Health and Welfare, 2011. 6. Cunningham J, Rumbold AR, Zhang X, Condon JR. Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia. Lancet Oncol. 2008;9:585-95. 7. National Hepatitis B Strategy 2010 - 2013. Canberra: Australian Government Department of Health and Ageing, 2010 22 April. Report No. 8. Carville KS, Cowie BC. Recognising the role of infection: preventing liver cancer in special populations. Cancer Forum. 2012;36(1): 21-4. 9. Cancer survival and prevalence in Australia: period estimates from 1982 to 2010. Canberra: Australian Institute of Health and Welfare, 2012.
D
hauwurd-Wurrung Elderly and
expected side effects. Patients are continually
Community Health Service (DWECH)
monitored and supported in partnership with
is situated in the South West of Victoria on
both the hepatology nurse and their GP.
Gunditjmara Country. They provide a fulltime medical clinic for Aboriginal and Torres Strait Islander people residing within the Glenelg Shire boundaries.
About the clinic DWECH is committed to providing a holistic approach to primary health. They ensure access to a range of culturally appropriate and effective services aimed at improving the physical, spiritual, psychological, social and emotional health and wellbeing of Aboriginal and Torres Strait Islanders. DWECH provides transport assistance to the clinic and employs Aboriginal people and culturally aware non-Aboriginal people to
In addition, DWECH is very fortunate to have Dr. Carina Joubert on site. Dr Joubert is currently the only doctor in Portland able to prescribe medications available for treating hepatitis C.
Other hepatitis related services The Care Co-ordination and Supplementary Services Program aims to improve the health outcomes for Aboriginal and Torres Strait Islander people with chronic health conditions through better access to coordinated and multidisciplinary care. Aboriginal Health Workers co-ordinate and support Indigenous patients, liasing with with
10.MacLachlan JH, Cowie BC. Liver cancer is the fastest increasing cause of cancer death in Australians. Med J Aust. 2012; 197(9): 492-3. Epub 2012/11/06.
deliver sensitive and inclusive care that
11.Preston-Thomas A, Fagan P, Nakata Y, Anderson E. Chronic hepatitis B - Care delivery and patient knowledge in the Torres Strait region of Australia. Aust Fam Physician. 2013;42(4):225-31. Epub 2013/04/04.
conducting annual health checks, GP
12.Wallace J, McNally S, Richmond J. National Hepatitis B Needs Assessment. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University, 2008.
DWECH also facilitates blood borne virus
members that work with people affected by
education sessions for staff and for the wider
viral hepatitis or at risk of hepatitis. They also
community.
provide updates on hepatitis C and hepatitis B
13. Third National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy 2010– 2013. Canberra: Australian Government Department of Health and Ageing, 2010. 14. National Hepatitis B Testing Policy. Commonwealth of Australia, 2012. 15.Garvey G, Cunningham J, Valery PC, Condon J, Roder D, Bailie R, et al. Reducing the burden of cancer for Aboriginal and Torres Strait Islander Australians: time for a coordinated, collaborative, priority-driven, Indigenous-led research program. Med J Aust. 2011;194(10):530-1. Epub 2011/06/08.
encourages empowerment and cultural pride. DWECH staff monitor Indigenous health by management plans and team care arrangements. Together they provide a customised health plan for each individual client to help address their health needs.
Introducing the new Outreach Hepatology Nurse
other health providers in the community to ensure patients receive appropriate care and any follow ups. The Sexual Health Team from the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) regularly visits DWECH with the aim of providing free education and training to staff and community
in relation to both workplace and client issues. DWECH has many visiting specialist
DWECH recently welcomed a new outreach
services including a podiatrist, diabetes
hepatology nurse, Margaret Wardrop.
educator, dietician, counselling, psychology services, youth support services and a liver
Ms Wardrop is available on a monthly basis to
clinic nurse who visits on a monthly basis.
consult patients with viral hepatitis in Portland, saving them the time and expense they would
DWECH works collaboratively with Quamby
otherwise incur travelling to Geelong or
House to provide support and services to
Melbourne.
clients who have concerns around alcohol and other drugs and any associated health
Patients are counselled and educated in
conditions.
regards to health management of their appropriate, and supported in their decision
Dhauwurd-Wurrung Elderly and Community Health Services
making.
18 Wellington Road, Portland Vic 3305.
hepatitis. They are given treatment options as
Phone: (03) 5521 7547 Patients are taught how to administer their medication and how best to manage any
13
June Good Liver:Good Liver 13/06/13 2:47 PM Page 14
World Hepatitis Day
www.hepvic.org.au/whd2013
Events and Street Shot exhibition 2013
World Hepatitis Day events
Street Shot 2013 Exhibition Opening
2010 when the World Health Assembly
Melbourne event: Friday 26 July
passed ‘Resolution WHA63.18’ on viral
Following the awards ceremony for Street
Visit the Exhibit ion: 26
hepatitis. This provided official endorsement and international awareness raising efforts.
Shot on Friday 26 July , a Love Your Liver lunch will be held at No Vacancy Gallery in central Melbourne.
WHD across the world seeks to increase
After lunch, the focus will be on reducing
the awareness and understanding of viral
the stigma and discrimination of people
hepatitis and the diseases that it causes. It
affected by viral hepatitis and a number of
provides an opportunity to focus on specific
positive speakers will share their lived
actions such as:
experience. There will be music and of
•
strengthening prevention, screening and
course Oliver, our Love Your Liver mascot,
control of viral hepatitis and its related
will be there.
W
orld Hepatitis Day (WHD) was launched by the World Hepatitis
Alliance in 2008. This was reinforced in May
of WHD as the primary focus for national
diseases;
•
For further details visit our Facebook
increasing hepatitis B vaccine coverage
(www.facebook.com/hepvic) or the website
and integration into national
(www.hepvic.org.au/whd2013)
immunisation programmes; and
•
coordinating a global response to hepatitis
Bendigo event: Thursday 1 August In partnership with the Victorian Hepatitis B Alliance, General Practice Victoria (GPV),
Locally, Hepatitis Victoria will concentrate its WHD efforts on the first of these actions. In doing so we have identified two aims:
• •
Community Health Service, Hepatitis Victoria will be holding a Love Your
To reduce stigma and discrimination
Liver event at Bendigo TAFE. The
associated with viral hepatitis across
event will target both health
Victoria.
professionals and the wider
Street Shot photography competition Two major WHD events, one in Melbourne and one in Bendigo.
•
Contact Hepatitis Victoria for more information: 9380 4644 or 1800 703 003. We are also working closely with
awarded to organisations so they can
Hepatitis Australia and the
hold their own WHD event.
National WHD campaign.
Engaging with media and policy makers
Plans are well underway, so keep an eye on our Facebook and website for
Involving the affected community across
details on how you can
all events and featuring positive
get involved.
speakers.
14
community and will include a Love Your Liver lunch.
Community grants of $500 each,
to raise the profile of viral hepatitis.
•
(CAN), Bendigo Health and Bendigo
across Victoria
contribute to these aims. These are:
•
(ASHM), Country Awareness Network
To increase awareness of viral hepatitis
A range of activities are planned to
• •
Australasian Society for HIV Medicine
July to 4A
ugust 2 No Vac 013 ancy G allery, Q 34 – 40 Jane B ell Lan V Building, e, Melb ourne. Awards C e remony Love Y and our Live r lunch: F riday 2 6 July 2013
Street Shot, Hepatitis Victoria’s annual health promotion photography project, is back for its fourth successive year.
About the exhibition and awards ceremony: The Street Shot exhibition officially opens on the evening of 25 July at No Vacancy Gallery in Melbourne’s QV.
June Good Liver:Good Liver 13/06/13 2:47 PM Page 15
hepatitis from Hepatitis Victoria educators and are then supported by youth services and schools to take photos to reflect what they’ve learnt. The project has been the catalyst for some impressive and striking pieces of art and we’re looking forward to seeing what the talented groups of young people we’re working with come up with this year. The winning entries from the exhibition will be announced at the awards ceremony on Friday 26 July 2013, as part of our World Hepatitis Day events. The judging panel will award prizes for both individual and team entries for the most outstanding work.
celebrations and a variety of activities will be held at the gallery on Friday 26 July. This year there is a very strong focus on community education through the telling of personal stories. Many of our volunteers will share their experiences in a bid to raise community awareness about viral hepatitis and to reduce stigma and discrimination.
Hepatitis Victoria educators have been delivering information sessions to young people, which has seen them travelling across the State, from Warnambool to Wodonga, often accompanied by our
The quality of works to date has been impressive and it is well worth the trip in to see the exhibition. The exhibition will run from 23 July to 4 August 2013.
extremely dedicated and enthusiastic
About Street Shot: Street Shot uses photography to raise
people about viral hepatitis transmission
awareness about viral hepatitis transmission amongst young people. It’s based on many other successful initiatives that use community arts to promote awareness and healthy behaviours. Young people receive health education about viral
involved have been very engaged in the
volunteer Tania and our Youth Peer Educator Chloe. So far we’ve spoken to over 100 young and prevention. The young people
Call fo r Sp
onsors We are in the p ro cess of sponso seeking rship fo r o ur Stree assist w t Shot e ith prize vent to s. We offe r a num ber of b sponso enefits rs, inclu to our d ing free Good L advertis iver ma ing in o gazine ur and on If you w our web ould lik s it e . e to pla support y your p ing you a rt in n g peop isabella le plea @hepv se conta ic.org.a ct u
sessions and are keen to take some shots and attend the exhibition. The Street Shot exhibition forms part of Hepatitis Victoria’s World Hepatitis Day
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June Good Liver:Good Liver 13/06/13 2:47 PM Page 16
On the road with the Three Wise Travelling Monkeys Pic 1
A
s part of the World Hepatitis Day campaign, Hepatitis Victoria is taking
part in the global ‘Three Wise Travelling Monkeys’. The international theme for World Hepatitis no evil’, as represented by the three wise monkeys, an old proverb that is commonly used to highlight how people often deal with problems by refusing to acknowledge them. The monkeys have been chosen for the campaign to highlight that around the world
Pic 1: Had coffee at Sonidos on Gertrude Street, Fitzroy with the Victorian Viral Hepatitis Educator.
hepatitis is still being largely ignored. We are
Pic 2: Watched the swans go by while
calling for people to uncover their senses
relaxing at Lake Wendourree after
and confront the realities of hepatitis.
a hep C session with 35 students.
We have been taking our monkeys across
Spoke to GPs about our new Hep C
Victoria and will continue to do so up until
GP toolkit.
World Hepatitis Day, uploading our photos onto the World Hepatitis Alliance monkey gallery: www.worldhepatitisalliance.org
Pic 2
Check out where the three wise monkeys have been so far...
Day 2013 is ‘see no evil, speak no evil, hear
Pic 3: Checked out an old Gold mine
Pic 3
at Red Hill in Castlemaine and explored gold mining equipment from the Gold rush in outback Victoria. Pic 4 and 5: Monkeys travelled to
n Swa
Hill
Adelaide, first attending the two day Hepatitis Australia board
Pic 4
meeting and national resources network and then taking some time out in Port Pirie to visit one of the biggest white pointer sharks caught
To A del aid and e Po rt Pi rie
in SA waters.
Castle ma in
Pic 5
e
go
Ben di
Gr
am p
ia n s
Ballarat B allarat
Lake L ake ak e Wendourree W endo ur ree
Southern
L
G ertr u d e S t
16
W il so n
s
Pro m
es k a
Alp
s
ce tran n E
June Good Liver:Good Liver 13/06/13 2:47 PM Page 17
Moving in Two new staff members
Hepatitis B Positive Speakers Project Call for participants
H
epatitis Australia has been funded by Bristol Myers Squibb to develop a
small group of hepatitis B positive speakers for education and advocacy purposes and to develop online/DVD media to extend the reach of the project. In the first instance the project involves recruiting people with chronic hepatitis B from across Australia, and providing them with tailored training and support to assist their development as hepatitis B positive speakers. It is anticipated the speakers will be available (as their schedules and lives
Alicia Lowndes
Kristy Garner
In April, Alicia joined us as our Marketing, Communications and Online Services Coordinator. Alicia is experienced using innovative online tools to engage the community, providing a range of digital technologies for people to interact with and share ideas. She is also experienced in traditional communications, coordinating all facets of communications and media activities.
We also welcome Kristy Garner who will be
Alicia has spent time overseas as a volunteer for TVE London, a not-for-profit film company that works with BBC World and Oxfam to produce films on environmental and human issues.
projects. She has a strong interest in social
We extend a warm welcome to Alicia who brings with her a unique skill set that is sure to strengthen our capabilities as we implement the new Strategic Plan.
also working towards the establishment of
permit) to participate in national advocacy and educational events. The State and Territory Hepatitis Organisations will also support the speakers at the local level and the speakers may wish to participate in local activities as they arise. A component of this project involves Hepatitis Australia producing an online media product (i.e. podcast), which tells the story of the speakers and delivers key
working part time on Street Shot, part of the Young People's Program and as our Development Coordinator. Kristy is a social and market researcher with five years direct experience in the field. Kristy’s other professional commitments when she is not at Hepatitis Victoria include contracting to Qdos Research and working on a range of qualitative and quantitative social research marketing and the application of marketing techniques to progress social issues. Also of note is Kristy's experience and keen interest in photography for which she is a small photography business. She brings this enthusiasm to her Street Shot work.
messages to the whole community about aspects of living with chronic hepatitis B. The podcast would be widely available for use in educational forums through Hepatitis Australia. Jacqui Richmond has been employed to
WE WOULD LOVE TO PUBLISH YOUR LETTERS
SEND QUESTIONS
Email your letter or questions to the Editor: alicia@hepvic.org.au.
We invite you to email questions to info@hepvic.org.au or post to Suite 5, 200 Sydney Road, Brunswick, 3056.
manage this 12 month project. If you are interested in participating in this project, please do not hesitate to contact Jacqui for further information. Jacqui can be contacted on projects@hepatitisaustralia.com
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June Good Liver:Good Liver 13/06/13 2:47 PM Page 18
Young blood Hepatitis C Peer education program Wyndham Community Education Centre.
Young people have limited opportunities to learn about hepatitis C at school because of its association with drug use, yet hepatitis C infections among young people continue to increase. More than one in 100 Australians have hepatitis C and most new infections are in people aged between 15 and 29. For any education about prevention to work, it must start in schools.
T
he Hepatitis C Peer Education Program seeks to start a dialogue with young
people about hepatitis, through exploring the popular topic of body art. Discussing body art (tattooing and piercing) provides an opportunity to engage with young people about transmission risks involved in skin penetration, without emphasising illicit drug use. This project aims to equip young people with the skills and knowledge to make healthy and informed choices. In 2013 Hepatitis Victoria partnered with a
I’m passionate about prevention and I think it’s important that this goes into VCAL programs
number of Victorian Certificate of Applied Learning (VCAL) programs to deliver a Personal Development Skills Unit on
Chloe, a Youth Peer Educator who provides
saying, “I am very proud of the achievements
hepatitis C. During term one, six educational
invaluable assistance to the program said,
of the VCAL students. They did an amazing
workshops were run with students at
“I’m passionate about prevention and I think
job of translating their learning into art.”
Wyndham Community Education Centre to
it’s important that this goes into VCAL
increase student’s knowledge on safer body
programs. I believe these types of issues
art behaviours and safer injecting drug use.
are everywhere, yet with greater awareness
Guest speakers included a youth peer
we can create pathways towards wellbeing”
educator who has family members living
John, a Hepatitis Victoria support group
with hepatitis C, the local Youth Alcohol and
member, spoke with the VCAL students
Other Drugs worker, and someone who is
about his personal experience of living with
living with hepatitis C today.
hepatitis C including unsuccessful treatment.
After each session, students incorporated
“I think it’s important to engage with high
their learnings into different forms of artwork
risk groups such as this one at Werribee in
which went on display at the Youth Resource Centre in Werribee. Local schools were
Young People’s Program Coordinator
A mask created by a student was on display
a frank yet responsible manner about my story of living with hepatitis C”, he said.
invited to check out the exhibition to learn
The teacher at Wyndham Community
about hepatitis C from their peers.
Education Centre reflected on the project
18
Isabella Natale
*Hepatitis Victoria acknowledges the funding received from the Victorian Government for the Hep C Peer Education Program
June Good Liver:Good Liver 13/06/13 2:47 PM Page 19
Hep Connect
Mark Farmer Memorial Awards Nominations now open
What is Hep Connect Hep Connect provides an opportunity for people with hepatitis C to mutually discuss their experience with a trained peer volunteer over the telephone. All peer volunteers have experience of living with hepatitis C and have undertaken hepatitis C treatment or are living with cirrhosis. Hep Connect is a FREE and CONFIDENTIAL service and can be accessed by calling the Hepatitis Infoline 1800 703 003 (free call)
Hepatitis Victoria recognises, celebrates, supports and appreciates the commitment, effort and achievements of individuals living with hepatitis C through the Mark Farmer Memorial Award. This Award provides Hepatitis Victoria with an opportunity to publicly acknowledge and celebrate individuals with hepatitis C who have:
•
Shared their knowledge and experience to help others in the community
•
Increased community knowledge and understanding of hepatitis C
•
Demonstrated positive use of self management principles in their daily life.
Hep Connect aims to:
• •
Assist people living with hepatitis C
•
Enhance peoples capacity to cope with treatment
•
Assist people to manage living with cirrhosis
•
Reduce isolation and increase overall hepatitis C support.
Assist people’s decision making process around treatment
Nominations now open Nominations are now open for the 2013 Mark Farmer Memorial Award and you can submit a nomination form on our website www.hepvic.org.au/markfarmeraward The award winner will be invited to the Hepatitis Victoria Annual General Meeting to receive a certificate and small gift. They will have the opportunity to be featured in an article in Good Liver magazine and, if they wish, a media release to their local paper. (Note: media participation is not a condition of the award) This award is in memory of Mark Farmer, a former board member who sadly passed away in 2009.
Hepatitis Victoria membership Make a difference. Become a member of Hepatitis Victoria. Having remained unchanged for several years, the Hepatitis Victoria membership fee for organisations is set to rise on 1 July 2013 from $77 to $150.
Be quick to take advantage of our promotional offer.
PROMOTIONAL OFFER! JOIN BEFORE THE PRICE RISE IN JULY, (currently $77 for organisations)
WITH NO RENEWAL UNTIL JULY 2014!
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June Good Liver:Good Liver 13/06/13 2:47 PM Page 20
Liver clinics
Liver clinics and liver specialists To access public hepatitis C treatment services a referral from a GP is needed. In most cases a referral is faxed to the hepatitis treatment service. The hepatitis treatment services will generally not discuss your treatment options with you until after they have received a referral from your GP. This list of hepatitis treatment services includes clinics that are known to Hepatitis Victoria. Not all possible services are listed and there may be others in your local area.
ALBURY Albury Community Health – Hepatitis Clinic Suite 3, Albury Wodonga Specialist Centre 2 Ramsey Place, West Albury. Contact: (02) 6058 1800 Fax: (02) 6058 1801
BAIRNSDALE Bairnsdale Regional Hospital Bairnsdale Regional Health Service Specialist Consulting Rooms. Princes Hwy, Bairnsdale. Contact: (03)5150 3478 Fax: (03) 5150 3404
BALLARAT Ballarat Base Hospital Drummond Street, Ballarat Contact: (03) 5320 4211 Fax: (03) 5320 4472
BALLARAT Ballarat Community Health 210 Stuart Street, Ballarat Contact: (03) 5338 4500 or (03) 5320 7500 Fax:(03) 5339 3044
BENDIGO Bendigo Health Cnr Arnold and Lucas Streets, Bendigo Contact: (03) 5454 8422 Fax: (03) 5454 8419
BOX HILL Box Hill Hospital 16 Arnold Street, Box Hill Contact: (03) 9895 3333 (ask for OPD) Fax: (03) 9895 4852
20
CLAYTON
MAROONDAH
Southern Health Monash Medical Centre 246 Clayton Road, Clayton Contact: (03) 9594 6035 Fax: (03) 9594 6925
Maroondah Hospital (Eastern Health) Out-Patients, Ground Floor, Davey Drive, Ringwood East Contact: (03) 9895 3333 Fax: (03) 9871 3202
CRANBOURNE Southern Health Monash Medical Centre Contact: (03) 95943177 Fax: (03) 9594 6245
EAST RINGWOOD Maroondah Hospital Davey Drive, East Ringwood Contact: (03) 9095 2434 Fax: (03) 9899 9137
EPPING Northern Hospital 185 Cooper Street, Contact: (03) 8405 8000 Fax: (03) 8405 8761
FITZROY St Vincents Hospital 35 Victoria Parade, Fitzroy Contact; (03) 9288 3771 Fax: (03) 9288 3489
FOOTSCRAY Western Hospital Eleanor Street, Footscray Contact: (03) 8345 6291
MOORABBIN Bayside Liver Clinic (Alfred Hospital) 999 Nepean Highway, Moorabbin Contact: (03) 9276 2223 Fax: (03) 9276 2194
MILDURA Mildara 234 Thirteenth Street, Mildura Contact: 0408 581 781
PARKVILLE Royal Melbourne Hospital Corner Royal Parade and Grattan Streets, Parkville Contact: (03) 9342 7212 Fax: (03) 9342 7277
PRAHRAN Alfred Hospital Gastroenterology Department 55 Commercial Road, Prahran Contact: (03) 9076 2223 Fax: (03) 9276 2194
Peninsula Liver Clinic 141 Cranbourne Road, Frankston Contact: (03) 9770 0139
Alfred Hospital Infectious Diseases Unit 55 Commercial Road, Prahran Contact: (03) 9076 6081 Fax: (03) 9076 6578
GEELONG
SHEPPARTON
Geelong Hospital Ryrie Steet, Geelong Contact: (03) 5246 5117 Fax: (03) 5221 3429
Goulburn Valley Health 50 Graham Street, Shepparton Telephone: (03) 5832 3600
SPRINGVALE
GIPPSLAND
Springvale Community Health 55 Buckingham Street, Springvale Contact: (03) 9594 3088
FRANKSTON
Central Gippsland Health Service Guthridge Parade, Sale. Contact: (03) 5143 8600 Email: enquires@cghs.com.au
HEIDELBERG Austin Hospital 145 Studley Road, Heidelberg Contact: (03) 9496 2787 Fax: (03) 9496 7232
TRARALGON Latrobe Regional Hospital Private Consulting Suites 3 and 4 Princes Highway, Traralgon West. Contact: (03) 5173 8111
June Good Liver:Good Liver 13/06/13 2:47 PM Page 21
Contacts
WARRNAMBOOL
North Richmond Community Health
Western Region Alcohol and Drug Centre (limited hepatitis treatment services) 172 Merri Street, Warrnambool Contact: 1300 009 723
Dr John Furler
WODONGA Murray Valley (Private) Hospital (Dr Tim Shanahan – Gastroenterologist) Nordsvan Drive, Wodonga. Vic. Contact: (02) 6056 3366
WODONGA Wodonga Regional Hospital Vermont Street. Wodonga Contact: (02) 6051 7413
Community-based hepatitis C treatment services Community based treatment clinics have been developed to enable more people to access treatment in their local communities.
Barkley Street Medical Centre Dr Elizabeth Leder Monthly visiting Gastroenterologist and hep C Nurse 60 Barkley Street, St. Kilda Contact: (03) 9534 0531
Cranbourne Integrated Care Centre Hepatitis C outreach treatment clinic as part of Southern Health Services 140–154 Sladen Street, Cranbourne Contact: (03) 5990 6789
Greater Dandenong Community Health Service Hepatitis C outreach treatment clinic 229 Thomas Street, Dandenong Contact: (03) 8792 2200
Health Works 4 –12 Buckley Street, Footscray Contact: (03) 9362 8100
Living Room 7 – 9 Hosier Lane, Melbourne Contact: (03) 9945 2100
23 Lennox Street, Richmond
Harm Reduction Victoria (HRV) 128 Peel Street, North Melbourne Contact: (03) 9329 1500 Email: admin@hrvic.org.au
Contact: (03) 9418 9800
Health Works
North Yarra Community Health
Primary healthcare and needle syringe program Hepatitis C information, support and treatment 4-12 Buckley Street, Footscray Contact: (03) 9362 8100 www.wrhc.com.au/Services_HEALTH.html
Weekly visiting Hep C Nurse
Dr Ohnmar John Weekly visiting Hep C Nurse 75 Brunswick St, Fitzroy Contact: (03) 9411 3555 or (03) 9288 2259
Nunawading Clinic 176 Springvale Road, Nunawading Twice per month Dr. David Ross GP s100 prescriber for HCV and Opiate Replacememnt Program Contact: (03) 9871 3333
St. Kyrollos Family Clinic Dr Ashraf Saddik Monthly visiting Hep C Nurse
Inner Space Primary healthcare and needle syringe program Hepatitis C information, support and treatment. 4 Johnson Street, Collingwood Contact: (03) 9468 2800 www.nych.org.au/services/drug.html
2A Moore Street, Coburg
Living Room
Contact: (03) 9386 0900
Primary healthcare and needle syringe program Hepatitis C information, support and treatment services 7–9 Hosier Lane (off Flinders Lane), Melbourne Contact: (03) 9662 4488 www.youthprojects.org.au
Werribee Mercy Hospital Consulting Suites 300 Princess Hwy, Werribee Contact: 9386 2259 Fax: (03) 9216 8633
Primary health care centres (for people who use drugs) Primary Needle Syringe Programs
Access Health Primary healthcare and needle syringe program for marginalised/street based injecting drug users, street sex workers and people experiencing homelessness. Hepatitis C information, support and treatment 31 Grey Street, St. Kilda Contact: (03) 9536 7780
South East Alcohol and Drug Service (Forster Street) Primary healthcare and needle syringe program Level 2, 229 Thomas Street, Dandenong Contact: (03) 9794 7895
Turning Point 54–62 Gertrude Street, Fitzroy Contact: (03) 8413 8413 Email: info@turningpoint.org.au Web: www.turningpoint.org.au
ANEX (Association for Needle Exchanges) 95 Drummond Street, Carlton Contact: (03) 9650 0699 Email: info@anex.org.au
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Indigenous Health
Multilingual Hepatitis C Resources
Ngwala Willumbong Co-op Limited
This website has over 400 pages of hepatitis C and HIV information in 18 languages. www.multiculturalhivhepc.net.au
93 Wellington Street, St Kilda
Indigenous drug and alcohol service Telephone: (03) 9510 3233 Email: reception@ngwala.org VACCHO (Victorian Aboriginal Community Controlled Health Organisation) 17 – 23 Sackville Street, Collingwood. Telephone: (03) 9411 9411 Email: wendyb@vaccho.com.au Web: www.vaccho.org.au Victorian Aboriginal Health Service 186 Nicholson Street, Fitzroy Telephone: (03) 9419 3000
Sexual Health Melbourne Sexual Health Centre 580 Swanston Street, City Telephone: (03) 9341 6200 Free call: 1800 032 017 Multicultural Health and Support Service, HIV, hepatitis C and sexually transmissible infections 23 Lennox Street, Richmond. Telephone: (03) 9418 9929 Go to: www.ceh.org.au/mhss.aspx
Related Health Services Haemophilia Foundation Victoria, 13 Keith Street, Hampton East Telephone: (03) 9555 7595 Email: info@hfv.org.au Hepatitis Australia Web forum for professionals in the hepatitis C sector.www.hepatitisaustralia.com/ forum/publicaccess/ HIV/Hepatitis/STI Education and Resource Centre at the Alfred Moubray Street, Prahran Statewide resource centre on HIV/AIDS, Hepatitis and Sexually Transmissible Infections Telephone: (03) 9076 6993 Web: www.alfredhealth.org.au
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Health Services Commissioner 30th Floor, 570 Bourke Street, City Freecall: 1800 136 066 Email: hsc@health.vic.gov.au Victorian Equal Opportunity and Human Rights Commission Information on state and federal equal opportunity laws and programs Level 3, 204 Lygon Street, Calrton Telephone 1300 891 848 Email: information@veohrc.vic.gov.au Web: www.humanrightscommission .vic.gov.au Victorian Viral Hepatitis Educator Training for Doctors, Nurses and other health professionals Telephone 9288 3586 Mobile 0407 865 140
Regional services These contacts are able to provide information about local viral hepatitis related services as well as active support groups. Ballarat Community Health Contact: Marg Stangl Telephone: (03) 5338 4500 Barwon - Surf Coast Health Service Telephone: 03) 4215 7850 Barwon Health Drug and Alcohol Services Telephone: (03) 4215 8700 Bendigo Health Care Group Contact: Catina Eyres Telephone: (03) 5454 6000
CAN (Country Awareness Network), Bendigo Information, education, support, referrals and advocacy to Victorian rural/regional communities regarding HIV/AIDS, Hepatitis C, other Blood Borne Viruses and Sexually Transmitted Infections Telephone: (03) 5443 8355 Email: can@can.org.au Web: www.can.org.au Jigsaw Youth Health Service (Barwon Health Geelong) Contact: Rochelle Hamilton Telephone: 1300 094 187 Latrobe - Mobile Drug Safety Worker Helen Warner Mobile: 0438 128 919 Mildura - Sunraysia Community Health Contact: Anne Watts Telephone: (03) 5022 5444 Email: schs@schs.com.au Moe Community Health Centre Telephone: 1800 242 696 Portland - Glenelg Southern Grampians Drug Treatment Service Contact: Bev McIlroy Telephone: (03) 5521 0350 Shepparton Community Health Telephone: (03) 5823 3200 Wangaratta - Ovens and King Community Health Centre Contact: Diane Hourigan Telephone: (03) 5723 2000 Warrnambool - Western Region Alcohol and Drug Centre (WRAD)
Dr Brough is offering limited specialist services from the WRAD centre on the 2nd Thursday of each month. Telephone: 1300 009 723
Camperdown Hepatitis C Support worker Contact: Jo Sloetjes Telephone: (03) 5593 3415 Email: camperdown.resource@svdp-vic.org.au Wimmera (East) Region (Birchip, Wycheproof, St Arnaud) Phil Blackwood (Naturopath/Psychologist) Mobile telephone: 0403 625 526
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Wodonga Community Health Contact: Jenny Horan/Anita Telephone: (02) 6022 8888 Yarra Valley Community Health Service Healesville Shop 2, 297 Maroondah Highway, Healesville. Once per month clinic GP referral – can be faxed to Dept of Hepatology, Eastern Health Telephone: 1300 130 381 Yarrawonga Community Health Contact: Cherie McQualter Whyte Telephone: (03) 5743 8111
HEPATITISVICTORIA
SUPPORT GROUP
Meets on the third Sunday of each month between 2.00 – 4.00pm The Hepatitis Support Group meets at the office of Hepatitis Victoria, Suite 5, 200 Sydney Road, Brunswick. The meetings are a great place to meet other people who are also living with hepatitis. The group is friendly and welcoming and comprises people from various backgrounds who come together once a month to talk about their experiences of living with hepatitis. One aspect of the group is support while another is socialising regularly with people who are going through the same sorts of challenges as you. It’s a great way to deal with those feelings of isolation and aloneness. You can call Garry on the Hepatitis Infoline 1800 703 003 if you want to either attend a meeting or would like to learn more about how the support group works.
Garry Sattell Community Participation Coordinator (Support Group Facilitator)
Upcoming Support Group dates in 2013
July 21 August 18 September 15 October 20 November 17 December 15
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Hepatitis Infoline Call to talk to an Educator about hepatitis. Information: We can answer questions and mail information to you. Support: We can provide support for a range of issues and concerns. Referral: We can refer you to other organisations and services.
The Hepatitis Infoline is a free and confidential service for all Victorians. Hours Monday to Friday 9.00am – 5.00pm
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