Book now for rural and remote nursing and midwifery courses in 2022.
Head to our face to face courses or online courses page to see what's available and secure your spot.

Helping people become 'health seekers'

2 Dec 2021

Lesley Salem became Australia’s first Indigenous Nurse Practitioner 19 years ago. Now, she works in Doomadgee in Far North Western Queensland where the 2017-founded primary health care service is encouraging people to become active ‘health seekers’. But self-determination doesn’t happen overnight and Salem views her life’s work as just the beginning.

I always want­ed to help a com­mu­ni­ty that was in need,” says Les­ley. The health sta­tis­tics here [in Doomadgee], where life expectan­cy is 49, are some of the worst in the world. Rheumat­ic heart dis­ease is rife, a con­di­tion that’s rare in most high-income coun­tries, yet in Aus­tralia it per­sists in Abo­rig­i­nal and Tor­res Strait Islander peo­ples. It is pre­ventable. Hun­dreds in this com­mu­ni­ty have dia­betes and malnutrition.”

Les­ley has been work­ing for four years with Gidgee Heal­ing after being sought out by the Abo­rig­i­nal health­care provider when it opened Doomadgee’s first ever pri­ma­ry health care ser­vice in 2017.

Until then, the com­mu­ni­ty of around 1400 had one tiny hos­pi­tal with a cou­ple of rooms for emer­gen­cies where you only went if you were sick,” says Les­ley. Today, Les­ley sees her role as help­ing locals embrace pre­ven­tion and become health seek­ers.’ And she says it’s work­ing.

Engage­ment with peo­ple in the com­mu­ni­ty is won­der­ful,” says Les­ley. We are suc­ceed­ing in encour­ag­ing peo­ple to enrol with us.

We can then iden­ti­fy their chron­ic dis­eases – we find adults have at least three – and put man­age­ment plans in place. We encour­age reg­u­lar health checks – not wait for some­thing to go wrong.”

Rheumat­ic heart dis­ease, caused by repeat­ed infec­tions such as impeti­go, skin sores and scratchy throats, should not be here, says Les­ley. She has seen patients as young as sev­en with the disease.

It used to be that peo­ple were so infect­ed, the com­mon sit­u­a­tion was the need for antibi­ot­ic injec­tions,” says Les­ley. That’s chang­ing with more knowl­edge in the com­mu­ni­ty. Now, even young chil­dren at school rock up when they have one sore that needs a band-aid.”

Peo­ple becom­ing health seek­ers’ rep­re­sents a mas­sive change from the ori­gins of the com­mu­ni­ty, says Les­ley. Doomadgee began as a mis­sion in the 1930s, when girls and boys, mem­bers of the Stolen Gen­er­a­tion, lived in sep­a­rate dor­mi­to­ries and were used as labour on neigh­bour­ing pas­toral sta­tions. The mis­sion final­ly left in the 1980s.

Lesley’s grand­moth­er, a Gringai woman, left the area she was raised in when her dad was a young boy.

She want­ed him to have an edu­ca­tion and Les­ley remem­bers sto­ries of her nan, sib­lings and par­ents liv­ing in a two-room shack on the Karu­ah River.

Self-deter­mi­na­tion is a won­der­ful con­cept, but log­i­cal­ly, this can’t be done overnight. We need to be trained and be capa­ble of being inde­pen­dent and to suc­ceed,” says Lesley.

Les­ley point­ed out that, apart from the short his­to­ry of med­ical sup­port in the com­mu­ni­ty, there are added hur­dles of pover­ty in the area where only 30 per cent of peo­ple have a fridge, many have poor lit­er­a­cy skills, and the lack of phones and com­put­ers make it dif­fi­cult to access services.

Les­ley believes edu­ca­tion is the key, a con­cept drummed into her since she was a child by her dad (Les Elvin), an emi­nent Indige­nous artist, who con­sid­ered edu­ca­tion was the way to pro­tect cul­ture and people.

Les­ley grew up in Cess­nock in the Hunter Val­ley on Won­narua Coun­try. She grew up with high-achiev­ing rel­a­tives who were deter­mined to make a difference.

In my mind the solu­tion is edu­ca­tion, get­ting the kids into school,” says Les­ley. When you have good edu­ca­tion, you make bet­ter health choices.

There’s only 45 per cent atten­dance in Doomadgee at the moment but there are some good peo­ple in the com­mu­ni­ty and good pro­grams being pro­mot­ed, such as an after hours school, and hold­ing school ses­sions down by the river.”

Les­ley also strong­ly believes that health pro­mo­tion pro­grams need to focus on today. Look­ing to the future is fine if you have a future to look for­ward to,” she says.

For many of these peo­ple, they don’t see much future; they’re inter­est­ed in today. So our health pro­grammes have to focus on the ben­e­fits today – let­ting them know you’ll be able to walk down to the riv­er with­out get­ting breath­less’ for exam­ple, and you’ll be able to bait your own fish­ing hooks’.”

Les­ley says she fell into nurs­ing’ when she left high school at the end of the 1970s. Before the intro­duc­tion of Nurse Prac­ti­tion­ers (NP) – Reg­is­tered Nurs­es who have com­plet­ed addi­tion­al uni­ver­si­ty study at Master’s degree lev­el and the most senior and inde­pen­dent clin­i­cal nurs­es in our health care sys­tem – Les­ley was work­ing at advanced lev­els, par­tic­u­lar­ly when she was in rur­al hos­pi­tals. She took advan­tage of all oppor­tu­ni­ties for advanced train­ing on offer to become the country’s first Indige­nous NP and the 13th overall.

I’ve loved every job I’ve had, and I love my work here – but it’s not all a bed of ros­es,” says Les­ley. I get despon­dent about the lack of resources and feel frus­trat­ed when I can’t do all the things we need to do.

I’m head­ing for 61. I look to the future with hope for this com­mu­ni­ty. But I have to accept that I will be retired before full ben­e­fits are evident.”

Read about Nurse Prac­ti­tion­ers Lyn Byers and Stephen Far­ring­ton.