CRANAplus Mem­ber Les­ley Woolf has been award­ed the Medal of the Order of Aus­tralia (OAM) in the King’s Birth­day 2024 Hon­ours list for her ser­vice to Indige­nous health and to rur­al and remote nurs­ing. She sees this award as a recog­ni­tion for the nurs­es who work in Abo­rig­i­nal health, and those who work in rur­al and remote areas around Australia.

Les­ley has been a nurse for over 50 years, 40 of those involved with rur­al and remote nurs­ing and specif­i­cal­ly in Abo­rig­i­nal com­mu­ni­ties and for Abo­rig­i­nal patients, a career which has tak­en her across Aus­tralia and also to the West­ern Province of PNG.

She is pas­sion­ate about advanc­ing and tran­si­tion­ing health ser­vices to Abo­rig­i­nal Com­mu­ni­ty Con­trolled Organ­i­sa­tions and applauds the North­ern Ter­ri­to­ry gov­ern­ment for its sup­port in this area.

Her inter­est in Abo­rig­i­nal health began short­ly after her train­ing when she was work­ing in Mount Isa, which has a large Abo­rig­i­nal pop­u­la­tion, and her focus increased not long after­wards, work­ing with remote communities.

“You see the bur­den of dis­ease and how sick peo­ple are and you want to do some­thing,” she says.

Les­ley has always cham­pi­oned nurs­es and, years before Abo­rig­i­nal com­mu­ni­ty-con­trolled health ser­vices became a real­i­ty, Les­ley was involved in a reg­is­tered nurse train­ing pro­gram which involved two cohorts of Abo­rig­i­nal stu­dents. The pro­gram which was run by the Deakin Uni­ver­si­ty in Mt Isa, was an oppor­tu­ni­ty to address the reg­is­tered nurse short­age and to give stu­dents the oppor­tu­ni­ty to train at home. 

“The response was amaz­ing. We were inun­dat­ed with appli­ca­tions. To sup­port the stu­dents, we offered free stu­dent accom­mo­da­tion, sec­ond­ed staff to pro­vide spe­cif­ic train­ing and there was a lot of in-kind support.

“They all fin­ished their train­ing and there are a num­ber of the grad­u­ates work­ing in senior nurs­ing posi­tions across Aus­tralia. This is what hap­pens when you take away bar­ri­ers and intro­duce sup­port.”

While Les­ley says she total­ly enjoyed all her roles in the main­stream pub­lic ser­vice, it is work­ing with Abo­rig­i­nal com­mu­ni­ty-con­trolled health ser­vices that she feels she has land­ed in a place that suits her perfectly.

“When work­ing in Kather­ine, I was approached by the then CEO of Sun­rise Health Ser­vice to assist in the recruit­ment of a suit­able per­son to facil­i­tate their coor­di­nat­ed care tri­al to tran­si­tion health ser­vices in the Kather­ine East region to com­mu­ni­ty control.”

“I found I could make deci­sions, work with­peo­ple on the ground, iden­ti­fy the real pri­or­i­ties and work with the teams on pre­ven­ta­tive health.”

“I knew this was an oppor­tu­ni­ty of a life­time for me.” After three years, the health ser­vices in the region were tran­si­tioned to com­mu­ni­ty control.”

Les­ley has been at Mala’la Health Ser­vice Abo­rig­i­nal Cor­po­ra­tion, which ser­vices Man­ingri­da and sur­round­ing home­lands in North East Arn­hem Land, for the past nine years.

“Hos­pi­tals are great and there will always be a place for hos­pi­tals where real­ly sick peo­ple go,” says Les­ley, ​“but there is cer­tain­ly a greater move­ment to do more in the com­mu­ni­ties par­tic­u­lar­ly in the area of telehealth.

“For exam­ple, a sick mum who is the matri­arch, the one hold­ing the fam­i­ly togeth­er, has the abil­i­ty to stay at home, thanks to telehealth.

“There’s a bit of a stereo­type around health care, the sug­ges­tion that care is bet­ter in the big­ger towns and cities. That is not always the case, per­haps par­tic­u­lar­ly in times of quick access to that care.”

Les­ley acknowl­edges that, until there are more Abo­rig­i­nal nurs­es, Abo­rig­i­nal Health Prac­ti­tion­ers and man­agers, there will be the need for non-Indige­nous staff in Abo­rig­i­nal con­trolled health centres.

“At the head of our man­age­ment struc­ture is a board of direc­tors con­sist­ing of Elders and tra­di­tion­al own­ers. The chair of the board has been an Abo­rig­i­nal Health Prac­ti­tion­er for many years. They are the gov­ern­ing body pro­vid­ing direc­tion and sup­port and advice and they make the final decisions.

“The board can make all the deci­sions, and the man­agers can put them in place, but it doesn’t work with­out the right peo­ple. You need the best peo­ple and the most appro­pri­ate peo­ple for it to work well. We talk to every nurse and doc­tor pri­or to them com­ing to work for us, and make sure they know what they are com­ing to, and ensure their atti­tudes are appropriate.

“Our CEO has been here for 11 years, with a lot of expe­ri­ence and our man­agers are all very expe­ri­enced and cul­tur­al­ly sensitive.

“I think it is work­ing because they are the right peo­ple, and we have a very strong work­place culture.

To illus­trate the ben­e­fits of tran­si­tion­ing to Abo­rig­i­nal com­mu­ni­ty con­trol, Les­ley gives a sum­ma­ry of a pro­gram in Man­ingri­da, dur­ing the time of tran­si­tion, which was to address the very high inci­dence of rheumat­ic heart disease.

“We got addi­tion­al fund­ing in 2019 and we set up a pro­gramme and there was a lot com­mu­ni­ty con­sul­ta­tion,” says Les­ley. ​“There was reluc­tance by some at the time, but we bit the bul­let, utilised those who were com­mit­ted and put their hands up to be involved. The school kids were screened, with 28 new cas­es iden­ti­fied, show­ing there was more rheumat­ic heart dis­ease than we were aware of.

“This was the start of a high­ly suc­cess­ful RHD pro­gram which has gone from strength to strength. The great work con­tin­ues to this day, with a ded­i­cat­ed Rheumat­ic Heart Dis­ease team with a focus on Healthy Homes.”

Les­ley, who is beyond retire­ment age, is not con­sid­er­ing that path at the moment, although the organ­i­sa­tion does talk about suc­ces­sion plan­ning, she says.

“There is so much to do and I love what I do. To leave it would be very hard. I’m proud of the work that I’ve done over the years, always being a cheer­leader for nurs­es, as well as see­ing the ben­e­fits of tran­si­tion to com­mu­ni­ty control.

“I have plans for this place: to increase the num­ber of aged-care beds and sup­port in this com­mu­ni­ty, real­ly to deal with the wait­ing list which is quite long. And I also want to see improved renal ser­vices here.”