PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

Other services are provided to the health centre through visiting teams from the Department ofHealth and Community Services, from both Nhulumbuy and Darwin and also through Miwatj.During the week that we were in the community, the clinic had several visiting teams, includingan eye health team, a foot health team, a mental health team and a public health nurse. It wasnot clear if any of these groups knew that the others were going to be there, which suggests thatthere is the potential for improving the coordination of services.Community B has a population of 1000. It has recently become part of a regional communitycontrolled health service. Previously the clinic was run by the Department of Health andCommunity Services and was characterized by the long term employment of the RN. Subsequentto the resignation of this person, staffing has been more unstable. There has also been areduction in the number of health workers at the clinic. The clinic itself is very similar to that ofcommunity A. Much of the initial consultation and diagnosis is done in a public waiting area. Thispractice deters people from visiting the clinic, due to the potential for embarrassment. Unlikecommunity A, the clinic is at the edge of the community and it is not a place where peoplecongregate. Instead, a driver is employed to collect people to come to the clinic. There is noresident doctor in the community, although it is hoped that there will be one soon.Health concerns in the communityIn both communities, people compared the current state of health unfavourably with that of thepast.“In the past men were strong, they had big bodies, but now they are nothing, all thatMunanga food. In the old days they used to grow bananas, cabbages, carrots,everything, they even tried to grow rice. There was not much sickness then”Diet was mentioned in both communities as an important contributor to the poor health profile.In community A, people commented that there were very few healthy food options at the localtakeaway and that fresh fruit and vegetables were very expensive. The store carried a range offruits and vegetables, although these were expensive ($4.60 for an iceberg lettuce, $4.50 for halfa Chinese cabbage). Meat was reasonably priced, but the choice was limited. Only white breadwas available. The take away‟s most popular food was fried chicken, although some lower fatoptions such as chicken wraps and sandwiches were available.The health workers commented:“people know about good food, but sometimes they don‟t want to cook it, sometimesthey don‟t have the pots and pans to do the cooking in the house”Appendix 4: Ethnographic Field Study – Evaluation of the NT Preventable Chronic Disease Strategy 2007 123