PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ... PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
Other people in community A commented that buying “good healthy food” from the shop wassomething of a luxury and that people only did this on pay day-the rest of the time they relied ontakeaway food.In community B, Council had intervened in the types of foods that were available in some of thetakeaway outlets, particularly those at the school and at the swimming pool complex. They hadalso (unsuccessfully) tried to prevent Coca Cola from being sold at any retail outlets in thecommunity. Although healthy options were available, the most popular takeaway foods remainedfried chicken and chips. The store had placed various health promotion signs concerning dietaround the store and the store keeper stated that they often had to educate consumers abouthow to cook foods when they were first introduced into the store. However, this assumed thatpeople had the means to cook these foods including working stoves, cook tops and pots andpans which were not evident in many households.In both communities there may be more complex reasons why takeaway food is preferable tofood that is prepared at home. The themes of people being poisoned through their food beingtampered with (usually through sorcery) were common. As reported in Senior:“They‟ll try and poison me, lots of ways to do it. They could poison my food, my tea, mymeat, my chewing tobacco. When we go out we take all our food inside, put it in thefridge and lock the house. You can‟t leave things lying around”. (114)Because of this risk, fast food prepared by non-Aboriginal people and sealed in individual plasticcontainers, could also been seen as safe food.Alcohol and substance misuse were also considered by community members to be importantcontributors to the poor health profile. Both communities have alcohol restrictions, andcommunity B is attempting to extend these restrictions to encompass a hundred kilometer zonearound the community.Petrol sniffing was a serious problem in community B but ceased in early 2005 due to theintroduction of Opal fuel and combination of other factors (see (117) ). Marijuana is considered tobe a problem in both communities, both because it affects mental health and because it isexpensive, leaving families with little money left to purchase food.“Young people, they are not healthy-they smoke too much ganja. People know its bad,but they still don‟t stop, some people go crazy”Finally fighting, social unrest and sorcery were feared as causes of sickness and sudden death inboth communities. At the time when we were conducting this research fear about sorceryAppendix 4: Ethnographic Field Study – Evaluation of the NT Preventable Chronic Disease Strategy 2007 124
ecame the main priority in many people‟s lives, overriding many other concerns, includinghealth.Management of Chronic disease patientsIn both communities a card system is used to record the details of the chronic disease patients.These patients are called in to the clinic for check ups every three months. Although some peopledid attend the clinic voluntarily while we were there for their checkups, it is clear that themajority have to be collected and brought to the clinic. One of the nurses in community Acommented that the success of any screening or recall for checkups depends on “how persuasivethe driver is”.Many of the people we talked to in the clinics were people who diagnosed with a chronic diseaseand had become familiar to the regime of care and check-ups that their condition imposed onthem. It was interesting that people with chronic diseases often considered themselves to behealthier than the general population, because of their regular contact with the clinic (this is alsonoted in Senior 2003).These people were generally favourable towards the idea of check ups-as one woman incommunity A commented:“it‟s good to go to the clinic, they check you out inside”Another woman commented:“I‟m not worried about going to the clinic, the clinic helps you look after yourselfSome of the chronic disease patients become diligent in their own self management. While wewere in the clinic in community A, two elderly women, came in for checkups. One had justreturned from her outstation, and was visiting the clinic as her first priority and the other wasjust about to go out to her outstation and was visiting to ensure that she had enough of hermedication for the period that she would be away.Screening and early detectionAlthough people who had been diagnosed with a chronic condition were generally in favour ofscreening for disease in the community, some people who had less contact with the clinic werehostile to the idea. Some people considered that being screened would become the first in aseries of steps to being diagnosed with a disease, to being removed from the community fortreatment and finally to death and autopsy:Appendix 4: Ethnographic Field Study – Evaluation of the NT Preventable Chronic Disease Strategy 2007 125
- Page 91 and 92: CHAPTER 4. CLINICAL OUTCOMES OF THE
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- Page 99 and 100: Figure 5.3 Vaccination coverage for
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- Page 103 and 104: eported that 50 per cent of the Ind
- Page 105 and 106: The current action plan identifies
- Page 107 and 108: The availability and cost of health
- Page 109 and 110: Hoy et al in 1995-2000 (100) , and
- Page 111 and 112: 5.6 Best practice management5.6.1 P
- Page 113 and 114: disease care in urban areas regardi
- Page 115 and 116: PCIS was developed by NTDH&CS as th
- Page 117 and 118: emote staff can access training and
- Page 119 and 120: In the Top End there appeared to be
- Page 121 and 122: APPENDIX 1EVALUATION OF THE NT PREV
- Page 123 and 124: 2.10 Generally speaking, on a scale
- Page 125 and 126: 4.4 Briefly recount any anecdotes y
- Page 127 and 128: 5.9 Generally speaking, on a scale
- Page 129 and 130: Section 8 • Summary questions8.1
- Page 131 and 132: Preventable Chronic Disease Program
- Page 133 and 134: Year Type Background What is it? /
- Page 135 and 136: Year Type Background What is it? /
- Page 137 and 138: An important background to this stu
- Page 139 and 140: New beliefs do not replace the old,
- Page 141: Other services are provided to the
- Page 145 and 146: to be healthy, how to get rid of di
- Page 147 and 148: (Draft Version - © August 2006 Jan
- Page 149 and 150: References1. Dunham, H., Ministeria
- Page 151 and 152: 35. Smith, J.D., Progress report fo
- Page 153 and 154: Research Centre for Aboriginal Heal
- Page 155: 114. Senior, K., 'A Gudbala Laif? h
Other people in community A commented that buying “good healthy food” from the shop wassomething of a luxury and that people only did this on pay day-the rest of the time they relied ontakeaway food.In community B, Council had intervened in the types of foods that were available in some of thetakeaway outlets, particularly those at the school and at the swimming pool complex. They hadalso (unsuccessfully) tried to prevent Coca Cola from being sold at any retail outlets in thecommunity. Although healthy options were available, the most popular takeaway foods remainedfried chicken and chips. The store had placed various health promotion signs concerning dietaround the store and the store keeper stated that they often had to educate consumers abouthow to cook foods when they were first introduced into the store. However, this assumed thatpeople had the means to cook these foods including working stoves, cook tops and pots andpans which were not evident in many households.In both communities there may be more complex reasons why takeaway food is preferable tofood that is prepared at home. The themes of people being poisoned through their food beingtampered with (usually through sorcery) were common. As reported in Senior:“They‟ll try and poison me, lots of ways to do it. They could poison my food, my tea, mymeat, my chewing tobacco. When we go out we take all our food inside, put it in thefridge and lock the house. You can‟t leave things lying around”. (114)Because of this risk, fast food prepared by non-Aboriginal people and sealed in individual plasticcontainers, could also been seen as safe food.Alcohol and substance misuse were also considered by community members to be importantcontributors to the poor health profile. Both communities have alcohol restrictions, andcommunity B is attempting to extend these restrictions to encompass a hundred kilometer zonearound the community.Petrol sniffing was a serious problem in community B but ceased in early 2005 due to theintroduction of Opal fuel and combination of other factors (see (117) ). Marijuana is considered tobe a problem in both communities, both because it affects mental health and because it isexpensive, leaving families with little money left to purchase food.“Young people, they are not healthy-they smoke too much ganja. People know its bad,but they still don‟t stop, some people go crazy”Finally fighting, social unrest and sorcery were feared as causes of sickness and sudden death inboth communities. At the time when we were conducting this research fear about sorceryAppendix 4: Ethnographic Field Study – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 124
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