Sunday, October 11, 2009

TERRITORY HEALTH BOMBSHELL

*In impoverished Bangladesh, 15 per cent of slum people in Dacca suffer from strongyloidiasis , which can be fatal. * In some parts of the Top End , where people have been tested for this disease , more than 30 per cent were positive. * The parasitic worm which causes the disease is endemic throughout Central Australia and a large number of children between the age of one and five are affected .* Data from Alice Springs Hospital shows that strongyliodiasis is present in people from nearly all communities in Central Australia , including over the border into South Australia and WA. * Non Indigenous staff who live in Aboriginal communities have contracted the disease. * Some “ grey nomads “ have contracted the disease during their travels in the north. *Strongyloidiasis in Central Australia is associated with human T-Lymphotropic Virus Type 1 (HTLV1) infection that suppresses the immune system.

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This disturbing Third World picture emerged during the week , just after the federal Shadow Minister for Indigenous Affairs, Tony Abbott, said the handling of Indigenous matters in the NT had reached a “ failed state” like condition. He cited the SIHIP fiasco, the case of houses unroofed at Santa Teresa settlement by a storm a year ago which had not yet been repaired, unsatisfactory Alice town camp conditions and no apparent reduction in the flow of grog in the area. The intervention was being weakened, he said , and the old status quo seemed to be asserting itself in the Territory. The need for consultation should not be used to stop the righting of intolerable situations , he declared . Even though some actions may be unpopular, a government had to govern.

Abbott’s claim of a “failed state”, which could be dismissed as political hyperbole, gained strength when an ABC Stateline TV report, with radio bulletin follow ups, revealed the apparently widespread existence in the NT of the parasitic worm strongyloides which can cause death and debilitation . The charge was made by the Aboriginal Resource and Development Services that the NT Health Department refuses to take the issue seriously . It said Health Department laboratory technicians did not want to carry out tests for strongyloidiasis caused by the worm infestation . According to the Health Department it is waiting for Commonwealth funding to carry out a “pilot” scheme. It appears the proposed pilot involves testing and treating "everyone" in Galiwin'ku ,Elcho island , with Ivermectin to combat the disease and scabies.



The ABC TV report focused on Elcho Island and told of a woman who had been feeling unwell for a long time who collapsed twice and a boy whose mother thought sorcery was responsible for his illness. The worm can enter the heart, lung, liver, kidneys and brain, even producing septicaemia and meningitis. It is not checked for in autopsies to determine the cause of death so the inference is that people have died from disease without the cause being properly detected. Up to one third of the indigenous population in the NT could be suffering . The microscopic worm can exist on damp grass , be picked up by going about bare footed and through cuts .

Until the ABC broke the story , the NT Health Department appears not to have thought it necessary to alert the NT community . Yet on September 17 this year, the National Strongyloides Working Group held its fifth workshop on Strongyloidiasis in Alice Springs. It was attended by experts from Brisbane Townsville ,Perth, Melbourne, Bendigo, Sydney and the NT . Proceedings seem to have gone unnoticed .

The meeting concluded that the disease should be made notifiable and a national strongyloidiasis register be established to find out the extent of the problem . This would enable people in areas where the disease is endemic to be tested and treated .

Photographs of houses in NT Indigenous communities showing plumbing that was not properly installed or maintained resulting in waste water with faeces pooling inside dwellings. The workshop report says this situation was an ideal environment for the spread of the disease and other diarrhoeal diseases . It goes on to say houses in these communities were not required to meet the standards enforced in the main cities and and towns of the NT. The points at the head of this post come from that workshop .

Other literature says the disease has been picked up by people travelling overseas and by defence force personnel serving in areas where it is endemic. Another piece of disturbing information is that the worm can be passed through mother's milk to babies with dire consequences.


While strongyloidiasis is presented as a national problem in Indigenous communities it is really a threat to the entire NT population . The Alice workshop defined the disease as being caused by the tiny tissue parasites and secondary infection by gut or respiratory system bacteria . The disease is life-long unless effectively treated . In the chronic form ,it is characterized by intermittent gut, skin and respiratory symptoms, as well as abcesses in various parts of the body. In the severe form , it can produce pneumonia and or sepicaemia and or meningitis and severe skin and gut conditions . It invariable ends in death unless the underlying disease is treated as well as the bacterial infection


NOTE : The disease occurs in refugees from various regions of the world where it is endemic .While there is a national programme to screen and treat refugees for the disease , there is no such programme for Indigenous people where the disease is known to be endemic- a situation which is a national scandal . It is an issue which should be pursued with vigour in the Legislative Assembly sitting which commences tomorrow.