Attach 5. Draft Proposal: Leonora Trachoma Prevention Hygiene Project

Western Australia is currently uniquely different to other areas of Australia where Trachoma is a problem. In 2017, the WA Country Health Services and the Environmental Health Service eliminated Trachoma by administering a common anti-biotic to people in Western Australia identified as having Trachoma. Administration of the Anti-biotic focused high incidence country areas north of a line from Geraldton to Kalgoorlie, and east of Kalgoorlie. This means that the incidence of Trachoma in Western Australia is now below the recommended World Health Organisation standard. This means that WA’s efforts are now being directed toward the prevention of the re-emergence of the condition.

The Leonora Community is unique.

  • It has two Aboriginal Nations residing in the town with visitors from other Nations temporarily being in the town from time to time.
  • There are 6-7 language groups in the town.

(1)Tjupan,

(2)Ngalia,

(3)Kuwarra (an educational kit has been developed),

(4)Kaalamaya,

(5)APY lands people (Ngaanyatjarra-Pitjatjantjarra-Yankunytjatjarra),

(6)Manyjulyjar[1],

(7)Maduwongga

  • Native Title has not been determined for any people in the town. There is significant tension associated with this issue. Hence, one language group and sometimes, 2 language groups do not collaborate easily with the others.
  • Most seem to have lost large portions of their culture and history.

Principle: Prevent Trachoma and other infectious diseases re-occurrence (scabies, impetigo & rheumatic fever) via:

  1. Community Coaching in schools and family settings aimed at improving personal hygiene practices;
  2. The provision of washing facilities (particularly a transportable laundrette); and
  3. The provision of washing aides (e.g. mirrors, towels, and possibly the trialling of several Ezywash Mechanical Washing Machines in homes lacking electrical machines)

Purpose: To reinforce the health benefits of washing and cleanliness.

Participants: The focus of the project is on the Aboriginal Community, but not exclusively so. It is expected that 200-250 people will be involved in the project.

Rotary District 9455’s Aboriginal Reference Group is identifying a Rotary Club who will lead the management of the project, together with a consortium on support Rotary Clubs. The Aboriginal Reference Group will have two of its members on the Project Management Group.

The Leonora Health Centre has offered to provide ongoing daily support to Coaches. The Shire of Leonora is willing to offer a permanent working space with access to photocopying and video conferencing facilities at low cost (to be negotiated) for local project coaches.

Background

  • ARG, in collaboration with the Population Health Branch of the WA Country Health Services (WACHS) and Goldfields Schools has identified the need to establish a pilot coaching program in Leonora. This pilot program would use the learnings from a prior Rotary program aimed at improving dental health within Indigenous communities, WACHS experiences with the Squeeky Clean Kids Soap program and School’s attempts to improve hygiene practices of children and families. These learnings highlighted the value of establishing paid training/coaching roles within the community who can provide ongoing focus and encouragement.
  • To maximise the benefit of this ongoing, community led training it is critical to ensure laundry are suitable, available and functional. To this end it is proposed the plan is to

(1)hire a portable laundry block for the washing of large laundry items (e.g. large blankets and doonas);

(2)contact a local maintenance service to ensure the continuous operation of the ablution block;

(3)to gain the essential support and co-operation of Aboriginal and Non-Indigenous communities in the town, including that of service provider agencies;

(4)ensure water quality, water supply, water waste and maintenance issues are effectively addressed by relevant Government agencies (i.e. Department of Communities and Housing, Water Corporation) per Healthabitat Australia research); and

(5)in collaboration with a Western Australian University and the Leonora community undertake a pre-project survey of existing hygiene practices and a post-project survey of hygiene practices to determine behavioural change. A follow-up survey will probably be required to demonstrate the sustainability of the project.

Preliminary Budget:

  • Hiring two-part time health and cleanliness coaches for the community. Estimated cost: $25,000/year ($50,000 for 2 years)
  • Rental of a portable laundry block. Estimated cost: $8,000 per year ($16,000 for two years). Machine costs for 5 Maytag Washing Machines (includes one spare) @ $800 each and 3 Maytag dryers (including one spare) @ $650 each Total Machine costs $6,000. Possible use of a Micro-financing model to achieve a sustainable business.
  • Survey of behavioural practices pre and post intervention.$12,000to ascertain extent of behavioural change (with separately funded follow-up survey twelve months after completion of project). Inclusion of Health Department incidence statistics.
  • Repairs and maintenance. Estimated cost $6,000(assuming potential donations of maintenance services, mirrors, towels, face washers and Ezywash Washing Machines comes to fruition).
  • Contingencies $9,000
  • Total Cost of 2-year project $99,000

Possible additional costs that may have to be added to budget are:

  • Day-to-day project management in town (half day)
  • Pre-Project Preparation and Training costs (may be freely available)
  • Micro-financing costs associated with Laundromat to achieve a sustainable outcome.
  • Video-conferencing costs (with Project Manager and other key personnel in Leonora + PMC intra/Interstate Clubs)
  • Fundraising costs (e.g. 3% fee for tax exempt fundraising through the Rotary Australia Benevolent Society)
  • Inflation costs over the two years and those associated with delayed commencement of the project until the total quantum of funds is raised.
  • Community education costs.
  • Any additional costs associated with the addition of a dental health component.

Implementation and Monitoring

(1)Rotary District 9455’s Aboriginal Reference Group is identifying a Rotary Club who may be willing to lead the management of the project through a Project Management Committee (PMC). The PMC would be comprised of a Chair and Treasurer from a lead Club, Club representatives from a consortium of 4-5 supporting Rotary Clubs and two representatives from the Aboriginal Reference Group.

(2)The Project Management Team in collaboration with WACHS, will review the effectiveness of coaching/facilitator materials at regular intervals.

(3)It will monitor Department of Communities and Housing Maintenance Services to ensure that there are no unforeseen impacts on the project by these services.

Anticipated Outcomes

(1)Improved awareness of benefits of domestic/school hygiene and cleanliness;

(2)Emergence of improved behavioural domestic/school hygiene and cleanliness practices;

(3)Evidence of sustainability or need for a supplementary follow-up program to achieve long-term sustainability.

(4)Effectiveness of model for use in other communities in Western Australia/Australia subject to appropriate tailoring to each unique community.

(5)Survey and process outcomes that encourage other providers to fund similar services to achieve comparable outcomes.

Where to From Here

  • Determine if a dental health component will be incorporated in the project.
  • Clarify project leadership in Leonora. If there is an Aboriginal Person that has the competence to lead the operational side of the project, then this would be the best option. The fall-back position is to identify a non-indigenous person in the town who could undertake this role on a half time basis. This would involve some additional costs.
  • Assess pre-project preparation and training requirements, including any additional costs.
  • Ensure the Laundromat model is sustainable in the long term.
  • Refine budget
  • Recruit leading WA Club and other Clubs constituting the consortium. Select ARG reps to part of the PMC.
  • Determine any costs associated with video conferencing.
  • Prepare final submission.
  • Obtain End of Trachoma by 2020 Committee endorsement of the plan.
  • Launch marketing, fund-raising, recruitment of sponsor programs, together with donations in kind from WA and Interstate Rotary Clubs.
  • Commence community Education

Bruce J Dufty

Chair Rotary District 9455’s Aboriginal Reference Group

21 March 2018

[1]The Language Centre believes that the eastern Martu people may speak two discrete languages. To date, they believed that there was just a single language group.