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Hope for Health

24 January 2017

By Patricia Thomas

Helen Guyupul- Hope for Health Coach in training


Elcho Island, is in northeast Arnhem Land can be reached by flying a couple of hours east of Darwin (in a Brasilia Embraer 120 aircraft). Lapped by the turquoise waters of the Arafura Sea to its west, teetering on the Gulf of Carpentaria to its east,  ‘Elcho’ is within paddling distance of Indonesia, East Timor and Papua New Guinea.   Its main township is Galiwin’ku, at the southern point of the island.

Hope for Health is a crowd-sourced initiative, co-founded by Tim and Kama Trudgen, with the support of the Yolngu (‘people’) on Elcho Island, to help improve the health of the indigenous population there. The Yolngu (‘people’) strive to retain their tradition and culture for their descendants.   They embrace education in both traditional and Balanda (‘outlander’ – not strictly ‘White people’) ways, but English is not always their first language.    Amongst the various clans on Elcho, it is estimated that there are 22 dialects.  The delivery of health messages from the government and clinics in the past hasn’t considered the language and cultural issue in their design leading to poor outcomes due to unrecognized assumptions from all involved. 

Osteopathy & Hope for HealthMelanie Woollam and I had the privilege of being selected by the HFH team, as its first osteopaths.  We shared all the daily responsibilities of running the ‘camp’ with other volunteers, including naturopaths and massage therapists.   The first retreat was held in Kin Kin, Queensland.   Retreat 2016 was held closer to home for the Yolngu participants, a thrilling, sand-drifting one hour drive from Galiwin’ku, in a stalwart 4WD,  to a homeland called Dharrawar.   Here we slept in tents, used drop toilets, relied on rationed generator power, and were completely off-grid.  Our ‘clinic’ was a few steps  from the edge of a spectacular ten metre ochre escarpment overlooking a long beach, where we would often see Yolngu hunting. It was very hot. The welcome breeze would pick up at around 11am. Our floor was a bamboo mat over sandy dirt, the uprights were freshly hewn saplings, and our walls were hessian weighted by stapled branches.    Our supplies were kept in milk crates, beneath which we’d find colonies of hermit crabs, if we didn’t move them for a while. One morning I found tracks of a large wild pig in my ‘room’, which’d been attracted by the smell of the coconut oil we used as slip.

When the sun rose, at around 5:45, the mosquito armada attacked, and we all rose to our duties.  The men and women divided themselves to have their measurements and exercise separately (a cultural choice).  The naturopaths and osteopaths would share the tasks of taking blood pressure, blood glucose and heart-rate readings.  Kate Jenkins, the HFH naturopath, would use the readings to ensure the appropriate safe adjustments to the supplements were measured and mixed by the naturopaths.  Soon after a group would take off for a 45 minute walk along the beach, whilst another group bounced on cellercisers to music, and then vice versa.  There was a lot of laughing.

In the outdoor kitchen the chef and staff worked almost ceaselessly planning and creating meals that matched the messages of the programme.  More often than not they used locally sourced foods, such as fish and wallaby.  Daily chores such as carrying bore water to be filtered for drinking were done.   In the first week the participants undertook a guided three-day nutritionally- complete liquid fast.  The monitoring and support required from all the therapists identified some difficulties, especially from those giving up smoking and sugar, but the positives apparent showed amazingly quickly, even to the participants amongst themselves !

At around 9:30am the daily lessons at the retreat were taught by a long-time non-indigenous local,  Tim, who is fluent in Yolngu Matha “‘people language’’, and culture.   Yolngu knowledge includes a sophisticated understanding on the balance of all the various food groups, and land management, required to sustain good health.  Over thousands of years the trade and borders between clans recognized the importance of ensuring that people got the right balance of resources, even when they were short of them in the lands that they managed.  Since the 1940s Yolngu have trusted that the Balanda had superior ways, as they perceived that they had more material success.   Tim’s lessons centred around the nuances of marketing as a selling tool rather than an information tool, nutritional education - including the benefits of Yolngu traditional diet compared with the food-groups introduced in the 1940’s (such as damper and golden syrup). Other elements included how to read nutrition labels accurately, and how to make better fresh food choices from the grocery store. 

Ex-Osteopathy Australia President, Patricia Thomas, with retreat participants, Helen and Jennifer

Osteopathic treatment could begin at any time from 9 onwards, although we couldn’t always accurately predict whether our patients would be able to come.  The incredible impact of chronic disease amongst the Yolngu was really brought home to Mel and me when we realized that often people could not come because they were required for a funeral, or for a ‘hearing ceremony’ to formally hear of the death of a clan/family member, or because they were stricken by the news of a friend’s downturn in health whilst in hospital, far from their own family.  When we arrived at Galiwin’ku, we learned that the morgue had six bodies awaiting burial, which must be done with culturally appropriate timing and ceremony.  Two more deaths were notified after the retreat began.  When,  in 2014, as president of Osteopathy Australia,  I acted to make OA a signatory supporting the “Close the Gap” the enormity of that gap was theoretical; at Dharrawar it became unfathomable.

Communication, and the sheer distance and cost it takes to get quality imaging for investigation were our challenges.  It is hard enough to do an accurately timed and measured MET with an experienced English-fluent patient, let alone someone who hasn’t ever had a musculoskeletal treatment.     We dealt with familiar issues, such as joint problems and headaches, but we also saw the serious impact of poorly-managed chronic disease,  such as foot sores due to peripheral neuropathy.  It was sobering to realize that many had not been diagnosed, despite previous health consultations elsewhere, because of the cultural divide in expectations in communication. Explaining the need for further investigation came with the real need to not induce a sense of hopelessness.   Osteopathy supported the goals of the programme through reiterating the lifestyle education message, in dealing with the familiar problems that we see in our everyday clinics, and also in reducing the impact of flu-like symptoms that anyone who has attempted a detox has experienced.

Amazingly, despite their incredible burdens, not one of the 30 participants showed us anything but generosity in teaching us their healing practices, and their dances,  patience towards our attempts to learn their language,  good humour (though there were more frowns during the three-day fast) and gracious thanks for us alleviating their discomforts. We shared so much that can’t really be explained in a short article. There was joy.

After the first retreat it was apparent that, due to the intricate Yolngu family and clan connections, the HFH information has influence in the wider community.  More formally, the message is maintained and delivered to the community via the training and continued teaching of the local health coaches and cooking classes run by trained former-participants.  This continues after the 2016 retreat.

On the plane flying over Arnhem Land I had a mixture of thoughts and emotions that, on leaving, three weeks later, seemed, in hindsight, quite consistent with what I would experience on the ground on Elcho Island.  It was exciting to anticipate being in the iconic remote Arnhem Land, but simultaneously calming, as humans are when humbled by the vast and the ancient.  Looking down from the plane, the vermicular forms and colours of the waterways, soil and vegetation were beautiful, yet they also reminded me of an MRI of a brain.  After the retreat we all felt part of something bigger, and better.  Hope for Health is very well named.

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View Patricia's photos from her experience with Hope for Health

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