Race, medicine and justice
The media spotlight has shone on the issue of race and medicine this fortnight, after the manager and specialist doctor for award-winning Aboriginal singer Geoffrey Gurrumul Yunipingu alleged he was subject to “racing profiling” at Royal Darwin Hospital. As reported in The Guardian, they claimed Gurrumul was not treated adequately for eight hours for internal bleeding, causing his health to decline, because doctors assumed his chronic liver disease was related to alcohol abuse, rather than childhood hepatitis.
But ABC News Online reported that the singer’s hospital records wrongly stated that he was unsuitable for a liver transplant.
In this opinion piece in The Guardian, Dr Ranjana Srivastava questioned whether the case might represent a failure of the medical system to adequately consult patients and take thorough histories, rather than racial profiling.
“Gurrumul’s high-profile case has now been referred to the health commissioner but there is a salient lesson in it for all patients. Inaccurate discharge summaries are not a typing error; they are a reflection of rushed medicine,” she wrote.
However, as detailed on Croakey, many health leaders suggested the case highlighted the need for all in the health sector to reflect upon what they are doing to help ensure a health system that is more culturally safe for Aboriginal and Torres Strait Islander people.
Australian Healthcare and Hospitals Association CEO Alison Verhoeven said:
“It is incumbent on all Australians and all institutions to reflect on our practices and the impact of our attitudes, behaviours and judgements about Aboriginal Australians.”
The concerns about the NT health system’s treatment of Gurrumul were also a hot topic at a workshop on racism and health held in Brisbane ahead of the inaugural World Indigenous Cancer Conference. Croakey’s Marie McInerney wrote that the workshop highlighted concerns about the hospital management’s immediate and defensive dismissal of the possibility of racial discrimination, when mounting evidence suggested it was not only likely in health systems, but probable and inevitable without major intervention.
Meanwhile, ABC News Online reported that the winner of the NT’s Aboriginal health practitioner of the year, Aboriginal health worker Sarah Bukulatjpi, was calling for more Indigenous health staff at Royal Darwin Hospital to ensure patients with chronic illness were not too intimidated to seek healthcare. As Croakey reported, The call was also made at the World Indigenous Cancer Conference by one of the delegates following an extraordinary on stage conversation between legendary Aboriginal singer songwriter Archie Roach and his physician Associate Professor Dr Lou Irving that conveyed a respectful, two-way patient-doctor relationship and reflected on many of the issues underlying disparities in cancer incidence, treatment and outcomes for Indigenous people across the world.
The broader issue of Aboriginal and Torres Strait Islander policy was explored in detail by Yorta Yorta woman and public health researcher Summer May Finlay in a piece on Croakey, entitled “Serious Whitefella Stuff: mandatory reading on Indigenous policy, funding and implementation”.
And justice policies were the focus of this piece on Croakey, in which Public Health Association of Australia CEO Michael Moore added his voice calls for action and accountability on the disproportionate incarceration of Aboriginal and Torres Strait Islander people, and a similar call from the Australian Bar Association for Justice Reinvestment and a shift from mandatory sentencing.
“The disproportionate incarceration of Aboriginal and Torres Strait Islander people does not ‘just happen’. It is the predictable outcome of governments’ policies,” Moore wrote.
Twenty-five years after the Royal Commission on Aboriginal Deaths in Custody, Indigenous incarceration and police custody rates have actually increased, wrote University of Technology Sydney Associate Professor in law, Thalia Anthony on The Conversation.
The Sydney Morning Herald reported that Indigenous children are 24 times more likely to be imprisoned than non-Indigenous children with children as young as 10 and 11 in detention and Indigenous leader Professor Pat Dodson told the National Press Club the significant increase in the rate of Indigenous imprisonment was “staggering”, as reported by ABC News Online.
“A quarter of a century after we handed down our findings the vicious cycle remains the same. Accepting the status quo permits the criminal justice system to continue to suck us up like a vacuum cleaner and deposit us like waste in custodial institution,” he said.
To mark the anniversary, Amnesty International Australia has released a comprehensive, 871-page report examining governments’ progress (or lack thereof) in implementing the Commission’s recommendations, as detailed on Croakey.
Health research ups and downs
Cash-strapped medical researchers are increasingly turning to crowdfunding to further their investigations, with The Guardian reporting that UK researchers are running a crowdfunding campaign to conduct pre-clinical safety tests on a drug with the potential to stop Alzheimer’s in its tracks.
Similarly, The Courier Mail revealed that Queensland scientist Susan Jordan hoped to raise $28,000 through crowdfunding for a study into how having a hysterectomy affects a patient’s future risk of heart disease and other health problems. With success rates for NHMRC grants plummeting from 22% to 15% in the five years between 2009 and 2014, more scientists are expected to crowd fund their studies, it said.
The news came as Australia’s long-running research program into general practice activity was given a last minute lifeline, just days after announcing that it would shut down on 30 June due to lack of funding. As detailed on Croakey, the BEACH (Bettering the Evaluation and Care of Health) program was granted a 12-month reprieve until long-term funding could be sorted out.
One medical research body that has been pledged forward funding is the Federal Government’s new Medical Research Future Fund, and Croakey reported on the make-up of the MRFF Advisory Board, including the appointment of scientist and former Australian of the Year Ian Frazer as Chair.
Meanwhile, the debate over the impact of cuts to CSIRO’s climate research continued, with news that the Bureau of Meteorology could take over some the organisation’s climate change research. CSIRO Fellow John Church, writing on The Conversation, said any transfer of climate change research capability and capacity would need to be done with considerable consultation with partner organisations and the broader science community – something he said had not happened as yet.
Other research was making news. In an opinion piece in The Australian, La Trobe University Deputy Vice Chancellor defended (paywalled) the University’s research that was behind the Safe Schools program. The newspaper also reported on the debate surrounding new research funded by the Australian Human Rights Commission and VicHealth that found that racial discrimination drains $44.9 billion a year from the economy and is a bigger health cost than smoking.
And ABC’s Lateline program investigated the case for and against sugar, looking at the continuing controversy surrounding a study known as The Australian Paradox, which claimed sugar intake was not related to the country’s growing obesity rates.
Sweet and sour
Sugar was also the focus of a new Australian study showing that a 20 per cent tax on sugar-sweetened beverages could save more than 1600 lives and raise at least $400 million a year for health initiatives, according to The Sydney Morning Herald. Another piece of research from the Queensland University of Technology suggested people could become addicted to sugar in much the same way as they become addicted to drugs, according to news.com.au.
Diabetes experts were also pushing for a sugar tax in Australia, after the World Health Organisation (WHO) warned that the number of adults with diabetes has quadrupled worldwide in under four decades to 422 million, with the condition becoming a “defining issue for global public health”, as reported in The Age.
“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain,” said WHO director-general Margaret Chan.
BBC News Online reported that the study showed there were now more obese people in the world than underweight people.
Writing on Croakey on World Health Day, ARC Discovery Indigenous Research Fellow Dr Mark Lock called for a national nutrition summit within six months, and the fast-tracking of the development of Australia’s national nutrition policy to address issues including food security and the increasing burden of obesity and type 2 diabetes. Dr Alana Mann, a senior lecturer at the University of Sydney, also urged governments to ensure affordable, accessible and healthy food was available to everyone and that there is a publicly-funded safety net for the most vulnerable in this article on Croakey.
There are fears hundreds of patients at an unnamed Melbourne medical facility may have been infected with hepatitis B by a healthcare worker, ABC News Online revealed, with the Department of Health and Human Services now contacting 654 people who may have come into contact with the worker over three years.
Also in Victoria, a cluster of Parkinson’s disease has been discovered in a key farming region where researchers say its prevalence is up to 78 per cent higher than the rest of the state. The Age reported there were calls for urgent research into links with pesticides and other farming techniques used in the Grampians and Loddon Mallee regions.
A Queensland mother who refused to be vaccinated against whooping cough had changed her firm stance after contracting the infection and passing it onto her newborn baby who remained in intensive care, according to ABC News Online.
Further afield, Zika virus continues to cause alarm, with The Guardian reporting that US health officials have confirmed there is no longer any doubt the virus causes babies to be born with abnormally small heads and other severe brain defects, and The Sydney Morning Herald revealing Brazilian scientists have discovered the virus may be associated with a second serious neurological issue in adults, similar to multiple sclerosis.
Zika virus was “scarier” than first thought and its impact on the US could be greater than predicted, said Dr Anne Schuchat of the US Centers for Disease Control and Prevention (CDC).
“Most of what we’ve learned is not reassuring,” Dr Schuchat told a White House briefing. “Everything we know about this virus seems to be scarier than we initially thought.”
Around the nation
The case of six-year-old Perth boy Oshin Kisko, who is to undergo chemotherapy against his parent’s will following court action by a hospital, has sparked debate around the country. 9News reported that his mother equates the treatment to “torture” and The Sydney Morning Herald revealed the Princess Margaret Hospital’s ethics committee was divided over whether the child should have active treatment to attempt to cure his brain cancer.
In Sydney, the fallout from revelations that St Vincent’s Hospital systematically under-dosed chemotherapy to cancer patients continues, with a damning report stating that the hospital misled the public and failed to disclose the seriousness of the error, prompting an unreserved apology from management.
Victoria became the first state in Australia to legalise the use of medicinal cannabis (paywalled), with a Bill passing parliament that will enable the manufacture, supply and access to medicinal cannabis products from 2017, when children with severe epilepsy will become the first to access the drug.
Debate over health reform in South Australia heightened, with The Australian reporting (paywalled) that an independent review had found the Government’s key justification for the health system overhaul— that “we’re killing a lot of people unnecessarily” — is not supported by reliable data.
Hospital parking is provoking anger among both patients and staff, as detailed in a story by news.com.au headlined “Hospitals profiting from parking misery” that revealed some patients were paying thousands of dollars a year for parking near Brisbane’s Lady Cilento Children’s Hospital. Meanwhile, doctor and nurses are considering resigning over car parking woes at Royal Prince Alfred Hospital in inner Sydney, The Sydney Morning Herald reported.
On the national front, Croakey looked at role of private health insurance in health care and equity in the Australian health system in this article and ABC’s The Drum asked whether the Prime Minister’s “crazy-brave strategy” on health and education funding would work, or fail spectacularly.
This fortnight saw international coverage of the devastating impact of suicide among Indigenous communities in Canada. The Sydney Morning Herald reported that a Canadian community of 2000 people had declared a state of emergency after 11 members tried to take their own lives on a single night.
Canadian Prime Minister Justin Trudeau said on Twitter:
“The news from Attawapiskat is heartbreaking. We’ll continue to work to improve living conditions for all indigenous peoples.”
In the US, the focus of Public Health Week turned to climate change, with the White House releasing a scientific report which warned global warming could lead to an increase in allergies and asthma, deaths by extreme heat and the proliferation of insect-borne diseases. As Croakey reported, the US Surgeon General Vivek Murthy said climate change represented a worse threat to public health than polio, as there was no “single source” that could be targeted:
“As far as history is concerned this is a new kind of threat that we are facing.”
Britain was reprimanded by the UN over its record on reducing inequality among children, as a report revealed the nation lagged behind some much poorer nations in achieving parity between rich and poor on health and educational outcomes, and warned about the likely impact of future welfare cuts, the Independent reported.
Finally, in Japan, it was revealed that death by overwork – a phenomenon known as “karoshi” – is on the rise.
Other Croakey reading you may have missed this fortnight:
- What’s on the agenda for the Health Election?
- Health Care Homes trials: some questions and answers on a work in progress
- Chronic care, equity & Trojan horses: What’s the role of PHI in new Health Care Homes?
- National Cervical Screening Program faces critical test: can it improve screening rates of Indigenous women?
- Journal Watch: Yoga – 99% Practice and 1% Theory? Not anymore
- Royal Commission sends NDIS a message on violence
- Tick a box – For the good of whom?
- Chronic disease prevention: pinning our hopes on the NSFCC
- The power of the glory: how extremism wins minds – and how to get them back
- Previewing the World Indigenous Cancer Conference, happening in Brisbane this week
- A collaborative Twitter-essay from the World Indigenous Cancer Conference (plus Selfiess)
- Community helps cancer patients navigate complex health system
- Australian Bar Association calls for Justice Reinvestment, shift from mandatory sentencing
- Luke Pearson: You cannot ‘get over’ a colonial past that is still being implemented today.
- More support needed for Aboriginal youth in contact with juvenile justice in SA
- Coal mining: urgent action needed to protect miners, communities & climate