A Thoughtful and Collaborative Approach to Hepatitis B is Essential When Working in Remote Aboriginal Communities

(A report back from presentation of Dr Paula Binks)

I had the privilege of attending this session at the 11th Australasian Viral Hepatitis Conference. Paula presented not only herself but introduced her community collaborators who were instrumental in the delivery of this project. This project was in response to a community identified need for education for HBV patients in their outreach liver clinic and in response to this Paul and her team initially developed a Hepatitis B story app in both English and Yolngu Matha the local Indigenous language. 

Prior to commencing the project a community sero-survey ‘Know your Hep B status’ and mother to child transmission project ‘BAMBI’ were completed. The results of the initial surveys revealed that a lot of people had never heard of Hepatitis B and of those who had many were embarrassed to talk about Hepatitis B. There was slow recruitment for testing and further education despite working with local community bases members and researchers with some of this attributed to a lack of community knowledge about Hepatitis B. 

 

The main learnings from this project seemed to be the importance of addressing the lack of health literacy amongst community members, encouraging community members to attend the clinic privately rather than talking to researchers more publicly to ensure that they were at least being screened for Hepatitis B, following the lead of community based researchers who are the experts in local knowledge and letting the community based researchers translate knowledge into the local Yolngu Matha dialect. 

 

This presentation emphasised to me the need for culturally appropriate care when dealing with Aboriginal people (Paula mentioned that in their project that ‘men spoke to men and women spoke to women), respect for kinship laws ‘not having yapa (sister) and wawa (brother) together hearing the story’, needing to be careful not to make women feel guilty for vertical transmission of HBV to their children and to educate the family about this matter we well and the vital importance of needing to work around cultural obligations. 

 

Overall this was a very informative speech detailing the many considerations that needed to be taken into account when working with remote Aboriginal communities. 

 

 

Author bio: 

Dr Thileepan Naren is a General Practitioner working at the Bendigo & District Aboriginal Co-operative.