This policy proposal is to develop technology hubs in in Aboriginal and Torres Strait Islander Communities as well as rural and remote communities. These hubs would provide telehealth; tele-allied health; telepsychiatry/psychology; tele-TAFE courses; tele-business training and tele-education. It would also assist in saving dying Indigenous languages and cultural practices. I was involved in a telehealth trial. A specialist from a city hospital would spend two days a week travelling to two regional hospitals. Almost one day of that was spent in travel. At the start of the trial he had almost a three-year waiting list at those hospitals. The trial involved a three-screen system for the specialist and trained registrars and a remote screen with camera at the two hospitals which was at the patient’s bedside. The specialist’s screens had (a)patient records , (b) the view of the patient and for the patient of the specialist via camera and (c) electronic monitoring/scans on the third. This system, by removing travel, cut the waiting list was brought down from3 years to zero in 6 months. With the development of Digi-hospital and more powerful computing this could be adapted to Indigenous health Clinics/community centres and small rural hospitals. The World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ (WHO, 1948). This is consistent with the biopsychosocial model of health, which considers physiological, psychological and social factors in health and illness, and interactions between these factors. Thus, for an Aboriginal or Torres Strait Islander community health would include: cultural health; linkage to land; mental health; safety and security; income; housing; education; good diet; sewerage/sealed septic and access to potable water. In Canada, they have developed a number of options to deliver health services to the Inuit and similar peoples as well as the first Nations peoples. This includes training lay people or nurses aides in small communities in basic skills like tele-physiotherapy and tele occupational therapy as well as the skills to assess homes and identify what aids are required. The physiotherapist obtains the health records and views the ability of the person to undertake certain skills tests and then identifies a list of exercises and reviews the ability of the person on a regular basis. Meanwhile the lay person supervises the exercises and ensures the patient is completing them properly. A similar process is used for occupational therapy. In many remote Aboriginal communities, the cost of constructing a house is in excess of $1 mil for a basic home. This is due to the fact that roads to these communities are only open for 3 to 4 months for the heavy trucks that carry the building materials and concrete. In addition, white tradesmen are sent to the community and paid remote allowances as well as provided with an expected level of accommodation. Housing in communities may accommodate 15 to 17 people in a three-bedroom home and this impacts on the community. In addition, maintenance is not carried out on houses due to a lack of tradespeople. The telehub could resolve this. TAFE courses online could train community members in carpentry; plumbing; concreting and electrical works. This could all be carried out through the hub in the community. Training projects could be printed out in the TAFE on 3-D printers. To ensure that work is being done correctly. Canada also uses a remote timber milling computer program to cut timber into assemble able housing frames. The timber could be ethically sourced from the local community. This would cut the cost of housing in these communities by a third and boosting the stock of available housing significantly. It would also provide for construction of safe shelters and maintenance of existing structures. One of the major issues in relation to psychiatric illness and substance abuse in communities is the lack of employment and feelings of self-worth. By exploding employment opportunities in this fashion; decreasing overcrowding in housing and improving drainage and sanitation, the impact on physical and mental well-being would be substantial. Another element in Aboriginal communities is the loss of language and culture. In the Northern Territory, Richard Trudgen, from Why Warriors has spent a lifetime gathering what would otherwise be now extinct languages. Some languages are limited to not just peoples or even clans but sometimes even to family groups. Many community people of the last two generations have lost much of their culture because of The Stolen Generation; because with a lack of culture significant numbers took prison sentences as an ‘initiation process and because there is a growing generation of FASD(Foetal Alcohol Spectrum Disorder) youth who have drifted away from community/cultural expectations. While elders are still with us, now is the time to capture the languages and cultural traditions and hold it in storage to educate community youth. Tele-psychiatry/psychology is a powerful tool for both Indigenous and Rural and Remote Communities. The highest three categories of suicide in Australia are Indigenous Peoples; Veterans; and Farmers/Farm workers. The hub could provide a centre in GP clinics; small rural hospitals; Community Health clinics where private soundproofed rooms could be made available. This could allow for private consultations and consultations with GP or authorised health worker to put in place a mental health plan. The GP or a tele-pharmacy could provide medication and script renewal to assist in the mental health plan. The plan could also allow for family members to identify indicators and organise more regular sessions. One of the biggest problems in rural communities is the dependence on the weather. Floods or droughts not only affect the farmers but also the small businesses in the towns that depend on the farmers incomes. Many small to medium businesses carry Farmers “on tick’ hoping for a good season to settle their books. Farmers overcapitalise in equipment or expansion, taking on too high a debt burden to meet during poor seasons, while the town businesses do not have the underpinning capital to maintain their businesses. A while back, an understanding local banker would allow for these factors, but in this age of centralised profit driven banks, this is not an option and there are many empty businesses following the long drought. A tele-hub could train those businesses and farmers in basic accounting law and practice; ASIC and other regulatory requirements; occupational health and safety requirements; as well as Government loans and grants to assist in maintaining their community. This is but a small overview of the opportunities for a tele-hub. State Government investment of about $20 mil over four years would make a huge difference. In many communities existing empty buildings could be adapted for a small cost leaving equipment as the major cost.
TECHNOLOGY HUBS IN INDIGENOUS, RURAL AND REMOTE COMMUNITIES