ANPHA and the last post!

I am currently feeling very sad, as I’ve arrived back in Sydney airport, ready to fly to Heathrow tomorrow morning.  I hear that I’m to be greeted with heavy rain and stormy weather and after 4 weeks of almost continuous sun, the prospect doesn’t fill me with joy! The 4 weeks have flown by and I have enjoyed every second of it – it has no doubt, been an experience of a lifetime.  I would encourage anybody who wants to travel and to investigate and learn more about a certain issue, to apply for a Winston Churchill Fellowship – even though it has been a lot work pre and during (and post while I write the report!) travel, it has been more than worth it.  I have met people through work that I’d never even imagined that I’ve meet and been to places that I’d never thought I’d see.  It has left me even more enthusiastic about public health and full of ideas about implementing certain things back at work (I’m sure they can’t wait to see me back!!). 

However, my last two days here have been hectic and it’s only now that I’m having a chance to relax after what’s been quite a tiring week.  Yesterday morning (Thursday), I arrived in the Australian National Preventative Health Agency (ANPHA), where I was joined with other interested individuals from the Australian Capital Territory (ACT), in a morning of discussion about tobacco control in Wales and then a broader discussion about tobacco control in general in both countries.  I have to admit that I was quite nervous about this, as even though I had prepared the presentation before going, I am always a bit apprehensive before presenting on a certain topic.  However, I enjoyed the morning’s discussion with like minded people and make a few contacts that provided me with more information about their organisation.  Members of staff at the Department of Health, had bought me a complete set of plain packaging cigarette packets (obviously empty!), so that I could take home and show people what the messages on the packets looked like.  I was very pleased with this gift, as it will be a visual tool that I can use when I get to Wales and show people, in order to engage their interest.

The staff at ANPHA (particularly Michele Mack and Anita Rodrigues Marcias), had been so helpful and accommodating before I arrived at ANPHA and even through Michele couldn’t be there yesterday (I had greatly looked forward to meeting with her), Anita (Tobacco Control Policy Officer) was a fantastic host, introducing me to ANPHA staff and visitors who had come to join in the morning’s discussion.  I must take tips as to how she makes networking look so effortless! ANPHA had arranged for me to have lunch with Kate, who is the Assistant Director of Alcohol Programs in ANPHA and who has previously lived in Scotland for some time, and we discussed more about the work that they do in ANPHA on alcohol related issues.  I then travelled to Deakin (around 15 minutes from Canberra), where I met with Jane Shelling, Manager of the National Drug Sector Information Service (a non governmental organisation, which is part of the Alcohol and other Drugs Council of Australia).  Jane is a Churchill Fellow herself and had travelled to Canada, the UK and the USA in 2010.  It was great to meet another Churchill Fellow (the Fellowship is well recognised in Australia) and talk about our different experiences and what I could do with the learning once I was back in Wales.  Here is a picture of Jane and I:

The Alcohol and other Drugs Council of Australia (ADCA) is the peak, national, non-government organisation representing the interests of the Australian alcohol and other drugs sector, providing a national voice for people working to reduce the harm caused by alcohol and other drugs.
ADCA works collaboratively with the government, non-government, business and community sectors to promote evidence-based, socially just approaches, aimed at preventing or reducing the health, economic and social harm caused by alcohol and other drugs to individuals, families, communities and the nation. I would do disservice to the services that the organisation provides by trying to explain myself, so follow the link below and have a look at the bottom of the home page, where it shows the range of online services that they provide.

Unfortunately, the organisation has not received an extension to their current funding and will be closing next week.  This will sadly cause a gap in the gathering and dissemination of evidence and resources surrounding alcohol and other drugs around Australia. 

Last night, Anita and Jack Quinane (Acting Manager of the Policy and Research Branch) met me for an Asian supper, where we further discussed public health issues within Australia.  Anita and Jack both used chopsticks very competently to eat, but I stuck with a fork and spoon! Since Meinir and Alun have gone home, I haven’t gone out for supper and have lived on dried pasta (mixed with milk!), so it was lovely to have some company for supper.  Thank you both for your company, as I know that they were very busy with other pressing matters in work. Here is Anita and I before I left on Friday: 

This morning, I went back to ANPHA again, where I presented on what’s happening in Wales surrounding alcohol related issues.  Both countries are very similar in terms of how normalised alcohol is – it’s connected to sport, to TV soaps (everything is based around the pub!), to advertising campaigns, to music festivals being sponsored by particular brands of alcohol.  There is also a social pressure to drink and being drunk is something that happens to thousands of people every weekend.  The big question posed is whether there will ever be a culture change where the consumption of alcohol will not be the norm (as has happened with tobacco).  It was re-iterated during the discussion this morning that when army personnel came back from WW2, 80% of them smoked and nobody at that time probably thought that smoking would not be the norm.  I very much hope that this is the case.  It was a very interesting discussion, which I enjoyed very much.  Here are some of us having an informal discussion after the presentation! 

Before leaving, I had a chance to discuss the work that the Social Marketing Team at ANPHA are involved in.  At present, the alcohol social marketing team are working on the Be The Influence campaign, which is targeted at 16-24 year olds.  They connect with this age group through Facebook, Twitter, Instagram, You Tube and through having a big yellow inflatable tent at music festivals called Recharge, Refresh and Regroup.  This is an alcohol free zone in festivals, where people can go to have water, re-charge their phones, chill out and re-charge themselves on massive bean bags.  While they’re there, the team have a chance to talk to them about alcohol related messages, through social media (by showing them You Tube clips that they have designed etc).  I hadn’t considered myself to be that out of touch with social media until I visited the team, as they were talking about ‘eyeballing’ sites and Instagram – concepts that I am not really familiar with! I though back to my own teenage years where the most important thing was when I was going to play hockey and trying to avoid a telling off from your parents for using the landline to talk to friends too much! Communication has certainly changed over the years and this campaign had energy, vibe and used active sports (such as surfing, bmxing and stakeboards) to promote their message.  Have a look at their website www. And like their page! http://www.tacklingbingedrinking.gov.au/internet/tackling/publishing.nsf

Here are the enthusiastic members of the Social Marketing Alcohol team, Melaine Moore and Rachel Stedman:

I also had a chance to discuss the work that the tobacco social media team develop with Mary-Jana Griffin – in this instance an app called My Quit Buddy.  This free app (which is available on all three platforms: IPhone, Android and Windows), is for smokers who want social media support whilst trying to give up.  The app has health related messages, shows the user how much he/she has saved whilst not smoking since they registered and games as distracters when a user gets a craving for cigarettes.  They also market their message through other ways – in Australia, drivers are encouraged to take a break from diving every two hours.  Across Australia there are Driver Reviver vans, manned by volunteers, giving out free tea/coffee and biscuits.  As individuals are not permitted to smoke in cars if they have passengers under the age of 12, many drivers use this stop as a place to have a cigarette.  When these drivers have their cup of tea in their polystyrine cups, they see adverts for my quit buddy displayed on the cups, see picture below.  Check out www.quitnow.gov.au for more info. 

Well, I thank you all for following me throughout my journey, it has been an amazing 4 weeks.  I am going to have a swim now before embarking on the very long journey that faces me tomorrow morning and put my fleece and jeans on to brave the elements when I get back! I would like to thank everybody who supported me both in the UK and in Australia during this trip – I hope I can return the favour to others one day.

Welsh Connections and plain packaging

It’s been a busy past few days since I last posted and I’ve gone from being in Sydney for two days, to Wollongong and I’m now in Canberra for the next couple of days.  My time here is rapidly coming to an end and I was just reflecting last night how much I’ve learnt while I’ve been here – not only about issues relating to alcohol and tobacco, but about the importance of displaying good communication skills, organisational skills (although you should see my suitcase by now!) and the willingness to be flexible to arrangements that are made whilst I’ve been over here.  Luckily I had been told whilst I was arranging my itinerary, to leave some free time in the diary in case new contacts were made whilst I was here and that certainly has happened.  It also takes independence to travel around a different country and meet different people from all walks of life - I certainly feel more confident in my ability in building relationships with people in a short space of time and will take this back to my work in Gwynedd. I hope that I have made contacts here for life, who I can turn to for information and vice versa on certain health related matters.

On Monday, I had arranged to meet with Dr Tony Jewell, former Chief Medical Officer (CMO) for Wales.  Tony and his wife Jane, live in Australia for certain parts of the year and I caught the ferry over to the district where he lives (where incidentally the smoking rates are very very low, around 5%).  We discussed his time as CMO in Wales, where he was instrumental in establishing Public Health Wales (PHW), forming a new organisation that would encompass public health matters in Wales (health protection, health promotion and health care quality).  I was working for PHW when Tony was appointed and as a strong advocate for public health, he was the driver behind many strategic documents, such as Our Healthy Future (which was a mini Bible to us) and Fairer Outcomes for All, which are still relevant today.  It was therefore an honour to discuss public health matters with Tony and we discussed the similarities and differences between Australia and Wales in terms of alcohol and tobacco issues.  As I’ve stated in previous posts, Australia has used legislation to great effect in the area of tobacco control and heavily promotes smoke free spaces – to the extent where it is now the norm to have spaces free of smoke.  This is slowly starting to happen in the UK, but there is a long way to go in order to make it a norm.  Mosman Council have now implemented smoke free zones in all public places in Mosman (apart from on the street), the first of its kind to do so in and around Sydney.  Australia has made tobacco control a priority and with everything that they’ve done regarding legislation and social marketing campaigns, they are certainly seeing the results in terms of smoking rates decreasing. 

On the way to meet the bus back to Sydney, Tony took me to see a sculpture on the pavement close by to where he lives.  As you can see from the picture, it is a sculpture to celebrate the association between two ancient cultures – the Celts and Aborigines.  Tony didn’t know what the association was with Mosman (the area where he lives), but it was nice to see a reference to Wales on a sculpture in the suburbs of Sydney! I would like to thank Tony and his wife for their time in meeting with me, it was certainly a pleasure. 

On Tuesday morning, I travelled to a suburb in Northern Sydney (Lane Cove), to meet with Victoria Parr.  Victoria is now the Managing Director of the Sydney branch of Latitude Insights, but previously to that, she worked for GFK Blue Moon, which was the company involved in researching and designing the plain packaging for the Government.  Victoria was the driving force behind this research and has a number of years experience in researching health related matters.   

Australia starting displaying health warnings on their cigarette packets in 2006 and it can be seen from graphs, that there was a definite decline in tobacco rates following this development.  However, these health warnings (and small pictures) were only displayed on the lids and on the back of the packet – the brand colours were still displayed as was the brand itself.  In 2010, the Australian Government decided to implement plain packaging (see photos below), complete with written health warnings, as well as graphic pictures.  The brand colours were also replaced with a non descript green colour, so that individuals didn’t make an association between colour and brand.  Plain packaging was therefore targeted initially towards the younger population, so that they didn’t start to make an association between brand and colour. 

What I hadn’t realised before talking with Victoria, was the background marketing research that had gone into the design of the plain packaging initiative.  This involved several studies and different types of methodology and engaging with people who smoked, in order to see what would be most visually effective on cigarette packets.  This involved discussing font, font size, the percentage of coverage on the packet which would be health warnings, etc etc.  This took several months and several prototypes to finally come up with the cigarette packets that are now on sale.  I’m sure you agree that the colour isn’t very appealing, neither are the graphics displayed on the packets.  The packs are also designed so that individuals are ashamed to bring them out in public and keep them hidden in their bags instead of leaving them on tables, with the aim of reducing the amount of time people take the packet out of their bag. For more information about the marketing research process surrounding the plain packaging, click on the below.  You can then see how much work went into the whole process!

http://www.health.gov.au/internet/yourhealth/publishing.nsf/Content/8B0333A18648BCF3CA25796E0023D826/$File/Market%20Research%20%20Plain%20Packaging%20of%20Tobacco%20Products.pdf

http://www.health.gov.au/internet/yourhealth/publishing.nsf/Content/mr-plainpack#.UvmtB_0rT8s

Again, I wish to thank Victoria for meeting with me on such short notice and for discuss the process through with me.  Here is Victoria and I: 

I then travelled from Sydney to Wollongong, which also has Welsh connections.  There, I met with Tanya Buchanan, Manager of Community Cultural and Economic Development for Wollongong City Council.  Tanya is the former Chief Executive Officer for ASH Wales and worked in Wales for around 6 years, so has an in depth knowledge of tobacco related issues in Wales.  It was great to meet with Tanya and we discussed what they are doing as a city council to promote smoke free areas.  Last November, they launched their Smoke Free Mall campaign in Wollongong (the mall is an inside and outside area), where they encourage people not to smoke in this area.  This was after a process of public engagement, where they initially researched into whether the public would be happy making the mall smoke free.  This information then informs the Council’s elected members, who then make a decision as to whether to move forward on the matter or not.  The Police are involved in enforcement of this policy, as they are with many smoke free legislation (such as smoke free cars).  Smoke free playgrounds, bus shelters and sport fields are also other smoke free areas around Wollongong.  They are now in the consultation process as to another public site within Wollongong which they hope to make smoke free. 

I was due to spend a longer period of time at Wollongong City Council, but due to time restrictions with public transport (only one bus going to Canberra from Wollongong daily), I had to cut my visit short there, which was a shame.  I really enjoyed meeting Tanya, because as well as talking about tobacco related issued, we also discussed the importance of planning and engagement when trying to implement a public health initiative.  Here is Tanya and I: 

Unfortunately, I wasn’t able to see the sights in Sydney, as I was only there for one full day, but I did see the Sydney Harbour Bridge and the Opera House from the ferry.  However, I was staying only five minutes from Darling Harbour, so I ventured down there for a stroll and I really liked the atmosphere there.  As Valentines Day is this month, they were marketing it as the Month of Love and they had many romantic activities going on (see picture below).  They had also slow (or soppy – you decide!) music on in the harbour, so I felt out of place there walking by myself surrounded by couples eating and drinking! But apart from the seagulls taking everybody’s food (similar to Caernarfon!), I very much enjoyed it there. 

I am in the Australian National Preventative Health Agency (ANPHA) tomorrow and Friday, where I will be presenting on the work that’s happening in Wales surrounding alcohol and tobacco.  I am a bit nervous, but I’m sure I’ll enjoy it!  I will therefore write my last post on Friday night, as I’m due to fly back Saturday morning.

Vic Health, Quit, MAV and yes, it's still hot here!

As you know, I'm still in Melbourne and am departing for Sydney on Sunday.  I have loved my time in Melbourne and have met many fantastic people who have been generous with their time.  I can now find my way around without the use of Googlemaps, although as I walk to meetings, I can find the venue quite easily, but I seem to take much longer getting back as I usually miss the correct turning, so the map is still very handy!

It's been a very couple of days in terms of meetings and these have left me with a lot of information to take back to Wales and disseminate.  I have been acutely aware since being here of my role and responsibility as an 'ambassador' for Wales, for Gwynedd Council and for the Winston Churchill Memorial Trust and this is something I take very seriously.  I hope during my meetings here that I've been able to raise awareness of the positive work that's happening in Wales re: health promotion and prevention and that it's been a dual sharing of knowledge and information, as well as highlight Wales in terms of culture and language.

It would be a very long post if I described in depth all that I've learnt over the past couple of days, so here is an overview.

On Thursday morning, I met with Irene Verins (Program Manager with VicHealth).  Irene explained the nature of the work happening in VicHealth, which I found very progressive and interesting.  VicHealth is a health promotion foundation, founded in 1987.  It was the first health promotion body in the world to be funded by tax on tobacco and its aim is to promote health in the state of Victoria.  VicHealth focuses on creating the conditions in which good health can flourish, from better public health policy and healthy urban environments to more inclusive and respectful communities.  They also advise governments, are innovative in their health promotion programmes and work in partnership with organisations across a variety of sectors.

Very similarly to Wales, VicHealth's focus in on
1.  Promoting healthy eating
2.  Encouraging regular physical activity
3.  Prevent tobacco use
4.  Prevent alcohol from harm
5.  Improve mental wellbeing.

For more information about VicHealth's Action Agenda for Health Promotion, click on the following link, it's an interesting read:
http://www.vichealth.vic.gov.au/Publications/VicHealth-General-Publications/VicHealth-Action-Agenda-for-Health-Promotion.aspx

Unfortunately, I didn't take a photo of Irene and I, apologies for that!

Later on yesterday afternoon, I went to the VicHealth building to meet with Claire Henty (Settings Co-ordinator) and Emma Harris (Achievement Programme Acting Manager) at the Centre of Excellence and Intervention and Prevention Science (CEIPS), who are delivering the state wide Achievement Program.  The Achievement Program, which is a settings based intervention, in early childhood education and care services, primary schools (and soon to be secondary schools) and workplaces.  The programme (which receives funding from both state and national government), focuses on 12 local government areas in Victoria identified most at risk of ill health.  Each of these 12 areas has a Healthy Together Communities team leading local health activities, including providing support to workplaces and early years/schools setting, to support them in working towards the Achievement Program. Other communities in Victoria can also work towards the Achievement Program, but a central team in CEIPS is supporting them. 

The Achievement Program in workplaces and in educational settings encourage establishments to work towards different health priority areas, including tobacco, alcohol, physical activity, healthy eating and mental health and wellbeing. The programme is very similar to the Healthy Schools and Pre School Scheme and the Corporate Health Standard in Wales, with some minor differences (but the same priniciple).  It's an exciting time in Victoria to be implementing such programmes and I hope that they funding continues after 2015, in order that the programme can be embedded in educational settings and workplaces, as they have done in Wales. 

For more information about the Achievement Programme, click on:

http://www.achievementprogram.healthytogether.vic.gov.au/health-professionals/the-achievement-program

I will certainly be taking a lot of information back to my colleagues in Public Health Wales, who work on the Healthy School Scheme there, in order to exchange information. Thank you Emma and Claire for taking time out at such short notice to speak with me.

Here is a picture of Emma, Claire and myself:

On Friday, I went back to VicHealth again, where I met with Sean O'Rourke (Senior Project Officer within the Alcohol and Tobacco Team in Vic Health).  Sean€ also met with me on very short notice, so I'm vey grateful that we were able to meet and discuss the work that the team does there on alcohol related issues.  Sean had been on an exchange programme when he was in his final year in University and spent a term in Leicester University, so he was familiar with the UK.  In fact, Sean had visited Aberystwyth, Machynlleth, Dolgellau and Caernarfon on his travels, so it was nice to be able to speak about home with somebody who had previously been there!

Sean and the Alcohol Team in VicHealth is currently working on a two year culture change project, which complements current Victorian legislation on alcohol, which is:
1.  An extension to the freeze on liquor licences serving alcohol after 1am (so no licences are given to new liquor outlets in Melbourne after 1am).
2.  An individual is banned from licenced premises if they've been convicted for an alcohol related offence.
3.  Licenced premises lose 'stars', based on a merit system, if any incidents happen on the premises. 

This 2 year culture change programme aims to address attitudes and subsequent behaviour related to alcohol.  There are two parts to the campaign:
1.  A website -  http://www.namethatpoint.com/#?utm_source=paidsearch&utm_medium=sem&utm_campaign=alcoholcommunity, asking individuals to contribute ideas to name that point where things could go either way.  This means that point on a night out where things are going great and you're having fun and relatively in control, but you have another drink and it all changes (have a look on the website, it's very interesting).  They want to capture the name of that point and use it in future campaigns, so that individuals can related to it more perhaps than a hard hitting campaign, as it's more relevant to them. 
2.  A survey re: people's attitudes to alcohol.  Both the survey and website will then inform the content of a multi media campaign, which aims to change people's attitues and behaviour towards alcohol. 

Sean also talked about a number of research projects around alcohol that had been funded by VicHealth and the outcomes of those projects, which are then able to inform future work programmes. Thank you Sean for taking the time to speak with me today - it was a very interesting meeting.

Here is a picture of Sean and I today in VicHealth:

After the meeting with Sean, I went straight to meet with Jan Black, a Policy Advisor with the Municipal Association of Victoria (similar to the Welsh Local Government Association in Wales). When Jan and I first started talking, I discovered that she had heard about Aberystwyth as she is an avid reader of Malcom Prices' books (these are detective novels based in Aberystwyth), so she was pleased to meet someone from there!

There are 79 Local Governments within the Victoria region (this was cut down from 212 around 1994-95).  Each Local Government has to develop a Municipal Health and Well Being Plan every four years (a Government requirement), which states what they will do in order to fulfill the state's health priorities (currently the Victorian Health and Well Being Plan 2012-2015).  The priority areas within the plans are based on local needs and requirements i.e. if there is a particular issue related to alcohol in a certain area, then they will focus on that in the plan. 

As well as Trading Standards roles, Local Government advocate for public spaces to be smoke free.  Beaches are now smoke free in Victoria (and Queensland), so people are asked not to smoke between the flags on the beaches.  It is noticable in Australia the work that is being done surroundin smoke free environments, with organisations being proud to be smoke free and invest money in order to advertise and promote this to the general public.  Melbourne University has only this week announced that is it smoke free and I saw these signs on the pavement outside the University advertising the fact that their premises were smoke free.  This means more than just not being able to smoke on the grounds - no retail outlets are able to sell cigarettes on the grounds either i.e. if there was a shop on the University campus, then there would be no cigarettes sold.

 

I very much enjoyed my time with Jan and it was very interesting to hear about the role of Local Government in health promotion and prevention.  Jan has said that she wants to visit Aberystwyth so I hope that she makes contact when she does.

Here is a picture of Jan and I;

Lastly on Friday (yes, it was a very busy day!), I met with Fiona Sharkie (Executive Director) and Luke Atkin (Head of Cessation and Partnership Projects) from Quit Victoria.  Quit Victoria is an organisation which receives funding from various sources, as well as VicHealth.  Quit Victoria's vision is dedicated to ending the pain, suffering and costs caused by tobacco. One of its key goals is to reduce smoking rates to 12% by 2015 (rates in Wales are on average 24%).  Quit aims to do this through the following approaches:
 1.  Build evidence base
 2.  Build capacity
3.  Advocate and influence
 4.  Work in partnership
 5.  Operational excellence and ethical practice
 6.  Universal and targeted population programmes
 7.  Provide services
 8.  Health education.

For more information click on:  http://www.quit.org.au/about/strategic-plan.html

I asked Fiona what she thought had made such an impact on reducing the tobacco rates in Australia and she stated that there were three strands to this:

 1.  Keeping the high price of cigarettes (currently almost A$20 for 25)
 2.  Legislation, such as smoke free areas and plain packaging
 3.  Social marketing campaigns
Luke explained about another service that was provided by Quit, which is Quitline.  This is a support service offered to the public who want to make a quit attempt, either through telephone support, online (through quit.org.au and Quitcoach), through text (QuitTxt), or through written literature.  This service is both a service for the mainstream population and the indigenous population (with its own staff).  They also employ a telephone translator service for those individuals who are more comfortable conversing in their first language.  It's a very similar service to Stop Smoking Wales, aimed at building capacity in organisations to offer brief advice. For more information see http://www.quit.org.au.

Here is a picture of Fiona, Luke and myself.  I would like to thank them for agreeing to see me late on a Friday afternoon at such short notice - I am very grateful. The Cancer Council (where Quit is based) was also having an open day and here are an example of some information materials that they had out for the public to see:

I don't feel that I have covered everything that has been discussed over the past couple of days, but it will give you a flavour of what I've learnt.  It has certainly given me a lot to think about.

Mei and Alun Skyped from Sydney on Friday night - they are going home Saturday morning.  I missed them more after speaking with them on Skype - we have had such a wonderful time here together and I feel sad that it's all coming to an end for them. They certainly don't want to go home!  I only have a week left here as well and that will fly by I'm sure.  I'm flying to Sydney on Sunday and then going to Wollongong and Canberra in the week, before flying back next Sat. 

I went to the market in Victoria Market on Wednesday night and it was as busy as the previous week! I bought two dresses (tried to haggle but they were having none of it!), and then went quickly from there before I ran out of money. I enjoyed all the noise and hustle and bustle there, apart from the queue for food - they can be quite long! Here is a picture of the market:


I also went to meet my sister today (she lives in Glen Waverly) and I couldn't resist going to see Ramsey Street in real life.....I was quite disappointed that I didn't see Toadie or Paul Robinson!!

Visit to the Australian Drug Foundation

I am pleased to note that the wifi is back up and running in the hotel again, so I'm not taking advantage of McDonalds' free wifi today!

This morning, I met with Geoff Munro, National Policy Manager at the Australian Drug Foundation (ADF).  Geoff has been with ADF for over 20 years (in various roles) and has a wealth of experience in the field of drugs and alcohol.  The history behind the ADF is documented in the book pictured below, detailing how ADF started and how it has evolved over the years, to adapt to circumstances. 

One of the founder members of the ADF was Edward Dunlop (an Australian surgeon), who was renowned for his leadership whilst being held prisoner by the Japanese in World War II.   Dunlop became a Japanese prisoner of war in 1942 when he was captured in Bandung, Java, together with the hospital he was commanding. Because of his leadership skills, he was placed in charge of prisoner-of-war camps in Java, was later transferred briefly to Changi, and in January 1943 commanded the first Australians sent to work on the Thai segment of the Burma-Thailand railway.

After being held in a number of camps in Java, he was eventually moved to the Thai-Burma railway, where prisoners of the Japanese were being used as forced labourers to construct a strategically important supply route between Bangkok and Rangoon. Conditions in the railway camps were primitive and horrific—food was totally inadequate, beatings were frequent and severe, there were no medical supplies, tropical disease was rampant, and the Japanese required a level of productivity that would have been difficult for fully fit and properly equipped men to achieve.

Along with a number of other Commonwealth Medical Officers, Dunlop's dedication and heroism became a legend among prisoners. A courageous leader and compassionate doctor, he restored morale in those terrible prison camps and jungle hospitals. Dunlop defied his captors, gave hope to the sick and eased the anguish of the dying. He became, in the words of one of his men, "a lighthouse of sanity in a universe of madness and suffering". His example was one of the reasons why Australian survival rates were the highest (this is all from Wikipedia).  Dunlop was also a founder member of the Australian Heart Foundation and the Cancer Council.

The book pictured above also mentioned the history of alcohol use in Australia - that it was the drug of choice in early Australia and the one most readily available.  Early financial transactions were conducted in rum and the implications of this relationship are still being experienced today.  The heavy use of alcohol in early Australia created many problems that afflict society today. For those convicted of alcohol related offences in the early days, the punishments consisted of imprisonment, forced labout or flogging.  This form of treatment continued until 1912, when prisons were overflowing and the Inebriates Act was introduced.  The Act handed responsibility for inebriates to mental hospitals - throughout the first half of the 20th century there were few treatment services other than those in psychiatric institutions (taken from Arduous Endeavour).

ADF started in 1959 as a service for alcohol treatment, but it now focuses on prevention and early intervention.  THere are five units within ADF -
1.  Information and research
2.  Workplace programmes
3.  Community programmes
4.  Marketing and Communications
5.  Finance and ICT.

The information and research unit publishes a quarterly publication (Prevention Research Quarterly) and commissions individuals working in the field of alcohol and drugs to contribute towards this publication.  One applicable to my role in Wales was titled Under the Influence: What local goverments can do to reduce drug and alcohol related harms in their communities.  I will be sharing this with colleagues when I get back to Wales.

THe ADF if now developing its new strategic plan for 2015 onwards.  This proposes to be a long term strategic vision in order to change the culture in Australia.  I was pleased to see such a long term vision, as change and culture shifts take years to happen.  Due to financial constraints within public services, there is more and more pressure to demonstrate change within a short period of time e.g. project funding being available for 1-3 years, when in fact, it takes much longer to change people's behaviour.  I look foward to seeing the plan having been developed and published.  

One of the flagship programmes that the ADF run is the Good Sports programme.  This is a national preventative health programme for the community sport sector.  The programme is a voluntary accreditation programme assisting sports clubs to manage alcohol better (apologies that the picture doesn't appear the right way up!). 



Wales and Australia both have a strong culture association between alcohol and sport (need I say no more than the Six Nations!).  The Good Sport programme helps sports clubs change their culture to become more focussed on young people and families and less on drinking alcohol.  THere are three levels to the programme, where clubs must work on implementing various criteria, such as an alcohol management policy, low and non alcoholic drink options, safe transport policy and Responsible Serving of Alcohol training.  A number of these clubs have a liquor licence and the bars are manned by volunteers, therefore regulation is difficult at times. 

I found this programme fascinating to discuss with Rod Glenn-Smith, the Good Sports Manager for Victoria, as alcohol is ingrained in sporting culture in Wales as well.  I found it difficult to envisage sport clubs in Wales changing their culture to the one promoted by Good Sports.  The culture is slowly changing in Australia through this programme and it receives funding from a variety of sources, including the Department of Health and road traffic authorities. The ADF also works with professional sports Unions, as the vision and direction in order to change the culture of alcohol within a particular sport has to be from top down as well as bottom up. 

Geoff and I also discussed the use of alcohol at school events, as many schools in Australia serve alcohol to parents at school fetes, school sports days and at school discos.  Parents can also bring their own alcohol to these events.  I was pleased to note that this was not the case in Wales.  Geoff has spoken publicly against this, which caused a public debate.  Many individuals feel that Australia is becoming a nanny state and that it should be an individual's choice whether to drink or not.  However, the boundaries between drinking at home and drinking in public has been almost been eradicated and alcohol is now seen everywhere and has to some extent, been normalised.  The ADF has now received funding to look at the effect that alcohol being available in school functions has on the health of the nation, so I look forward to reading the results of that research in time. 

Geoff also put me in touch with 3 other organisations in Melbourne, so I have a busy schedule between now and the weekend, which is great.

Here is a picture of Geoff and I (Rod has to go to another meeting).

I would like to thank Geoff, Rod and the staff at the ADF for being so welcoming, I was very much enthused by this morning's discussion.

The sun is still shining here now, so I have planned to go to the Victoria Market tonight for a walk.  I went there last week and was unprepared for how busy it was going to be - I know what to expect tonight!

Visit to VACCHO

If you didn't already know, the Chinese are celebrating their New Year, so Melbourne was very colourful over the weekend, with all kinds of celebrations happening across the city (as can be seen from the picture above).  There is a large Chinese population in Melbourne (as there was in Cairns) and it was lovely to see everybody joining in the celebrations (I refrained from the karaoke that was on!). Meinir and Alun have left for Sydney, so I am on my own now until I get home, so I'm missing their company already - it has been great having them here with me.  I have moved accomodation and the wifi is patchy there, so I've had to come to MacDonalds to get free wifi (trying to choose something healthy from the menu was a challenge!).  I haven't got much battery left on the laptop, so I hope I finish the post before the laptop dies!

Yesterday (Monday), I visited VACCHO (Victorian Aboriginal Community Controlled Health Organisation), where I met with Robyn Bradley (State Tobacco Co-ordinator) and Keren (Researcher).  VACCHO  is Victoria’s peak representative Aboriginal health body and champions community control and health equality for Aboriginal commuity. 

It currently has 28 members, with each member being an Aboriginal community controlled organisation. The majority are multifunctional services with health as a central part of their responsibility and some are full health services. The role of VACCHO is to build the capacity of its membership and to advocate for issues on their behalf.

We had a very interesting discussion about the work that VACCHO has been involved in regarding Smoking during Pregnancy, where they have supported their members to develop smoke free policies in their workplaces (similar to Wuchopperen mentioned in a previous post).  They have supported members to develop their own smoke free policies (so that neither clients or staff can smoke on the premises, whilst also stating whether or not they can smoke on the grounds (some have banned it altogether, some have designated smoking areas).  They started this process by consulting with the staff and clients, in order to gain their point of view and gain evidence that this was a supported policy by all. 

Whilst implementing the smoke free policy, they also trained the health professionals working in these workplaces, on how to approach individuals who breached the smoke free policy.  It is quite difficult to approach somebody who is smoking in a smoke free area, as it can cause confrontation, so training was delivered to the staff in order to be able to do so.  Some of the clients who smoke are anxious and worried (they may be waiting for results etc), so it is natural that they want to smoke whilst waiting. 

The third strand of the policy was providing support to individuals who want to give up.  Nicotine Replacement Therapy is available for free for Aboriginal and Torres Straight Islanders through the Pharmaceutical Benefit Scheme.  Individuals are therefore supported to give up through using replacement therapy.

Here is a photo of Keren, Robyn and myself:

We also have a very interesting discussion about the use of language when developing effective and culturally appropriate materials for the target audience.  The Aboriginal community in the Victoria area often use Koori English in their daily conversations (English with some Aboriginal words interspersed).  VACCHO developed these support materials for individuals wanting to quit, containing Koori English:

They were developed in consultation with the Aboriginal community, so that it was visually appropriate, as well as containing appropriate language. 

VACCHO are currently developing their work programme for the forthcoming years, having received a directive from the Federal Government to concentrate their work efforts on Smoking in Youth and further work in Smoking in Pregnancy.  Thank you to Keren and Robyn for their time - I much enjoyed the discussion that we had, especially around the language, as there are similar language issues both in Wales and in the Aboriginal community.

As I mentioned at the start of the post, Meinir and Alun have now gone to Sydney.  However, on the weekend, we took a fantastic (but very long), trip to the Great Ocean Road to see the 12 Apostoles.  It was well worth the long day:

I mentioned in a previous post that I had seen drive throughs which sell alcohol - here is a picture as proof:

I also saw this outside a nightclub in Melbourne - it's a machine that tests the alcohol on your breath and notes whether you are safe to drive or not.  A very useful device I thought and one which probably prevents many from getting into their car and driving home after drinking:

I am meeting with Geoff Munroe tomorrow from the Australian Drug Foundation, so I will update my blog after the meeting.  Hopefully this will be from the comfort of my accomodation and not in McDonalds!

Hot in the city!!

For those of you who are familiar with Melbourne, you can see from the picture of the Yarra river above that we have arrived and as you have probably heard on the news, it's so hot here! Thankfully it's not in the 40's like it has been in the past few weeks, but it is still hot enough.  I'm not a big fan of the heat, so I'm keeping my hat on and seeing a lot of the shade!

A lot of things have happened since the last post - on Tuesday night I went for dinner with Jan (Robertson from James Cook University), where we talked more about our jobs and life in general.  Meeting Jan has certainly been one of the trip highlights and I'm sure we will keep in contact in the future.  She also gave me a CD of an aboriginal band called Yothu Yindi (see pics below), who have made indigenous music more mainstream.  Thank you Jan!

For some reason, the photo is coming out upside down and I've tried three times to get it the right way round, but I'm not having any luck - sorry!

Before leaving Cairns, we saw this photo in a pub and thought that a lot of people would relate to this!

We flew to Melbourne on Wednesday and left the rain and the gale force winds behind in Cairns.  We went to St Kilda yesterday (about 3 miles from the centre of Melbourne), as there is a beach there.  Meinir and Alun wanted to sunbathe, but as a lot of you know, I can't stand sitting down in the sun (I did try for 15 mins but it was too hot), so I spent the day walking up and down the prom as it was cooler walking than sunbathing.  Unfortunately, I fogot to put sun cream on my neck and I was a nice shade of red by the night.  I usually cover up in the sun, but on this occasion, forgot that I didn't have a high neck t shirt and I am now paying the price.  The sun is very strong here and even 15 mins outside is enough time to burn. Mei and Alun loved it though and sunbathed for a large majority of the day! I also had 15 bites on my legs and 2 on my arms (a presant from the insects in Cairns), so last night I felt like one big itch! Lesson learnt on both fronts.  Here is a picture of St Kilda:

This morning (Friday), I had a meeting with Brian Vandenberg, Senior Policy Advisor for Cancer Council Victoria.  He works also (two days a week), as Executive Officer for National Alliance for Action on Alcohol (NAAA).  The Cancer Council's offices were around 2 miles away from our hotel, so Meinir (the group map reader), kindly got up and navigated me by foot to the offices.  Those who know of my map reading skills probably think that it was a very good idea that Meinir came with me! However, I successfully negotiated my way back on my own without having to ask for directions, which is a first for me!

Brian and I had a very interesting morning discussing his work, whilst also looking at the differences and similarities in the work that's going on in Wales and Australia re: alcohol.  Alcohol is not as much of a priority area in both countries (compared to obesity and tobacco), which is interesting to note, as alcohol misuse is a widespread issues in both countries.  Brian's work with the Cancer Council has a national focus, mainly concerned with taxes on alcohol and alcohol advertising. 

At present, one of the aspects that Brian is working on, is lobbying the Government regarding putting warning labels on alcohol products (similar to plain packaging cigarettes, but not as graphic).  The guidelines for safe use of alcohol in Australia is no more than 2 units on average a day and not more than 4 units in one sitting (binge drinking).  We also discussed the importance of increasing the public's perception that there are no health benefits to be gained from taking up drinking and the conflicting messages that the public are subjected to regarding alcohol.

Interestingly, Brian mentioned that Thailand has notified World Trade Organisation members of it's plans to introduce graphic warning messages on its alcohol products (for examples of the messages, see the link below).
http://www.eurocare.org/library/updates/thailand_notifies_wto_members_of_plans_to_introduce_alcohol_warning_labels

Here is a picture of Brian and I:

 We then went on to discuss the link between sport and alcohol, which is strong in both countries.  Alcohol advertising and sport go hand in hand in both countries, with the Australian cricket team sponsored by a well known beer.  Brian mentioned that there is a ban on advertising during the time when children watch TV (i.e. before 8.30pm), apart from if there's a sporting programme on, where traditionally pulls in high viewing figures.  We also discussed the fact that if there's a major sporting event on, like the 6 nations rugby in the UK, or the Ashes in Australia, then large amounts of alcohol are consumed as part of those sporting events.  There is a massive culture shift to be made - Brian is optimistic that this culture shift will happen, whereas I'm not so convinced!  Here are pictures of the Australian cricket shirt, as well as the Heineken Cup, a rugby tournament in Wales, Italy, England, Ireland, Scotland and France.

As I mentioned earlier on, Brian is also Executive Officer for the NAAA, which was set up in 2009.  The NAAA is a national coallition representing more than 70 organisations from across Australia. It aims to highlight the widespread concern in Australia about alcohol related harm.  At present, there is no Alcohol Strategy published by the Australian Government and this is one of the issues that the NAAA is lobbying for.  It also asks the Government to consider a 5 points plan to prevent alcohol related harm, these being:
1.  Reduce harmful drinking through changes to alcohol taxation
2.  Protect children from alcohol marketing and promotions
3.  Improve safety and cut the costs to communities caused by alcohol
4. Give individuals information to make healthier and safer choices
5.  Provide national leadership and motivation for action.

The NAAA have also produced a National Alcohol Policy Scorecard, which scores different states for their policies on alcohol, from regulating physical availability to education and persuasion.  States are then rated on their position on the scorecard, which is very interesting.  Brian is going to forward this document on to me if anybody wants me to forward it to them.

It was a very interesting morning's discussion with Brian, who was very knowledgable about alcohol related issues across Australia.  Thanks Brian for taking the time to meet with me!

On the way to meet Brian this morning, I excitedly saw two examples of plain packaging on the floor (Mei walked away whilst I crouched down to take photos of them!).  Here are the pics:

We are hoping to visit Ramsey Street over the weekend (it's got to be done!), as well as meeting my sister (who lives in Melbourne), with her partner (I am looking forward to seeing her).  Will post soon!

Work......and bank hols!

As you can see from the picture above, we have been snorkelling in the Great Barrier Reef and it was just amazing.  We could swim amongst the fish (which were so colourful) and swim just above the coral - what a fantastic experience.  The three of us snorkelled together and I was enjoying until Meinir pointed out that there were two reef sharks swimming by us - I quickly swum back to the boat at that point (although they aren't dangerous, I wasn't taking the risk!!!).

Yesterday (Monday), we drove back from Port Douglas to Cairns and on the way, stopped in Hunter's Crocodile Adventures, where we saw wildlife, such as crocs (see pic below of Meinir feeding the crocs), koalas and wallabies.  We all really enjoyed there - the staff were friendly and were full of bad jokes!

Mei and I also loved the koalas and spent a lot of time looking at them!

On the way back to Cairns, we also stopped in Kuranda, a very pretty village, where we took a walk in the rainforest (Alun moaned all the way as it was very humid!). The hat was essential by the way (no comments please!), as the sun was so hot on my head!

Bank hols over and it was back to work this morning (Tuesday).  I had arranged to meet Charlie Adams (Healthy Lifestyle Manager), Nancy Long (Director Business Development) and Nelson Lee (Regional Tobacco Co-ordinator) in Wuchopperen Health Service.  Wuchopperen Health Service is a host organisation to the Tackling Smoking Programme, which is a Federal programme and part of the Closing the Gap strategy.  Below is a picture of us (from left to right) - Nelson, Nancy, myself and Charlie.

Closing the Gap is a commitment by all Australian governments to improve the lives of Indigenous Australians, and in particular provide a better future for Indigenous children.  The 6 targets Closing the Gap is to:

• To close the life-expectancy gap within a generation
• To halve the gap in mortality rates for Indigenous children under five within a decade
• To ensure access to early childhood education for all Indigenous four years olds in remote communities within five years
• To halve the gap in reading, writing and numeracy achievements for children within a decade
• To halve the gap in Indigenous Year 12 achievement by 2020
• To halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade.

The Tackling smoking program is a state wide program that aims to reduce the initiation, prevalence and consumption of tobacco smoking among Aboriginal people in Australia.  We discussed the work that the programme does in the Cairns region, focussing on interventions such as the Smoking Management Policy, outreach work, being present and communicating with the communities in community events and social marketing. 

The Smoking Marketing Policy encourages workplaces to be smokfree, whilst assisting staff also to quit smoking. Staff in these workplaces are not allowed to smoke whilst wearing uniform and both staff are community members visiting the smoke free organisations are reminded not to smoke by using signs such as the ones below:

Role models are sometimes not present within Aboriginal communities (as in all communities) and due to this, the character D Warrior has been created.  D Warrior's message has been printed on a t shirt below (Durries mean cigarettes):

Here is D Warrior, the character:

D Warrior has a high visibility profile, to remind individuals (and especially children) that there is a role model there that supports the smoke free.  D Warrior also attends events, in order to spread the smoke free message. He also appears on water bottels, lanyards, towels, t shirts, bags and stress balls, so that smoke free message is constant and normalised.

As was discussed in previous meetings, the need to develop materials which are culturally appropriate was also discussed. In some communities, literacy and numeracy levels are very low, so visual aids/campaigns are used instead of writing, which some people may not understand.  It's all about trying to convey a message through pictures with maximum effect.  Some individuals in remote communities do not have a TV or radio, making outreach work vital, as mass media camapigns and social marketing campaigns would not reach the targeted community. 

Legislation has certainly helped to make environments snoke free within Australia - in Queensland smoking is not permitted in sports grounds (even if there is no staduim there), in playgrounds (or around playgrounds) and in outside areas where food and drinks are served (to name a few).  What I have noticed in the time that I have been in Australia is that I haven't seen any cigarettes on sale, or any plain packages, as all cigarettes are not displayed in shops or supermarkers (as is starting to be the case in the UK) and are kept behind a plain screen.  One of the things that I wanted to see whilst I was here was an example of a plain packet of cigarettes, but as yet, I haven't seen one packet anywhere.

Thank you very much to Charlie, Nelson and Nancy for the informative meeting this morning - I have had plenty of information to research further into and hopefully adapt to the work that is happening at hime. 

We are leaving Cairns tomorrow (and leaving the rain hopefully) and making our way to Melbourne, where the sun is out!  The time is going too fast and we are trying to make the most of it, as we will be back before we turn round!