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! 

Wilting and on the move.....

It's Bank Holidays here in Australia, so we decided to come to Port Douglas for the weekend, in order to see the Great Barrier Reef (Sunday).  Port Douglas is around an hour North of Cairns, but before heading up here this morning, we took a trip to Yarrabah, a small Aboriginal community of around 3,000 people, 37km east of Cairns.  Yarrabah means 'Paradise by the Sea' and it certainly is that as can be seen from the picture above. 

It was breathtakingly beautiful there and very peaceful on the beach, with only small barefooted children playing around us. Here is another photo of the beach (and me on it!):

 Jan had spoken to me yesterday about Alcohol Management Plans (AMP's).   AMPs currently operate in 19 discrete Aboriginal and Torres Strait Islander communities across 15 Local Government Areas and were introduced to reduce alcohol related violence, particularly against women and children. Around the Yarrabah area, along with other aboriginal areas, alcohol is restricted to the following limits: 

The maximum amount of alcohol a person can have if they live in the restricted area is limited to:

• 11.25 litres (1 x 30 can carton) of light or mid-strength beer

OR

• 750 ml (1 bottle) of unfortified wine.

  For example, if you lived in a town in Wales (for example Aberystwyth), you would only be allowed to bring in the following limits into the town, with the aim of trying to restrict the amount of alcohol coming into an area.  If you bought more than this into the town, then you would be fined the following:

Maximum penalties for possessing illegal alcohol in the restricted area are:

• first offence 375 penalty units (currently $41,250)
• second offence 525 penalty units (currently $57,750) or 6 months imprisonment
• third or subsequent offence 750 penalty units (currently $82,500) or 18 months imprisonment.

Vehicles found carrying alcohol above the set limit in the restricted area may be confiscated.
It is also an offence to attempt to bring illegal alcohol into the restricted area. The maximum is 375 penalty units (currently $41,250).
The on the spot fine for drinking in a public place is $110 or $247 if under the age of 18.
The maximum penalty for possessing alcohol in a dry place is 19 penalty units (currently $2090).
These penalties apply to all people residing in, travelling through, visiting or working in the restricted area.

These restricted areas are only found in Aboriginal communities and are not imposed on other Australian communities. I ask myself how I would feel having this restriction imposed in the area where I live... Here is a picture of the sign on the way into Yarrabah:

Unfortunately, the museum there was closed, so we made our way up to Port Douglas, a very beautiful drive along the coast.  It is so hot here that we were just sweating sitting in a chair!! Here are some pics of us here:

We are all looking forward to seeing the Great Barrief Reef tomorrow and have bought our disposable underwater cameras in readiness! Hopefully, I will be able to post some pics on this blog in the next couple of days!

Hello from a very warm and humid Cairns!

It seems like only yesterday since I last posted, as time is just flying by.  We flew into Cairns yesterday only to land in a storm - we were all quite disheartened! However, it is the rainy season here, so we were expecting it, but hoping that we would be lucky and that we would find sunshine.  But, upon waking up this morning, the sun was shining and it has been a very hot and humid day here.

Cairns is very different to the Gold Coast, as the sea and the rainforests meet - it's beautiful here.  The picture above is of the rainforest and the sea meeting (taken from the prom - I always have to have a walk on the prom everywhere I go!). 

Today, I met with Prof Alan Cough and Jan Robertson (Research Fellow), ar the James Cook University.  Over the years, they have worked with the indigenous community on many aspects of public health.  I spent the morning with Jan discussing various projects, inverventions and studies that they had worked in partnership with the indigenous communities.  We especially discussed a tobacco study that Jan had been involved in for 5 years with three remote Aboriginal communities to identify appropriate strategies to reduce the very high prevalence of tobacco use.  The work that Jan and I do involve the same public health principles, but adapted differently to be culturally applicable.  Here is a picture of Alan, Jan and I, with the Welsh tea towels that I had taken with me as a gift to them!

It was fascinating listening to Jan explain how they worked with the various indigenous communities and how culture and language could be a barrier to participation.  For example, English can be the 3rd or 4th language to some members within these communities, therefore being flexible and adapting to cultural needs was vitally important if the relationship was to be established between the community and individuals trying to engage with communities.  A traditional way of exchanging knowledge is through story telling and Jan often used pictures to tell a story or to feedback information that they had gathered to the community. 

 The picture above is of an extract taken from a series of short stories that Jan had compiled into a book called Short Ones - Tobacco Stories from Arnhem Land (a remote Aborigine community).  Through the eyes of individuals from Arnhem Land, the smoking stories explain and help individuals from other cultures about historial aspects of tobacco use, including the use of bush tobacco, or tobacco introduced by missionaries, pastoralists or Macassan traders.  It's also designed to share with other Indigenous Australians, to encourage them to break free from tobacco.  Tobacco use in certain indigenous communities can be as high as 80%.  It can therefore be very difficult to quit smoking when the environment is not smoke free and a large majority of the population smoke. 

The picture below is an example of a 'luniny' - a pipe traditionally used for smoking.
 

The picture below is an example of work designed by the local communities, asking people not to smoke, especially in the houses (so that people trying to give up are not exposed to smoking inside the house).  These stickers are then placed around the house (such as on the fridge), reminding family members that others are trying to give up. The message on this sticker means 'Good (respectful, healthy) family - no smoking tobacco'. 

 
Jan and I also discussed my work in Wales and what approaches/interventions I could use within work, which was a very interesting discussion.  Sometime you meet people through work who are very passionate and care very much about the communities that they work with and Jan is one of these individuals.  She is enthusiastic and energetic and made me think differently about the way I work at home.  I wish I could bottle Jan's energy and take it home with me! Jan has kindly invited me for supper on Monday night to discuss more about our work, as the time flew by today and we still had things to talk about! I am very grateful to Jan and Alan for the welcome I received today.  I could write more about what we discussed, but I'd be here all night!

It is Australia Day here on Sunday, so Monday is a bank holiday.  We are travelling to Port Douglas for the weekend to go diving in the Great Barrier Reef - I can't wait! Here are a couple of pictures of the past couple of days:

Meinir and I in Byron Bay.

Pavlova (the Koala) and I!

I have learnt so much in such as short period of time about Australia, its people and it's culture.  I am looking forward to the next weeks, where I will no doubt learnt a lot more. I do miss Wales though, even though the weather is not as good there, but friends and family are much more important than the weather!

First few days.....

Well, what a whirwind of a few days! We (my friend Meinir and her nephew Alun), arrived late on Sunday night, where we stayed in Brisbane and then travelled to Palm Beach (not far from Brisbane, on the Gold Coast), on the Monday morning, where we're staying until Thursday.  Monday was spent trying to get over the jet lag and then it was up to Brisbane yesterday for a day of meetings. 

My first meeting was with staff Queensland Health (Rebecca Whitehead, Roger Meany, Simone Nalatu and Niamh Scully).  Niamh had previously worked for Powys Health Promotion Unit a number of years ago (so did I, but not at the same time), so we had a mutual friend who worked there, who put us in contact.  I'm really grateful to Niamh for arranging for me for me to meet everybody and for the welcome I received there. 

Niamh and Rebecca (Senior Health Promotion Officer with the Intergovernmental Partnerships Team) firstly have me an overview of how the health system works in Australia, which is both similar and different to how it works in the UK.  It took me some time to familiarise myself with the different aspects of Government and I think I'm right when I say that the Federal Government is similar to the UK Government.  Each state then has it's own state government, which is like an individual Welsh Government in each state! The state government can legislate on certain laws and there are variations within each state i.e. there is different tobacco legislation in different states across Australia.  The Federal Government can also legislate on issues that affect all of Australian residents, such as plain packaging.  We also discussed how the change in Government in the past couple of years had affected the priority that preventative health has and that chronic disease management has a higher priority.

Simone then talked about her work as an Advanced Health Promotion Officer within the Community Partnerships team, focussing on Indigenous Health.  This was an interesting conversation to be involved in, as she outlined the work that the department was doing in order to engage with the indigenous population in terms of preventative health and making sure that interventions are culturally apprioriate.  One of the projects that she'd been involved with was the Smokecheck training, which trained members from the indigenous population to be Quitline staff (a telephone line set up to support people who want to give up smoking, similar to Stop Smoking Wales).  She has also been involved in campaigns aimed at promoting services such as Quit Line and as it happened, I saw one (see photo below), on the train on the way home.

Roger, a Manager within the Intergovernmental Partnerships Team, then spoke about the role of local government within Queensland - a role which differs greatly to the one they play in the UK.  Local government in the UK provide many more services than the local government here (where the state government provides those services).  Local government therefore have little to do with preventative health, which was interesting to note.  I do have a picture of us all at yesterday's meeting, but for some reason (and there is steam coming out of my ears!), I cannot download more photos.  When I do work it out, I will post.

I then travelled to another part of Brisbane in the afternoon to meet with Sam and Niamh, who work for Drug Arm Australia.  They work as Prevention Workers for Drug Arm Aus, implementing evidence based projects in the Brisbane and Gold Coast area.  Sam and Niamh were also very welcoming and we discussed different projects that they had been involved in, trying to reduce the use of tobacco and alcohol in the area.  Some of these, such as the Schoolies project, were harm reduction project, whilst others were preventative health projects.  The Schoolies project is a project aimed at young people, who decend onto the Gold Coast after they finished their exams and this has, in the past, caused difficulties in terms of youngsters getting drunk.  They have now set up an alcohol free party for U18's, a re-charge zone (where volunteers look after youg people who are suffering from the effects of alcohol) and services like the ambulance are also there.  Whilst the alcohol free party is very well attended, there is still the issue of pre-loading (where people drink before they go out).  We also dicussed a variety of other projects that they are involved in.  Unfortunately, funding for this work (and for the posts of Prevention Workers) is unstable at present and the future is not clear.

I learnt a great deal yesterday (too much to write in this blog) and was enthused by what I learnt and what we could possibly implement bach in Wales.  We are flying to Cairns tomorrow, where I am going to James Cook Univeristy to meet with Prof Alan Clough and Jan Robertson and also to Wuchopperen Health Service, to meet Nelson Lee, Regional Tobacco Co-ordinator.  Nelson works directly with the indigenous population, so I am looking forward very much to both meetings.

For some reason, I can upload photos from my phone, but not my camera, so here are ones Meinir and I on the beach in Surfers Paradise, where we had a walk last night. I cannot believe that this experience is happening to me - I am in Australia where the weather is fantastic (although a bit too hot!) and am getting to meet people who work in the same field as myself.  I am very grateful to the Winston Churchill Fellowship for giving me this opportunity!

Will post soon - hopefully my camera will be able to upload by then! Btw, I apologise for any spelling mistakes on this blog - it doesn't allow me to back and make any changes for some reason!