The Observatory

Aboriginal-led solutions key to closing the vision gap

More than 150 Indigenous leaders, health professionals, and research and policy experts from across Australia attended the Close the Gap for Vision by 2020: Striving Together National Conference on March 15 and 16. 
Speakers at the annual conference hosted by Indigenous Eye Health, part of the Melbourne School of Population and Global Health, acknowledged the achievements of the sector in closing the gap in eye health but called for Indigenous-led solutions and cultural safety in the delivery of services to Aboriginal and Torres Strait Islander patients.
Although there were many examples of good practice on the ground, such as the The Royal Victorian Eye and Ear Hospital’s strong action to reduce cataract surgery waiting times and VACCHO’s approach to eliminate barriers to access primary care via collaboration, speakers had a consistent reminder: broader systemic problems can only be overcome by ensuring self-determination for Aboriginal and Torres Strait Islander people. 
Dr Jackie Huggins (co-Chair of the National Congress of Australia’s First Peoples) said simply funding mainstream services will not close the gap. She said some organisations receive funding for Aboriginal health but don’t have a cultural framework or know how to work with Aboriginal and Torres Strait Islander people.
Dr Huggins said the first close the gap report emphasised the importance of cooperation and coordination, but these approaches were not uniformly adopted.
Similarly, Vision 2020 Australia’s Aboriginal and Torres Strait Islander Committee Chair, Dr Dawn Casey (COO, NACCHO), said it will be hard to improve Aboriginal health when funding bodies and Aboriginal service providers are “not on the same page”.
Dr Casey spoke about the longevity of ACCHOs delivering clinically effective health outcomes for over 40 years: “Our mob trust us”. While medical professionals have a role to play in closing the gap, sustainable approaches must be embedded in ACCHOs. 
Chief Operating Officer of NACCHO Dr Dawn Casey speaks at the Close the Gap for Vision by 2020 conference
Dr Dawn Casey (pictured): Aboriginal and Torres Strait Islander people must be at centre stage in determining how to close the gap.
Cultural safety in service delivery was viewed by all speakers with upmost importance. Where services are provided by mainstream organisations, they must be provided in culturally sensitive and culturally safe ways.
Richard Frankland creatively demonstrated the concept of “cultural load”, while Ian Hamm (CEO, VACCHO) said best practice is strength-based culturally safe health services. Carla Northam (CEO, Vision 2020 Australia) told the conference that services must “think outside the box”, innovate and be creative in their practice to effectively close the gap in vision for Aboriginal and Torres Strait Islander people.
Speaker Professor Marcia Langton pointed out that good science and outstanding policy already exist to eliminate trachoma. But she said that this still has not occurred because of the impact of poverty in Aboriginal communities.
The Minister for Health, the Honourable Greg Hunt, in announcing $6 million in research funding, invited conference-goers to be involved in the “next great wave” to eliminate avoidable blindness. He called for a “refreshed roadmap” to be led by Professor Hugh Taylor and conference hosts, Indigenous Eye Health.
Minister Hunt said “We are making the commitment today to work to achieve the end of avoidable Indigenous blindness, on our watch”. One of the ways he committed to doing this was through including Indigenous eye and ear health as a National Mission of the Medical Research Future Fund.
Minister Hunt said there were few higher pursuits than giving, restoring and protecting sight and said we can eliminate trachoma in our time, on our watch. The task is to keep pushing forward by focussing on 15 trachoma “hot spots”.
The Minister for Health, the Honorable Greg Hunt, standing next to Milpa the Trachoma Goanna (a person in a large green and orange goanna costume) at the Close the Gap for Vision by 2020 Conference.
On a positive note, conference-goers heard about Melbourne Football Club’s longstanding commitment to raise awareness in remote communities about trachoma, along with Milpa the Trachoma Goanna. Darwin-based optometrist Helen Summers said that encouraging the same specialists to visit the same communities creates opportunities for better engagement and success. 
Romlie Mokak from the Lowitja Institute closed out the conference by reinforcing calls for solutions to be led by Aboriginal and Torres Strait Islander people: “The future must be determined by us.”
Vision 2020 Australia is committed to working with Aboriginal and Torres Strait Islander people and developing culturally safe resources. Read more about Indigenous Eye Health