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Rural Health examples

Nyirrpi Grandmothers' Women's

Health Program

Women's health business is the business of the Grandmothers

and the Aboriginal health workers together. The health service staff have

to understand that the Grandmothers are the right people to be in charge

of women's health business

(Nola Wilson, "The Nyirripi Grandmothers' Women's Health Program", Aboriginal

and Islander Health Worker Journal, Vol.23, No.3, May-June 1999, pages

3-5).

Aims

• To keep women's health strong in Nyirrpi.
  

  
  

• To honour the Grandmothers' authority over women's health.
  

  
  

• To obtain the Grandmothers' advice on women's health services,

  including advice to the Northern Territory Health Service.
  

  
  

• To strengthen community control of the health services.

The Program aims

to address the many health problems such as poor nutrition, sugar diabetes,

cancer and sexually transmitted diseases that are prevalent in Aboriginal

communities.

Image

L-R: Nola, Valerie and Margaret with paintings they did as part of

their evaluation of the Grandmother's Program, 1997.

What the Program does

Health professionals

were not working effectively with Aboriginal communities to alleviate

their health problems. Now the Grandmothers in the community work with

health professionals to create awareness and share their knowledge about

women's health business. Working alongside the Aboriginal Health Worker

and a community nurse, the Grandmothers have created a safe and respectful

environment where women's health issues can be discussed and treated.

Nola Wilson is the

Program's Aboriginal Health Worker.

I became interested

in working as an Aboriginal Health Worker because there was no-one at

Nyirripi to do women's health ... I used to get the women to come and

see the community nurse. The women would listen to me because I spoke

Walpiri to them and I speak slowly. They used to get shy of the Kardyia

[white] sister because she only came sometimes. I wasn't working then,

but I used to help her get the women. Then she asked me to become a

health worker, so we went to the council to ask. They said yes.

It was hard

for me being women's Aboriginal Health Worker. Some didn't listen to

me when I talked to them about women's health business because they

only listen if the Grandmothers tell them. The Grandmothers didn't know

about Kardyia women's health business.

One day in 1995

Valmai, the Women's Health sister, asked me and another Aboriginal Health

Worker to go around and ask some of the women to come for their health

checks. Some of the old women got cross and hit us with sticks. Those

old women did not know what women's checks were all about. They thought

they were STD checks, and they thought we were cheeky for talking to

them about those things. It was hard to get young women and old women

to come for their women's checks. The women used to be scared and cross

when they would see that Kardyia women's health sister come. They used

to say, "tell that woman to stay away from us".

But not now.

After this Colin [the community nurse] and Valmai talked with me about

starting the Grandmothers' Program. We talked to the Nyirripi women

about it and we chose Valerie and Alice to be the Grandmothers to help

me and Valmai to do things right away. We chose Valerie as the Walpiri

Grandmother and Alice as the Pintubi Grandmother, so all women would

be represented. We had a big meeting in the women's centre. Valerie

told the women what the health checks were for. We talked about a woman

who had passed away from that cancer. At that meeting there were a lot

of Grandmothers. They said it was alright for me to do young women,

but Valmai must do the older women. Now the women are happy to have

their checks from Valmai and me. Now that we have the Grandmothers'

Program it is easier to get all the women to listen to me. If I talk

once to a young girl and she says no, then I ask the Grandmothers to

talk to them. They always listen to the Grandmothers.

An integral part

of the Program is when the Grandmothers, Nola and the community nurse

take the young women and girls out bush and teach them about women's health

business. Nola teaches the women about western women's health ways and

the Grandmothers along with Nola teach the traditional ways of health.

The Grandmothers will also encourage women to go to the clinic for checkups.

Image:

Nola Wilson and young girls from the Nyirripi community

What makes it successful

According to Valmai

McDonald, the Women's Health Educator who helped set up the Program, the

primary reason for its success is the wisdom, commitment and hard work

of Nola Wilson and the Grandmothers involved.

Other factors include:

• Nola and the

  Grandmothers include all the women of Nyirripi in the Program's activities.

  They do not restrict the benefits to an exclusive group They are very

  proud that all the women are involved.
  

  
  

• The community

  women accept Nola as teacher and clinician for western style women's

  health services.
  

  
  

• The Grandmothers

  in charge of the Program help Nola to teach women and girls about

  modern day women's health issues and western style women's health

  services.
  

  
  

• All the girls

  and women of the community want to be involved in the cultural education

  activities organised by the senior women as part of the Program.
  

  
  

• Key 'outsiders'

  involved in the Program acknowledge the primacy of Aboriginal women's

  law and culture.
  

  
  

• Nola and the

  Grandmothers work as a team.
  

  
  

• The Grandmothers

  and Nola have accumulated good women's health education resources

  and they are in control of these local resources.
  

  
  

• The Grandmothers

  and Nola have control of the financial resources of the Program. They

  manage their own grant money and, among other things, pay for fuel

  for the truck to take them out bush, buy food, bought a video camera

  to make their own videos and pay for themselves to attend conferences

  to talk about the Program.

Difficulties encountered

According to Valmai

McDonald who was the Women's Health Educator, Remote Health, Northern

Territory Health Services and based in Alice Springs when the Grandmothers'

Program was established in 1996, there are unlimited uncontrollable factors,

which make small local Programs very vulnerable. She says,

Many [of the

problems] are to do with remote Aboriginal people being geographically,

bureaucratically, and culturally hemmed in by the alien mainstream.

It is probably impossible for us white fellas to imagine what it is

like for remote Aboriginal people to try to maintain a world that works

when just about every indicator of power and influence is defined from

out of a different world view. It does not matter what you know, it

does not matter what profound wisdom you have about how to care for

each other and your environment: if you can't speak English and you

don't know how to interact with complex mainstream institutions, you

have very limited ability to assert the parameters for a worthwhile

life.

The difficulties

for such a Program are largely to do with the inevitable dependence

of the local people on the goodwill and support of the 'outsiders'.

The Nyirripi Grandmothers' Women's Health Program is self-sustaining

in that it is independent of 'outsider' direction. But it still needs

continuing 'outsider' support because the larger environment within

which the women have to work is not under their control. That's why

'sustainability' does not mean not needing support. It means able to

be maintained and develop in a context of encouragement and helpfulness."

Funding sources

The Grandmothers'

Women's Health Program was developed by the women at Nyirripi in partnership

with the Alice Springs Remote Health Service Women's Health Unit. The

Northern Territory Women's Cancer Prevention Program funds the Program.