The National Trachoma and Eye Health Program symbol.
NAIDOC week offers an important opportunity to celebrate Aboriginal and Torres Strait Islander culture, resilience, and achievements. This year’s theme – “because of her – we can!” – celebrates the inspiring contributions Aboriginal and Torres Strait Islander women make to benefit of communities, and Australia as a whole.
The National Trachoma and Eye Health Program
One of the most celebrated health programs in Australia’s history is the National Trachoma and Eye Health Program, with the goal of eliminating trachoma in Aboriginal and Torres Strait Islander communities. The planning for the program started in 1974, and by 1976 the first teams started travelling throughout Australia. The main part of the program carried until the end of the decade. Today, the program is most associated with Fred Hollows, the pioneer ophthalmologist who played a key role in leading the Program. It is important to remember that Hollows didn’t go at it on his own.
The National Trachoma and Eye Health Program was born out of a collaboration between RANZCO in its previous iteration (known then as the Royal Australian College of Ophthalmologists), the National Aboriginal and Islander Health Organisation (NAIHO), and the Department of Health, together with local Aboriginal Community Controlled Health Services and other community-based organisations throughout Australia. The program included the creation of teams spreading across Australia, working methodically to screen, diagnose, and treat Aboriginal and Torres Strait Islander patients for trachoma and other eye conditions. The teams included ophthalmologists, nurses, orthoptists, optometrists, Aboriginal Health Workers, microbiologists, local community liaisons officers, as well as mechanics, cooks, drivers, and other volunteers who took care of many necessary aspects of such a complex operation. From 1976-1979, the teams screened over 100,000 people in 465 communities across Australia. Over 1,000 operations were carried during the course of the program, and over 27,000 people were treated for trachoma.
Outreach summary of the National Trachoma and Eye Health Program. Source: Royal Australian College of Ophthalmologists, 1980.
One of the biggest lessons of the National Trachoma and Eye Health Program is the importance of collaboration. The Program was such a success because of the commitment of all parties. The role on-the-ground of community liaison officers, Aboriginal Health Workers, and nurses was key to accessing communities and creating a safe environment for patients to be screened and treated by the visiting teams.
In 2008, five participants in the on-the-ground teams of the Program published a book, each writing an essay about their memories and point of view of the extraordinary program. The book, Beyond Sandy Blight: Five Aboriginal Experiences as Staff on the National Trachoma and Eye Health Program, was published by the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS), and is available online via the AIATSIS website here.
Jilpia Nappaljari Jones
Jilpia Jones, a Walmadjari woman and a pioneering nurse, was one of the first registered nurses to work at the Redfern Aboriginal Medical Service (AMS), starting during its first year of operation in 1971. The Redfern AMS was the first Aboriginal Community Controlled Health Service in Australia, a pioneering model of community owned service delivery which is now practiced by over 150 community controlled health services throughout Australia.
In the book, Jones recalls the confronting reality which awaited her team through missions and camps in remote Australia, confronted by racist attitudes of some of the mission staff and station managers, and the poor living conditions which contributed greatly to the spread of disease, including trachoma.
After detailing her experience with teams travelling through Queensland and different parts of Western Australia, Jones joined the team that travelled through the Kimberley. Jones writes about her team’s arrival into Fitzroy Crossing, where Jones had a unique and unexpected experience of meeting her birth mother. Jones was born in the area but forcibly removed from her family as a young child and was told her mother had died. But when arriving in Fitzroy Crossing and telling locals that this was her birth place, the community members realised who she was, and reunited her with her mother.
At the end of her chapter, Jones reflects on the National Trachoma and Eye Health Program:
“My time with the NTEHP was a very influential part of my life. Travelling throughout Australia with the NTEHP showed me that racism and discrimination directed against my people was more widespread than I had experienced before. I also learnt to become aware of occult racism often expressed as a kindly, if patronizing, attitude. The perpetrators of this attitude genuinely believed they were ‘being nice to the Blacks’. Certainly, this attitude was more likely to be encountered in the leafy suburbs of north shore Sydney than in the ‘big house’ in the home paddock 500 km outside Alice Springs. There, it was definitely ‘in your face’.
Fred Hollows taught me to believe in myself and to be equal among all people, even if you walked where others feared to tread.
The ophthalmologists who worked with the team taught me a lot and I like to think that we in turn taught them about us. It was encouraging how many were willing to learn from us, and that they respected our culture. This was reconciliation in action. Sometimes the numbers who flocked to see us and the distances we travelled reminded us of Alexander the Great and frequently we felt like his Macedonians in that we were following our leader to the ends of the earth."
Rose Murrey, a Nyangumarta woman, worked as an organiser and receptionist in the same team as Jilpia Jones, which predominantly worked in the Kimberley region.
In her chapter of the book, Rose reflects on the role Aboriginal team members brought to the program teams:
“When I think back on what the Aboriginal team members brought to the NTEHP, it’s a combination of health knowledge, bush and mechanical skills, respect for other Aboriginal people’s ways, the ability to speak out when you have to, to finish what you start, and amazing senses of humour.”
Murray finishes with a reflection on the power of the program and its legacy:
“If we could harness that energy and vision that we had back in the trachoma days and had teams of skilled, hardworking people in each community, I would sleep much easier. I would know that my grandchildren and other children would have a healthier and safer life. I would know that access to appropriate and safe health education and medical treatment was happening to all.”
Reflecting back on this groundbreaking project now, 40 years on, we can see the lasting success of the Program by the dramatic reduction of the rates of trachoma, though the effort to completely eliminate trachoma continues today.
But perhaps the most important lesson has been the irreplaceable role of community leadership and involvement in all aspects of community health projects. The breakthrough work of Jiplia Jones, Rose Murray, and many other Aboriginal and Torres Strait Islander women and men has allowed the Program to achieve so much. It is our task to continue building these relationships as a cornerstone of improving health outcomes of Aboriginal and Torres Strait Islander Australians.
Because of her, we can!
Guy Gillor, RANZCO Policy Manager