Clinical Management of Sexual Transmitted Infections with a Focused Approach on Syphilis — Palm Island, Australia.
Part 1 of 4 on Palm Island, Queensland, Australia
This Palm Island blog will be in 4 parts where I have teamed up with three other colleagues. The focus is on Palm Island, a rural community, with either a prevention or management plan of a certain disease that has a detrimental cause on the island.
This chapter will focus on the management of sexually transmitted disease with a focus on syphilis on Palm Island, Queensland, Australia.
Introduction
The further I researched Palm Island, the more I discovered how different it is to Australia. Palm Island could be described almost like a third world country with a high amount of a younger population and almost no one above 65 years old. Education and health is low and behind compared to Queensland which is only a 20 minute airplane flight. Palm Island has a lot of issues that needs to be addressed which is difficult when the socio-economic status is very low.
““A nation’s greatness is measured by how it treats its weakest members.””
Palm Island is one of 16 Islands in the Palm Island Group and contains 42 communities/culture. Historical research indicates that the Manburra people (pronounced Mun burra) originally occupied this region prior to first contact with Europeans. The contemporary Aboriginal name for Palm Islanders is ‘Bwgcolman people’ (pronounced Bwook-a-mun), which means ‘many tribes – one people’. Many of today’s community members are descendants of Aboriginal and Torres Strait Islander people forcibly removed to Palm Island from Queensland.
A Dark History: "the ideal place for a delightful holiday' and that its remoteness also made it suitable for use as a penitentiary" for "individuals we desire to punish". People who were "mixed blood" were also included. On arrival, children were separated from their parents and then segregated by gender. Aborigines were forbidden to speak their language and from going into "white" zones. In 2001 - The "Peoples Democratic Republic of Palm Island" was an expression of grievances against the Australian and Queensland Governments for neglect of Palm Islanders.
Economy, employment and education is low. Queensland and Australia: Children aged 0 – 14 years made up 19.4% and 18.7% respectively of the population and people aged over 65 years and over made up 15.2% and 15.8% respectively of the population 50.6% is under 25 on Palm Island.
These six conditions are responsible for 65 per cent of the total burden of disease for Palm Island. Ears and Eyes is also a major issue on Palm Island.
STIs is disproportionate in Aboriginal and Torres Strait Islander particularly those living in rural and remote areas. More recently, the re-emergence of infectious syphilis, with multiple outbreaks declared across four of the five North Queensland (NQ), Hospital and Health Services (HHS), and the occurrences of baby deaths from congenital syphilis, have demonstrated the need for an urgent and coordinated response. Appropriate clinical management of syphilis is crucial.
You may feel healthy living with syphilis but it is still in your blood. Townsville in 1995 should 2%, 7.8% and 92% which was for people who had syphilis, people who had it before and people who never had respectively.
There are 3 constant doctors on Palm Island. There are fortnightly visits by sexual health NP and SH Consultant. The visits and medication charges are free.
A new $16.5 million health facility is underway on Palm Island.
Appropriate treatment to follow screening checks, access to appropriate tests, procedures and medication to successfully manage syphilis on Palm Island.
In summary: Eliminate, control, progressively reduce the prevalence of syphilis, chlamydia and gonorrhoea amongst Aboriginal and Torres Strait Islander people in North Queensland.
Published 30th April 2019. Last reviewed 30th December 2021.
Reference
1. Queensland Historical Atlas. Palm Island Dancers, 1930. Queensland Historical Atlas website. https://www.qhatlas.com.au/photograph/palm-island-dancers-1930. Published 2014. Accessed April 2, 2019.
2. Allyson Horn. Welcome sign at Palm Island. ABC NEWS. https://www.abc.net.au/news/2015-08-04/welcome-sign-at-palm-island-off-townsville-in-north-queensland/6670306. Published 2015. Accessed April 2, 2019.
3. Palm Island Aboriginal Shire Council. About Palm Island. Palm Island Aboriginal Shire Council website. http://www.palmcouncil.qld.gov.au/about-palm-island. Updated January 10, 2018. Accessed April 2, 2019.
4. Joanne Watson. Palm Island. Queensland Historical Atlas website. http://www.qhatlas.com.au/content/palm-island. Published 2012. Accessed April 2, 2019.
5. PHIDU Torrens University Australia. Social Health Atlas, Primary Health Networks (incl. Local Government Areas). PHIDU Torrens University Australia website. http://phidu.torrens.edu.au/current/maps/sha-aust/phn_lga_single_map/atlas.html. Published 2019. Accessed April 2, 2019.
6. Australian Government Federal Registry Legislation. Great Barrier Reef Marine Park Regulations 1983. Australian Government website. https://www.legislation.gov.au/Details/F2017C00960. Published 1983. Accessed April 2, 2019.
7. Wilson P. Crime Morality & Justice. Australia: Australian Institute of Criminology; 1992.
8. Australian Early Development Census. Hinchinbrook community. Australian Early Development Census website. https://www.aedc.gov.au/data/data-explorer?id=138343. Published 2018. Accessed April 2, 2019.
9. Australian Government Department of Health. Modified Monash Model (2015). DoctorConnect. http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/locator. Published 2015. Accessed April 2, 2019.
10. Australian Government Department of Health. ASGS remoteness areas (2016). DoctorConnect. http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/locator. Published 2016. Accessed April 2, 2019.
11. Australian Bureau Statistics. Palm Island (S) (LGA) (35790). Australian Bureau Statistics website. https://itt.abs.gov.au/itt/r.jsp?RegionSummary®ion=35790&dataset=ABS_REGIONAL_LGA&geoconcept=REGION&datasetASGS=ABS_REGIONAL_ASGS&datasetLGA=ABS_NRP9_LGA®ionLGA=REGION®ionASGS=REGION. Updated March 31, 2017. Accessed April 2, 2019.
12. Australian Bureau Statistics. 2016 Census QuickStats. Australian Bureau Statistics website. https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/LGA35790#cultural. Updated October 23, 2017. Accessed April 2, 2019.
13. Robertson J, Clough A. Evaluation of Yarrabah and Palm Island Money Management Programs. (2011). Report. Indigenous Consumer Assistance Network, Cairns.
14. Robertson, J. and Clough, A. (2011). Evaluation of Yarrabah and Palm Island Money Management Programs. [online] Cairns: Indigenous Consumer Assistance Network. Available at: https://financialcapability.gov.au/files/research-moneymanagementprograms-evaluationreport-2011.pdf. Accessed April 2, 2019.
15. Queensland Government. Life expectancy at birth (years) by sex, Queensland and Australia, 1881–1890 to 2015–2017. Queensland Government website. http://www.qgso.qld.gov.au/products/tables/life-expectancy-birth-years-sex-qld/index.php. Updated October 30, 2017. Accessed April 3, 2019.
16. Queensland Health. Closing the Gap: Performance Report 2016. Queensland Health website. https://cabinet.qld.gov.au/documents/2017/Mar/ClGapHealth/Attachments/Report.pdf. Published 2016. Accessed April 14, 2019.
17. Primary Health Northern Queensland. Health Snapshot Palm Island Aboriginal Shire 2016. Primary Health Northern Queensland website. https://www.primaryhealth.com.au/wp-content/uploads/2015/09/Palm-Island-Aboriginal-Shire-Council.pdf. Published 2016. Accessed April 3, 2019.
18. Palm Island Aboriginal Shire Council. Palm Island Health Action Plan, Health for the People, Health by the People, the Palm Island Way, 2010-2015. Brisbane: State of Queensland; 2011.
19. NACCHO Aboriginal Health News Alerts. Aboriginal sexual health commitment and Investment needed to address syphilis epidemic. NACCHO website. https://nacchocommunique.com/tag/syphilis/. Published 2018. Accessed April 3, 2019.
20. Queensland Health. North Queensland Aboriginal and Torres Strait Islander sexually transmissible infections action plan 2016-2021. Brisbane: state of Queensland (Queensland Health); 2016.
21. YoungDeadlyFree. Infographics – Syphilis. YoungDeadlyFreewebsite. http://youngdeadlyfree.org.au/resources/infographics/. Published 2018. Accessed April 13, 2019.
22. Griffith C. Syphilis endemic on island. Technology Journalist Australian website. http://www.chrisgriffith.com/1990s/1995/syph1.html?fbclid=IwAR0x6WOuV4-3wHt132DsTHE0jNamtFMDKQ9QeocmerUYBEDHeRQySe5sUT0. Published 1995. Accessed April 13, 2019.
23. Humphreys JS, McGrail MR, Joyce CM, Scott A, KalbG. Who should receive recruitment and retention incentives? Improved targeting of rural doctors using medical workforce data. AustJ Rural Health. 2012;20(1):3-10. doi:10.1111/j.1440-1584.2011.01252.x.
24. Harris MF, ZwarNA. Care of patients with chronic disease: the challenge for general practice. Med J Aust. 2007;187(2):104-107. https://www.mja.com.au/journal/2007/187/2/care-patients-chronic-disease-challenge-general-practice. Accessed April 13, 2019.
