May 10

May 10 Otitis Media in Children — Palm Island, Australia.

Part 3 of 4 on Palm Island, Queensland, Australia

This chapter will focus on the prevention and management of otitis media in children on Palm Island, Queensland, Australia. The slides were written by Lara Emmett.

Introduction

Nearly all of us and every child by the age of 5, would have experienced otitis media. However; on Palm island, 75% of children suffer hearing loss from this condition. Otitis media rates are exceeding 4%, which the World Health Organisation defines as a health emergency, hence I wanted to learn more about how and why this situation has occurred.

Palm Island, otitis media, Andreas Astier.

Palm Island is Located 65km North West of Townsville and can be seen from the Strand. Its main island is known as Great Palm where all the services are. It is classified as RA 4 which is labelled as very remote, or 7 on the modified Monash model.

The traditional owners of the area are believed to be the Manburra people. Palm island has a history of instability – from 1800s to mid 1900s, Europeans unfairly treated Aboriginals and Torres Strait Islanders on the island which they relocated ther… — The traditional owners of the area are believed to be the Manburra people. Palm island has a history of instability – from 1800s to mid 1900s, Europeans unfairly treated Aboriginals and Torres Strait Islanders on the island which they relocated there. This has led to the social unrest that still lies there today and includes vandalism, domestic violence and high crime rates.

As of 2017, the population of Palm Island was estimated to be approx. 2,600 by the Australian Bureau Statistics. However, according to the local council, the population is believed to be between 3000 - 5000. You can see that Palm Island’s population… — As of 2017, the population of Palm Island was estimated to be approx. 2,600 by the Australian Bureau Statistics. However, according to the local council, the population is believed to be between 3000 - 5000. You can see that Palm Island’s population is also expanding with high numbers of youth, versus Queensland’s population which is stationary.

94% of individuals are of Aboriginal and/or Torres Strait Islander descent, whereas in Queensland the figure is 4 percent. Palm Island has a relatively high proportion of 0-4-year old, but a lower proportion of the elderly. This is synonymous with t… — 94% of individuals are of Aboriginal and/or Torres Strait Islander descent, whereas in Queensland the figure is 4 percent. Palm Island has a relatively high proportion of 0-4-year old, but a lower proportion of the elderly. This is synonymous with the higher birth rate and lower life expectancy.

Palm island ranks as the 10th most disadvantaged living area in Australia. There are only 2 schools in Palm Island, one from prep to yr6 and other prep to yr12 and otherwise families send their children to boarding schools in Townsville. Attendance … — Palm island ranks as the 10th most disadvantaged living area in Australia. There are only 2 schools in Palm Island, one from prep to yr6 and other prep to yr12 and otherwise families send their children to boarding schools in Townsville. Attendance rates have only 30% of the children attending school 90% or more of the time which reflects the alarming stats of low yr12 completion. Unemployment rates are near 30% which is 23% more than Aus. average. Centre link payments are therefore main source of income. There are few employment opportunities too on Palm Island, and only 2 out of 11 businesses are locally owned and virtually no tourism. Income is also significantly lower than Australian average and additionally costs of goods are higher.

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This issue is of relevance to the Palm Island community and she attributes its high prevalence to the education non-completion cycle and socioeconomic disadvantage. It’s a common case seen but there needs to be more focus on the bigger picture.

Otitis media is an infection of the middle ear and the bacteria responsible is most commonly Streptococcus pneumoniae. This bacterium causes respiratory infections and can travel up the Eustachian tube to cause Otitis media. A sore ear will delay a … — Otitis media is an infection of the middle ear and the bacteria responsible is most commonly Streptococcus pneumoniae. This bacterium causes respiratory infections and can travel up the Eustachian tube to cause Otitis media. A sore ear will delay a child’s learning, by affecting their concentration abilities, language development, communication and school attendance.
Acute otitis media is what we have all probably had before. Symptoms are a sore throat, earache and fever. Usually it lasts a couple of days before swelling goes down. Otitis media with effusion is fluid build-up pressing on the ear drum. It’s incredibly painful and can actually burst. Perforation of the ear drum can heal usually by itself but if too large, it will need surgery. Recurrent otitis media can permanently damage the bones and nerves of the inner ear resulting in irreversible hearing loss.

Younger children and parents, the health education programs are the best way to deliver these messages. There are vaccines available – however these don’t cover all strains of bacterial causes and require a number of doses. Aboriginals need an extra… — Younger children and parents, the health education programs are the best way to deliver these messages. There are vaccines available – however these don’t cover all strains of bacterial causes and require a number of doses. Aboriginals need an extra dosage in order to maximise their immune response. On Palm Island antibiotics are given immediately to combat the infection. Surgical procedures can also be performed.

There is GP practice and hospital which provides antibiotics and vaccines. In Palm Island’s schools, they run the Breath Blow Cough program run by teachers daily for 15 mins. the aim is to teach kids about hygiene and ear health. Deadly ears team co… — There is GP practice and hospital which provides antibiotics and vaccines. In Palm Island’s schools, they run the Breath Blow Cough program run by teachers daily for 15 mins. the aim is to teach kids about hygiene and ear health. Deadly ears team comes in three times a year and is made up of two teams:
**Firstly, Allied health professionals** – beginning with an Audiologist who assess the hearing loss and refers the patient for further treatment; **Occupational Therapist and Speech Pathologist** who both work with patients that have already been diagnosed.
**Secondly is the Ear Nose and Throat team** - a full surgical team flies into Palm island and operates where necessary.
The deadly ears team then continues to liaise with the GP and health clinic with continued treatment for patients.

Despite the positive aspects of Palm Island services and programs, the rural community’s social norms and society structure play a major factor in Otitis media prevalence. The large youth population is a breeding ground for the spread of bacteria an… — Despite the positive aspects of Palm Island services and programs, the rural community’s social norms and society structure play a major factor in Otitis media prevalence. The large youth population is a breeding ground for the spread of bacteria and is not helped by high smoking rates. Additionally, Lack of school attendance and disrupted learning does not help education or understanding towards this condition. These issues are not seen as a priority to parents, because a high majority did not complete school and issues like overcrowding are a bigger concern, as 300 people still remain on the waiting list for housing. Furthermore, hygiene is not always easy to maintain as the families with low income often forgo regularly cleaning of clothes and bedsheets as it costs money for electricity.

Strengths for the services would be the education programs running on Palm Island as well as the school nurses being involved. There is also no shortage of antibiotics or vaccines. Another strength is The Palm Island Health Action Plan – the local c… — Strengths for the services would be the education programs running on Palm Island as well as the school nurses being involved. There is also no shortage of antibiotics or vaccines. Another strength is The Palm Island Health Action Plan – the local council and the government have established goals for improving both health outcomes and expanding services. However, it has come to a point where Otitis media being so high, that the population see it as normal to have runny ears and do not always see the need to seek treatment. For the vaccines to be effective parents and health services need to ensure following up for additional doses.

Reducing the prevalence of otitis media in children should focus on the community running their own events to create awareness of this issue. Together, this makes the issue discussed more with parents who may not otherwise attend school info session… — Reducing the prevalence of otitis media in children should focus on the community running their own events to create awareness of this issue. Together, this makes the issue discussed more with parents who may not otherwise attend school info sessions or understand what programs are being run. Additionally, reducing otitis media can be achieved by targeting poor hygiene, overcrowded housing and implementing follow up reminders to attend the health clinic for vaccinations.

In summary, Otitis media and associated hearing loss is prevalent on Palm Island. This is due to the poor education surrounding the condition, poor hygiene and housing. Services available to combat this include medical treatment from the clinic, hos… — In summary, Otitis media and associated hearing loss is prevalent on Palm Island. This is due to the poor education surrounding the condition, poor hygiene and housing. Services available to combat this include medical treatment from the clinic, hospital, Deadly Ears Program and education programs being run in the schools. However, the rural location of Palm Island means that this isolated community has adopted otitis media as a social norm. Despite the strengths for health services, it is important for the Palm Island community to be aware of otitis media and the associated risk factors, considering that it is a preventable condition.

Published 10th May 2019. Last reviewed 30th December 2021.

Reference

1. Palm Island Aboriginal Shire Council. About Palm Island. Palm Island Aboriginal Shire Council website. http://www.palmcouncil.qld.gov.au/about-palm-island. Updated 2018. Accessed March 29, 2019.

2. Australian Government: Department of Health. Search the Map. Doctor Connect. http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/locator. Updated 2019. Accessed March 19, 2019.

3. Google Maps.

4. Queensland Government. Working in Palm Island Fact Sheet. Queensland Government Department of Housing and Works Website. http://www.hpw.qld.gov.au/SiteCollectionDocuments/WorkingInPalmIslandFactSheet.pdf. Accessed March 30, 2019.

5. Queensland Places. Palm Island Aboriginal Shire Council. Centre for the Government of Queensland Website. https://queenslandplaces.com.au/palm-island-aboriginal-shire-counci. Updated 2018. Accessed on March 19, 2019.

6. Australian Bureau of Statistics. Palm Island. Australian Bureau of Statistics Website. http://www.stat.abs.gov.au. Updated October 29, 2018. Accessed March 30, 2019.

7. Empower Economics. Economic Impact Assessment Of The Palm Island Community Company. Empower North; 2016:5-6. https://qpc.blob.core.windows.net/wordpress/2017/08/11-029-Attachment-3-PICC-Economic-Impact-Assessment.pdf. Accessed March 30, 2019.

8. Morris PS, Leach AJ. Acute and chronic otitis media. PediatrClin North Am. 2009;56(6):1383-99. doi: 10.1016/j.pcl.2009.09.007.

9. Queensland State School Reporting (2017). BwgcolmanCommunity School Annual Report 2017. [online] Department of Education, pp.3, 11. Available at: https://bwgcolmancs.eq.edu.au/Supportandresources/Formsanddocuments/Annual%20reports/Bwgcolman%20Community%20School%20Annual%20Report%202017.pdf. Accessed 22 Mar. 2019.

10. Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report. Australian Institute of Health and Welfare Website. https://www.aihw.gov.au/reports/indigenous-health-welfare/health-performance-framework/contents/tier-1-health-status-and-outcomes/1-15-ear-health. Updated December 2018. Accessed April, 2019.

11. Centre of Research Excellence in Ear and Hearing Health. Otitis Media. Ear and Hearing Health website. https://www.earandhearinghealth.org.au/what_is_otitis_media#. Updated 2018. Accessed March 9, 2019.

12. Health Direct. Otitis Media. Health Direct website. https://www.healthdirect.gov.au/otitis-media. Updated on May 2018. Accessed on March 19, 2019.

13. My Dr. Otitis media in children. My Dr website. https://www.mydr.com.au/kids-teens-health/otitis-media-in-children. Updated on December 2018. Accessed on March 19, 2019.

14. Allen P. Understanding ear infections. New Zealand: Beecham Research Laboratories; 1989:11-13.

15. The Department of Health. Developmental Research to inform Indigenous Social Marketing Campaigns. Australian Government Department of Health Website. http://www.health.gov.au/internet/publications/publishing.nsf/Content/oatish-indigenous-ear-health-toc~literature-review~3.10_approaches. Updated February, 2012. Accessed on March 22, 2019.

16. Queensland Government. Deadly Ears Resources. Children’s Health Queensland Hospital and Health Service Website. https://www.childrens.health.qld.gov.au/chq/our-services/community-health-services/deadly-ears/resources/. Updated October, 2018. Accessed April 7, 2019.

17. Australian Bureau of Statistics. Palm Island. Australian Bureau of Statistics Website. http://www.stat.abs.gov.au. Updated October 29, 2018. Accessed March 30, 2019.

18. ABC News. https://www.abc.net.au/news/2019-04-04/queensland-indigenous-communities-frustrated-as-decade-old-deal/10967774