In the remote Western Australian town of Fitzroy Crossing, an innovative scheme has helped in promoting safe sex amongst the Aboriginal community - hanging condoms on trees.
Working on the 'community knows best' principle, Nindilingarri Cultural Health Service (NCHS), a grassroots organization, began placing condoms in 300 cm-long PVC pipes and hanging them with wire hooks on river gum and eucalyptus trees - unique condom dispensers. The local people congregate for their evening drink and socializing under these trees. Eight containers were hung at Crossing Inn and another eight a few kilometres away - the two traditional meeting grounds for the community.
Initially, people took offence and even smashed some of the containers. "But three years since the project took off, women who would turn their faces away from us are now pointing at the empty containers to be refilled," says Patrick Davies, the project coordinator at NCHS.
Before the start of this scheme, the only places where condoms were available were the supermarket and the district hospital and virtually none of the Aborigines were accessing condoms from these two outlets. Since the start of the 'condoms on trees' project, the 3,500 people living in Fitzroy Crossing are using up to 3,000 condoms a month.
And the positive effects of this innovative scheme are already visible. For instance, cases of Sexually Transmitted Diseases (STDs) such as gonorrhoea, syphilis and chlamydia, which were rated the highest in the Kimberley region, are now showing a steady decline in Fitzroy Crossing. Says Davies,
"It is the first time that the community has been involved in public health. The Government Public Health had been doing screenings for STDs, which the people resented, as it was not done in any other part of the country. Also, they never found the contacts so incidence of the disease didn't come down." Davies, along with colleagues Tom Lawford and Ronnie Jimbidee, has been instrumental in implementing this novel concept under which they have been able to target all the four language groups - Bunuba, Gooniyandi, Walmatjarri and Wangkatjungka - in the area.
"We had to approach sexual health issues with sensitivity, tact, timing and appropriate use of language when explaining disease, in particular sexual health matters. Some people come in for a drink and take the condoms back home with them. That's a good thing because it's creating awareness. At the gatherings, there are about 80 per cent men and 20 per cent women," adds Davies. Posters around Fitzroy Crossing advertise 'Free Condoms in a Tree Near You'. The containers, painted with pictures of different football teams and messages on sexual health, hang like weaverbird nests with a bird hole cap at the bottom. Each container with a capacity of 30 to 40 condoms needs to be filled every two days.
This is a much-needed scheme, since the primary health of indigenous people in Australia is worse than in many developing countries. NCHS was set up in recognition of the fact that indigenous people suffer cultural, social, physical and economic disadvantages, which cause health problems beyond those of the general community. NCHS works in partnership with government health services in providing culturally appropriate health services to the Aboriginal people and encourages the maintenance and renewal of traditional Aboriginal medicine, bush foods and culture.
In the words of the residents of Fitzroy Crossing, "We want to be responsible for our own health and we want to work on health issues in our own way. We want the government to work with our new way."
The indigenous people of this town, situated approximately half way between Perth and Darwin on the edge of the Great Sandy Desert with a mostly hot and dry climate, are fast learning to dress their own wounds. NCHS is also developing special health groups using its own Primary Health Care Unit
team of senior Aboriginal women from each language group to develop a number of young women's groups.
In the long term, the NCHS aims at training Aboriginal health workers who will take responsibility for all Aboriginal primary health care services in the town. This will allow culturally appropriate services to be delivered while overcoming the problem of recruiting and keeping nurses in remote areas such as Fitzroy Crossing. The nearest large town with banking, shops and entertainment is 400 km away. It will also provide employment to the Aboriginal people, thereby raising their economic and living standards, including their health and diet.
Blending local knowledge with mainstream medicine has borne fruit. People are now willing to discuss sexual health and related diseases. Davies feels, "This can be a universal concept. Condoms should be made accessible in traditional public meeting places. It can work in every town and city. We all have our winos who sit in parks and they are a high risk group - that's where the action happens."
This innovative concept can go a long way in helping prevent the spread of HIV infections and AIDS in the Asia Pacific countries, where people are still too shy to talk about sexual health issues.