Bureaucratic blocks blamed for failure to tackle blinding disease

Date

December 29, 2012

Eye patient Dapne White of Alice Springs is examined at the town’s base hospital. Photo: Glenn Campbell

A NATIONAL strategy to eradicate the endemic blinding eye disease trachoma in remote indigenous Australia is failing to achieve its objective because of alleged bureaucratic bungling and indifference.

Australia is the only developed country in the world with the disease, which is regarded by the World Health Organisation as an indicator of indigenous healthcare.

Trachoma, normally only found in the Third World countries of Africa, is easily treated with antibiotics and lessons in personal hygiene.

The Rudd government made $16 million available to wipe out trachoma in 2008 as part of a $58 million package to address indigenous eye care.

”But progress is glacial,” he said. ”NSW has not got off its backside.”

He said ”blockages” to progress had occurred between mid-level Commonwealth and state bureaucrats, who ”meet every three months, fail to resolve their differences and then agree to meet in another three months.

”The duplication, but more importantly the stagnation, is terrible.”

Melbourne University’s Indigenous Eye Health Unit estimates there are 20,000 indigenous Australians, including 5000 children, who are at risk of contracting trachoma in remote communities.

Professor Hugh Taylor, who heads the unit, said trachoma could be eliminated in five years with proper funding and co-operation.

Professor Funder said he had come to the conclusion that the ”appalling” Commonwealth-state relationship was an impediment to forging an effective trachoma strategy even though there had been widespread agreement ”at the very top” on the need to eliminate the disease.

Inquiries by Fairfax Media reveal significant progress to reduce trachoma rates has been made in the Northern Territory, Western Australia and, more recently, South Australia, but Queensland, home to the nation’s second-biggest indigenous population, and NSW, with the biggest, failed to embrace comprehensive screening and preventive measures.

In contrast, NT Health accepted the Rudd offer in 2008 and has since screened 83 per cent of high-risk communities and introduced treatment strategies that have led to a fall in trachoma rates from 20 per cent to 11 per cent.

Health officials report the program has been effective but there remains significant work to be done.

A spokeswoman for NT Health said there was no doubt increased screening and treatment had significantly reduced the amount of trachoma.

In the same period, NSW has haggled with Canberra over the scope and timing of screening programs and only recently reached agreement on how to proceed. Queensland, where trachoma was recently rediscovered in an island community, has been equally slow to act, claiming a limited study of six communities found it was not a significant problem.

Research by Melbourne University’s indigenous eye care unit found rates of preventable eye disease remain at alarming levels in most states. Two-thirds of remote communities surveyed have endemic trachoma.

Blinding cataracts are 12 times more common in indigenous adults, 40 per cent of whom have not yet had corrective surgery.

Professor Taylor said it was puzzling trachoma had been found in one Queensland island community but no steps had been undertaken to investigate similar communities.

He said no major investigation had been undertaken recently in western NSW, where trachoma was first discovered to be a significant health issue by the late Fred Hollows in the 1970s. This year it is estimated NSW’s indigenous population will reach 176,000.

A spokesman for the NSW Health Department confirmed that discussions had only begun on plans to screen trachoma last year. ”Because the trachoma strategy was a new program, steps were taken to ensure the program was feasible, ethical and undertaken with appropriate community consent and engagement,” he said.

He claimed the Northern Territory and Western Australia were more advanced because they were extending existing trachoma screening programs.

Trachoma has not been a significant problem in Victoria since the 1890s due a mild climate and a relatively small indigenous population not located in remote communities.

Professor Funder said Kevin Rudd should have stuck to his ”word” in threatening to take over state health departments. ”It was unfortunate that he got rolled before he could do it.”