Community Engagement Key to Torres Strait Vaccine Success
The Australian Covid-19 vaccination program continues to stumble. A successful rollout in the Torres Strait requires more dialogue with locals.
Words by Sean Davey
Photographs © Kenton/Davey (Oculi)
The 50km journey by dinghy from Thursday Island to Badu Island in the Torres Strait can be beautiful or dangerous, depending on weather. To locals however, disruptions are not uncommon. When the Covid-19 pandemic hit in 2020, the Torres Strait went into lockdown in line with the rest of the country, and locals were encouraged not to travel between islands.
Charlotte Nona is the director of Queensland Regional Health in the Torres Strait and Northern Peninsula.
‘On Badu there’s only one front line health worker for the for a population of nearly 1000 people. We have more patients per capita with chronic disease here, so it is not realistically sufficient to provide sufficient care.’
When, on 9 April, the federal government announced that the Astra Zeneca vaccine not be given to people under 50 years old, planned vaccination program for the Torres Strait was immediately suspended. With 80% of the population in the Torres Strait under 50 years old, the suspension was understandable, yet it was another change in policy for locals to understand.
‘English is a third language for many people here’ says Nona.
A perceived lack of ongoing community engagement and cultural awareness has raised concerns about how the Covid-19 vaccine rollout program will be received on Badu, when it eventually takes place.
‘If you want good outcomes in these communities, you need to first and foremost build trust, and to build trust you need to come in at least one or two weeks ahead.
‘You really need to do health promotion, one-to-one health education with the people, and have community meetings. We can make things work here but you really need to have the conversations with the people.’
Horace Ngagalaig is solidly built, and at 60, his years of crayfish diving, hunting and playing football are evident. Ngagalaig was raised on Badu Island and now works in Brisbane providing cultural care for Torres Strait Islanders and other indigenous people who travel to the mainland for specialist medical care.
‘The gap between community consultation and any vaccine rollout is reassurance. It’s the same when they come to the hospital and they are not in their own community. They will always look to the indigenous person to become a supportive voice for that reassurance.’
Ngagalaig has first hand experience rolling out a vaccine program in the Torres Strait. In 1995 an outbreak of Japanese encephalitis hit the region.
‘We had people die from it, but we had time to sit with people before the vaccination came. People were able to absorb all the information, and the health workers were also getting the vaccination to show that it worked.’
‘But this one is so quick. We had a lot more information back then, but people forget that it was rolled out from a primary health care model with locals on the ground.’
Ngagalaig and Nona believe sustained, locally delivered health education is vital to any vaccination program.
‘Yarning is important because you have to get that information as well as give it, it takes time to observe that information, understand it and ask questions’ says Nona.
‘You can’t come in and just expect people to trust you if you are a stranger.’
‘With the boys, we know that football and traditional hunting (of dugong and turtle) are big things. So we can use those topics of conversation.
‘The yarning could be about something else, but it’s about integrating the health information into that process, and then the questions will be asked.’
Ngagalaig recently travelled to Badu Island for a tombstone unveiling ceremony, one of the most important ceremonies in Torres Strait culture. With widespread travel restrictions within Australian in 2020, many of these important cultural ceremonies were postponed.
‘We might be at a tombstone unveiling ceremony or a funeral, but after, when we are sitting around having a yarn, we are asking questions and consulting with each other about potential issues.’
After two delayed vaccine rollouts, the Queensland Health Department has now said it will hold information sessions on Badu prior to the Pfizer vaccine being delivered.
Dr Tony Brown is the Executive Director of Medical Services for the Torres Strait and Cape York.
‘It is vital that we reach out to each community and provide them with clear information and advice about the vaccines, the risks and benefits associated with them and anything else our communities might want to know prior to restarting the vaccination program.’
Charlotte Nona remains positive that the rollout can be delivered with success.
‘We can make things work here but you really need to have the conversations with the people.
‘Just not with the expectation that you come in on the Monday, and provide sessions to the community, and then you do the rollout after lunch. It doesn’t work like that.’
