Cairns Base Hospital

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Cairns Base Hospital

• Indigenous womens health

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Population

• FNQ population approx 250,000
• Half live within 2 hours of Cairns
• Remainder live in remote indigenous communities
  and towns
• 30 of our patients are indigenous cf 5
  Queensland total
• We see a mix of indigenous women remote, rural,
  urban both at CBH and where they live

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Indigenous women

• 30 of patients are indigenous
• 20 are aboriginal
• 8 TSI
• 2 both aboriginal and TSI

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Services

• Specialist OG services at CBH public
• Private OG services in Cairns
• No visiting oncology service
• Public outreach service visits each community 7-8
  times per year
• Mobile womens health nurse
• RFDS
• Remote nurses and health workers

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Health issues

• Isolation
• Education
• Nutrition
• Substance abuse alcohol and tobacco
• Distance
• Self-esteem
• Respect
• Welfare dependency and work opportunity
• Relocation for birth
• Poor attendance rates
• Sexual abuse
• Domestic violence

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Staffing issues

• Many staff specialists do not have FRANZCOG
  qualifications
• Staff specialists cannot access MSOAP
• Remote communities do not have stable staffing eg
  no midwife
• Reliance on OST GPs
• Crucial role of advanced DRANZCO trainees in
  remote towns

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Successes

• PNM has fallen from 20-30/1000 in 1990 to 8/1000
  today
• Syphilis rates have fallen
• Good advanced DRANZCOG training program
• Good success at attracting and retaining public
  specialists
• High interest in VBAC!

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Failures

• Indigenous PNM still too high
• Life span too low
• Teenage pregnancy
• High cervical cancer rate 8x
• Poor attendance rates at all clinics
• Screening programs wont work
• Recruitment and retainment of staff

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Suggestions

• Involve indigenous women in their care
• More female practitioners
• Expand advanced DRANZCOG and revitalise
  obstetrics in regional areas where it is
  ESSENTIAL!
• Opportunistic screening
• GPs with special skills eg colposcopy
• Coordination of care