Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

by leave—Not many Australians are aware that Australia’s closest international border is only a few kilometres away—in fact, 30-odd minutes away by banana boat—from the Torres Strait and that Australia and Papua New Guinea share a unique treaty arrangement that permits free movement between treaty villages on either side. A number of media reports in the last year or two have intimated that there is an influx of PNG nationals arriving, via the treaty, in the Torres Strait and that infection risks for communicable diseases like TB and HIV-AIDS are very high. The inquiry and a delegation of the health committee sought to examine these issues in detail. We hope that this report goes some way towards highlighting the issues in their complexity, tempering some of the unsubstantiated fears and reaffirming why we permit a relatively small number of sick PNG nationals access to health services in the Torres Strait under specific conditions. We do so for humanitarian and practical reasons, because that is what good neighbours do.

The report shows that a range of structures exist and that systems are in place for managing this process from treaty consultation processes through to Queensland Health treatment guidelines. There are costs associated with treating these individuals and, while the numbers treated are small, costs for serious conditions like MDR-TB are not insignificant. It is in everyone’s interests to try to mitigate these.

The committee heard and saw for itself some of the push factors for why treatment may be sought on the Australian side. There are vast disparities between health facilities in PNG and those in Australia. Major challenges on the PNG side include a lack of human resources, equipment and infrastructure, coupled with rugged geography and governance issues that make difficult the distribution of essential supplies and service delivery.

The committee learnt that the problems are not solely due to a lack of money, especially in the Western Province, which is actually one of the richest provinces in the country. Australian aid in the region is substantial, seeking to strengthen health facilities along the border in the Western Province as well as the national health system in PNG and the Solomon Islands. Extra resources are being allocated to the Saibai Health Clinic—Saibai being in the Torres Strait on our side—in recognition that it caters for PNG nationals, in addition to Torres Strait residents. The Office of Development Effectiveness reports indicate that overseas aid effectiveness is a bit of a mixed bag and that it is more successful in some areas than in others. Placing Australian advisers in line agencies, such as the Ministry of Health, to work alongside host counterparts in the Solomon Islands is one strategy that appears to work well.

On overseas aid it is worth mentioning something not well known: assistance flows two ways. It is not well known in Australia that PNG provided aid to Australia for its victims of natural disasters, of the Victorian bushfires and the Queensland floods. So it does flow both ways. Australia works in partnership with the governments of PNG and the Solomon Islands to achieve better health outcomes and determines priorities in both countries, in line with what those governments want. PNG and the Solomon Islands are sovereign nations and Australia can only, and only wishes to, assist. Ultimately, the PNG and Solomon Islands governments are responsible for delivering health services to their own citizens.

In this report the delegation highlighted the problems but also what works or could work better in Australia’s role in facilitating these solutions. For instance, Australia has clearly made a fundamental difference to the water and sanitation situations in treaty villages in the Western Province of PNG through supplying rainwater tanks that provide a minimum level of safe drinking water. The delegation also recommended that this installation program be expanded to provide more than the minimum level of water required. Installing adequate water and sanitation in villages is part of getting the basics right for better health outcomes. We saw that, if you do not get those basics right, the health outcomes that flow through obviously are not as good. We know that a lot of illnesses and diseases are eradicated just by having sanitation in these villages.

The delegation also noted that the PNG government, together with Sustainable Development, have undertaken to improve water supply and would like to see this done as soon as possible. That said, the delegation recognises the very real logistic and practical difficulties that stand in the way of any speedy or comprehensive installation.

In the Solomon Islands Australia has built basic but functional health clinics, complete with solar fridges for cold storage of vaccines where electricity does not exist. The delegation learnt that one-off projects, supply deliveries and volunteer or staff placements can sometimes do more harm than good, despite donors’ best intentions. The committee has recommended that a contact point be established that provides community organisations with basic information on the suitability of their intended donations in particular regions. Similarly, when building new health facilities or offering other goods and services to assist, the Australian government and Australian community organisations must consult donor partners and local communities. New health facilities must be consistent with suitable support measures that will need to be put in place for staff and to maintain that new structure.

The delegation heard from nearly everyone it met with during the visit about the huge benefits of twinning arrangements between health institutions in respective countries, be they hospitals, laboratories, universities or parliaments. Developing and maintaining institutional relationships is not up to governments per se; rather, it is up to the institutions themselves. However, the delegation has recommended that the Australian government do all that it can to encourage and support sustainable schemes and exchanges.

Fostering greater people-to-people links, genuine exchange and sharing of information and training lies at the heart of a new era of re-engagement and underscores true partnership. Myriad benefits are being reaped from the Australian Leadership Awards. There is the relationship that exists between the Solomon Islands parliament, for example, and the New South Wales parliament, and there are courses like those run by the Australian National University’s Centre for Democratic Institutions. Women in politics courses are designed to assist participants from the region get more women elected in their national parliaments. The delegation hopes to see more women parliamentarians elected in the region in coming years and for the Australian parliament to do all it can to support that process—hence our recommendation to the Presiding Officers to establish a parliamentary mentoring program, especially for women MPs. The delegation believes such a program would have reciprocal benefits for and enrich all our parliaments.

This inaugural committee delegation visit to the PNG and Solomon Islands was the first joint parliamentary delegation in recent memory to the treaty villages, and the first parliamentary health delegation in recent memory. The symbolism of such a visit is very important. The delegation visit was warmly welcomed by governments at the highest national and provincial levels, and by institutions and community organisations. Delegates were also made to feel incredibly welcome in the villages and were privileged to spend time in villages that are not easy to get to in either the Western Province of PNG or the Solomon Islands. Wherever the delegation went it experienced and shared the goodwill that exists with the people of PNG and the Solomon Islands.

Of course, governments must go beyond symbolism and in-principle agreements to fund and implement the better health infrastructure and services that are required on both sides of the border. That is something which the Australian and Papua New Guinea governments have both undertaken to do with a new package of measures which is designed to strengthen health services on both sides of the border. This package is in its infancy but already the delegation heard that measures such as installing health communication officers on both sides of the border are proving effective. The delegation has recommended that consideration be given to expanding such positions in the future because their job is so vital and possibly beyond the capabilities of any one or two individuals. The delegation was told that close communication between partners is a key to any program’s success, including that achieved by the national malaria program in the Solomon Islands.

The delegation was fortunate to be able to meet with ministers, parliamentarians, health professionals and communities for discussion on a range of health issues, from TB, HIV-AIDS and malaria to the rise of diabetes in the region and the encroaching impacts of climate change on health. All dialogue was conducted in a frank and very open manner. Delegates were especially impressed, and indeed humbled, by all the health professionals and community workers that we met with in the Torres Strait, PNG and the Solomon Islands. They are so clearly committed to providing the best patient care they can under the circumstances, and often they have limited tools and support. They are the unsung heroes of any health system.

Beyond aid, PNG and the Solomon Islands require robust integrated healthcare systems that incorporate a range of outreach services in outlying areas. Australia has rural and remote areas too that governments find difficult to service. PNG and the Solomon Islands are not alone in grappling with how best to deal with moving a fragmented health system to a less fragmented one. Australia has long struggled with the issue of major health reform, and still we hear the debates as to what level of government—national, state or local—should take responsibility for health services funding and delivery. Major structural reform is again on the agenda here in Australia, so we have something fundamental in common here.

Similarly, we must all deal with the impacts of climate change on health, and we should take note of some of the experiences we learned from each other while we were over there as to what does and does not work. For example, at the hospital on the island of Gizo we saw the effects of climate change on rising sea levels where the water has come right up to the hospital’s border. They had to actually physically move the hospital and they are building a new one. Climate change is a real threat and is already affecting people’s lives. It is already having an impact on health in the Pacific. The delegation’s visit played a role in that sharing and learning process in that we heard from them and they heard from us. Delegates hope to see the parliamentarians we met in the PNG and Solomon Islands back in Australia in the near future to continue our engagement. It is so important for leaders and communities in our respective countries to have ongoing dialogue about the range of health issues that affect our region.

In the few minutes that I have left, I would like to take this opportunity to thank my committee—my deputy chair, Steve Irons, and the secretariat, Sara Edson, James Catchpole and Penny Wijnberg—for their assistance and their help. The secretariat did an absolutely A-class job in getting the itineraries and the meetings all set up for us and in the development of this particular report. But I must say that we were also warmly welcomed and appreciated in both countries. There was generous hospitality and support provided by our host parliamentarians and governments of Papua New Guinea and Solomon Islands, and we were assisted ably by our high commissions in both countries.

We are very grateful to the many people who helped make the visit such a success. In particular, I would like to thank the Governor of the Western Province of Papua New Guinea, the Hon. Bob Danaya, and, of course, the local member for South Fly in PNG, the Hon. Sali Subam. They accompanied us on our visit to the three treaty villages—our closest neighbours in Australia—of Mabadawan, Sigabadaru and Buzi. We were warmly welcomed with full traditional welcomes when we attended these villages. The three villages, as I said, are some of the most isolated villages in the world. There are no roads leading into them. There are no aeroplanes and airports. The only way you can get to them from Daru, the capital of the Western Province, is by banana boat. We were lucky that we went by helicopter. You can see the problems in getting aid into these places, because, as I said, there are no roads or other infrastructure. I really felt for the people when we saw them. They were so welcoming and so happy to see us. I hope this report does make some sort of difference to their lives.

As I said, I thank my committee colleagues on the delegation for their very hard work, and the committee secretariat and parliamentary relations officers for their efforts in coordinating the delegation’s program. I commend the report to the House.

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

As Deputy Chair of the House of Representatives Standing Committee on Health and Ageing, I am pleased to speak, along with the chairman of the committee and other members, on this report of the Australian parliamentary committee delegation to Papua New Guinea and the Solomon Islands. To give a bit of background about the work we did prior to making the visit, I will read from the report:

Before the delegation travelled to Papua New Guinea (PNG), the Committee wanted to learn more about the Torres Strait treaty, the status of health services in the Western Province of PNG, Australian assistance to the health sector in Western Province, the health concerns of Torres Strait residents and the jointly agreed Package of Measures designed to address health problems on both sides of the border.

The Committee also sought information on some of the major health issues jointly affecting PNG, Solomon Islands (SI) and Australia alike, including, avoidable blindness; child and maternal health; violence against women; water and sanitation; HIV/AIDS; tuberculosis (TB); mosquito borne diseases (malaria and dengue fever); the health impacts of climate change; and a rise in non-communicable diseases like diabetes.

We have just heard from the member for Hindmarsh, the chair of the committee. I thank him for his speech, which covered the details of the report very comprehensively. I also acknowledge his efforts, along with those of the other committee members who travelled, in putting this report together. I would also like to recognise the secretariat staff Sara Edson and Penny Wijnberg, along with James Catchpole. Sara and Penny produced a great effort in protecting us from mosquitoes, organising our days while we were away and providing a supply of water when it was needed.

Although I could not join the delegation on the Papua New Guinea and Solomon Islands leg due to community commitments in my electorate of Swan, I was part of the delegation’s visit to the Torres Strait, an account of which is included in this report. I was fortunate enough to enjoy my birthday whilst on the trip to the Torres Strait, and on that day we flew to Saibai Island. The member for Kingston was horrified that I was offered the opportunity to take control of the plane on the way back from Saibai Island. But I managed to calm her down by not taking control—and I saw the relieved look on her face.

Whilst on Saibai Island we visited the local clinic, which is managed by a Western Australian lady from Mandurah. She is doing a great job there with limited resources. One of the things the committee found while we were away was that there is a lack of resources in these areas. The manager of the clinic related to us a story about a PNG national who had recently collapsed in the reception area of the clinic. The man was revived and sent to Thursday Island but died the next day. He had tuberculosis and HIV, both undiagnosed. This man had been waiting four months to get into the clinic. It is unfortunate that the state of health care on an island that is two kilometres from our resources in Australia is such that this person had to wait four months to get into a clinic and dies with undiagnosed tuberculosis and HIV. It is an indictment of the way our resources are delivered and how underresourced our clinics are. It is no fault of the people who work in the clinic; it is about the way we deliver resources to them.

The visit was arranged in the context of some community concern about the treaty arrangement that permits free movement between certain villages in the Torres Strait Islands and Papua New Guinea. The committee sought to find out more about a range of health issues, including tuberculosis, HIV-AIDS, malaria and diabetes, some of which have been linked to this treaty of free movement between the villages. The report makes various recommendations to the government and I would like to take the time to discuss these in more detail. Recommendations 5 and 14 both refer to improving nutrition and tackling health issues such as diabetes. Recommendation 5 states:

The Committee recommends that the Australian government partner with non-government organisations and communities to find nutritional solutions that promote healthy eating and redress malnutrition, in affected areas in the Torres Strait and Papua New Guinea.

Recommendation 14 states:

The Committee recommends that the Australian government support education programs about diabetes prevention and nutrition in the Torres Strait, the Solomon Islands and Papua New Guinea, in areas where diabetes and nutrition are problematic.

The committee has done plenty of work on the topic of diabetes and diabetes prevention. The more research the committee does, the more we understand how this issue permeates the whole of our society. The report notes:

Hypertension, a precursor to cardiovascular disease, and diabetes are on the rise (through increased salt and sugar intakes) …

The delegation asked what was being done in respect of preventative health and was advised that it is much more difficult to procure funding for prevention than for treatment. The hospital has recently applied for funding from the World Diabetes Foundation.

I continue to support healthy living and activity in the electorate of Swan. I am pleased to inform the House that during April I will be starting a number of walking groups across the electorate to kick off a healthy living program in my electorate of Swan. It is good to see the member for Kingston has arrived. I will not repeat the story about the plane, but I did mention your horror, Member for Kingston, when you thought I was going to take control of that plane!

Whilst type 2 diabetes is largely preventable, type 1 is not. Today’s Juvenile Diabetes Research Foundation 2010 Kids in the House day brings 111 children and teenagers and their families from across Australia to Parliament House in Canberra to raise awareness of type 1 diabetes. I am pleased that Thomas Lyons, a young lad from my electorate, is here in Parliament House today with his mother, Nicki. Thomas was very happy to meet Tony Abbott, the opposition leader, as we were walking down the corridor. Thomas and his family spoke to me about the condition of juvenile diabetes and the challenges that he faces on a day-to-day basis. I was also lucky to meet this morning with Baden Ross-Willmore from Nola Marino’s electorate of Forrest. I look forward to catching up with them all at lunchtime.

The Juvenile Diabetes Research Foundation is lobbying for $40 million of federal government funding to establish a clinical trial network for type 1 diabetes that it says would provide a range of benefits, including access to new treatments, improved diabetes management and reduced medical and hospital costs for people with type 1 diabetes. I will be interested to see the federal government’s response to this request and I ask the government to seriously consider this funding.

Going back to the report, while I am sure the freedom of movement between Torres Strait and PNG villages contributes to health issues, it is worth mentioning that there are certain benefits to that relationship. Given the health related issues, we must keep a watchful eye on this relationship and do all we can to help address the burden of issues.

In conclusion, this is an interesting report that highlights a number of important issues. With you, Deputy Speaker Georganas, being the chair of the committee, I hope the government will take a serious look at the report and that the outcomes from it are beneficial to our closest neighbours. It is important that we do not forget our fellow Australians in the Torres Strait. I also thank the committee members who were on the trip. They helped me celebrate my birthday while we were up there and gave me a nice present, which was very well received. I also thank the people, particularly those in the Torres Strait, who accommodated us, looked after us and gave us all the support we needed to help put this report together. I commend the report to the House.

Amanda Rishworth (Kingston, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to rise to speak on the Standing Committee on Health and Ageing report Regional health issues jointly affecting Australia and the South Pacific. This report is the result of the work of some months. The committee travelled to various places to gather significant evidence on some of the health issues affecting our region and, in particular, our nearest neighbours.

This inquiry had as a backdrop the federal government’s new era of engagement in the Pacific, and particularly it enabled not just the government but the parliament of Australia to engage directly with some of its closest neighbours, including Papua New Guinea and the Solomon Islands. The aim of the inquiry was to investigate shared health concerns with some of our closest neighbours, and it was regularly noted by the chair during the visit that one of the primary reasons for this was that diseases do not respect nations’ borders and therefore the health concerns of our nearest neighbours are the health concerns of us all.

Papua New Guinea is Australia’s closest neighbour, and indeed, as previous speakers have mentioned, a lot of Australians do not realise just how close a neighbour it is. In some areas there are only five kilometres separating parts of the Torres Strait from the Western Province of PNG. I was surprised, as I know a lot of people were, to see that while I was standing on the island of Saibai I could actually see the coast of the Western Province. Due to the proximity and traditional movement of the people in the Western Province and the Torres Strait, there are special circumstances that allow for the free movement of people between the Torres Strait and the 13 treaty villages on the Papua New Guinean side.

The committee travelled to the Torres Strait and to three of the treaty villages to investigate how health care was provided on both sides and how the interaction between these two groups of people was impacting on health care. The committee learned that the treaty allowed for people to travel from Australia to the PNG side for traditional purposes, including for trade and family connections. What the treaty does not allow is for people to travel for healthcare purposes. However, what we did learn when we visited both sides was that there is some movement to the Australian side of people who need access to care. This was raised both in the Torres Strait and on the PNG side. We heard from many medical officers who said that for humanitarian reasons, obviously, but also for practical reasons they would not deny health care to those in need because by not treating someone who perhaps presents with tuberculosis you are then leaving both Australia and the Western Province vulnerable to the spread of that disease. We heard that for very practical reasons it is sensible, if PNG locals are travelling across the border, to treat disease.

After travelling to the treaty villages, the reasons that some of the locals would travel to Australia made a lot of common sense to me. To access a hospital in the capital of Daru can take in excess of two hours by boat. Compare that with 15 to 30 minutes to get to Australia. This is one of the major issues. We also learnt that another issue is to do with the level of health services that are available on the PNG side. At times within these treaty villages the level of services can be problematic. There was certainly some discussion about this, and within our recommendations we have talked about supporting an initiative that was discussed in evidence which would allow health workers from Australia to travel directly to the treaty villages, perhaps to assist with health but perhaps also to follow up patients that have presented at Saibai. At the moment health workers would not be able to cross that five-kilometre border; they would have to go through Port Moresby, Daru and then to the treaty villages. Certainly the committee thought that this was a sensible recommendation that would help in a practical way to provide services to that border area.

During our travels to both PNG and the Solomon Islands we also learnt that there are a number of things that Australia is assisting with and needs to be aware of. As previous members have noted, diabetes and lifestyle diseases are occurring in Australia and need to be addressed if we are going to improve the health of our nation. These diseases have the potential to explode in both the Solomon Islands and Papua New Guinea. These lifestyle issues have the potential to be more prevalent in the capital cities of Honiara and Port Moresby, as people’s lifestyles include more fast foods and less nutrition and they become more sedentary in their jobs. As it is in some of our remote Indigenous communities, malnutrition was also a problem in some remote areas of the Solomon Islands and PNG. We have made some recommendations on how we might look at diabetes and malnutrition, which are areas that do need to be addressed.

We heard a lot of evidence about workforce shortages. We think we have workforce shortages in Australia, but there certainly are workforce shortages both in the Solomon Islands and in Papua New Guinea. This is something that both countries are struggling with. How do they train enough health workers, doctors and nurses to service their population?

Because these two nations are geographically spread out, another issue confronting them both is how they can post workers out to the many islands, towns and villages that are quite a way from the capital city and keep them there. We heard evidence that, if housing was not provided for those workers, especially in the treaty villages, then they would not be able to stay there. If you cannot provide housing for the health workers who are posted there then there is not much incentive for them to stay. We recommend that, when AusAID and other aid organisations invest in aid posts, they take into consideration providing, where practicable, housing and other support for the health workers, who are often very isolated.

Non-government organisations do a huge amount of work in providing health services to many people in both the Solomon Islands and Papua New Guinea. We heard evidence that, while a lot of the NGOs have good intentions, especially some of the smaller NGOs, and send old glasses to the Vision Centre at the Port Moresby Hospital, indeed it is not that helpful because it actually costs more to replace the lenses in the second-hand frames than it does to manufacture new glasses. This was something we heard pretty regularly.

We heard that a lot of doctors visit the Solomon Islands and provide medication to people in the outer islands but that medication is not available from the Solomon Islands government. You can see that it will be problematic if people are provided with one type of medication and cannot get continued access to it. The committee recommended that Australia look at setting up a contact point for small non-government organisations, such as Rotary clubs and Lions clubs, to get advice on the best way to help people in the Solomon Islands, PNG and countries that require support. There are many recommendations, and I encourage everyone to have a good look at the report.

I would now like to say some thankyous. We had a lot of support and a lot of help from so many different people, both here in Australia and in Papua New Guinea and the Solomon Islands. I thank all the Australian organisations and government departments that briefed the committee and provided submissions to the inquiry. For our visit to the Torres Strait, I extend a thankyou to the Torres Strait Regional Authority, who met with us and openly shared their perspective. I extend a special thankyou to Brett Young, who organised the visit.

For our visit to Papua New Guinea, I thank all the Papua New Guinean members of parliament and officials who welcomed us very warmly to their country and were willing to have frank and open discussions with us. In particular I extend a big thankyou to the Hon. Bob Danaya, Governor of Western Province, and Sail Sabam, the local member for South Fly, who accompanied us on the trip. I also thank all the PNG health professionals in Port Moresby, in Daru and in the treaty villages who shared with us their experience of training health professionals and delivering health services on the front line and provided us with their thoughts on the strengths and weaknesses in their respective areas. I have to comment on the dedication and commitment of these health workers on the front line. They were quite inspiring to me, as I know they were to other members of the committee.

I give great thanks to everyone at the Australian High Commission in PNG, especially to the then high commissioner Mr Chris Moraitis. I also give thanks to all the staff, in particular Deputy High Commissioner Jon Feakes, Adrian Lochrin and Paul Murphy, who travelled with us, who provided us with guidance and were particularly patient in answering all of my questions. I also extend a big thankyou to the AusAID staff, who were able to offer a wealth of knowledge and support in the healthcare area, and in particular to Dr Ann Malcolm and Ms Fiona Cornwall.

On our visit to the Solomon Islands, we were very privileged to meet with many members of parliament and officials in Honiara and in Western Province. I give particular thanks to the Premier of Ghizo Island for their hospitality. They really gave us a lot of time. I also thank the health professionals from the Solomon Islands who shared with us their front-line experience and were very welcoming and honest.

I thank very much the Australian high commissioner in the Solomon Islands Mr Frank Ingruber and everyone at the high commission. I thank the AusAID staff who helped us. In particular, I give thanks to Kamal Azmi and a special thanks to Justin Baguley, who travelled with us to Western Province and provided us with a wealth of practical information about what was happening on the ground.

Finally, the last thankyou needs to go to the secretariat, especially to Sara Edson, who was particularly helpful to all of us during the trip, especially when I managed to have a knee injury. She made sure that I was okay and that I got the proper treatment. Thank you very much to Sara and to the rest of the secretariat of the House of Representatives Standing Committee on Health and Ageing.

This report addresses some of the serious issues in our region, both for today and for the future. The recommendations in this report are concrete recommendations, practical things that Australia and the Australian government can do to further improve health in both our country and the region. I commend the report to the House.

Julie Owens (Parramatta, Australian Labor Party) Share this | Link to this | Hansard source

I am very pleased to stand and speak briefly to this report of the Australian Parliamentary Committee Delegation to Papua New Guinea and the Solomon Islands. I went to Tonga on a delegation last year, but not to either of those two places, with the Clerk of the House. I learned when I was there that there is something that our New Zealand counterparts do better than we do: they educate themselves about the Pacific region. In fact, members on the Labour side of the New Zealand parliament are required to spend their first study grant in the Asia-Pacific region. That is something not required of us but it is something that is very worth while. When you are in some of those Pacific islands, particularly in the New Zealand region, you realise how strong the connection is between our New Zealand counterparts and the members of parliament in those areas because of that consistent flow of people, which is now two-way.

So I am very sad to see that, at the end of this parliament, we will lose two members of our parliament who are perhaps the most informed about the Asia-Pacific region—that is, Bob McMullan and Duncan Kerr. They are both people who have over many years paid significant attention to the needs of the region and who certainly lead in our caucus in terms of knowledge and recommendations. They will be a very great loss. But it is good to see that the Prime Minister has declared that Australia must usher in a new era of engagement with the Pacific and has begun to send delegations to that area in order for us to learn a great deal more and to engage more with what are very important neighbours. The Prime Minister has suggested that we should host next year’s Pacific Islands Forum to send a very clear message to our region that we are really back in business in our relationships with that region.

The relationship is important for many reasons but, in particular, for health reasons because Australia has a very large and growing population from that region. In my area I have a very large population of people from Tonga, Samoa, Papua New Guinea and the Torres Strait Islands. They are very strong communities in my electorate and the health issues that affect their homelands also affect their communities. It goes quite quickly backwards and forwards: whatever issues are being faced in Samoa are also being faced to some extent by people within my community. There are also cross-border communicable diseases such as malaria, tuberculosis and sexually transmitted diseases, including HIV-AIDS. Australia has had a very strong commitment to providing aid in those areas over many years.

When I was in Tonga, I was quite surprised by some of the health issues faced there and the reasons for them. As we all know, Tonga, like Samoa, is a very sporting nation. If you look at the rugby teams you can see their commitment to sport. In Tonga there were young men, in particular, everywhere in their rugby jerseys, particularly Australian rugby jerseys. While I was there, the Australian schoolboys rugby team played the Tonga rugby team. The Australian team only just won, by the way, and they came back looking very bruised and battered. When I asked how many Tongan Australians were on the Australian team, I found that there were six. So one could say that the Australian team had a few ring-ins from Tonga.

Clearly there is a very important role for sport, yet Tonga suffers incredible levels of obesity. According to the locals, the problem of obesity was not always there and in fact is quite a recent phenomenon. Tonga used to be a whaling nation. They ate a lot of whale meat, which is very fatty, but it was one of the first countries to ban whaling, even though whale meat played such an important role in its diet and culture. But they retained their love of fat, which, when they were a whaling nation, was quite rare. The whales did not exactly float up on the beach, so it was a rare thing for the people to consume that much fat. Now when you go to the local stores you find imported cans of pork belly, which is something I cannot imagine we would eat in Australia. Yet so much of the diet in Tonga now is imported very low-quality and extremely fatty meat in tins, which contributes greatly to the obesity epidemic in Tonga, in spite of the people’s extraordinary commitment to sport.

As I read this report it is interesting to note the difference in the focus when we look at Pacific nations and when we look at Australia. In Australia when we talk about our health system we are really talking about a medical services system which, over the years, has focused on the treatment of illness and, more recently, prevention in the early stages of an illness—that is, the identification of illnesses early, such as breast cancer, prostate cancer and, more recently, type 2 diabetes.

This report is clearly talking specifically about issues which prevent people from getting good health in the first place. We are talking about issues as basic as nutrition, hygiene, clean water, the availability of toilets, the treatment of sewage—issues that in Australia we now consider to be quite basic but which, in countries such as these, are preventing people from being healthy in the first place. Clearly Australia has a very important role in assisting our neighbours to provide conditions in which a person can be healthy. Also, though, we have a capacity to learn from the focus on health which we provide when we talk about other nations in terms of our own health system. This is an important report. I understand it has been a very long time coming. When you read it and you see the range of recommendations and how specific they often are to one program or another, you can see how far we have to go in addressing the very real health issues of our neighbours. It is a very important report. It is a report that opens the door and asks a lot of questions of us all in terms of what we do and what we can do for our neighbours. I commend it to the House. It is important. It is a good read. As I said, it points out to me just how far we have to go in making a very real difference in the lives of our neighbours.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I would like to put on record my thanks to the member for Parramatta for standing in for me and making a contribution to this debate. I know she is quite passionate about health issues. The reason she stood in for me was that I was in my office meeting with Dane and, his mother, Kim Boyd from the Juvenile Diabetes Foundation. I would like to note that we have present in the House some young people who are here to meet with members of parliament to educate us about juvenile diabetes. I welcome them to the House, and I thank the member for Parramatta for allowing me to meet with Dane and his mother.

To start my contribution to the debate, Mr Deputy Speaker Georganas, I would like to acknowledge the role that you played as chair of the committee. I also acknowledge my colleague the member for Kingston, from South Australia, who was also a part of the delegation that visited PNG and the Solomon Islands. I would like to thank the committee secretariat, particularly Sara Edson, whom I notice is in the House with us today, for her enormous contribution and for looking after us. Every time we turned around she had the sunscreen that we needed and sound advice. Thank you, Sara. I also put on record my thanks to AusAID, DFAT, the government representatives we met in both PNG and the Solomon Islands and the NGO groups that we met with. I would also like to thank those in Australia—Queensland Health, the NGOs and other professionals—who briefed us on the issues prior to us visiting PNG and the Solomon Islands, and when we visited the Torres Strait Islands, which was quite an education in itself.

Mr Deputy Speaker, you would be well aware that the Australian government made an enormous commitment to our relationship with PNG and the Pacific islands in the area of health in the 2009-10 budget. Official development assistance to PNG and the Pacific region was set at $1.9 billion. Of that, $133 million was to be spent in the area of health. This shows Australia’s commitment to developing a strong partnership with the Pacific nations.

It was only when I visited the Torres Strait Islands and saw the treaty and how the treaty worked in practice that I truly understood how close PNG was to Australia and how there were so many shared issues between our two countries. It also made me aware of issues that existed on both sides of the border. When the committee visited the Torres Strait we met with people that lived in the Torres Strait and we heard their concerns about health issues and about diseases being brought from across the border, from PNG to Australia, diseases such as TB and sexually-transmitted diseases, and their concerns that the health resources, particularly on Saibai where there is an excellent health clinic, were being stretched to the extreme.

It was interesting to visit the clinic. On the day we visited Saibai there were some people who had come across the Torres Strait from PNG. As a little aside, we met some of those people when we visited one of the villages and one of the villagers remembered the member for Kingston and presented her with a spear, which I know she displays proudly.

But when we were in the Torres Strait we learnt of the health issues that are so predominant in PNG. There is poor child and maternal health and the backup if a woman gets into trouble when she is giving birth is limited. We heard of an occasion when a woman had been involved in giving birth for two days and the baby was actually stuck. It was only because she could link into the health services that were available within Australia that her life was saved.

I would like to turn very quickly to recommendation 2 of the report, which highlights the fact that we need to support this partnership. The recommendation was that collaborative research be undertaken between PNG and the Solomon Islands and the Torres Strait Islands into sexually-transmitted diseases and the network. There is not a lot of information around. We need to demystify a number of the issues relating to this particular area and it could best be done by collaborative research on both sides of the border.

I would like to turn to PNG. There are enormous challenges within the health system in PNG. We talk about challenges here in Australia where we are looking at health reform currently. Our health reform will actually put Australia at the absolute cutting edge of delivery of health services. It is only when you visit places like Port Moresby and Daru, where we visited the hospital, that you can appreciate the challenges faced by health professionals in trying to deliver health services to people that have very high health needs. We learnt about how challenging the delivery of health services in those areas can be. And then there are the treaty villages, which are very remote. As the chair of the committee mentioned, it takes 30 minutes by banana boat from Australia, but it takes a lot longer to get to Daru. It highlighted a number of issues when we were in PNG.

There is little likelihood that Millennium Development Goals 4 and 5, which I believe are very important, will be met in PNG. For things to improve in PNG, we need to commit to a strong partnership with them. We need to commit to helping PNG develop their resources and we need to partner with them on programs that are directed at violence against women. I think that violence against women in PNG and the Solomon Islands is an issue that impacts on the health of both of those nations. I noticed this morning that a report has been released on alcohol abuse in both PNG and the Pacific area. Maybe as this unfolds we will find there is a correlation between the abuse of alcohol and violence against women. It is only by developing partnerships with PNG and the Solomon Islands within our law enforcement agencies, which Australia has been doing for quite some time, and between our educational institutions, health institutions, governments and government departments that this can be effective.

The other thing that struck me both in PNG and in the Solomon Islands was the dedication of those health workers who are involved in those countries. Unique programs are being run in those countries. One of the programs that I found particularly exciting was the one where health workers and other people were going out and working with sex workers in the community to teach them about safe sex and trying to educate them in a way that would counteract the effects of HIV, because HIV is quite rampant in PNG. One of the things that actually protects certain areas is the remoteness of the country. As remote settlements are connected, it will lead to an increase in sexually transmitted diseases—in particular, HIV. There is some fantastic work being conducted by aid agencies in both countries.

As I think was previously mentioned by the chair—and I am sure the member for Kingston will have mentioned it too—climate change is having an impact on those communities in the Solomon Islands. When we visited Ghizo Island we saw how the water had moved closer to the hospital, and the hospital would need to be moved to ensure its safety. We also saw the impact that climate change has had on surrounding island communities, where they had to leave their homes and move to the island of Ghizo. Associated with climate change are increases in malaria and dengue fever and the creation of more health challenges for those communities. I have to note in my contribution to this debate that there has been some fantastic work done in relation to malaria in the Solomon Islands, and we were fortunate enough to meet with some experts in that area.

I think one of the things that we can really do, other than give financial support, is contribute through partnerships with different organisations and groups and develop the process of mentoring—being there and being able to provide support as requested from communities in both the Solomon Islands and PNG. We were fortunate enough to meet some wonderful women who were interested in politics. I think the women in this parliament could develop some formal relationships to help mentor those women, because entering politics and becoming a member of parliament increases their ability to have input into decisions that will influence the health of women within their nation.

Another important issue is that we as a nation should listen to the communities in those countries. Any expenditure of money, any aid programs that we undertake, should be driven by the communities and countries in which those programs are delivered. We learnt that, quite often, the programs that are unsuccessful have been imposed on the communities from outside, while the ones that are successful are community driven. So I think it is very important that what we do in relation to the delivery of health services and health infrastructure is driven by the countries we are involved with.

The trip was a fantastic experience. I feel very privileged to have visited some places that have never been visited by members of the Australian parliament before. I hope that the recommendations we have made in our report will really make a difference. Once again I thank the secretariat and, in particular, Sara Edson for her contribution. (Time expired)

Debate (on motion by Mr Briggs) adjourned.