Breaking down barriers to support western Sydney Aboriginal and Torres Strait Islander mums-to-be

This year’s National Reconciliation Week theme, Be a Voice for Generations, urged Australians to use their power, words and actions to create a better, more just Australia for all of us.

The Western Sydney Local Health District (WSLHD) Aboriginal and Torres Strait Islander Mums and Bubs Program Steering Committee is working hard to do just this, implementing various district-wide initiatives to support Aboriginal and Torres Strait Islander mums-to-be and their families across the district.

The committee is made up of representatives from WSLHD teams: Aboriginal Health Strategy, Population Health, Priority Populations, Westmead Dragonfly Midwifery group, Perinatal, Referral and Liaison Service (PEARLS), and the Greater Western Aboriginal Health Service’s (GWAHS) Connected Beginnings and the Australian Nurse-Family Partnership Program. They also collaborate with the Aboriginal Maternal Infant Health Service (AMIHS), the Westmead Hospital Foundation, local pharmacies and bulk-billing ultrasound services and the Primary Health Networks (PHN).

With over 30 attendees, 40 per cent of who identify as Aboriginal and Torres Strait Islander, this committee is breaking down silos to improve health services for Aboriginal and Torres Strait families in a culturally appropriate way through establishing sustainable partnerships.

Committee member Jo Fuller is the Integrated and Community Health Priority Populations program lead at WSLHD, and since 2016 has managed the Aboriginal Health portfolio and was a founding member in starting this committee.

Jo is passionate about service collaboration and strongly believes that reconciliation needs to be driven by non-Aboriginal and Torres Strait Island peoples.

Through the Mums and Bubs Program Steering Committee, we have been able to establish culturally sensitive and appropriate services and provide alternative pathways for the delivery of non-Aboriginal services to the local Aboriginal and Torres Strait Islander communities across western Sydney,” said Jo.

One example of this is the Westmead Hospital Midwifery Caseload Practice and Westmead Dragonfly Midwifery group that offers culturally safe midwifery continuity of care for women from Aboriginal and Torres Strait Islander families with a service that runs 24/7 during pregnancies and up to six weeks following birth.

The first mother through the WSLHD Dragonfly Midwifery Clinic Joelle Harland-Sykes with her twins Jacob and Zakariya in May 2021.

Until 2020, Bulbwul Werowe AMIHS in Mt Druitt was the main referral pathway for Aboriginal and Torres Strait Islander women in western Sydney accessing antenatal care. However, due to the growing number of expectant mothers in the local area, AMIHS were not able to take on all referrals, identifying an opportunity for Westmead Hospital to fill the obvious service gap.

“Many Aboriginal and Torres Strait Islander people don’t feel comfortable in a hospital setting given their ancestral history with health systems and the stolen generation, so providing a culturally supportive environment to new mums is essential to supporting mother and infant health,” said committee member and Westmead Dragonfly Midwifery group manager, Carolyn Hilsabeck.

“We renovated an offsite one-bedroom unit so that women didn’t have to come up to the hospital for their appointments and women are loving the service.”

Aboriginal Elder Uncle Elvis and Kiralee Moss performing the smoking ceremony for Anne-Shirley Braun and baby Amelia at first yarning circle at Westmead Hospital’s Cultural Gathering Place in June 2021.

One of the Aboriginal health practitioners from the Dragonfly group, proud Ngiyampaa/Wiradjuri woman Miriam Maloinato, describes her role as “the gap that helps bring our women closer to their babies and successfully obtain care”.

This involves antenatal, neonatal and postnatal support, organising transport and doctor appointments at the Dragonfly clinic, being a liaison and advocate for parents at their appointments, helping with housing issues, or creating fun activities such as belly-casting, painting and cooking to ensure a positive and supportive experience.

“We all need to do our part to influence services to become more culturally appropriate and safe, and the enhanced maternity services are a great example of this,” said Jo.

“Working collaboratively is the only way; you won’t get very far if you do things in isolation.”

Members of the WSLHD Centre for Population Health team also sit on the committee and has achieved and continues to deliver impactful work around. Some of this work includes the delivery of childhood immunisations by setting up outreach clinics, assisting with smoking cessation during pregnancy through creating partnerships to fund initiatives such as nicotine replacement therapy (NRT), the Go4Fun program and ensuring they are known in the community by attending outreach events.

Together as a committee, we have established successful outcomes from tailored initiatives like the Dragonfly program at Westmead and Blacktown, a paediatrician clinic, Aboriginal-focused anti-smoking videos and quit smoking training packages and providing of free NRT to Aboriginal pregnant women,” said WSLHD’s Belinda Cashman, district director, Aboriginal Health Strategy.

“We are also looking into the establishment of an ENT clinic for our Aboriginal children, and are currently finalising the Aboriginal maternity model of care for the district, which will be the first of its kind for us.

“WSLHD is committed to closing the gap, and these opportunities and pathways are just some of the things that will help us to get there.”

Families make healthy food fun in western Sydney at Kimberwalli

External committee member, Avijit Saha, represents the GWAHS Connected Beginnings service, a program for pregnant mothers and children aged under five years in the Mount Druitt and Doonside regions, designed to ensure children are healthy and well prepared for school.

He says the collaboration the committee creates is “wonderful” and “stops double dipping”.

“In the meetings we learn who’s doing what, which is very important and helps to identify any gaps and how to best fill them together,” said Avijit.

“We do monthly outreach clinics to local preschools, which provides another community touchpoint and opportunity for collaboration.”

In the coming months, the committee is focusing on initiatives including the Westmead quality improvement project for Aboriginal and Torres Strait Islanders quitting smoking in pregnancy and the creation of a gathering space, which will feature a healing garden across from the Westmead Dragonfly Midwifery group offsite clinic.

Belinda Cashman (Acting Director Aboriginal Health Strategy), Koorine Trewlynn (Principal Project Officer Kimberwalli)

“Everyone should be able to seek services wherever they’re comfortable – so we need to talk to each other and collaborate to ensure positive outcomes and ensure cultural appropriateness and safety,” said Jo.

“And that is what we’re doing here.”