Effects of ACE gene polymorphism on vitamin D therapy according to parathyroid hormone level in patients on hemodialysis.

INTRODUCTION

The Yolngu people of North-east Arnhem Land, Northern Territory, Australia, have lived with alcohol for just over 30 years. For some it has had devastating health, social, family and cultural impacts. This is particularly the case for a group of Yolngu people who permanently or transiently camp on the fringes of the predominately non-Indigenous township of Nhulunbuy. The Miwatj Health Aboriginal Corporation Outreach Program was a response to alcohol use by this Aboriginal community. An evaluation, in consultation with Miwatj Health, sought to examine the conception, development and success of the Outreach Program.

METHODS

This was a qualitative study that used: unconcealed participant observation, formal semi-structured interviews, group interviews, opportunistic impromptu discussion, and documentary/archival review. Interviews were conducted with Outreach Program staff, Yolngu community members, Aboriginal health workers, Miwatj Health doctors, Living with Alcohol representatives, the town administrator, Nhulunbuy police sergeant, the publican and local council officer. Group interviews were conducted with two groups of campers, Outreach Program workers and Aboriginal health care workers.

DISCUSSION: For the Yolngu people the focus of the Outreach Program was meant to be on talking with and counselling drinkers, cultural activities, and liaising with other substance misuse programs and the police. The Outreach Program has achieved some success and helped a small number of Yolngu to limit their alcohol use and reconnect with the community. However, the Outreach Program has come to focus more and more on cleaning up litter; a key issue for the non-Indigenous community.

CONCLUSION

This article focused on one key finding from the evaluation and that is the impact that funding (or lack of funding), the source of funding and the parameters imposed by funding bodies can have on the success or otherwise of a community driven program. The ability of Indigenous communities to determine appropriate program approaches and implementation is undermined when funding sources place restrictions which reflect non-Indigenous values and dominate program outcomes.