Strong Women, Strong Culture: Community Control Success Stories at Waminda
October 31st, 2019
It’s a crisp, Spring morning for the visit to Waminda South Coast Women’s Health and Welfare Aboriginal Corporation. There’s been rain, so the pastures and bushland surrounding the NSW South Coast town of Nowra are lush and green. The town and its surrounds sit beside the Shoalhaven River, nestled between the Coolangatta Mountain and the sea: landforms of great significance for what is known as the Yuin Nation, and its peoples.
The area has a traumatic colonial history of dispossession, violence and family separation; its legacy continues for the Aboriginal community today, but this is not a story of defeat. It’s a story of strong women, strong community and strong culture. Of how doing healthcare the Waminda way brings wholeness to women and their families.
Waminda is much more than the sum of its clinics. No opportunity to connect with the community is missed. Clients from all over the Shoalhaven region – Jerrinja and Wreck Bay Aboriginal communities, Nowra/Bomaderry and as far afield as Ulladulla and Kiama – access Waminda’s services in various ways. These are just a few of them.
No Wrong Door: Holistic Health Clinic
There’s free fresh fruit at the reception desk in this downtown Nowra location, which hosts Waminda’s clinical services including Aboriginal Health Workers, General Practitioners, Nurse Practitioners and Midwives. It’s the place of first contact for many clients, while others are referred from elsewhere in the service. Every person is triaged by an Aboriginal Health Practitioner first up.
Practice Manager Sharon Trindall, says there are currently more than 1,400 Aboriginal women and family members on the books, after a period of exponential growth following her arrival at Waminda (straight out of acute care nursing) four years ago. Care is client-driven, and 715 health checks are offered to everyone who is eligible.
“We watch our data really closely – see where the gaps are; where we need to improve. What we’re picking up is complex. The checks identify chronic conditions, multiple comorbidities, social issues, family issues. They are holistic. Even if that person doesn’t elect to do their screening or preventive care you have the conversation with them” explains Trindall.
Hayley Longbottom, Waminda’s Health and Wellbeing Manager and also an Aboriginal Health Practitioner, explains the service’s woman-led, integrated and holistic ethos.
“Here there’s no wrong door approach,” Longbottom says. “A woman walks through that door and we deal with everything she brings with her. We walk beside her, not in front of or behind, but right beside her. People are their own healers. Everyone’s on their own journey. We’re talking about a whole person in terms of her family, her community” says Hayley Longbottom.
This approach is beautifully illustrated in two key graphics, the Waminda Model of Care, and the Balaang (Women’s) Healing framework, which was developed through women’s yarning circles.
Led since 2007 by dynamic CEO Faye Worner, Waminda’s 110-plus staff are a tight-knit bunch. It’s a uniquely collaborative environment and, as we yarn, people frequently finish each other’s sentences in a way that is amplifying and supportive. Many are from the Yuin nation and have grown up locally. There’s an immense satisfaction in giving back to community.
Elvera Golden-Brown, Aboriginal Health Worker
“One of the things I’m proudest of isn’t clinical. It’s the fact that since I’ve been here so many family members have followed me over. They were seeing mainstream doctors or not getting much healthcare at all. Here they feel comfortable and safe, and happy to see mob around. They’re not going to be judged”
“You get people coming in and saying, ‘I wouldn’t be alive without Waminda’. That’s a powerful thing”
Case management: connecting to country
Tamara Ardler, Drug and Alcohol Caseworker says most of her clients’ problems with addiction relate to past or ongoing trauma. Rather than focusing on addiction, she tries to bring hope and focus on strengths.
Support available within Waminda includes Healing Counsellors, physical and mental health checkups through the doctors, and referral to Dead or Deadly or Balaang Gunyah (see below). Connecting women back to country and community is a major aim.
“Through drug and alcohol use a lot of people lose their connections. It’s about bringing them back,” Ardler says.
Birthing on Country
Melanie Briggs is an Aboriginal midwife and Waminda’s Project Officer for Birthing on Country. For Waminda, that means making birthing culturally safe for women so that they feel connected to their culture and feel safe in the space: bringing culture back in to birthing practices.
Currently, Waminda provides a maternity model of care to women who are having an Aboriginal baby through the Minga Goodjaga (Mother and Baby) program. Midwives deliver antenatal and postnatal care through pregnancy and the first six months postpartum, but Briggs wants to do much more.
In the short term that entails working with Nowra’s hospitals and stakeholders, so that women can have continuity across the spectrum of midwifery care with their chosen Aboriginal or culturally sensitive and competent non-Aboriginal midwife. In the long term, there’s a proposal on the desks of the State and Federal Ministers for health, and the Minister for Aboriginal Affairs, for a purpose-built service, designed by and for Aboriginal women.
“ACCHOs are the highest employer of Aboriginal people in the country – over 6,000 –, and yet we’re still having to access mainstream services to get birthing support. There’s so much to do” says Briggs.
Innovations in comprehensive care
Kristine Falzon is Waminda’s Cancer Care & Wellness Project Coordinator, supporting programs for health and wellbeing, tobacco control, palliative care, and cancer prevention, investigation and management. It’s “a whole of life approach to health care, from prevention, right through to screening, investigation, treatment support, palliative and end of life care,” she says.
Waminda’s regular pamper days in outlying communities are popular. Along with beauty and self-care services, these events provide opportunities for cancer screening and education, and identification of social and other needs, acting as a “soft” referral pathway.
Much of Falzon’s work involves advocacy, preparing submissions, working with external bodies like Cancer Australia, and looking at opportunities arising from funding for specific initiatives. She recently presented on behalf of Waminda’s cancer services at the World Indigenous Cancer Conference in Calgary.
A big win for the community was a Cancer Institute Grant Partnership with Shoalhaven Cancer Care Centre when the Centre was first being built seven years ago.
With good leadership on both sides, the project resulted in “cross-learning rather than coming from a deficit or superiority position” Falzon says. Aboriginal Health Workers act as conduits between the community and mainstream services, helping to make the Centre more culturally safe. The model is described in further detail here. Though a great example of “how things can be done effectively and appropriately in collaboration” Falzon notes that the partnership was not extended beyond 2012/13, meaning lobbying has had to continue.
Asked what it is about Waminda that allows innovation to flourish, Falzon underscores connectedness to the community and a deep understanding of its needs as pivotal to their success.
“We’re accountable to our community first and foremost and we are community women,” she says. “It’s also about being brave and fierce enough to be able to stand your ground and say, no that’s not right for our community.”
Going the extra mile at Nabu
Behind a double shopfront, on a leafy downtown street, sits the headquarters of Nabu, Waminda’s Intensive Family Support Service. Nabu works for preservation (keeping children with their families) and restoration (restoring children in out-of-home care to family). Sitting with the team, their shared passion and commitment is evident, and their success rate (100% for preservation and 91% for restoration in 2016/17) reflects this.
The team consists of Caseworkers, Family Support Workers, Cultural Mentors, and Elder/Cultural Mentors. The caseload is shared, and all Waminda’s resources can be called upon when the families need them.
With all activities led by what their clients need at any given time, no two days are the same. Whether it’s going the extra mile to support a client in court or packing boxes to help someone move house, this team goes all out to support their families.
Nabu was recently funded for twelve months through Their Futures Matter and is about to expand, in response to a burgeoning waitlist.
Nabu HQ is also the home of Waminda’s Healing Counsellors. Debra Bowman, who trained through Nunkuwarrin Yunti in Aboriginal narrative practice, explains that she provides therapeutic support across the whole of Waminda, wherever it’s needed.
“My work involves walking beside the woman and letting her reconnect to who she is, because every person is their own healer, it’s just about providing that space and that support,” Bowman says.
Tina Dickson, Cultural mentor
“Growing up, I had experience with out of home care. When I see these families coming together and mum standing her ground and being the strong woman keeping her family together, it’s a healing thing for them and me”
Moo Morunga, Caseworker
“When our families are in crisis, we sit with them and listen. Let them unpack and just sit with it. We don’t have to give advice – just sit, listen and respect ”
Tehika Hepi, Community Mentor
“Our referrals from Family and Community Services look at the risks, whereas we look at the strengths”
Dead or Deadly
Though it is situated in an unassuming dwelling in suburban Nowra, Waminda’s flagship healthy lifestyle service is a bit famous. It was singled out in 2018, by then-Minister for Indigenous Health and Aged Care Ken Wyatt as a success story in chronic disease prevention and management.
It’s been a labour of love for Waminda, with the service “robbing Peter to pay Paul”, even depending on contest prize winnings to keep Dead or Deadly afloat because “we knew women wanted and needed the program,” says health and wellbeing manager Hayley Longbottom.
When a woman comes in, “it’s not just about her jumping on a treadmill. It’s about her journey, her wellness,” the team explains. Every person’s needs are assessed by an Aboriginal Health Worker and a plan is made.
Smoking, diet, risk factors, diabetes screening and management, mental health and social isolation are all on the agenda – if the woman wants them to be. Over the past couple of years, shared medical appointments have been instituted. These health-focused yarning circles, which include a facilitator, a doctor and an Aboriginal Health Clinician (sometimes with the in-house cook on hand), have proved a huge success.
The cook also gets involved when Youth Social Worker, Olivia De Pietro, leads after-school outreach to girls aged 12 to 18, in Dead or Deadly’s Bulwul Balaang (young women’s) program.
Anita Mongta, Aboriginal Health Worker.
“We all work with our clients to support their mental health and wellbeing. We cater to everybody; make them feel welcome. And once they do identify mental health issues, our healing counsellors can come into our space, or they can meet clients somewhere else where they feel comfortable. We don’t isolate mental health from the rest of care”
Kalinda Wills, Aboriginal Health Worker
“A lot of our clients do have anxiety and depression. They’re coming in here because it’s a safe space where they feel welcome; where they don’t focus on their anxiety and depression. They focus on their health, and coming in and socialising, and getting their needs catered for”
Clever fearlessness, and a garden by the Shoalhaven
It’s back in the car for our next stop, as we follow the Shoalhaven river out towards the coast, then turn down a country lane and into the driveway of a redbrick house. The first thing to notice is the garden, home to Kareela Ngura (country of trees and water), Waminda’s sustainable permaculture and bush tucker rural industry project.
Upstairs, the small NDIS team endeavours to address the “massive unmet need” for assistance in the Shoalhaven region for women with disabilities. Alison Moyle is Program manager of Waranj Dhurawaraga (growing strong together). She and Aboriginal Health Worker, Stephanie Rooney, support people to access and use their NDIS funding.
This can be very labour-intensive. For instance, many people will need support to apply for NDIS several times before they are deemed eligible, but here again the Waminda way – walking beside people as they exercise their own choice and control – prevails.
“I love Waminda’s clever fearlessness. Looking at things strategically but saying, ‘Look there is the need there so we’re going to step into this space and do what we can” – Says Moyle.
Respite and healing at Balaang Gunyah
Out by the coast at Orient Point we reach today’s final destination, Balaang Gunyah (Women’s place). It’s a rambling old beach house with a wide, inbuilt verandah. There’s a safe play area out front and huge, mature eucalypts surround the compound. Cullunghutti can be seen in the distance, and Jerrinja Aboriginal community is just down the road.
Balaang Gunyah feels like the place where all Waminda’s services intersect. People have been talking about it all day as a place of congregation, respite, yarning, culture and healing. Open for about three and a half years, it’s the only Aboriginal women’s place in the Shoalhaven region, and was much needed.
Cultural Mentor Tresia Farrell is from Jerrinja. Along with facilitating Balaang Gunyah’s very popular Arts and Crafts Group and other activities, part of her job is to take people out on country, show them significant places, share yarns about those places and help them reconnect. She’s seen women “blossom” when they replace social isolation with connection.
Donya Whaddy, a Support Officer, is from Wreck Bay Aboriginal Community. She has been involved with Waminda for a long time, including as a client when she faced some difficulties of her own. Like everyone who works there, she’s immensely proud to be part of everything that Waminda stands for.
“Our Elders worked really hard to get this place off the ground. It’s been a long journey and it’s powerful to be able to work and give back to women, our community. All respect to my Elders past and present who made this happen. If it wasn’t for them, I wouldn’t be here” says Whaddy.