Well I will be when the pharmacy student I have had stopping with me for three weeks leaves on Tuesday. Being a small place he sleeps in my office. And being a uni student he seems to need a lot of sleep (??) so my late night office time doesn’t exist. But I shouldn’t complain. He volunteered to swag a few hundred metres away in the scrub last night. No, he wasn’t forced (that’s to his mum who I think reads this blog).

So last night I had a free run to catch up on 500 or so non urgent emails and mainly wiping out about 1000 posts on my RSS Reader and caught up on a bit of reading. Here’s a few hi-lights.

The Sydney Morning Herald had a great article titled Between the Rock and a hard place looking at Mutijulu Community at Uluru since the Intervention. Like this blog it is a bit of a wander but you get a feel for the place.

My friends over at Life in the Fast Lane are a couple of ED docs in Western Australia and have a great case study on Hypokalaemia and Metabolic Acidosis. These case studies are to assist those doing their FACEM examinations.

H1N1 influenza 09 (human swine influenza) is here to stay and the current ASID/TSANZ guidelines were recently published in the Medical Journal of Australia. Then there is the media release from DoHA put out on June 25th a couple of days after Australia’s first (indigenous) death from H1N1 influenza telling us Indigenous Australians are recognised in planning and they just didn’t make up this plan for indigenous Australians the day before (which I think they did).

An article Branding the blacks – a “community of thieves” and the tyranny of terminology in the Northern Myth usually written by Bob Gosford in Yuendumu has a great article by Sue Stanton looking at the way terms and names are used to entrench power rather than improving the fate of aboriginal people. A great discussion in the comments at the end of the article.

Things improve as I read how pharmacists can save the world. Perhaps not quite. Drug Injury Watch has a great article hi-lighting the effect of pharmacists in reducing the number of medication errors in hospitals.

Papulankutja Artists at Blackstone have a nice article Paint ‘Right Way’ looking at a recent painting of a Dreamtime painting by Thomas Reid as he starts painting the stories told to him by his father (another great artist) Cliff Reid.

I hope all that reading keep you all off my back as I catch up a little.

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Many thanks to Kate Pearson host of the WAWA show.

For those really hard up for something to do you can find me saved in the archives until Wednesday 8th July. Scroll down Wednesday to the WAWA show at 1300hrs and click to listen to Kate’s show.

Over the last couple of months it has been difficult timewise to be able to post regularly. Keep staying subscribed, or check in regularly as I hope to improve on my recent poor record.

Robbo

The concept of the “polypill” was first published in 2003 when Wald and Law conducted a theoretical projection analysis of a single pill which contained six drugs. That polypill comprised of three anti-hypertensives at half dose (thiazide, beta blocker and ACE inhibitor), plus aspirin, a statin and folic acid. The predicted benefit from this analysis was an 88% reduction in ischaemic heart disease events and an 80% reduction in stroke.

A year earlier Yusuf had proposed a similar combination but without the catchy name: the predicted benefit of this four-drug combination was a 75% reduction of cumulative risk of CVD events when used for secondary prevention.

The complete RGH E-Bulletin can be downloaded here

Compare this article to the Kanyini Vascular Collaboration which also includes a polypill trial.

The Bulletin is a joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.

Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041

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The SPARCL trial has found that statins exert beneficial effects in reducing occurrence of overall stroke. When subtypes of strokes were analysed, statins were associated with a reduction of ischemic stroke but also a significant increase in haemorrhagic stroke risk. Similar results were observed in a subgroup of patients with a history of cerebrovascular disease in the Heart Protection Study in which the use of statins increased the occurrence of haemorrhagic stroke without an effect on overall stroke incidence.

The rest of the RGH E-Bulletin can be read here.

A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

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According to the manufacturer, the reason for this is due to increased costs associated with the manufacture of these two preparations.

The table below outlines oral oestrogen preparations (oestrogen as a sole ingredient) that are currently available in Australia and their approximate daily doses. Should patients be unable to obtain Premarin® or Premia Continuous® via a private prescription, the PBS eligibility of the various preparations is also listed.

To read the complete article download the small PDF here.

A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

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Suboptimal inhaler technique is a major barrier to effectiveness of inhalation therapy. Many patients, particularly the elderly and the very young have difficulty correctly using currently available inhaler devices.

Consequently, there is ongoing research into the development of inhaler devices that are easy to use and provide improved lung deposition. The Respimat® Soft Mist inhaler is a novel, metered-dose device for delivery of inhaled drugs to patients with asthma and chronic obstructive pulmonary disease.

The Respimat® inhaler uses mechanical power from a spring rather than propellants to release a ‘Soft Mist’ which lasts longer and is slower moving than that emitted from a pressurised metered dose inhaler (MDI). As compared to the MDI, which initially releases particles of a relatively large diameter (15 to 20 μm), the Respimat® inhaler releases a high proportion of particles which are respirable (<5μm).

To continue reading the newsletter download it here

A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

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It’s no surprise that smoking of tobacco is the major cause of the burdens of injury and disease. Smoking accounted for 20% of all indigenous deaths and 12.1% of the total burden of disease and injury.

The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that nicotine patches be placed on the pharmaceutical benefits scheme for indigenous Australians. This has allowed it to be provided in a 28 day pack on an authority prescription or through the Section 100 supply arrangements of pharmaceuticals to remote area Aboriginal Health Services.

Only one strength of one brand was approved. It was approved even before the company had a 28 day PBS pack available! There is now a regular supply of the PBS quantity nicotine patch.

The following was supplied by Graham Perl, Pharmacy Relations Manager, Johnson & Johnson Pacific. (I don’t usually promote companies or products but as this is the only patch available to assist Indigenous Australians I am making an exception.)

PBS Listing for Nicorette Patch 28’s

Nicorette 15mg/16 hour Patch 28-pack is now available as an Authority PBS listed product for Aboriginal and Torres Strait Islander people and Section 100 for those in regional and remote areas

Nicorette treats tobacco dependence by relieving nicotine craving and withdrawal symptoms, facilitating smoking cessation

PBS Indication:
Nicotine dependence in an Aboriginal or a Torres Strait Islander person

PBS Listing details
- Maximum quantity 28 patches (1 pack) plus 2 repeats (12 weeks treatment)
- Available on Section 100 for remote access
- Pack size of 28 patches (28 days treatment)
- Authority
- Maximum 2 courses of 12 week treatment per year

How is Nicorette Patch used?
- place patch on non-hairy, clean dry skin such as upper thigh, hip, under arm or chest (alternate application site each day)
- apply in the morning, remove at night (after about 16 hours)
- dispose by folding sticky sides together and disposal out of reach of children

Contra-indications
- generalised chronic dermatological disorders (eg: psoriasis, dermatitis, urticaria), non-smokers, children under 12 years of age

Precautions
- stable cardiovascular disease (unstable CV conditions require medical supervision)
- diabetes (blood sugar requires closer monitoring)
- Moderate to severe hepatic impairment and severe renal impairment (potential reduced clearance)
- Uncontrolled hyperthyroidism and phaeochromocytoma

Common adverse reactions
- local skin irritation, headache, indigestion, nausea, vomiting

Smoking and using Nicorette patch
- Continuing to smoke with Patch may increase nicotine-related side effects
- Intermittent forms of Nicorette e.g. gum and Inhaler (not PBS listed) while continuing to smoke (and trying to cut down) has not been shown to increase adverse effects related to nicotine)

Pregnancy / lactation and Nicorette
- Nicotine is harmful to the foetus. Ideally smoking cessation should be achieved without NRT. If not possible, it is preferable to use intermittent (gum/microtab/inhaler) forms of nicotine delivery as they provide a lower daily dose of nicotine. Risk with NRT is lower than that of smoking.
- Lactation – intermittent forms of NRT are preferable. Breastfeeding should occur just before using the product

Smoking relapse and continued craving
- combination therapy with Nicorette Patch plus 2 mg Nicorette gum may be necessary in patients who have relapsed in the past or experience cravings using single therapy. The combination is more effective than either product alone, increasing the patient’s chances of successful quitting. No more than12 x 2mg gum with Patch per day.

Nicorette contains nicotine. Stop smoking aid. Use only as directed.

Note that this is general information only and if you follow only this or believe it without speaking to your healthcare professional you are a bit of a wally.

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The Communiqué will highlight selected cases that have been reported to the State Coroner’s Office may interest the Aged Care Community.

The aims of the Communiqué are:

• To improve the awareness of clinicians, health workers, carers and those in positions of governance about adverse events resulting from systems failures. Lessons from past cases can then be applied to their own institutions.

• To improve residential aged care workers’ understanding of the coronial system and the work performed by the Clinical Liaison Service.

Each edition focuses on a theme. The September 2008 issue (pdf) looked at diabetes with three cases emphasising the need for system approaches for managing residents with this condition.

As well as exploring the Coronial inquiry there is also an expert commentary highlighting various aspects. So in the diabetes issue mentioned above there was practical information based on the experiences of a diabetes educator who has implemented successful changes in aged care settings,

The current edition (pdf) looks at deaths caused by pneumonia in an aged care setting. Pneumonia is usually considered a natural cause of death. However to better prevent these deaths we need to closely examine what has occurred in the past.

The Communiqué is produced quarterly and is available on the site or sent electronically to your email address. Subscribing is as easy as emailing racc@vifm.org asking to be added to the Residential Aged Care Coronial Communiqué list.

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MEET the white face of a new black race – the political Aborigine.

I’m not saying any of those I’ve named chose to be Aboriginal for anything but the most heartfelt and honest of reasons. I certainly don’t accuse them of opportunism, even if full-blood Aborigines may wonder how such fair people can claim to be one of them and in some cases take black jobs.

I’m saying only that this self-identification as Aboriginal strikes me as self-obsessed, and driven more by politics than by any racial reality.

but goes on to target people like Larissa Behrendt, Associate Professor Anita Heiss, Lowtija O’Donohue and Mick Dodson among many other indigenous high achievers, claiming what seems to me that as some are from mixed heritage, or don’t look black they should not describe themselves as Aboriginal. In the case of Mick Dodson it seems he shouldn’t call himself aboriginal because he went to a Catholic boarding school from the age of ten. Mick doesn’t look white so I guess Mr Bolt needed some other reason to disparage his heritage.

Chris Graham the editor of the National Indigenous Times has responded in the Croakey Health Blog (part of Crikey.com.au)

From the Croakey article:

For the record, here’s what Bolt and his followers are actually arguing: white people are pretending to be black so they can access benefits. But they’re not really black. They’re white. And that’s why black people are bad.

Let’s pretend, for the sake of argument, that Bolt is correct. White people are milking the tax-payer to access money set aside for disadvantaged black people. Well that reflects poorly on white people, not black people.

And yet Bolt’s vitriol — and that of the sycophants who egg him on through his blog — is directed at black people. Now that’s what I call self-loathing.

I urge you to read both Andrew Bolt’s column and the rebuttal of incorrect facts and argument from Chris Graham.

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I don’t for a minute believe that 820 out of every 1000 Indigenous people in remote Australia have gone to hospital. Some are bound to be frequent visitors. But how many re-present at a hospital due to being booted out too soon.

I haven’t found any data for Australia but the blog Notes from Dr. RW looks at an interesting study from the NEJM on Medicare Readmission Rates in America.

Let me steal some of the quotes from the blog.

Almost one fifth (19.6%) of the 11,855,702 Medicare beneficiaries who had been discharged from a hospital were rehospitalized within 30 days, and 34.0% were rehospitalized within 90 days; 67.1% of patients who had been discharged with medical conditions and 51.5% of those who had been discharged after surgical procedures were rehospitalized or died within the first year after discharge. In the case of 50.2% of the patients who were rehospitalized within 30 days after a medical discharge to the community, there was no bill for a visit to a physician’s office between the time of discharge and rehospitalization.

Twenty per cent re-hospitalised within thirty days. Half of those had not been seen by a doctor before being readmitted. Put this into the remote Australia context where doctors are very thin on the ground. Discharges are often difficult to obtain from a hospital in a timely manner. We usually know when the patient is coming back home due to bookings via the patient Assisted Transport Service and our own Patient Liasion staff, but they are not always seen at the clinic on return. As well as perhaps being discharged too soon the continuity of care lapses due to many other reasons, lack of communication in particular. I am not surprised that some re-present.

Being discharged early may save the hospital money on weekends and public holidays as they cut back on staffing but costs are borne by other parts of the health service. From overworked Remote Area Nurses trying to see these patients and chase up discharge notes and obtain prescriptions to the Royal Flying Doctor Service flying the patient back to hospital and the costs borne by the Patient Assisted Travel Scheme (PATS)

The article goes on to state:

Even a small decrease in the readmission rate could result in substantial savings for the Medicare program. The recently enacted prospective-payment legislation, however, creates economic incentives that could increase readmission rates

I am sure a study done in Australia would show early discharges leading to representations costs the hospital system heaps rather than saving money.

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If this is the case it reflects very poorly on the Intervention (now called the Northern Territory Emergency Response) as it was originally all about saving the kids.

But this may not be the case across all of remote Northern Territory. The ABC has Dr John Boffa from Congress (and an advisor to AMSANT) quoting data from the ‘Growth Assessment and Action Database’ which collects data on Aboriginal children from across the Territory. The data showed that across the Territory until April 2008 the anaemia rates for children had not changed and were remaining steady at 25%. Note this data is six months older than the data produced by Sunrise.

This figure of 25% is disturbing in itself. Even worse is the first year of the intervention was spent collecting all this data again, despite it already existing. They could have actually been helping kids and families. Two years in to the intervention and they are only now realising that they have a snowball’s chance in hell of providing some of the extra services required.

John Boffa says “local data needs to be analysed carefully”. There may well be valid reasons why a large area is suffering. It may be the shops not providing good food or the Basics Card (quarantined money used only for food. Money is obtained using a swipe card in selected stores) not working.

This trebling in anaemia needs to be investigated and extra resources provided long term in most areas to educate and constantly represent and work with families to correct it, and also to set up systems to prevent it. However that requires will. I am unsure that exists at a government level despite the nice words.

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Allow me to make a few comments that may clarify some of the points I made yesterday.

• Some pharmacies do an outstanding effort with their S100 support funds. Some communities still do not access these funds. Some services I have heard of from health services around Australia are pretty poor.

• From personal experience I am aware of conflicting advice within boards in a number of areas. The Australian Pharmacy Council to their credit have a process looking at way legislation can impede pharmacists in rural and remote areas from providing care.

• At least one state health department has also been looking at how pharmacy/pharmacists can work better in rural areas.

• The current business rules contained within the November 2008 S100 Pharmacy support kit state:

“It should be noted that any Outstation/s that do not meet this definition, will not be included in the calculation of the Allowance.”

With more health services going to a hub and spoke model to give support to health staff, with nurses and GPs providing regular clinics and on call visits, with visiting physicians being funded under MSOAP to visit these small communities the Guild feel we don’t have a place in the care of these patients.

Unfortunately this seems to have resulted from a query I put to DoHA who then spoke to the Guild. When this appeared in the draft document I mealed DoHA an received this response.

“Whilst there is technically a requirement for a full-time Health Worker to be employed at each Outstation, it is the Department’s view is that if a valid State/Territory Poison Licence for each of these is in place, and there is a ‘fully functioning clinic and medicines’ room in which ‘S4 medicines’ are stored, this would be adequate as a minimum requirement.”

• If you care about indigenous health please remove all sharp objects from your reach before you read the submissions from our pharmacy bodies to the National Health and Hospital Reform Commission

• Despite hearing some months ago that Qld PSA would be employing someone to deal with rural and remote issues for PSA the job has yet to be advertised. The board at PSA national also needs a member whose role it is to bring the issues before the board.

• The professional Programs and Services Advisory Committee (PPSAC) had alternative proposals to look at funding of pharmacists for remote health services rather than the S100 support service. . I can understand the Pharmacy Guild not liking it but what was the Pharmaceutical Society of Australia’s (PSA) position? There was no consultation that I am aware of.

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This E-Bulletin addresses the use of Complementary and Alternative Medicines (CAM) for patients with Rheumatoid Arthritis. The definition of CAMs used here includes practices and products that are not presently considered to be part of conventional medicine practiced by medical doctors or allied heath professionals.

Many CAM therapies are heavily advertised and make attractive claims, often based on personal stories. People with a chronic condition such as rheumatoid arthritis (RA), may be attracted to CAMs if conventional treatment is not working as well as they would like, or if there are side effects from conventional treatment. There is sometimes a belief that CAM therapies are safer and more natural. There is relatively limited information on how CAMs may work, how they compare to conventional treatments, what is the most effective dose and how they might interact with other medication.

Click on the picture below for the complete article.

Subscription details are contained in the newsletter.

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Well I’m off to the pharmacy to get my weekly supply of medicines. I said “pharmacy”, but perhaps “nursery” is more appropriate. The pharmacies these days are staffed and run by nurses. Funny, although being in short supply, nurses have spread into new areas of health whilst pharmacy seems to have lost the right to work in even the basic area in which they have been trained as well as other areas in which they still work around the world.

We have only ourselves to blame.

Various commentators from the AMA to Oxfam have stated over the years that indigenous health requires another $400million each year to provide adequate health care to our indigenous population. Yet all pharmacy can offer in reports to the National Health and Hospital Reform Commission with regard to indigenous health is squabbling over who performs visits to remote clinics while our major professional body ignores it all together.

If pharmacy is unable to articulate a role that it can play in remote health with the sickest and most disadvantaged in our community that at least equates with if not exceeds our “usual” role performed in the rest of Australia (retail and hospital), and is not arguing with the rights of other health professionals to perform our role why should we keep the role we currently have in mainstream?

Some comments on what led me to this article will appear tomorrow

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Australia Post has released a new Postage Stamp series titled “Indigenous Culture“. The stamps reproduce indigenous art from five living indigenous artists from works held in our public collections.

Four of the paintings are by women artists.

The artists and communities where they lived are:

Visit one of my local indigenous controlled art centres here

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• Aboriginal community Kalumburu struggles for a better future. Is the church hindering it moving forward? http://bit.ly/R8AT
• Census:139 people in Walgett shire sleep without a roof over their head. 2nd highest in NSW. Mayor denies it exists http://bit.ly/TWjWp
• Idiots scrawl graffiti on Kakadu rock art tens of thousands of years old http://bit.ly/ooKi7
• Burden of proof of connection to land may move from Aboriginal claimants to states etc to prove it doesn’t exist . http://bit.ly/lsYM
• Spirit songs of healing – Arnhem land dancers come to fire struck St Andrews to perform healing ceremony http://bit.ly/127rqV
• Fed govt realises intervention cannot deliver follow up dental care to remote indigenous communities. First of many? http://bit.ly/uAE57

The Indigenous News Updates are sourced from news and other articles from around the country that I have posted on Twitter.

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For you city folk stressing about your emergency services: It was nearly nine hours before she reached Alice Springs Hospital for treatment.

It was a very sad affair, but it did focus the government’s mind on remote Indigenous Aged Care, particularly the under-funding of these facilities with an immediate $46mil promised for upgrading facility and appropriate levels of staff. However it is one thing having funds to employ an appropriate level of staff. They also need somewhere to live. If you say it is shared accommodation you won’t get applicants. So housing for staff also needs to be looked at.

A discussion on standards for Indigenous Aged Care facilities (currently exempt – in my view as a way to ensure appropriate funding need not be given over many years) is a whole separate post, with the cultural requirements (i.e. prefer to share rooms, dogs, fire among many) to be considered.

Not all remote communities or areas have an aged care and elderly patients may have to be moved a long way from country, their spiritual home, for care. It is also difficult to bring palliative care patients home to die “on country”. A few days ago an increase in funding of $863,000 for Home and Community Care (HACC) services in the Northern Territory was announced. This is part of a larger package but this amount looks pretty piddly when you look at the cost of delivering services in remote communities. But then we don’t know how much of this would be used in Darwin or Alice Springs.

HACC services out bush are invaluable. At it’s best local Indigenous Australians are employed to care after their own community. The services provided are quite extensive from the provision of meals, transport, assistance with hygiene (showers etc) ensuring medications have been taken among many. It delays the time our senior citizens have to move from home and country.

Also on the right track is funding to provide employment for

* 274 positions in Home and Community Care (HACC) Services; and
* 45 positions in Aboriginal and Torres Strait Islander Flexible Aged Care services.

These are all permanent part time positions. There is no mention of flexibility in the funding as to whether it will allow employees time to attend funerals or cultural activities (business). Again, I am unsure of how many of these will be in the bush. As part of the package training will be provided on site. Again I wonder about the accommodation available to house them in remote communities.

These jobs and the extra funding for HACC and Aged Care are long overdue. They are needed in a wider area than just the Northern Territory. I have some concerns about the money provided through the Intervention (or Northern Territory Emergency Response as it is now called). My view is this is done to make it look like the Intervention is producing results. However this whole response was built around the fabrication of keeping kids safe and healthier. More on that perhaps in a later post.

The Investigative report conducted by the Aged Care Commissioner into the death at Docker River can be found here

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Smoking is the most important risk factor for COPD. In 2004-05, 24.2% of Australian males and 18.4% of Australian females over the age of 18 years smoked[1]. Smoking-related diseases have increased substantially in women, and death rates from COPD in women are expected to rise accordingly. The death rate from COPD among indigenous Australians is five times that for non-indigenous Australians, and smoking is a leading cause of healthy years lost by indigenous people both in Australia and New Zealand.

The key recommendations are summarised in the “COPDX Plan”:

• Confirm diagnosis
• Optimise function
• Prevent deterioration
• Develop a self-management plan and manage
• eXacerbations

See page 10 of the guidelines for a summary of the COPDX guidelines. If you didn’t click on the link above this link will take you to the Lung Foundation Guidelines (pdf).

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The Kanyini Vascular Collaboration is a research project to try and identify barriers to best practice chronic disease management in Aboriginal and Torres Strait Islander people to improve their health. I have written extensively about this research trial some time ago and thought it time for a quick update.

The polypill trial is about to enter final planning when we gather in Sydney next week.

There has been a little bit of work published with more on the way. An article has been published in the Canadian Medical Association Journal titled “Addressing inequities in access to quality health care for indigenous people” looking at the inequities and barriers in both a practical and historical context with some comparisons to the problems in delivering a service to the Canadian Aborigine population.

The Heart, Lung and Circulation (Volume 17, Supplement 3, 2008, Page S157) has an article titled “The Identification and Management of Vascular Diseases and Their Risk Factors in Eight Indigenous Primary Health Care Services—The Results of the Kanyini Vascular Collaboration Audit study“. Unfortunately, unless you have access through a library you have to pay for the article.

The Kanyini Vascular Collaboration also produces it’s own newsletter which can be downloaded here (678kb pdf).

I will keep you up to date as the trial progresses.

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• No education gap, just bad schools in remote areas of the Northern Territory. gaps in literacy is not race but location http://bit.ly/RX199
  
• Indigenous literacy gone from fix the problem in 4yrs to half fix the problem in ten years . Is a remote area problem http://bit.ly/45gdS
• Teachers are being “bamboozled” by mysticism surrounding Aboriginal children – educational standards slip. http://bit.ly/xLQor
• Territory’s Education Department has inadvertently created an underclass. http://bit.ly/23xfO
• Centre for Independent Studies labels the Northern Territory’s education system a ‘failure’ Are their ideas better? http://bit.ly/4EzzTP
• Making remote schools work just takes commitment. – everything in remote does. The government has to lead http://bit.ly/45gdS
• Gap between indigenous & other children in basic education requirements increases the longer they are at primary school http://bit.ly/1abOXa
• Childcare centres to fly the Aboriginal flag & teach youngsters about reconciliation and racism -govt plan http://bit.ly/AyCg6

The Indigenous News Updates are sourced from news and other articles from around the country that I have posted on Twitter.

An updated page with news links related to the death of Mr Ward who died being transported 400km in a prison transfer vehicle with no failed air-conditioning during summer can be found here

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