Strong Women

In Milingimbi we meet Judy Lirririnyin and Julie Gapalathana, Strong Women from the Milingimbi community. Milingimbi is an Aboriginal settlement on the island of the same name, and in the local language known as Yurrwi. The island is off the north coast of Arnhem Land.

"Aboriginal society is holistic, everything has its place and everything is linked, family, country and culture is health. Therefore in remote communities prevention is everything"

Judy Lirririnyin (foreground) and Julie Gapalathana

Judy describes their work in the community as coming from the roots of a tree and then spreading up into its branches. Their work is to represent the Northern Territory’s Strong women, strong babies, strong culture program in their community of Milingimbi. The program has been operating in Aboriginal communities in the Northern Territory for more than 20 years. Judy tells us her involvement with the program began in 1993.

Judy and Julie are working to improve the health status of Aboriginal women and their babies. Rather than just imposing Western medicine on to the young women of the community their work is about encouraging traditional cultural practices, strengthening family and improving nutrition and lifestyle by educating young women about the importance of a healthy diet and importantly that they should not smoke. Through their support of pregnant Aboriginal women and their babies, their diet, education and antenatal care, Judy and Julie are helping to increase the birth weight of babies born to Milingimbi mums and because of this to improve early childhood development and health.

Typically smoking rates in Aboriginal communities Australia wide are very high, far far higher than in its white population. Roughly slightly less than 50 per cent of Aboriginal people over 15 smoke, about a third of the over 15 Aboriginal population has never smoked. In remote communities the figure is higher again, perhaps touching 70 per cent or more. For the rest of Australia the over 15 smoking population is around 16 per cent and falling.

Radical changes in diet away from traditional foods to western foods and beverages with their high levels of saturated fats, sugar and salt have not helped Indigenous health. Alcohol has also caused chronic health problems for Indigenous communities as has substance abuse, which includes petrol sniffing. Many remote communities like Milingimbi are dry communities so there is no alcohol. All these things are western in origin and have been significantly disruptive to the health of Indigenous communities.

It seems to me that the challenge is to reverse the harm done.

A matter of generations, building stronger foundations

What Judy and Julie are doing is not just for one generation but will influence the health of the mother and child as well as future generations. This is because our lifestyles and our resulting health outcomes influence the health of our future generations, this is now understood through the science of epigenetics. So by improving the health of Aboriginal women and their babies today Judy and Julie are influencing the health foundations of a population and doing so well into the future.

A particular example with its underlying cause in poor nutrition is the likely predisposition to an insulin-resistant state. Studies have shown that low birth weight and malnourished babies have low skeletal mass, high abdominal visceral fat and sometimes even reduced functional kidney tissue. This body composition persists postnatally and predisposes the individual to an insulin-resistant state and to chronic diseases such as diabetes, heart disease and kidney failure in relatively early adult life.

In remote communities these health outcomes can be particularly dire because of the logistics issues surrounding remote medicine. For the patient it can mean leaving family, country and community, perhaps for months at a time if not forever, and this cycle all adds to the likelihood of deteriorating mental and physical health outcomes for both patient and family.

Aboriginal society is holistic, everything has its place and everything is linked, family, country and culture is health. Therefore in remote communities prevention is everything, it is the key to the future.

If they are successful in their task, from a government point of view, the work that Judy and Julie are doing is likely to save a great deal of money and do so well into the future.

The temporary Strong Women's room in Milingimbi

Recently, and on a temporary basis, Judy Lirririnyin and Julie Gapalathana have been allocated a Strong Women’s room that they can use as an office and meeting place. They are concerned that they have not been provided with a permanent facility for them to continue to develop and improve the results of the Strong women, strong babies, strong culture program.

Let’s hope for all our sakes they succeed in getting a permanent centre of their own.

Our warm thanks to Judy Lirririnyin and Julie Gapalathana and to program coordinator Marlene Liddle.

SUBJECT: Indigenous health / Strong Women / Preventative medicine / Culture and health / Milingimbi / Arnhem Land / Yolngu

Julie, Andrea Hylands and Judy in Milingimbi