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Bila-Muuji means 'river friends' and is a regional grouping of AMS's.
It was established in 1995 with Brewarrina, Dareton, Dubbo, Wellington and Walgett. Bila-Muuji meets
bi-monthly at the six locations of the AMS's. Our vision is to support each service through the establishment of a broad network of AMS's in rural and remote NSW, and to identify and address shared issues impacting on our communities.
Together we have achieved many benefits and successes as highlighted in this report. As a regional body with a unified voice, Bila-Muuji has carried more weight than one voice in the wilderness.
The six AMS's which are members of Bila-Muuji provide services including but not restricted to health promotion, disease prevention, substance misuse, men’s and women’s health, children and aged services, mental health, clinical and disability services, dental and hospital services as well as seeking the amelioration of poverty, with Aboriginal communities. All services are delivered from a holistic perspective that is, “not just the physical well-being of the individual but the social, emotional, and cultural well-being of the whole community. This is a whole-of-life view and includes the cyclical concept of life-death-life”
The Chief Executive Officers of AMS's in rural and remote NSW had often expressed a desire to meet as a regional forum. Initially, it was to share ideas and to support each other. However, it rapidly became clear that this forum was the ideal structure to raise issues of concern at a local, state and national level. During the years of operation we have worked with agencies and governments who were often reluctant to listen to problems confronting us as individual services.
An example is the NSW Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS). As our services represent rural and remote communities, the need to access specialist health care outside our communities is very common. IPTAAS was designed to assist patients in isolated communities access health care by reimbursing patients a proportion of out-of-pocket expenses for such things as fuel and accommodation. However, the scheme was not easily accessed by Aboriginal people and failed to meet their needs.
These issues were a concern to all member organisation's, however nothing changed. At a Bila-Muuji meeting, a decision was made to write to the NSW Minister for Health outlining our concerns. This lead to the Chief Executive Officer of the NSW Aboriginal Health and Medical Research Council (AH&MRC) being invited to join the NSW Health Steering Committee which was to conduct a review of IPTAAS. This representation ensured that the concerns of Aboriginal communities were taken into account. In recent weeks, a report on the review of IPTAAS has been released and recommends linkages to AMS's be established to ensure that the special health and cultural needs of Aboriginal people are recognised.
This example highlights that by forming a united voice, funding agencies may be more likely to listen to a community's needs and provide appropriate resources to deliver health care from a holistic perspective.
Bila-Muuji came about through humble beginnings. In late 1995, a note was passed from Chief Executive Officer to Chief Executive Officer in a NSW AHRC meeting. The note simply read 'do you want to meet? If so, when?' Those seeking to meet were Walgett, Bourke, Brewarrina, Dareton, Dubbo and Wellington which are located in Macquarie and Far West Health regions of NSW.
This represents a significant percentage of the State and approximately 13,000 Aboriginal people, according to the Australian Bureau of Statistics 1996, though this figure is most likely an underestimate.
Bila-Muuji services are all modest in size and staffing. In 1995, the average number of staff at these services was five which included the Chief Executive Officer as well as administration and health staff. Only two services had a doctor or nurse. The demand placed on AMS staff by the community was and still is tremendous. We are required to be available 24 hours a day, seven days a week, and to possess skills in numerous areas. The Chief Executive Officers have the added burden of representing and articulating the health needs of their communities. This task carries with it a vast responsibility and it is this very issue that is central to Bila-Muuji's existence.
Bila-Muuji had a direct impact on services in 1996 when Bourke AMS raised concern as to the extent of methylated spirits being consumed by their community. There was a lack of information and education on the effects of drinking methylated spirits, and a lack of regulation controlling its sale. Following Bila-Muuji intervention, the Centre for Education and Information on Drugs and Alcohol (CEIDA) developed a culturally sensitive training package. In addition, Bourke AMS worked with Consumer Affairs and accessed the Poisons' Information Act regarding human consumption of methylated spirits. This highlights how there had been concerns at local level but one service did not have the voice to prompt change until we united as a group.
Bila-Muuji has also been sensitive to the political change within the health system, in regard to accrediting health agencies. We foresaw the importance of achieving a similar status, in the event of AMS's being included in this funding requirement. Numerous meetings took place to discuss what approach should be taken to investigate the process of such accreditation. Bila-Muuji spoke with agencies that were endorsed by the Commonwealth Department of Health and Aged Care as recognised Accreditation bodies. A mutual decision was reached that the Community Health Accreditation Standard Program (CHASP) was not only the most appropriate for AMS's but would give us an equally recognised standard with mainstream health services.
At the same time, a visit was arranged by the First Assistant Secretary of the Office of Aboriginal and Torres Strait Islander Health Services (OATSIHS), within the Department of Health and Family Services, to the Northwest region. Bila-Muuji planned to present their submission for funding to the First Assistant Secretary at each AMS visit. The submission was for a consultant to work with us to develop policies and procedures and organisational plans based on community needs to assist with the process of accreditation. During the visit, member services spoke on the necessity to provide funding for this purpose.
The recent approval of funding to appoint a consultant is a result of our collective determination to achieve an important step in our professional organisational development. Each AMS first met with the consultant to decide on the process required to meet our needs. A decision was made by Bila-Muuji members that the consultant travel to each AMS one day per fortnight and meet with staff and Directors, to provide guidance and support towards our goals.
Policy development has occurred by each AMS sharing the load. As a policy was developed it was shared with the other five AMS's The first drafts were modified to suit the needs of each individual organisation. This process saved time and built on the skills of each other. Two of our AMS's are about to undertake accreditation on several of the CHASP standards. Bila-Muuji negotiated incremental accreditation, which has allowed an ongoing process of review rather than a one off, every three years.
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