Preventing lung disease in indigenous communities

A pilot health initiative partly developed at the University of Sydney could significantly reduce the debilitating impact of chronic lung disease within indigenous communities.

According to Associate Professor Jenny Alison, Indigenous Australians die from chronic obstructive pulmonary disease (COPD) at a rate of five times the national average. COPD is a chronic and irreversible disorder that causes the partial obstruction of airways, and leads to acute breathlessness and a reduced ability to undertake physical activity.

Associate Professor Alison is a major collaborator on a program designed to train remote area health workers and physiotherapists to diagnose and manage COPD cases in the Northern Territory and Kimberly - an area characterised by a high incidence of the disease.

"One of the mainstays of COPD management is exercise training and the application of pulmonary rehabilitation principles," says Alison. "This has been shown to improve the quality of life for those suffering the disease. Our program is designed to teach health workers how to implement these training strategies."

Alison says the key to managing the disease centres on improving the body's ability to utilise oxygen. "While you can't change someone's actual lung function, what you can do is improve the ability of their muscles to utilise oxygen.

"We achieve this by training people just like we'd train an athlete, but at the other end of the scale. This can go a long way to alleviating the breathlessness associated with the disease."

While the reason for the relatively high incidence of COPD among indigenous Australians is unknown, Alison believes it can possibly be attributed to smoking and the poorer management of chronic lung conditions in childhood.

With the project having already been trialed in four different communities in the Northern Territory and Kimberly, Alison says a crucial injection of funding is required to enable a much wider rollout to commence. "There are many significant problems within the Indigenous population, but COPD is definitely one of them," she says. "This initiative is one strategy to alleviate it."

Alison is also coordinator of the University's Master of Health Science (Physiotherapy) program. Designed to up-skill qualified physiotherapists in key specialist areas, it is hoped the degree will help address a current nationwide shortage of much-needed practitioners.

"The specialist areas we offer are cardiopulmonary, manipulative, neurological paediatric and sports physiotherapy," says Alison. "The benefit to the wider community would be more specialist physiotherapists who could deal with the more difficult problems within each of these areas. Specialists in these fields could up-skill other physiotherapists and also offer leadership in these specialist areas."