These community generator power failures often necessitates removing these drugs in a safe and approved manner from these communities and replacing them quickly. This often means items transported from another community.

Some emergency missions to overseas disasters have used large portable fridges. However these have needed careful monitoring with certain drugs placed in certain areas and adjustments to the thermostat if numbers of items are removed. Whilst these are good for setting up a remote emergency clinic they do require some specialised knowledge to maintain the correct storage for various drugs.

I have been trialling a new portable refrigerator. It has a volume of 25 litres which allows us to transfer adequate quantities of drugs urgently to a clinic until bulk supplies arrive in a week or two by plane.

Twinbird Vaccine Fridge

We obtained the Twinbird from Rollex Group Australia. While considerably more expensive than say an Engel, it performs very well.

I have been using it for several months monitoring temperatures with a third party data logger. The temperature monitoring and alarm system seem quite accurate. The fridge does use a different sort of cooling system than the compressor style, allowing more accurate temperature control. There are two baskets inside the refrigerator so there is no direct contact by the vaccine or blood products with the sides where they may freeze.

The power cord could be more robust, and it requires an optional DC converter to run inside on AC power (Engel etc require just a separate cord to plug into the unit). It is light, but seems quite solid and has handled rough bush trips with ease.. I would have liked some way to be able to lock the fridge. It also now comes with a printer option for temperature recording and I will be including this option in future purchases as we expand our on-lands logistics capability.

But then I think we have it easy compared to some locations around the world! This is the Vaccine Fridge CFS49IS System with CFS standing for “Camel Fridge System”.

If you like this post and what else you see on the blog please subscribe by RSS feed (the orange button) or by email. The email subscription is just under my profile picture. Or you can visit my subscription page.

If you like this post and what else you see on the blog please subscribe by RSS feed (the orange button) or by email. The email subscription is just under my profile picture. Or you can visit my subscription page.

I am sure their services will be much in demand, particularly by the pharmaceutical industry. (Click on the picture to down load the small file.)

This bulletin is produced by the Repatriation General Hospital in Adelaide.

Even their Chief Pharmacist, Chris Alderman has a sense of humour. Here’s a joke he submitted to Auspharm

Pearly Gates

An emergency physician, a psychiatrist, a pharmacist and a hospital administrator all had the misfortune to pass away on the same day. Arriving simultaneously at the Pearly Gates, they were all asked by Saint Peter to plead their cases for entry.

“All of my life I’ve worked with people in extremis”said the ER doctor ­ “I pull them back from death’s door and save them from a premature parting.” “Fair enough” said St Peter, “welcome to the kingdom of heaven!”

“I’ve devoted my career to helping the troubled and disturbed, I’ve been there when troubled folk have needed support” said the psychiatrist. “Well done, you’ve earned your time in paradise eternal, please go through” said St Peter.

“Each day, I’ve tended to the needs of people who’ve needed my help. I’ve supplied their medicines, given them good advice, and I’ve prevented them from being hurt when mistakes are made” said the pharmacist. “You’ve earned your place in heaven, go on in” said St Peter.

“I’ve had to make the tough decisions about how the hospital runs. Who gets treated, what gets funded, and how it all gets paid for” said the administrator, “I’ve done my bit too.”

St Peter looked pensive and eventually replied “Well done - you can come in.” “But you can only stay for three days …”

Boxing Day - The cricket calls

Since then it has been talked about a lot including an editorial in the Australian Prescriber in 2005 asking whether a polypill would be friend or foe and would a “one size fits all” approach be beneficial to patients. The use of a polypill as primary prevention from cardiovascular death was contentious.

Moving along to the present and a number of polypill trials are commencing or are planned, including in India, and a six country trial including England, NewZealand and Australia.This trial will include people who have a raised risk of heart attack or stroke, but are not on any medication and have no other related health issues.

Several years ago in a discussion with a doctor it was asked why we don’t have a polypill made. With less tablets for our patients to take perhaps it would improve adherence. I could see a lot of problems, particularly testing for stability if we were going to have large amounts produced. It would also be very costly. I asked around and found the Kanyini Vascular Collaboration was in the planning stages. We have been involved with it ever since.

The S100 supply of medications to remote indigenous communities has certainly improved access to drugs but indigenous people experience a greater burden of all disease including heart disease, diabetes and kidney disease than the non-Indigenous population. The study is looking to find out why this occurs and how to improve it.

The study is funded by the National Health and Medical Research Council (NHMRC) and is being run by The Baker Heart Research Institute, Alice Springs and The George Institute for International Health, Sydney.

Aboriginal health services around the country are involved, including city, rural and remote. A map with the participating services can be found here. Ngaanyatjarra Health Service is the only aboriginal health service in Western Australia participating in the trial.

It consists of many parts, some will run concurrently, others staged, over a number of years.

The aim of the Kanyini Vascular Audit

is to quantify the magnitude of evidence-practice gaps in the identification and management of vascular risk among Aboriginal and Torres Strait Islander people.

There is a Qualitative Study involving:

patients at high cardiovascular disease risk, their families and community members, professional health care providers, managers and policy makers in Aboriginal and Torres Strait Islander health to give us greater understanding of the barriers faced and the ways our indigenous population can access best practice chronic disease care and prevention.

There will also be two studies trialling different interventions that will be directed by the results of the research that is currently occurring.

I started off writing about a polypill. There is also a polypill component to this research that we hope to commence this year. There will be two different versions. Other treatments can be added as required. They contain an angiotensin converting enzyme inhibitor, statin, aspirin, Beta blocker or thiazide diuretic.

The logistics of this will be interesting for my mob as they move between three states and may be evacuated to three cities by the RFDS. However I am very excited that the health problems of indigenous Australia have started to be looked at seriously at a policy and practical level rather than just as statistics to bandy around.

“Kanyini” is a word in use in several central Australian aboriginal languages.It is a great word that can be translated as “to have, to hold and to care”.

From the website:

“Kanyini is a verb which reflects a commitment, a full engagement; vitalising again and again all that went before and all that will go after”*

It represents one of the four foundations of Aboriginal life in Central Australia: Tjukurpa (Law, Dreaming); Walytja (Family); Ngurra (Land, Country) and Kanyini. In essence, Kanyini describes the principle and primacy of caring for others - an obligation to nurture, protect and care for other people, family, country and the law.

There is a documentary titled Kanyini. The story guide may be of interest.

You need to enter by item number. To find the item number go to the PBS website and enter your drug name. Overseas readers (particularly the staes) may be amazed at the prices here compared to home. A pdf of the entire Pharmaceutical Benefits schedule can be downloaded here

If you wish to join thousands of other subscribers email Chris at Chris.Alderman@health.sa.gov.au

click on picture for document

click on picture for the article

Many thanks to AusPharmList for accessing their archives.

This is a new website from the Alcohol and Other Drugs Council of Australia. It covers all - or rather more likely, most substances that are inhaled for their mind-altering effects.

I have only had a cursory look and most things seem to be covered. petrol is there, but there seems to be no easy way to find OPAL unleaded after it has been run through poly-styrene to try and give it some aromatics.

There is a newsletter available. The site will be useful for workers in the field, health workers and teachers amongst others. http://www.inhalantsinfo.org.au/

Social and Emotional Wellbeing (SEWB) Needs of Indigenous People

Darren Garvey is currently a lecturer for the Aboriginal Health Unit at the Centre for Aboriginal Studies, Curtin University of Technology.

His review looks at different aspects of the social and emotional wellbeing of Indigenous Australian people and places it into an Australian context. He covers major research findings and interventions with Aboriginal people. Social and Emotional wellbeing looks more at mental health, rather than mental illness. It’s a 29 page referenced review (which I am still reading). I consider this to be essential reading if you work in indigenous health, particularly mental health.
http://healthbulletin.org.au/wp-content/uploads/2008/09/sewb-review-bulletin-170908.pdf

Podcasts from the Cochrane Library

Does life get any better than this. Cochrane Reviews on the MP3 player. It beats the last poetry reading you went to hands down! I have only listened to one. I am saving them up until I pick up a new MP3 player. My last one bit the dust after a couple of years of bouncing around on dirt tracks.

There are a number of reviews available. From the site:
- Acupuncture and assisted conception
- Blood pressure lowering efficacy of angiotensin receptor blockers for primary hypertension
- Blood pressure lowering efficacy of angiotensin converting enzyme (ACE) inhibitors for primary hypertension
- Blood pressure lowering efficacy of renin inhibitors for primary hypertension
- Hospital at home versus in-patient hospital care
- Increased police patrols for preventing alcohol-impaired driving
- LHRH agonists for adjuvant therapy of early breast cancer in premenopausal women
- Mouthrinses for the treatment of halitosis
- Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers
- Organising health care services for persons with an intellectual disability
- Platinum versus non-platinum chemotherapy regimens for small cell lung cancer
- Procaine treatments for cognition and dementia
- Regular treatment with formoterol for chronic asthma: serious adverse events
- Rehabilitation after lumbar disc surgery
- St John’s wort for major depression

You can even subscribe. http://www.cochrane.org/podcasts/

Pilbara language dictionaries

Head off to Wangka Maya to obtain free, interactive and downloadable dictionaries for the following Pilbara language dictionaries: Bayungu, Burduna, Jiwarli, Martu Wangka, Nyamal, Nyangumarta, Thalanyji, Warnman, and Yulparija (windows only).

http://acl.arts.usyd.edu.au/projects/wangkamaya

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Go to my friends at Auspharm for the whole RGH e-bulletin.

There is one error in the document. “Hospitality” should read as “hostility”!

You can find the RGH bulletin here stored by my good friends at Auspharm or subscribe to the email address on the newsletter.

If you like this post and what else you see on the blog please subscribe by RSS feed (the orange button) or by email. The email subscription is just under my profile picture. Or you can visit my subscription page.