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.

Musical Kangaroo

Well the drive up the Stuart Highway can be boring to some.

Today we have an extra part to our Pleasant Sunday Afternoon. And it’s for free. Actually, I am unsure if I can even give it away! Those who have read my Top Ten list may have seen a comment from a transmogrified Welshman sandnsurf about wanting a Top Eleven rather than a Top Ten list. I am always one to try and satisfy my readers (don’t push it!).

HighHeels but not in the desert

Ok. I admit it. From the mulch you can see it is not in the desert. And that is a blackberry device and not a satellite phone so it also can’t be me! But the picture may give something else away.

Consider it showing my newer subscribers some earlier “quality” posts.

So my ten most popular posts are:

1. “A Drive in The Country: It took this truck driver and his truck 18 hours. Bogged three times in sand. That’s a lot of wheels to dig out. And some pretty big holes. I guess that is something to look forward to as I drive out next week”.

2. When Remote Australia and Mining Australia meet: This surprised me coming so high in the ranking. My view on how mining companies in Australia seem to disregard and damage the remote communities near their sites.

3. A Little Bit of Rain: With plenty of photos and video it showed what Central Australia can be like after rain.

4. Remote Weather Report was a report I sent out to people who may be travelling in our area which I later posted. Describes what can happen when heavy rain hits - particularly for a very mobile population

5. Can Bush Tucker Reduce the Burden of Heart Disease and Diabetes? Here I commented on an Article in the West Australian Newspaper and talked about food and prices out bush.

6. Kunmarnanya my Lord, Kunmarnanya. I’m known as Robbo almost everywhere I go. I started using my nickname for cultural reasons. This explains why.

7. A Snake in the Hand is Worth…. is a little story about a snake on my fence: I race to the gate and instead of placing my hand on the expected tubular frame it landed on something sinuous, scaly and muscular.

8. Oodnadatta Track is a Pleasant Sunday Afternoon story with a picture of a stop sign in the desert. Believe me. That is all that is there.

9. You Have Peak Hour Traffic and I Have…… was a video looking at the traffic obstacles I have on my way to work. Camels and lots of them.

10. CRANA Opens its Doors where I commented on Council of Remote Area Nurses of Australia opening membership to other professions with some comments on other bodies representing those out bush.

Well that’s it for another year!

But the best use of it I have seen was by Mr Onthemoon over the Christmas period. I am unsure if he was trying to entice followers, perhaps it was for altruistic reasons, but he went crazy and made 90 avatars in 90 hours. He has even written about his extravaganztacular: My twitter avatar adventure meltdown extravaganztacular to gain cheap publicity. You know him as the cartoonist at Crikey with FirstDogOnTheMoon

It started as this white board (me upper right corner) and ended up as this along with 16 million new followers (his words).
If you like what you have seen of him so far take a look here.
Oh, you might have noticed I received an avatar. We are still discussing which one is me.

And this is going in as a Pleasant Sunday Afternoon though it is Thursday. That’s the good thing about having your own blog!

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.

These facts and other amazing little delights can be found on the EPA-USA FAQ page. The EPA-USA said they have been looking into this problem since 1999. You can read a doozy of a 41 page report quaintly titled errata.pdf.

Should you be worried about your health? Again we refer to the EPA-USA FAQ page: Studies have shown that pharmaceuticals are present in some of our nation’s water bodies. Further research suggests that there may be some ecological harm when certain drugs are present. To date, no evidence has been found of human health effects from PPCPs in the environment.

The American Pharmacists Association produced a press release in February of 2007 on how to correctly dispose of pharmaceuticals. Here’s a few highlights.

DO NOT FLUSH unused medications. Consumers were once advised to flush their expired or unused medications

When tossing unused medications…..Crush solid medications or dissolve in water and mix with kitty litter or a solid kitchen substance….. then place in a sealed plastic bag …before tossing in the trash.

Check for approved state and local collection programs or with area hazardous waste facilities. In certain states, you may be able to take your unused medications to your community pharmacy.

This year the EPA-US Great Lakes ran the Great Lakes 2008 Earth Day Challenge with one of the aims to collect “1 Million Unwanted Pills”. To reinforce the point here’s a quote from the same page:

Traces of medicines have been found in streams and the Great Lakes where we get our drinking water and have also been detected near wastewater treatment outflows. Some of these medicines can lead to reproductive and developmental problems in fish and other animals. We often treat leftover medicine as a common household waste. More than half of people surveyed throw their unused medicines in the trash while a third flush them down the drain. In both cases, the medicines have the potential to be released into our rivers and lakes

August 6th 2008: Another press release from the EPA titled “EPA Continues Work to Understand Potential Impacts of Pharmaceuticals in Water”

The agency’s work to increase industry stewardship and scientific understanding of pharmaceuticals in water continues,” said Benjamin H. Grumbles, EPA’s assistant administrator for water. “By reaching out to the National Academy of Sciences and requesting information from the health care industry, EPA is taking important steps to enhance its efforts.

There’s a lot more words in that press release but I think you will agree that there is an adhoc approach in the USA for dealing with pharmaceutical waste, with a lot of nice words thrown in.

What’s happening in Australia?

It really is as easy as 1,2,3. July 2008 marked the 10 year anniversary of the Return of Unwanted Medicine Program. Simply walk into any retail pharmacy in Australia with your out of date or unwanted medications and they are accepted and placed in a yellow 20 litre sealable container. They are returned to the pharmaceutical wholesalers and from there collected by the waste disposal experts for high temperature incineration which is the safest way to destroy this sort of waste. Drivers are accredited and random audits are carried out. There is the chance for diversion but in 10yrs there have only been a handful of instances.

The RUM Project is funded by the Commonwealth Department of Health & Ageing.

Over 400 Tonnes (440t US)of unwanted and out of date medicines are collected every year.

( As an aside, Australia has about 22 million people. The USA had 305 million or so when I checked at the population clock. Would 6100t (US) of pharmaceutical waste really be stopped from going into normal waste in the States?)

If I’m writing this there has to be a bush slant. There is.
Our clinics are in one state, our head office and a lot of logistics come from another state (still one of the closest towns to us). When a pharmaceutical item goes out of date and put in the bin it becomes waste. This is then legally not allowed to cross state borders! Several years ago pharmaceutical waste was sometimes placed in the correct containers but most often not as it was difficut to have empty buckets supplied by plane. It was then driven back in the back of a troopie by anyone going into town to one of our suppliers, repacked (i.e. now double-handling waste) into the appropriate containers then entering the RUM process.

To improve this process we now deal direct with RUM. Our environmental health bloke and myself move around the lands and we are the ones who remove waste and sharps sealed in approved containers to a central point. The pharmaceutical waste is then placed into metal crates supplied by RUM and locked and trucked to Perth using a driver accredited to handle waste (again done by RUM for us). I have a key and the contracted waste management company in Perth has a key.

Now all we need is for the roads to be capable of taking trucks again and I can get some trucked out.

The system we run is probably the best, and simplest in the country and I hope can be emulated by other remote health services.

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.

One in six Aboriginal people in Australia report having been admitted to hospital in the last 12 months.

Despite staying longer when admitted, Aboriginal people are less likely to have treatment in hospital than other patients, and it seems that this difference is at least in part due to the differences in the way that Aboriginal patients are dealt with by the system and individuals within it.

There is a myth, a belief held by many Australians, including those in the media and in politics, that vast amounts of money have been spent on Aboriginal health over decades but all to no avail. This myth needs to be challenged.

It’s a myth on two counts. First, any increases in resources for Aboriginal health have been modest and patchy, as evidenced by the plethora of pilot programs that are trialled but not universally implemented.

Secondly, despite the relatively small increase in investment, there have been some measure of improvement in Aboriginal health status in recent years. The recent commitment to close the gap in life expectancy between Aboriginal and non-Aboriginal Australians within a generation is welcome. However no one should be under any illusion that this can be done without significantly expanding resources. I would suggest three key areas for action.

First we know that a person’s social and economic position in society, their early life experiences, their exposure to stress, their educational and employment status, and their exclusion from participation in society all exert a powerful influence on their health throughout life. Of particular importance are poverty and education, including parental and particularly maternal education. Therefore we have to make a determined effort to address the social determinants of health if we expect long-term changes in the health of Aboriginal communities.

Second, there is abundant evidence from overseas, both from Indigenous and non-Indigenous contexts, that access to appropriate, comprehensive primary health care services is critical to good health. There is also accumulating evidence from within Australia that improved primary health care services, especially those under Aboriginal community control, are contributing at both the local and national levels to better health in our communities. So we need to make a determined effort to extend and improve primary health care services.

Third, we need better and more appropriate hospital care for Aboriginal people. In recent times the focus has been very much on primary health care as the key strategy for improving Aboriginal health. This is as it should be given the long-term gains it is bringing to the detection and management of disease. However, we should not lose sight of the fact that one in six Aboriginal people in Australia report having been admitted to hospital in the last 12 months.

Despite staying longer when admitted, Aboriginal people are less likely to have treatment in hospital than other patients, and it seems that this difference is at least in part due to the differences in the way that Aboriginal patients are dealt with by the system and individuals within it.

This is the start of a speech given by Pat Anderson, Chairperson, Cooperative Research Centre for
Indigenous Health to the National Rural Health Alliance Public Symposium in September 2008.
For more see the NRHA 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.

Gurrumul is a Yolngu man from Elcho Island. If Elcho Island sounds familiar it is because I have shown videos of young Yolgnu men dancing to Zorba the Greek.

“His beautiful voice will never leave you as he sings the songs of his Gumatj country. His solo performances are a rare treat and should not be missed”

Gurrumul was a member of the ARIA award winning Yothu Yindi band until 2002 and as well as a solo career is a member of the Saltwater Band

I Was Born Blind/ Gurrumul History
This song is in English

Djarimirri
This is sung in Yolngu. But you don’t need words with this.

here is a brief video biography of Geoffrey Gurrumul Yunupingu. Watch until the end for another beautiful piece of music.

For those who had forgotten where he came from here is Yothu Yindi and “Treaty” which won an Aria award and was a hit in Australia. A lot of whitefellas danced around to this not realising it was a song of indigenous dispossession.

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.

That was part of a post (pdf) I wrote in April 2007 to Auspharm. The article quoted is “