All-Aboriginal team helps Top End mums raise healthier babies
Towards the end of our interview, in between giggles, Kirri McKenzie hinted at something that has been worrying her.
She is 26 weeks pregnant and woke up that morning feeling teary and short-tempered.
“All I was thinking is, ‘am I going to’?” she said, her big grin flickering off and on.
She has been watching, warily, for any possible signs of pre-natal depression — she presses her hand to her heart at the thought.
“But I guess it was just this morning, and now this morning’s over,” she said.
She laughed: “It’s past lunch now, so we’re getting there!”
Nurse Katerina Keeler sat next to Kirri on the couch watching on, and gently chipped in.
“Don’t forget about all those hormones changing as well,” she said.
Kirri nodded, put her smile back on, and launched in to an anecdote about her recent mood swings and cravings, and a meltdown triggered by the theft of a much-needed hash brown by a younger sibling.
She has Kat’s help on hand for the next two years, at least, although Kirri has already declared the young nurse a de facto aunty for her soon-to-be first-born.
The two are paired together as part of a nurse home visiting program for women having Aboriginal or Torres Strait Islander babies, a program that will hit a milestone in 2019 of 10 years’ operation in Australia.
The Nurse and Family Partnership team, including Colleen Voss (far left) and Katerina Keeler (second from left). (Supplied: Danila Dilba)
‘We’ve already been there’
The program was imported from the United States where it was first created to help younger, poorer families raise healthier babies.
It was adapted for an Indigenous Australian context and extra funding from the Australian government in 2018 saw it expand to new sites, so it now operates in all states except Tasmania and Western Australia.
In Darwin, where the program has been running for 18 months, the team is all Aboriginal women, working from Danila Dilba Health Service’s northern suburbs clinic.
The shared cultural background helps nervous clients feel more comfortable, said nurse supervisor Colleen Voss.
“They know they’re not going to be judged by anybody,” she said.
“We know what they’re going through because we come from communities also, and we’ve already been there and done all that.”
Navigating the systems
Kat and the other nurse home visitors talk their clients through pregnancy to toddlerhood, covering everything from healthy eating and breastfeeding to the risks of smoking and foetal alcohol spectrum disorder.
But they also go above and beyond the strictly medical stuff, and trouble-shoot problems that could otherwise spiral.
Kirri needed help dealing with Centrelink (“the worst place on earth!”) when she was fired after ongoing morning sickness early in her pregnancy.
And Kat said many clients are living in over-crowded housing, where they have less control over the environment surrounding them and their baby.
“There’s a big wait-list, about five to six years, for [public] housing here in Darwin,” she said.
“That’s one of the biggest stressors that we always have a yarn about with our clients — we help put in the housing application forms, we help with the ID and stuff.
“We just help them navigate those systems a bit easier.”
A long-term vision
In 2017 the Northern Territory youth detention and child protection royal commission said in its final report, like others already had, that early, effective support for vulnerable families can make collisions with those systems less likely later on.
The report also recommended a Productivity Commission review of spending on child and family services in the Northern Territory to ensure that they are coordinated — the NT and Federal Governments are still yet to agree on an inquiry’s terms of reference.
Katerina Keeler said she wants her clients to leave the program feeling empowered to make good choices for themselves and their young families.
“If they have a healthy pregnancy then the bubba’s going to be healthy once bubba comes along, and they’re going to be healthy adults,” she said.
“That [will] be passed on intergenerationally as well, that’s where we’re really going to close the gap.”