Closing the health gap

Despite improvements in recent decades, Aboriginal women are still suffering serious problems when it comes to their reproductive health, according to South Australia's Young Tall Poppy of the Year, Dr Alice Rumbold.

As a teenager growing up in Adelaide, Alice Rumbold's two loves were science and music.

An accomplished cellist and pianist, the former Marryatville High School student had to make the choice between the two when it came to her university studies. Science won and set her on a different path altogether.

"I have always been interested in science but I have applied it to a health perspective from day one," she said.

Now a senior research fellow in the Discipline of Obstetrics and Gynaecology and the Robinson Institute at the University of Adelaide, Dr Rumbold's undergraduate science degree has led to a career in health research.

A desire to address inequalities in health has, not surprisingly, resulted in the 31-year-old working in Australia's most disadvantaged sector - remote Aboriginal communities.

"Indigenous people face health setbacks on a day-to-day basis," she said. "Sexually transmitted infections such as gonorrhoea and chlamydia are unacceptably high in Aboriginal communities, compounded by other health problems such as diabetes, polycystic ovary syndrome and obesity.

"These are all having a marked impact on the reproductive health of Aboriginal women, particularly in pregnancy outcomes.

"Infertility, pelvic inflammatory disease and ongoing pelvic pain are the end result of these health issues and the tragedy is that most of these conditions are largely preventable."

Dr Rumbold has spent the past five years working with Aboriginal communities since graduating from the University of Adelaide in 2005 with her PhD.

She worked at the Menzies School of Health Research in Darwin for several years, spending weeks at a time in remote Aboriginal communities, gradually building trust and respect among Aboriginal women.

"An enormous amount of effort and time is needed to establish a good understanding of Aboriginal culture and to break down the long-term distrust that some of these communities have of researchers," she said.

"You have to put in the time to establish good relationships and sometimes this aspect is not recognised by funding bodies, which are keen to see results as quickly as possible."

The upside is that Aboriginal health is a key priority of both sides of politics in Australia and there is a bipartisan commitment to address the appalling inequity.

In 2005 the Close the Gap campaign was born, calling on federal, state and territory governments to commit to closing the life expectancy gap between Indigenous and non-Indigenous Australians within a generation.

Dr Rumbold is tackling the problem on several fronts. Her research is helping to pinpoint why there is such a high incidence of reproductive cancers in Indigenous communities and how to better detect and manage sexually transmitted infections in these remote areas.

She still holds a joint appointment with the Menzies School of Health Research where she is also involved in developing resources for pregnant Aboriginal women. These include routine antenatal screening tests to detect Down Syndrome and neural tube defects.

"We are making headway but it is very slow. In the Northern Territory, the incidence of cervical cancer among Aboriginal women has decreased in the past decade, but it is still markedly higher than in the overall Australian population," she said.

"Despite a range of public health initiatives that have been introduced, sexually transmitted infections are also unacceptably high."

In 2009, Dr Rumbold was named South Australia's Young Tall Poppy Scientist of the Year for her groundbreaking work in reproductive health.

She hopes the honour will put the spotlight on Indigenous health and encourage more researchers - and Aboriginal people - to pursue a similar career.

"It is important to engage Aboriginal people in leadership roles in the health sector, particularly in research. However, to do this, we need to address the lack of educational opportunities that Aboriginal people face," she said

"I'm also keen to convince young people that studying science provides them with a lot of scope for many exciting careers. You can travel the world, mix fieldwork with research and laboratory work and get the opportunity to make a real difference to individuals and communities.

"It's a journey of discovery."

STORY CANDY GIBSON