Kirsten Thompson

CLINIC 34 / NORTHERN TERRITORY AIDS & HEPATITIS COUNCIL 2010 - 2014

    I think at that time, the hep treatment program was just expanding with the different drugs that were coming through, and there were so many more people coming out of the woodwork who were actually getting tested, because there was publicity around the place.

    I am Kirsten Thompson. My involvement with Clinic 34 in Darwin was from 2010 to 2012, and then I worked with NTAHC from 2012 to 2014. I’m still sending clients over there from here, which is Family Planning.

    I became the Hep C CNC in mid-2010. Prior to that, I’d been working a little bit with NTAHC with HIV clients. Once I’d started on the Hep C side of things there was much more involvement, especially with new diagnoses. It was absolutely fantastic. You’d tell someone they’re positive, get straight on the phone, and one of the NTAHC staff would come over, or we’d take someone over there, or arrange for a meet and greet, and then the NTAHC mob would take it from there and supply the care.

    I was clinically involved, and didn’t have the ability to look at housing situations and relationship issues and all that sort of stuff. And I think at that time, the hep treatment program was just expanding with the different drugs that were coming through, and there were so many more people coming out of the woodwork who were actually getting tested, because there was publicity around the place. People in their forties and fifties were finally finding out why they’ve been feeling a bit crappy for the past few years. So that’s why it was so good to have a place like NTAHC to call up and say, right, I’m overrun at the moment. Let’s see what we can do for these people who have just found out.

    During my time, the process was pretty damn smooth. I can’t speak for prior to me but after me, because I worked for NTAHC then, it was pretty smooth. It was great.

    I can’t speak about it from the general community because I was so heavily involved, and my view is very skewed towards the hep-positive people, but through educational activities that I’ve been involved in with different places that I’ve worked, there is still, to this day, such a stigma surrounding it.

    Now the new treatments have arrived things are looking even better. The PBS listing came through on 1 March, and the process of telemedicine will accelerate their dispensation.

    Telemedicine is where the GP himself then gets on the phone to a consultant, and says, blah, blah, ABC about this person, we can email through all their test results and their records, what do you recommend? Do you agree with what I’m saying, and if so, then they can sign off and start the person on the treatment. So that’s all in the pipeline at the moment. I know of three GPs personally who I’ve been speaking with about the need for a protocol written through Infectious Diseases as to how this telemedicine is going to occur, what the protocol is going to be – and then we’ll have doctors that are able to prescribe.

    This is very exciting, and these new treatments are now just twelve-week courses (as different from 24 or 48 week courses of very harsh combination therapies of the not so distant past). And even those with cirrhosis are now looking at treating so it’s even better. We can now foresee a world in the future where we might have eradicated Hep C – in four or five generation’s time, maybe.

    However, the cost of the drugs is astronomical, which is going to be a big factor. I think with the government putting it on PBS, that’s fantastic, but I do think there’s going to be a bit of a kickback where there are other sections of health that aren’t going to be getting this sort of money and people are going to start complaining about that.

    When I finished at Clinic 34, I moved to the ‘dark side’ over to NTAHC. I left the clinical and came over to do care and support and education, and it was a real eye-opener. It was just a completely different perspective in the client care area. I was handing out drugs and looking after symptoms and that sort of thing at Clinic 34, and any problems I’d contact a doctor saying, “this one’s not working, this one’s having side effects, this one’s bloods have dropped this much”, and then over at NTAHC it was: this person hasn’t eaten for three days, I need to get some food in to them so that then their bloods might go better, because probably it’s the starvation – and the homelessness and the relationship issues and domestic violence and things like that which effect the person. So it was a steep learning curve, but it was great.

    I always wanted the two to work as one, and since I left Clinic 34 the hep C program was actually removed from the Sexual Health Unit, and moved in to the Liver Clinic at Royal Darwin Hospital which, in my personal opinion, just made it a lot less personalised. It’s Outpatients Department: you wait for six hours to see someone because something else has happened. So I personally believe it should be treatment, and care and support, all in the one area.

    My time at NTAHC was lots of fun, a great team, a nice and relaxed atmosphere, but when it came to the crunch, on the whole, most people were extremely professional, which is what you need in that sort of thing.

    When I first moved to NTAHC there was a lot of in-fighting and cliqueiness – and that’s from my perspective, from Clinic 34. The people I worked closely with, the care and support team – Lana Pockock (now Monro) and Panos Couros – were doing their job perfectly, but you’d get involved in different aspects, or different parts of the organisation of NTAHC, and it’d be this section’s not talking to this section’s not talking to that section, it was just very cliquey.

    I think there was a bit of a broom swept through by Craig Cooper, the new ED. He was brilliant. I think it was a very needed thing, and I think having someone coming in from the outside to do it and not a local was needed, because that person was already in cliques, and you sometimes just need that out-of-perspective, just to come in and say, “Hey, I know we drink together, but you’ve actually got to do the job here, too.”

    The programs NTAHC was delivering were, obviously, care and support, and it was very strong. The NSP is always a very-needed harm minimisation program. Sometimes a little dysfunctional, but it gets done.

    Events, yeah, a lot of them stick out in my mind, but one in particular was the World Hepatitis Day down at the waterfront in 2013, which just involved members of the public coming down and we were able to just spurt a little bit of information in to each person’s face. I thought that was the best program, and the best event that has ever been because it involved everyone. The Parliament House Hep B forum in 2014 was great, very focused, but was only for people in the industry. I love the World AIDS Day ones at the Precinct and the Christchurch Cathedral – they were out in the open and just grabbed people as they went past, and it was perfect. The same with the Youth Week event done by a young volunteer, Rennon Schafer, that also grabbed people as they went past.

    I think to me, that works better, that’s just my opinion. The focus on the industry is great, but it’s still the same people every time and we’re preaching to the converted. We need to get out there and go “NTAHC, NTAHC, rah, rah”, but do it in a public forum in a safe way – like those three events, they were brilliant and Alex Galeazzi just does a fantastic job with them.

    Also the health promotion graphics and Andy Ewings’s ability to understand what I’m trying to say and put it in to pictures and words on a piece of paper or on a screen are second-to-none. I’m not artistic in any way, shape or form, and he just takes my dribble and makes it in to something usable and presentable. There was that one that I remember, I was still working at Clinic 34, and it was the Strong Blood campaign – loved it.

    I have fond memories of getting caught having lots of beer in my personal fridge, and then having that same person come and ask for one later on. It was great camaraderie and people, people did get on and it was good. Every job, not everybody is going to get on a hundred percent of the time, we all know that, but I think people are able to talk about it.

    I think the Sister Girl work was also really good. I have to throw that one in. I really enjoyed doing work with those girls. After a couple of years I still only got through to about four of them, but you take every little win you can, and not to expect something to be done for you because it’s been done before. You’ve actually got to get out and do it yourself, and lay the groundwork again. I think that was, that was a major point. A number of the girls do have hep C, a couple of them do have HIV. So it’s really good to be able to connect on a few different levels because these sisters had not discussed their blood-borne virus issues with other people, very rarely, and for them to be able to come to the one-stop shop was great.