A New Approach to Cancer Care in Yarrabah
When Colin Costello was undergoing cancer treatment, he had to leave his home community in Far North Queensland for seven months at a time. Yarrabah, located about an hour from Cairns, became his temporary base during this period. However, the Aboriginal community of 2,500 people remained the heart of his support network.
“A lot of people care in Yarrabah,” Mr Costello said. His experience highlighted the importance of having a strong community support system, especially during difficult times.
A new community-run program has recently been introduced in Yarrabah, a development that wasn’t available when Mr Costello faced his illness in 2018. This initiative aims to improve cultural safety for Indigenous cancer patients and is expected to make life easier for those in the community facing a cancer diagnosis. It also seeks to prevent others from developing the disease through early intervention and education.
Chanten Lefoe has returned to live in Yarrabah after 15 years away to take up a role as one of two new local cancer care support officers. For him, coming back to his roots feels like a calling.
“It’s like a sense of calling, coming back home,” he said. “What [community] gave to me when I was growing up, now I’m giving back.”
His job varies day-to-day but involves driving patients to appointments, translating medical jargon, supporting patients’ relatives, and having conversations about health. Many community members have not received a great education and may be reluctant to travel long distances.
“So, they can just do everything from here, and we can … be a delegated voice for them,” Mr Lefoe explained. Tailored care also means making the nearly hour-long journey to Cairns more useful for patients, aligning it so they can get grocery shopping and errands done too.
“It’s also about if they want to go down the beach for 15 minutes if they’re dying of boredom, not dying from their diagnosis,” he added.
The community-led Gurriny Yealamucka Health Services Aboriginal Corporation (GYHSAC) is delivering the $2.3 million program, funded by the National Aboriginal Community Controlled Health Organisation. GYHSAC head of clinical services Jason King said the program, which began in April, would change the way Yarrabah residents “interact and live with cancer in the community”.
“For the people of Yarrabah, having an opportunity to have … not just a say but to carry out the care of their own people is incredibly powerful,” he said.
The program also has a health promotion aspect, aimed at preventing cancer through culturally safe education. “It’s a reality for people who live here that you get sick, you go to the hospital, and sometimes, you don’t come back,” the clinician said.
Dr King mentioned that many Yarrabah residents had a long-standing fear of the health system, which could lead to cancers being detected later than necessary. “We talk about demographics and we talk about epidemiology, but cultural safety is a core layer of that,” he said. “A different experience of history, of government programs and racism, for example, leads directly to different outcomes in health.”
Yarrabah is ranked by the Australian Bureau of Statistics as the nation’s fifth most socio-economically disadvantaged local government area based on 2021 Census data. The 10 most-disadvantaged council areas are all located in regional to very remote parts of Queensland or the Northern Territory, with majority First Nations populations.
Dr King said disadvantage was a root cause behind about 80 per cent of presentations to Yarrabah’s clinic, making community-led health care even more important. He said federal and state governments were increasingly looking to local solutions to address challenges in health.
Now a cancer survivor, Mr Costello is encouraged the new program may help others. “There’s a lot of people here who are good at making decisions,” he said. “Yarrabah knows what they need for health care.”
