Yolngu stories make sense of medicines Yolngu stories make sense of medicines

The Yolngu people of North East Arnhem Land have high rates of chronic conditions, such as diabetes and kidney disease, that require increasingly complex medicines and medicine regimens. However, they have few opportunities to obtain and share information about medicines. Also, English is not their first language, and their understanding of healing is based on traditional Aboriginal culture rather than western culture.

A team comprising a pharmacist, an Aboriginal interpreter, and a nurse who speaks the local language are endeavouring to overcome these problems through the ‘Sharing True Stories about Medicines’ project. They are working with a remote community and an outstation in North East Arnhem Land to develop culturally appropriate stories that can be used to help Yolngu people learn about their medicines.

‘On our initial visits, we found that the people had a real interest in learning about medicines. One of their main questions was “Where do these medicines come from?” So, we developed a “medicine story” to answer the question.’

Helen Guyala interpreting for the pharmacist and patient in a remote community in Arnhem Land, NT. 

The story has been recorded in the local language, and broadcast on a radio station set up recently in East Arnhem Land. ‘The story has also been used to train Aboriginal Health Workers and interpreters in the region. Developing stories that can be told by Aboriginal Health Workers is very important, because they dispense or help to dispense many medicines prescribed by local and visiting doctors. Teaching interpreters the stories is good preparation for them working with doctors and pharmacists who may need their help to talk about medicines.

‘On subsequent visits, we found that the people were keen to learn more about the medicines in their dosette boxes*. Using the interpreter, we answered their questions, and discussed with them how to recognise their medicines by their shape, colour and markings.

‘Pharmacists at the Royal Darwin Hospital are now working on plain English stories for some of the more commonly prescribed medicines. It is difficult to write or speak in plain English without simplifying the story, but this is what the people want. They want the “true story”. Hopefully, the exercise of putting the stories into plain English will help the pharmacists improve their skills in relation to talking to Aboriginal people about medicines.

‘We also used photographs of ramipril, one of the more common medicines, to explain and talk about ‘dose’, because many people do not understand the concept. Ramipril tablets come in different colours depending on the dose. We showed them the different coloured tablets, and explained that each colour is a different strength or dose of the medicine. We found that having real tablets on hand when showing the photographs made it easier for people to understand this concept.

Exploring new ways of conducting home medicines reviews.

‘Many people were taking different doses of ramipril, but did not realise that it was the same medicine as others were taking, or as they had been taking previously. We explained that the doctor may change their dose, which means they will have a different coloured tablet in their dosette box, even though it’s still the same medicine.

‘We hope to continue researching and working on quality use of medicines issues in remote communities, because we have found that the people are very interested in learning about their medicines. We also hope that interpreters working with other Indigenous groups in the geographic, cultural and language area will also be able to use the stories we have developed.’

The ‘Sharing True Stories about Medicines’ project was funded by the NPS Rural Community Quality Use of Medicines Program. For more information about the project, contact Alice Mitchell, patient educator, at alicem@ards.com.au, or Bhavini Patel, Director of Pharmacy, Royal Darwin Hospital, at bhavini.patel@nt.gov.au.

*Dosette boxes are a type of medication organiser with labelled compartments for each day of the week. See Winter 2005 edition of MedicinesTalk for more information.