Remote Laundries: Reducing the risk of rheumatic heart disease in remote communities

  • Frederick ‘Freddie’ Scrubby, who works at the Barunga laundry. Standing in front of laundry machines.

Frederick ‘Freddie’ Scrubby, who works at the Barunga laundry

By
Jasmine Just, Le Smith, Elizabeth Morgan-Brett
National Heart Foundation of Australia & Aboriginal Investment Group
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Acute rheumatic fever is an illness caused by an abnormal immune reaction to a Strep A infection of the throat or skin that can cause sore joints, fevers, rashes, uncontrollable jerky body movements and heart inflammation. Acute rheumatic fever can be prevented if the initial Strep A infection is diagnosed and treated early.

A severe episode of acute rheumatic fever, or recurrent episodes, can permanently damage the heart valves, causing a condition called rheumatic heart disease (RHD). RHD can lead to complications like heart failure and abnormal heart rhythms.

While RHD is mostly preventable and has been eradicated in many parts of the world, Aboriginal and Torres Strait Islander communities experience some of the highest rates globally.

The RHD Endgame Strategy is a blueprint to eliminate RHD in Australia by 2031. The strategy has five priority action areas including healthy environments, with a focus on access to basic hygiene measures including hot water, running showers and washing machines. Washing bedding, towels and clothing with the correct detergent, hot water and hot drying cycles kills scabies, which in turn reduces the risk of Strep A-infected skin sores.

In 2019, the Aboriginal Investment Group, based in the Northern Territory, launched the Remote Laundries project to give local communities free access to washing machines and dryers. Laundries are currently operational in the remote communities of Barunga, Casuarina, Angurugu and Bickerton Island. Each laundry is set up in a repurposed shipping container, ready to ‘plug and play’. The laundries are fitted with large commercial washers and dryers, with units customised for the communities that receive them. Importantly, each laundry also creates at least five positions for local staff.

Since the first laundry cycle in Barunga, the local health service has reported a 60% decrease in people presenting with scabies.

“In addition to reducing the risk of rheumatic heart disease, having access to reliable laundry facilities contributes to good mental and physical wellbeing,” says Elizabeth Morgan-Brett, CEO of the Aboriginal Investment Group. “The beauty of AIG’s Remote Laundries project is its simplicity; free washing and drying services for women, men and children, supporting health and wellbeing, pride and dignity.”

In 2023, the Heart Foundation First Nations Heart Health team travelled to Angurugu, Milyakburra and Barunga to deliver bespoke, culturally appropriate education to community members, laundry staff and the Champions from the Champions4Change program. The Champions4Change program is an advocacy and leadership program for people with lived experience of RHD and the people caring for them. Champions are community leaders and play a critical role in influencing positive behaviour change.

Educational workshops included yarning circles to discuss skin health, acute rheumatic fever and RHD. Prior to each workshop, attendees completed a survey to explore their current knowledge and confidence in speaking about these conditions with their community. The post-workshop survey demonstrated both an improvement in knowledge and an increase in confidence.

“With community and First Nations leadership behind this project, we have a valuable opportunity to support the delivery of culturally appropriate, place-based health education in-community for the prevention of acute rheumatic fever and rheumatic heart disease,” explains Le Smith, National Manager Population Health & Wellbeing at the Heart Foundation. “Building the skills, confidence and capacity of community members, laundry staff and Champions to lead local efforts brings more effective and sustained change.”

In addition to educational activities, the Heart Foundation continues to partner with the Aboriginal Investment Group to seek funding so Remote Laundries can thrive and benefit more remote communities.

For more information about Remote Laundries, visit remotelaundries.org.au

To learn more about the Heart Foundation’s work, visit heartfoundation.org.au/bundles/your-heart/acute-rheumatic-fever-and-rheumatic-heart

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