EHO Knows: The Trachoma Project w/ Melissa Stoneham

Shane: [00:00:00] Welcome to the next episode of EHO Knows. Now, in today’s episode, you’re gonna hear a story about how something so small and so trivial, something that we take for granted, uh, in our everyday life. If you remove it. Has devastating effects on, on entire communities.

Um, and then the joke is that the solution is really, really simple, but you can’t do it yourself. And so, uh, in today’s episode, I’ve got associate professor Melissa Stoneham, talking about how she’s worked with Rotary and managed to, to literally be saving lives. Changing communities through doing something so, so simple.

So, uh, thank you. Welcome Melissa. Welcome to EHO knows.

Melissa: thanks Shane. It’s great to be here.

Shane: okay.

Melissa, I’ve heard you from stage and I know a little bit about you. in 30 seconds, tell the world about who you are.

Melissa: Oh goodness. So I am an EHO by trade, and I started in local government land like most eh [00:01:00] But realized not too long after I graduated, maybe three or four years, that regulatory world was not for me. So I’ve studied a few things here and there, Shane, and I’ve sort of gone into the sort of health advocacy, health promotion, healthy public policy sphere. And yeah, for the last 20 odd years I’ve been working with Curtin University, uh, in a whole range of different areas, but mainly public health advocacy and more recently right back to my Roots, which is working with communities in environmental health.

Shane: I heard you talk earlier this year and what really, really amazed me was, as I said in the intro, it’s about such a small, uh, thing that we do, but causes such a major problem. Um, so what is the, the problem that we’re trying to solve?

Melissa: So I run the ending Trama project in Western Australia. trachoma is a disease that causes blindness. It’s a hundred percent preventable. Um, and it’s Australia’s the [00:02:00] only developed country to have endemic Tacoma, which means that, um. For a developed country like us, it’s where it’s, it’s disappointing.

It’s a shaming that we have such a disease, which is a hundred percent preventable. All of our cases in Australia are in our Aboriginal and Torres Strait Islander communities, and most of them are in desert communities, and that’s because they have less access to water. So Tacoma is caused by a bacteria that’s in the ground, and you need to have repeated infections over time for it to cause blindness.

But as I said, it’s a hundred percent preventable through basic environmental health.

Shane: So the chances of you getting it, or myself or, or any of our listeners getting it is zero. Like we, we just don’t see it. in major cities, we don’t see it, uh, definitely in the middle class, upper class, but we also don’t see it in the working class in, in the cities like in Sydney. What are the chances of meeting someone with Trama, uh, in Sydney or Melbourne?[00:03:00]

Melissa: ’em these days. It used to be more common in the mainstream, uh, population, but as we developed and got better hygiene, it

Shane: I.

Melissa: And so now most cases, I would say, you know, 99% we see in Aboriginal and Torres Strait Islander communities and remote communities only.

Shane: Okay, and are we talking about something that just impacts 1%, 2%? What’s the Yeah. Is, is it small and trivial or how many people I.

Melissa: we screen four to 9-year-old kids because it’s more common in. You know, the, the first signs are more common in childhood. So we know that, um, we don’t know population stats for coma ’cause we don’t really measure it in adults. But in kids it can be as high as 21% of children in remote communities have Tacoma.

So that’s like one in five, which is not required because if they had good hygiene and we had good environmental health in those communities, we wouldn’t have anybody. It’s a bit like having sand in your [00:04:00] eyes, so it’s like always scratchy. Uh, and it, you, it does affect you, you know, your health and wellbeing and your mental health because your eyes are so sore.

Shane: okay, so what’s the most extreme thing that can happen with Tracom?

Melissa: So, like I said, it does take an around about a hundred. Infections, repeated infections for you, for you to go blind. So if you leave it untreated, it will just continue to get worse and worse over life. So we do flip a lot of eyelids, um, when we go out to remote communities and we travel with the nurses and they do. Checks to make sure people’s eyes are in good condition. And if they’re not, they refer them on to, you know, the clinic or other services if required. it just happens over time. And I guess that’s one of the insidious things about trachoma is that it’s not like instant. So people go, oh my goodness, I’m gonna go blind tomorrow.

No, it will take years for this to happen. And so that is why it’s so important that we have that prevention message about, uh. health and good hygiene, both at school and in the home, and access to clean and fresh [00:05:00] water.

Shane: In one sense that makes it even worse because you’re saying that this is literally something that’s, um, you know, a childhood long problem, hundreds of cases before you go blind. But if you don’t do that, you go blind. Um, if you go blind, what’s the treatment?

Melissa: Well, you can have surgery. So WHO has this safe strategy for trama. So it’s surgery, antibiotics, facial cleans, and environmental health. flipped that round and we call it EFAs. So we think the most important thing is prevention. So environmental health should go first, followed by facial cleanliness, which is the major risk factor. Antibiotics, if none of that works. And then surgery is the last resort. So if you have troma in a remote community, you pretty much have to leave home, go to the city. surgery and hope that it works and then return back to your community. So it’s, it’s very traumatic for these people. And as I keep saying, we can prevent this from the very beginning if we have good environmental health.

Shane: So what causes it in the first place? It’s.

Melissa: It’s a [00:06:00] chlamydia

Shane: Uh, bacteria.

Melissa: Yeah. From the dirt. Um, so it’s constantly in the environment, but the main risk factor for Trama is, uh. Facial cleanliness. So clean eyes, clean nose. So when you see the kids with, you know, runny noses and facial and secretions coming from their eyes, that’s a, a sign that we need to focus on that family. but basically it’s all about hygiene. So the ability to wash, so wash themselves, their face, their hands, and their clothes. And if we can do that, then we can. Prevent Trama, but it’s not as easy as that as you know, because in remote communities, most of the homes or many of the homes. maintenance schedules are pretty, they’re not very reactive.

And so people might be waiting for months if they have a tap that isn’t working or a drain that isn’t blocked. so, although housing see that as a less important issue compared to say, an electrical fault a health point of view, if you put a health lens over that, it’s a really important issue because if [00:07:00] you can’t wash your hands, your face, or your body or your clothes, ’cause your tap isn’t working, or your drain won’t. drain then, you know, that’s gonna have some fairly, it can have some fairly severe health impacts. So we’re working with housing on that.

Shane: Yes. And so that’s a good one for them. But what I found really, really interesting was you talked about, um, towels and so, in my house. We’ve got a cupboard full of towels. Um, and we just take it for granted. Uh, but there were just a bunch of really bizarre issues relating to towels. were your findings there with towels?

Melissa: So we have a key message that we use in AraC Coma Project, which is the six steps to stop germs. And so that’s blow your nose until empty and put the tissue in the bin. Wash your. your hands with soap every day. Uh, wash your face to get rid of the secretions. Brush your teeth morning and night. Uh, have a shower every day and don’t share towels.

And so it’s that. Don’t share towels [00:08:00] message, which we found it really difficult to implement because when you, um, look at the price of towels in remote communities, we’ve seen towels for like up to $60 each. And in, ’cause the stores are very small and then they’ll have maybe four or five towels in stock and they’re all the same color.

Shane: so when you say $60 for towel, you’re talking about top the range plus Sheridan towels that you just like to snuggle up in.

Melissa: No, they’re not Sheridan quality. They’re just really expensive because I guess they don’t sell a lot of them. And it’s, you know, the getting stock out to remote stores can be challenging if, if something doesn’t sell, I guess they just don’t reorder it, so it just sits on the

Shane: So we’re talking budget motel thin, it barely counts as a towel, but can still be costing $60.

Melissa: And if

five kids and we are encouraging them not to share towels, which is, well, let’s just say that’s $300, they’re not gonna spend that on towels. So. We wanted to really make [00:09:00] that message resonate with our families that we work with. So we give them hygiene kits now, which have been funded through the Endra Coma Project Rotary at one of our major partners, and they provide the hygiene kits in the contents that align with that message.

So, uh, blow your nose until we provide tissues. Wash your hands, um, with soap. Comes from soap aid. so that’s free soap. clean your face from secretions. We give them a face washer, different colors, uh, brush your teeth. We get toothpaste and toothbrushes for adults and kids have a shower every day. We give out shampoo and conditioner and don’t share towels.

So we have the ability to give up two 12 different colored towels for each household, depending on how many people live there. Um, and that’s been really an important part of our program.

Shane: And it’s just amazing how it’s the small things that we take for granted because like I know at home that’s my towel. Um, you get to the stage where you’ve got his and hers towels or whatever. But yeah, it, it’s pretty much taken for [00:10:00] granted in my house that that’s my towel and you know, that’s the hand towel.

Or whatever. you were talking about the $60 towels, but also it was just, they’re all just in the one color. You don’t have any concept of individual ownership of a towel or, you know, this is my towel for the day or whatever. So, 12 different colored towels. There’s suddenly a groundbreaking concept in that suddenly children can have a concept of, oh yeah, this is my towel, and yeah, it’s something as simple as just doing that starts to break the cycle.

Melissa: provide a solution. We see a problem, Shane. So we were giving these towels out and then they didn’t have anywhere to hang them. So maybe the towel rails were broken or they didn’t have a towel rail. ’cause these bathroom designs are quite old. So we give out towel hooks now and we encourage. People to put the towel hooks behind their bedroom doors and hang their towels on their own hooks. because the last thing we really wanna see is when we walk into a home and we see the towels we’ve given out on the previous visit [00:11:00] the floor. ’cause that’s sort of, the gates, the whole germ theory.

So we’re giving out these towel hooks now, which is, you know, another great solution to a really simple problem. So yeah, we are learning as we go along with this project.

Shane: and so we’ve now got, uh, you know, the basics. You know, if you were ever to say, what do you need? I would’ve automatically have gone for, yeah, of course. Um, tissues, soap, uh, they’re the essentials. Um, but then, yeah, the really eye opener one for me was, you know, just that concept of towels, different towels.

Now, something as simple as a hook on the back of the door so that your towel’s not. On the floor or thrown wherever, and you’ve got that concept of keeping it for yourself. so now you’ve got a list of basics, and then you mentioned rotary. What’s the rotary story here?

Melissa: I think most people remember back, you know, I don’t know, was it 20 years ago when Rotary wanted to eradicate polio? Probably longer. And that was their big campaign. Well, their current one is to eradicate Trama. And so when [00:12:00] we were looking, you know, we were given a certain amount of funding for our project and, and that. ’cause our project really is to build capacity with the environmental health workers in remote communities so that they can go into homes and identify risk factors for Trama. So that’s really our job. But we didn’t feel that that was the whole solution. We wanted who live in remote communities to have that, you know, emergency plumbing fixes, which.

Which the environmental health practitioners can provide, but also access to hygiene products that they can’t afford at their local shop or can’t access because they’re just not stopped. So we, that’s why we joined with Rotary and the Indigenous Eye Health Unit with Melbourne Uni, who gave us the message, the Six Steps Rotary were the ones that enable us to bring that message to life.

They’re the ones that gave us all of the hygiene kit contents in the towels we just got last week. Another. of another 5,000 colored towels, Shane. So this is an ongoing commitment from Rotary and we wouldn’t be able to do our project as well as we do without their support. And not only did [00:13:00] they provide the hygiene kits and the contents, but they also gave us two washer dry trailers. So we can take these two remote communities on the back of our four wheel drive and. we can do, you know, the bulky things like bedding. Um, so when we walk into a home and we have a look at people’s washing machines, they’re either not functioning very well or they’re too small for them to wash their bed linen. most, a lot of the remote communities we visit still have those twin tubs. You know, I don’t know. I had one, my mom had one when I was growing up. They’re pretty old, but they seem to like them out there, but they’re just not big enough to do quilts and blankets, so they just don’t get washed and we won’t be able to eliminate.

Trama and other environmental health related diseases, unless we can get that bedding washed. So the donation of two washer dry trailers has been a really great addition to our project. So Rotary, our project would still be working, but not working as well as it could.

Shane: and the title of your talk was about leveraging. And so you’ve really got this concept of, you know, the [00:14:00] answers. Um, and you can get a little bit of funding, but it takes a lot more funding. And so Rotary’s, um, awesome at that, but it takes a lot of, effort. And so you’ve literally got volunteers, Not in the remote communities, but able to locally be able to, you know, do the, the fundraising, getting the packs together or whatever, and then shipping them over. Um, but then at the same time, you’ve still got Rotary on site, sending in teams and helping with, the rollout. So it’s, it’s a huge partnership.

so from Rotarian’s point of view, what do they say? Rocking up at these remote communities, helping with the rollout? Um, what’s the experience there?

Melissa: So we were really lucky to be able to take, um, a, a rotary. a representative with us to the Nan Lands when we launched the washer dryer trailer out at Waldon. uh, that was great for them. Uh, they did the launch with the, the local public health manager. There were a lot of people in Qia [00:15:00] that came out.

We did, you know, Tails in the. the ground and, you know, lots of community people. But I think even better than that was the fact that we took, uh, that Rotarian into the homes with us. And so he could see the type of conditions that we have been talking about, that are really hard to imagine if you live in the city.

He lived in Melbourne, so it was a long way for him to visit, uh, warden out in the lands. Uh, but it was really great and he had, uh, I think it was really rewarding for him to be able to see the types of conditions that we’re trying to. Prevent, and he got a lot of kudos on that trip. I think, uh, we’re all about reciprocity.

So what we can do for them and what they can do for us, that’s how it works. So if we can take them on trips as often as possible so that they can feel, know, in contact with the, the condition they’re trying to prevent, then we are happy. More than happy to do that. So I think that was a win-win for everybody.

Shane: Yeah, you touched on it briefly then as well. So you’ve got now [00:16:00] volunteers helping, getting all the kits together. Uh, you’ve got the kits rolling out, but you’ve also got education happening, so it’s not just a matter of, Hey, here’s a bunch of towels and whatever. You are. Now stepping into these communities and doing an education program, uh, what’s involved with that?

Melissa: So there’s a few parts to that, Shane, but I guess the important thing to say out front is that. Although we don’t go to communities every three months, we train the environmental health practitioners up to go into every home at least once every three to four months. So this is a constant visit. So it’s not just a one off in out.

See you later, baby. So it’s a constant reinforcement of let’s check your plumbing, let’s fix what we can. Let’s report what we can’t fix. Let’s give you a hygiene kit. Let’s give you a hygiene yarn around the six steps of stopping germs so that all happens. Um. when we are in community and hopefully when we’re not in community, ’cause that’s what we’re trying to upskill them to do. But when we do go to community with the environmental health workers, we tend to focus on [00:17:00] the schools as well as the yarns that we have inside the homes with, with the adults. So when we go to the schools, uh, kids are great, you know, they love Milpa, uh, which is. Trama Goana mascot and the six Steps to Stop Germs.

So at the school, we take them through the six steps, and then mostly we get them to create their own little video using our Six Steps to Stopping Germs song. Um, and it’s a whole lot of fun. They, they make up their own dance moves to each step along with, you know, the important actions, which. Highlight that step and yeah, there’s lots of smiles, lots of laughs.

And then we give the video back to the community and they play it at, you know, school functions and in the clinic waiting room. And the kids just love watching themselves. So, and at the end of a week, so we’ve been to most houses, we’ve had yarns with the adults, we’ve worked with the kids at schools. If we have a nurse with us, they’ll be doing SSIS checks.

Uh, on the older people. And then at the end of the week, we try and have a community function to thank everybody for hosting us. So that might be, we’ve got [00:18:00] water slides, jumping castles, and, and a movie, movie theater. And then we have a, a big community barbecue. Uh, and Milpa, the gona comes out and yeah, everybody just gets together and it’s that reinforcement of the whole message of why we’ve been there all week, which is six steps to stop germs and make sure you report your plumbing if it isn’t working.

Shane: have you seen measurable results yet?

Melissa: Yeah, so we have been doing this for seven years, and the type of results we are seeing when we go into homes, we see less severe plumbing issues. we used to. So when we walked into homes seven years ago, we would see bathroom walls completely missing, bathtubs, falling out of homes, you know, trees, growing showers, really black mold, terribly, you know, blocked drains.

And so we’re seeing less of that and more of the, you know, oh no shower head. You know, the drain’s blocked. We can plunge that. Let’s fix that for you. Now. It’s just the constant wear and tear with so many people living in a home in remote communities. There’s that [00:19:00] constant wear and tear of plumbing. And so it’s not because the people aren’t looking after it, it’s just because it gets used a lot.

And so that’s why we’re constantly replacing in repairing.

Shane: And then in the case of, um, extreme coma, are you seeing, like if we step into, um, a high school now, will you be seeing a difference in the quality of eyesight with, um, with high school key? It’s now.

Melissa: So we, I can tell you that the screening data has shown a reduction in Trama. So when we started, we had 41 remote communities that were at risk of trama from last year’s screening. We have that down to about 30, 33 communities. So that’s a reduction in, you know, 10 or so remote communities that are now, uh, trama free.

And I think Australia before too long will actually eliminate trama. We’re hoping.

Shane: Then the challenge is, it’s the, um, it’s the lack of stories. That’s then the sign of success. It’s very easy to go in and see a blind person and say, Hey, we’ve got a problem. Um, it’s when you then [00:20:00] step in and you don’t have all these problems that, you then go. Fantastic. We’ve now got success.

Um, so you are literally seeing communities being removed from the at risk and, so that’s the success. Any resistance, any problems? I.

Melissa: we’ve had many problems over the seven years. You know, when we first wanted to give out soap, for example, people were saying, you can’t give out soap. There’s an assumption you’re saying people are dirty and no, we are not. just, it’s soaps expensive in the shop. It’s hard to get, people don’t buy it because they have other priorities, so let’s just give it out. So that was one. Towels were the same. You can’t give out towels. You know, you can’t keep giving, giving. And we are saying, well, we have to, until we make them a normal part of family life, so that when we can’t provide the towels any longer, they’re gonna want to buy a towel, from the shop, or the shop will be. Advocated or will advocate with the shop owners to try to get more towels at a cheaper price. Uh, [00:21:00] so I guess resistance has come from the type of, you know, hygiene that we give out. Um, other than that, you know, it’s, it’s not resistance, but it’s really hard working with housing, trying to get them to see a, that a house is not really just an asset, it’s a social determinant of health.

It’s where people live. It’s where people should feel happy and safe and healthy. But when you. It takes so long to get out to do maintenance, just basic maintenance in a home. you know, it becomes a real health hazard and we’re just trying to get housing to shift the way they think about. A house, going forward and we’ve had some success with that de depending on the regions.

And we do try to take the housing offices with us when we go and visit the homes so that they can see what we do and how important it is to have a functional bathroom and laundry rather than just have, you know, electricity that’s not gonna electrocute you. So it’s a real. Long journey, that one. Um, where I think we are getting [00:22:00] somewhere, but I guess that’s our biggest challenge moving forward as well as trying to make this project sustainable, which is why we’re trying to impart skills in community. Uh, because I think our funding probably will only last another two or three years. And then I think, we’ll, we’ll have to step back and see how it goes.

Shane: What. I find ironic about what you’re just describing though is, um, towers cheap housing. I know how bad it is just to get a tradie and I’m in the western ci uh, suburbs of Sydney, and you go, let alone trying to get a tradie to go hundreds of, of miles into nowhere just to do some basic plumbing.

Yes, they can do a whole stack while they’re there, but it’s expensive. Um, and yet the joke is towels are cheap, soap’s cheap. but I guess as a, if, if you were a politician, um, the last thing that you want to do is make a, a public announcement that we are now gonna give away, [00:23:00] uh, soap and towels to an indigenous community.

Um, which is the cheapest and most effective thing we can do to improve their health, but then has the implication of, oh, wait a minute, they’re dirty and smelly. So it just, it, it’s just ironic that the cheapest and simplest thing we can do, just give it away, comes with an implication of, oh, wait a minute, that’s bad.

But if the same politician stood up and said, we are about to spend $500 million on improving housing in remote communities, then they’d be going, Hey, that, that’s absolutely amazing. You’re doing something. So, um, not saying that we don’t have to do the, the latter, but. Giving away towels and, and soap is it’s a no brainer.

And yet it has that stigma attached, uh, to it. Um,

Melissa: Yeah, I

Shane: so.

Melissa: sorry. I guess that just shows that environmental health is not just about a setting, you know, having a functional home [00:24:00] where the taps work, but it’s what people do in that home, and if they don’t have soap, they can’t wash their hands with soap. If they don’t have a towel, they can’t dry themselves, or they’ll share a towel or they’ll pick one up off the ground. So it’s that combination of having. The environment, which is the house, and you know, behavior change, which is enabling people to be able to wash, including their bed linen, so that you’ve got that whole comprehensive approach. And I guess that’s what we’ve been trying to create in the ending Tacoma project.

Shane: And thank you very much for the soundbite. That’s now going to be the extract as to what the episode’s all about. but it, it’s, right. It really just comes down to, uh. Yeah, I make the comment that we don’t have trama in the cities because these are all the things that we now take for granted. Um, even in a welfare class in the cities, we still have this concept of, of these are now the basics, um, and we just have to transfer that concept, uh, into these remote communities.

Um, and [00:25:00] once you break the cycle, you can remove the communities from the. Um, the at risk sort of, um, list. Um, and I assume it’s, it’s also the case that, you know, kids then step into preschool, into primary school, into Yeah, school and, and then spread it so you know, each child you can remove outta that is breaking the cycle in the community.

Um, and yet it’s, it’s purely our grassroots. Break it in the house and you can break it in the community. so a couple years left. Is that good or bad news being told, Hey, we are looking at success here. And the problem is as you have less and less cases, then um, you’re going, okay, that’s, you know, time to move on.

Um, are you happy or sad that three years.

Melissa: I guess all good things come to an end, but I, I also feel that the last seven years, although we’ve been funded. By Trama, we’ve been dealing with a whole range [00:26:00] of other environmental health related diseases in the homes like scabies and otitis media, all of those issues that are related to basic hygiene. And so we would hope for one day that the politicians funding that isn’t. Body par part related or disease related. So for example, RHD, rheumatic heart disease is a really terrible disease, but the risk factors are the same for trama. sores and scabies are terrible and they’re normalized. In aboriginal communities, they’re everywhere.

But the risk factors are the same. If they get, the politicians could just break down this silo of diseases or body parts and just give out the funding. For a pro. I’m not saying that maybe I feel our program’s pretty holistic and I’d like to think we could just prevent all of those diseases, but you know, a bigger scale up our program across the state, across the whole top of Australia, really, which is where it’s needed. And then we might see some, you know, some change, some long term [00:27:00] sustainable change. That’s what I would really, if I was a politician, that’s what I would do.

Shane: how much of a problem is it where you’ve just got isolated communities that really don’t have, um, a, a purpose? Um, and so just things like basic hygiene just falls by the wayside.

So, you know, it’s one thing to educate and equip, but are there communities out there that just are resistant to improvement because of the larger, Factors involved?

Melissa: Most of the communities we work with are pretty happy to see us come into town that they know what we’re about. I think they’re pretty keen to get their plumbing fixed. Most families want the best for their kids. Uh, it’s just really challenging sometimes to be able to provide that. So I, I don’t. Think, you know, there’s lots of challenges. The lack of water is a big one. Uh, the reason we don’t have Tacoma on the coast is because the kids go swimming and so their eyes get washed. [00:28:00] Um, whereas in the desert, there’s no water. So there’s lots of challenges. But I think most communities are pretty, they, you know, that they live on country and they do have quite a strong purpose of cultural, you know, relationships with the land and, and their kin.

And I think. really just want the best for their families, but the challenges are quite overwhelming.

Shane: Yes. Cool. So how many years have you been going now?

Melissa: Uh, this will be our eighth, next year will be our eighth year. So yeah, seven years we’ve been doing this project.

Shane: Okay. And are you now? Still building up momentum or winding down. Whereabouts are you in the grand scheme of things?

Melissa: It’s sort of, well, we know it’s coming to an end, so we’re looking at, you know, how do we gift our washer dryer trailers to Aboriginal owned community organizations that we know will value them and look after them. So that’s one discussion on the table. We’re continuing to upskill the environmental health practitioners who live and [00:29:00] work in remote communities so that when we are no longer here and we organize these.

Blitzes where we mentor them, um, that they have the skills to be able to continue, or if the workforce turns over, they’ve got someone there that can provide those skills. So we are looking at, you know, how we can create the sustainability. And we always have, it’s just that it’s, I guess we’re getting to the point.

And so, we’re not sure what’s gonna happen with the hygiene kits. Uh. And, you know, just if Rotary continue to fund them, who would actually distribute

Shane: I.

Melissa: Uh, ‘ cause there is a lot of reporting back to Rotary. We don’t, we want them to know for sure that their hygiene kits are getting to those that need them most.

And so we do as much as we can to provide that information back to them. But yeah, I guess we are looking at sustainability going to the future and how we can keep this project going without the, you know, the organizing and facilitating from purpose.

Shane: we’ll wrap up in a second, but what’s all the take home messages for environmental health officers listening to the podcast?[00:30:00]

Melissa: Look, environmental health has been a fantastic foundation for me. It’s springboarded me into a whole range of careers, and it’s interesting that at the end of my career, I’ve come right back to the basics of environmental health, which is. Personal hygiene and health in the home. I think that environmental health officers and practitioners should always remember that, uh, prevention is better than cure.

And that’s our core business. And although we often can’t see the effects because prevention is invisible and difficult to measure, uh, we should never lose sight of, of why we decided to study this, you know, this area and, and the good things that will, that can come from it.

Shane: That’s absolutely amazing, and thank you very, very much for your, your awesome work. if anyone does want to have information, um, contact you or, uh. Do a Google search. Um, but what resources do you offer? How can you, if an environmental health officer needs any [00:31:00] help, what can they do?

Melissa: So they can hop on our website, um, which is, uh. The Public Health Advocacy Institute of West Australia’s website, I can give you those details. We have a YouTube account, uh, just gimme an email at um m Stoneham at curtin edu au.

Shane: and if you’ve got a billion dollars sitting there that you wanna donate, we’ve got a really good cause for it. Uh, if you are a Rotarian, just, um, thank you. Very much for the awesome work. Um, and a couple of incidental sort of messages that I picked up on is, uh, you’re part of a community. So yeah, step back into the community and ask for help.

Uh, and it’s about education. It’s about the grassroots, um, changing, uh, individual lives. So all that sort of stuff that you can do day in, day out. Is, is worth its weight in gold to the [00:32:00] point where we now just in cities don’t even think about, um, the, the problems of trama because we’ve now built up that base level of, of knowledge and um, and that’s basically environmental health.

So the more and more it’s in the house, the less you have to do. Out, um, out and about. So thank you very much and all the best in the, um, in the future. Thank you, Melissa.

Melissa: Thank you, Shane. It’s been a pleasure.