PRODUCED SEPTEMBER 1995
General Overview Back to Summary
I felt this conference was particularly useful and would have been a great benefit for anyone attending. It is a pity that more of our Centre's Staff were not able to attend. This Conference unlike Newcastle was much more hands on the number of sessions available and the time frames were well worked out this was a credit to the organisers. The pace and times allowed gave everyone a chance to pursue their particular interest in much more detail and get hot debate while everything was still fresh in their minds, leading to not so much a sit and listen (which is also important) but getting involved and bouncing ideas. This gave me a chance to not only learn, but also to give from my experience, in a situation where everyone gains.
Initial Feelings and Thoughts Back to Summary
To keep alert and take in a lot of information over three days requires a very interesting and lively event, I can say without any doubt this was one such event. I went with the idea that I would take notes as the conference proceeded, after talking to the organisers and learning what they intended, I decided it was more beneficial to listen and participate with my full attention being focused on the moment. I have received a draft of the conference proceedings using that and e-mail, plus of course memory. I have put together this paper for your information and hope that I have done justice to your confidence in me, and the people who attended the Trail Conference.
Summaries of outcomes from my perspective Back to Summary
The theme of the Conference was the Community. Be it from a personal or professional perspective. The one thing that stood out in my mind was the acceptance by all involved, that it is the people who are directly affected by this problem, who are the ones who need to be more directly involved, in deciding the acceptable outcomes. They are the ones who own the problem and therefore they should have a strong voice in deciding with the co-operation of professional people, on how to deal with it. I feel there has been a steep learning curve for a lot of departments and people ie: EPA in America, scientists and health professionals as well as the community about the need for a much more consultative approach in dealing with particular problems, be it " Lead " or some other problem. It is with knowledge and a realistic voice where all the cards are laid on the table that people give of their best.
THE HIDDEN AGENDA Back to Summary
Unfortunately for a lot of Departments here or oversees, there is a basic mistrust by the general public of Government and the HIDDEN AGENDA. Which in the past and now, is the phrase used by some to discredit those who have strong feelings, toward a particular subject. Without realising that the majority of people do not get involved just for the sake of it, but because of it. For genuine reasons and yes I would say that as in all things none of us would get involved, if we didn't have some sort of AGENDA or barrow to push this is not a bad thing. As we get involved we see the bigger picture and hopefully are able to put things into perspective. I hope from what I have learned from listening and talking that there is an acceptance from all that no matter what the concern, it is important! But in the end we accept the majority decision and get on with the job.
GETTING ON WITH THE JOB Back to Summary
As important as it is to get scientific data and prove that what we are doing works, it is also important to get on with the job and make some well educated guesses. Not to always wait for proven results before taking the next step, to incorporate data collection as part of the remediation process, not because of it. In the end we must be prepared to accept that everything we do is not just a trial project. If we remediate a certain area and can see no significant change in children's levels, does that mean it wasn't effective or has it added to the overall betterment of the environment, or in fact had an effect that can't be measured. A social benefit that may create a domino type reaction, where people once they see something done continue to improve on it.
EARLIER INTERVENTION Back to Summary
An area of concern for me that I brought up at the Conference was the need for earlier intervention in younger children 6 months on, I feel there is a bigger push needed on prevention rather than cure. That we don't accept, present levels of concern. That action levels may need to be different depending on age, example a child at 6 months with a level of say 5, may in fact be in great danger of being overlooked until at least 18 months. When in fact this is probably the most vulnerable period for children as they are most inclined to hand to mouth at these ages, and are most likely to be in close contact with the floor and ground. My concerns are that younger children may in fact be more susceptible to damage (at lower levels), than perhaps at an older age, for example 2 plus. This was an Interesting session and was the subject of much discussion, with lots of unknowns and variables brought into play, in the end I felt justified in raising it and was rewarded with a particular summary suggesting this was an area that needed looking into much more closely.
BACKGROUND LEVELS Back to Summary
To continue on from my comments on earlier intervention, it is important that we find out what the background level for lead in children is in Broken Hill so as to use this level as a guide to what is the action level for our children.
AUSTRALIAN
NATIONAL HEALTH & MEDICAL RESEARCH COUNCIL (NHMRC)
The Australian NHMRC guidelines are as far as I am concerned only to be accepted as a guideline and are by no means what communities should accept as the correct or anywhere near correct action.
In Trail for instance they have an action level of above >10ug/dL for children under one year, rather than >15ug/dL as they have a background level of 10ug/dL in children under one year at this time, that seems an appropriate level to concentrate on. Until such time as it is shown that they have lowered that background level significantly, it would be hard, if not impossible, to deal with children in a case management style due to sheer numbers.
But in other communities such as in Butte, their average background level is about 3ug/dL. This is a definite case where waiting until the child's level reached >15ug/dL as in our case, would be wrong and an unnecessary risk for those particular children at that site.
EVERY COMMUNITY IS DIFFERENT Back to Summary
We have to look at each community as a separate entity, one that has certain specifics. The need to look at the population and culture, and understand what it is about that area that makes it unique, has to be the main deciding factor on what action needs to be taken.
SCIENTIFIC DATA Back to Summary
Dare I say it, the need for scientific data at this point is absolutely vital. It is only with testing and monitoring that the appropriate evidence and facts can be gleaned. The need for information at the beginning of any project is absolutely vital in understanding the problem and of course in deciding on appropriate actions that need to be taken.
What the level of action is in Broken Hill I don't know at this time. This will become more obvious when we get more statistics and should be available soon. But it is most important that all communities understand and react to their particular set of circumstances, not accept what is at the moment the Australian NHMRC recommendations as correct in all cases.
ACTION LEVEL TO HIGH AT THE MOMENT Back to Summary
In fact I would go as far as to say that the level of action is way to high and does not allow for a quick enough reaction time, especially in young children under one year of age. The important thing is to gain this information in a manner that doesn't slow down the project and most importantly that the children that need help are helped as soon as is possible.
HOW WE ATTACKED THE PROBLEM WHERE WE HAVE GONE WRONG
Our biggest mistake from my point of view, is the fact that we have really only attacked the lead problem in Broken Hill from one front. This has been up to this point very much dealing with the immediate obvious problem, that is children with high levels. Our actions have tended to be the obvious ones that of remediating that child's personal environment, which of course is the correct short term answer, and it has so far shown considerable success. But it has also been a shortsighted answer that could have and should have been far more proactive on many fronts.
REASONS WHY? HOW THINGS CAN BE IMPROVED FOR US AND FOR OTHER COMMUNITIES Back to Summary
Unfortunately for all of us there is only limited money and staff. There wasn't enough consideration given to all points of view in the short-term submission. As a result, our priorities have been focused mainly in one direction whereas, we should have been looking at and dealing with a far greater range of actions, with the same earnest as immediate remediation of a particular environment of a child with a high blood level. This has shown up in our lack of action on the total environmental front. Although under the circumstances we have achieved some small steps, it is by far a long way from satisfactory.
FUTURE EFFORTS Back to Summary
I would hope that if nothing else future efforts, in not only ours but also other communities, will be focused on total remediation of an area, not just short term quick fix solutions. That will tend to make a problem look as if it has been fixed, because of figures that show a fall in blood lead levels but will, I'm sure, if nothing else is done, slowly but surely rise again. This would be criminal and show a total lack of foresight. I can see no reason to wait years to deal with a problem, when a lot of the solutions are achievable in the short term. Because of the planning required to achieve some of these solutions, it is imperative to begin as soon as is possible, not wait and treat it as something for the long term, therefore putting it on the back burner. Use the experience gained from all over the world. In the end the solutions are very similar the task is to adjust to your particular set of circumstances.
YEARS OF DEALING WITH HEALTH PROBLEMS NOT JUST LEAD
If we have learnt nothing else from years of work by many professional and community people in dealing with lead and other health problems, it doesn't go away. It is a continual ongoing problem that will reappear with apathy and time.
ONGOING MONITORING AND EDUCATION Back to Summary
We have to continue to monitor and educate, along with more intensive total remediation. Our objective should be to make the Broken Hill environment, and other areas with these problems, as safe as is practicable. This will require time and money and most of all dedication and understanding by all those involved.
As has been shown in many oversees areas, the need to get the community to take ownership is one of the biggest problems. We cannot expect it all to be done for us, so far we as a community have still to learn that lesson. It is not enough to complain that things are not being done. We have to slowly but surely, change people's understanding of the problem, especially those who have the opinion that we don't have a problem, to one where they want to get involved and understand and do something about it.
ORGANISATIONS IN BROKEN HILL AND OTHER COMMUNITIES
There are many organisations in Broken Hill, as there are in most communities, who wish to do more for the community, but often don't have the necessary information or knowledge.
LEAD CENTRE'S ROLE NOW AND IN THE FUTURE Back to Summary
Part of the Broken Hill Environmental Lead Centre's efforts should be to encourage just that sort of action. To deal with the lead problem it has to be a community effort.
THE NEED FOR RESOURCES AND INFORMATION - THE LONG TERM SUBMISSION Back to Summary
Of course this cannot be achieved without resources and as has been shown by the Greening Project, there are people and organisations that want to do more. It is absolutely vital that in the Long-Term Submission we ask for more money to be made available to the program, so groups can achieve projects. This will help to give ownership and pride.
EDUCATION - SITE SPECIFIC Back to Summary
It was also very obvious, from all the experts who talked at the conference and at workshops, that it is absolutely vital that education material be very site specific, and that all parts of the community be represented and consulted. Putting together information that will appeal to that particular community and culture, and so as not to alienate particular groups, and with their input, you are more likely to get the reaction you want and need.
INSTITUTIONALISING THE PROGRAM Back to Summary
Council must play an important part in the future long term health of the population of Broken Hill. It will be necessary for the Program to be continued by the Stakeholders of the community and there will always be a need for ongoing Education, Monitoring & Maintenance. It will never come to a point where the Lead Problem in Broken Hill will go away. We can only hope that with time and good management, we will get to the stage where it is under control. This will require local laws and management so that proper protocols are set in place to minimise or completely stop re-contamination of any area of Broken Hill.
For example it may mean that no soil can be removed without permission and the appropriate precautions be taken to stop the likelihood of contaminating, not only that particular area, but also neighbouring sites. This may seem extreme but I feel it will be necessary for the long term. We must never get to the stage where we think everything is alright. That's when we will stop being aware and it will all start again.
Since arriving home I have had time to reflect on the trip. I am pleased to say I have been given the strength to carry on and feel vindicated in my views, and justified in my position as Community Representative. The need to persevere, not to let myself become complacent. I have met many interesting people in Canada and America, the only difference is the way we speak, the problems are the same, the concerns are just as great. We all want the same, the best that is possible for our children and therefore the community.
CONTACTS & FRIENDSHIP Back to Summary
I am now in contact with David L Johnson ( Syracuse USA ). This fellow is a scientist who has the unenviable position of "just putting together a Task Force" and for some unknown reason feels I have something useful to say. Also I feel I have made some strong and lasting friends in Trail. It is great to be able contact and conference with people that you have met, a good way of keeping up with the latest ideas.
SOMETHING FOR THE FUTURE Back to Summary
The people of Broken Hill can be justly proud of the achievements to date of the Environmental Lead Centre. And, all the people who have put in the time and effort - we have achieved what has taken others a lot longer to achieve, considering money and time constraints. I felt justly proud to talk to others about Broken Hill and hope that one day, we will hold a conference here, so others can see as well, our situation and the difficulties we have overcome.
I'll finish by saying, if there was a theme from this conference then it would most easily be phrased by saying:
KNOWLEDGE IS POWER, POWER IS THE PEOPLE INVOLVED IN OPEN, FRANK AND HONEST DISCUSSION.
Thank you once again for letting me be part of this conference.
Keith Buxton Page 22
January 9, 2003
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