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During 1994During -1995 health conditions of about 13 760 persons in 155 remote and rural Aboriginal communities in 20 local shires in Western Australia (WA) were surveyed. A semiquantitative questionnaire sought data about the communities and their services, including water supplies, power, sanitation and disposal of solid and liquid waste; a separate section dealt with conditions of individual dwellings. Data were recorded by experienced local workers. Thirty-five communities considered to have the worst conditions were evaluated on-site by a team of senior personnel in mid-1995. Environmental health problems were prevalent and often serious: over one-third of the communities had water supply or sanitation problems and 70 per cent had housing problems, with overcrowding and substandard housing being commonplace. Thirty-six per cent had difficulties with waste water disposal, 37 per cent had no rubbish disposal, and in others, the methods of disposal were often inadequate; pests were problems in 44 per cent of communities and the hygiene and maintenance of communal toilets was unacceptable in 25 per cent. Seventy-two per cent had no on-site environmental health worker and 44 per cent had no on-site or visiting medical, nursing or health worker personnel. An action plan was developed and the highest-priority communities were targeted in a program of major works (for example, housing, drainage and sewerage) and minor works, which have been commenced. The remote-area environmental health workers' program is being expanded. Increased intersectoral collaboration and enhanced community involvement in decision making have occurred as a result of this work. (Aust N 2

During 1994-1995 environmental health conditions of about 13 760 persons in 155 remote and rural Aboriginal communities in 20 local shires in Western Australia (WA) were surveyed. A semiquantitative questionnaire sought data about the communities and their services, including water supplies, power, sanitation and disposal of solid and liquid waste; a separate section dealt with conditions of individual dwellings. Data were recorded by experienced local workers. Thirty-five communities considered to have the worst conditions were evaluated on-site by a team of senior personnel in mid-1995. Environmental health problems were prevalent and often serious: over one-third of the communities had water supply or sanitation problems and 70 per cent had housing problems, with overcrowding and substandard housing being commonplace. Thirty-six per cent had difficulties with waste water disposal, 37 per cent had no rubbish disposal, and in others, the methods of disposal were often inadequate; pests were problems in 44 per cent of communities and the hygiene and maintenance of communal toilets was unacceptable in 25 per cent. Seventy-two per cent had no on-site environmental health worker and 44 per cent had no on-site or visiting medical, nursing or health worker personnel. An action plan was developed and the highest-priority communities were targeted in a program of major works (for example, housing, drainage and sewerage) and minor works, which have been commenced. The remote-area environmental health workers' program is being expanded. Increased intersectoral collaboration and enhanced community involvement in decision making have occurred as a result of this work. (Aust N 2

Equity in health care and institutional trust: a communitarian viewEqüidade na assistência à saúde e confi ança institucional: uma perspectiva comunitária

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