Talking about sex education
The idea of a Rural Sexual Health Nurse Practitioner in the Goulburn Valley region was first conceived of in 2007, when doctors from Training Victoria performed a review of sexual health services in Victoria.
“Needless to say, they determined they were very metrocentric,” said Suzanne Wallis, who has been in the role since it officially started in December 2011. “One of the recommendations was that there should be a Nurse Practitioner in each region.”
The role was designed as a resource for capacity building in bringing expert clinical services into regional Victoria. The Centre for Excellence in Rural Sexual Health (CERSH) partnered with GV Health in 2016 to make it an ongoing position.
“It’s an interesting position,” said Carolynne Winbanks, Program Manager of Community Health. “It’s an interesting position, really varied between capacity building, education and seeing clients.”
Ms Wallis works with a range of organisations to help educate young people to make better choices in relation to their sexual and emotional health.
“Nurses do this very well, particularly if talking about adolescent sexual health – they engage better in that space,” said Ms Wallis. “We’ve been delivering programs on respectful relationships to students in year nine for the last few years, which gives them the building blocks.”
The program, ‘Taking Care Of Me’, educates secondary school students on six main topics, which include STIs and blood borne viruses, putting on a condom, sex and the law and respectful relationships. The program was developed in conjunction with The Bridge, Family Care, Noise Network and schools across the Hume region.
Community leaders, including police liaison officers, are part of the presentation to students, who are deeply engaged and keen for the program to continue.
“It’s about helping young people to make good choices – we know they’ll be risk takers, but we want to mitigate harm where possible,” said Ms Wallis. “What I’ve found is it’s not necessarily a message for now, but maybe in a few years’ time when someone may need to make informed informed decisions to make it a good experience.”
Ms Wallis says sexual health is more than educating people about sexually transmitted infections (STIs).
“It’s also a sense of wellbeing, being able to express who you are in a safe environment.”
The Meryula Clinic frames its work around the World Health Organisation (WHO) definition of sexual health. The WHO website states:
“Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.”
Providing sexual and reproductive health services in a rural setting allows clinicians to be more targeted to specific community needs, but also means that opportunities must be created to allow people to explore educational opportunities for themselves. Access to many services can be limited – for example, an individual may live in a town with one pharmacy who may not dispense the morning after pill.
“It can be very fraught, especially for young people and marginalised groups like sex workers,” said Ms Wallis. “Inadvertent disclosure is a big risk in a small town.”
The clinic also works with multicultural and refugee groups in the areas of women’s empowerment and sexual health. It also offers the services of three forensic nurses in the field of assessing cases of reported sexual assault.
“Often the victim is lost to follow up,” said Ms Wallis. “They don’t want to go their GP owing to privacy concerns, so this service allows them to get some power back and facilitate their healing journey.”