Working within NSW correctional centres, a dynamic duo is making remarkable strides in hepatitis C testing, treatment, and education. Meet Nicole and Amanda, the dedicated nurses leading the Justice Health NSW Hepatitis C Testing Squad, transforming healthcare delivery in these unique settings.
CAPTION: Amanda Cochrane and Nicole Kesby leading a team at Bathurst Correctional Centre in June 2024. Justice Health NSW invite Hep NSW peer workers to provide people in corrections with access to harm reduction, liver health and Hepatitis C education.
A Passion for Public Health
Both Nicole and Amanda discovered their calling in public health through different paths. Nicole’s journey began working on the COVID-19 hotline, which ignited her passion for population health. Amanda’s route was through a research position with the PIVOT study, where she was introduced to point-of-care testing and saw firsthand how it could improve the care cascade for people in custody living with hepatitis C.
“This was my introduction to public health, and I found I loved it!” Amanda recalls.
Making a Difference Where It Matters
What keeps these dedicated professionals committed to their work? For Nicole, it is simple: “The work we do is meaningful, makes a difference in people’s lives, has positive outcomes, and has a goal for elimination, which is definitely worth fighting for.”
Amanda adds, “I love working with the team and get satisfaction out of identifying people who need our help in an environment where patients have no control over anything. This role allows me to give patients some control by helping them make informed decisions about their health.”
CAPTION: Hepatitis C testing at Bathurst Correctional Centre, June 2024.
The Game-Changing Impact of Point-of-Care Testing
Q: How has point-of-care testing transformed hepatitis C care in correctional facilities?
A: “Point-of-care testing has done many things for our patient population, including better access, faster results and shorter time to treatment and cure,” Nicole explains. “However, it has also done much to improve understanding of what HCV is, how it is contracted, and how to improve harm minimisation, which has paved the way for destigmatisation.”
Amanda enthusiastically agrees: “I have learned that a GeneXpert unit is the greatest thing since the invention of Penicillin! For our patient cohort to get a result within a day or two is mind-blowing. It allows them to get treated in custody without fear of stigma that some say stops them from seeking treatment in the community.”
The quick turnaround time is especially crucial in corrections where patient movements due to court appearances, transfers, or release can interrupt traditional testing and treatment pathways.
Lessons Learned and Advice for Others
Q: What advice would help others implementing point-of-care testing?
A: Nicole is unequivocal: “Do not hesitate! Point-of-care testing is the future for HCV and many communicable and preventable diseases.”
Amanda emphasises collaboration: “Get as much help from key stakeholders as you can. Organisations from Hepatitis NSW, NUAA, and, in our case, Corrective Services NSW. Working collaboratively allows us to reach more people so we can inform, test, and treat promptly.”
Nicole shares one key insight: “We cannot underestimate the value of collaboration and partnering with Corrective Services NSW for support.”
Partners in Care: The Power of Teamwork
CAPTION: Amanda Cochrane and Nicole Kesby leading a team at Bathurst Correctional Centre in June 2024. Justice Health NSW invite Hep NSW peer workers to provide people in corrections with access to harm reduction, liver health and Hepatitis C education.
What makes this duo so effective is their complementary strengths. Nicole describes Amanda as “knowledgeable, an excellent problem solver, sounding board, easy-going (except when driving), and passionate. Most of all, she is such a hard worker with a patient-focused mindset.”
Amanda says of Nicole: “Nicole brings a fabulous organisational brain, great work ethic, humour to a sometimes-repetitive role, and the ability to listen empathetically daily.”
They’ve developed such a strong working relationship that Amanda jokes Nicole could never be without “me, of course!” at work. “We work so well together and can almost read each other’s thoughts. In many ways, we are opposites, but I think that has worked in our favour as we divide and conquer to get the job done from data entry, organising trips, quality control, testing, follow-up... the list goes on.”
Their teamwork extends beyond their partnership. Hepatitis NSW, NUAA, and Corrective Services NSW often support Amanda and Nicole. During high-intensity testing campaigns, peer workers from Hep NSW provide vital education to people in custody about harm reduction, liver health, and hepatitis C, creating a comprehensive approach that combines testing, treatment, and prevention through education.
Making a Lasting Impact
Through their dedication and the implementation of point-of-care testing, Nicole and Amanda are not just identifying and treating hepatitis C—they’re changing lives and working toward elimination goals in these important healthcare settings.
Their work exemplifies how innovative approaches like point-of-care testing, combined with passionate healthcare professionals, can reach priority populations effectively. NSW correctional facilities have become sites of healthcare innovation where significant strides toward hepatitis C elimination are happening daily, demonstrating how strategic public health initiatives can succeed across diverse healthcare environments.