For people living in metro areas, a broken hot water system or washing machine is a nuisance. But it can usually be sorted by a phone call for a same-day repair or a quick trip to the hardware store.

In remote communities, the same repair is slowed by distance and lack of services, often taking weeks or months to fix. When families can’t easily wash themselves or their clothes, the risk of infections, including skin infections, rises.

Compared with non-Indigenous Australians, Aboriginal people are 2.3 times more likely to be hospitalised and 1.7 times more likely to die from illnesses linked to poor environmental conditions.

Illnesses such as acute rheumatic fever and rheumatic heart disease – often driven by untreated skin sores and sore throats – remain common in remote communities. These diseases were once widespread among all Australian children, but have largely disappeared elsewhere thanks to improvements in housing and services.

There’s been plenty of public discussion about remote housing but the voices of people living with these conditions is usually missing.

To inform this discussion, we yarned with more than 200 people over four years about housing, infrastructure and the services they rely on to stay healthy across nine communities in the Kimberley region of Western Australia. Our results are published in Health & Place.

Long waits for repairs

People told us they had no choice but to live in homes too small for their families. This pushed plumbing, hot water and laundries past breaking point.

Once broken, they were unable to be repaired until the next service trip, often months later. Many told us they relied on relatives or neighbours while their own taps, showers or washers sat waiting for repair.

People told us they knew the environment was making them sick when basic services failed, but they were limited in what they could do about it.

Local Aboriginal environmental health teams – praised by community and able to handle small jobs – were constrained by narrow remits, funding limits and bureaucracy.

Those living in public housing also faced a convoluted process in order to achieve repairs.

One local woman taught herself to fix a broken industrial washing machine behind the art centre so Elders and mums could wash their clothes and linen. When we asked why, she said:

It was for the old ladies. I wanted to help make sure they felt clean.

She has run this unofficial community laundromat for a decade.

What’s causing this?

People framed inadequate housing maintenance and household “environmental health” in remote Aboriginal communities as the cumulative result of successive state and federal policies that have failed to deliver.

Decades of policy fragmentation have normalised substandard environmental health in the home. None of this was new to the people living it. Their stories have been consistently ignored.

These housing and inadequate environmental conditions sit within a longer history of colonisation: dispossession, mission and pastoral control, and later public housing regimes that centralised asset ownership and decision-making away from Aboriginal communities.

When families can’t access secure land and home ownership, they become dependent on government housing systems, with limited ability to assert their rights. Economic exclusion compounds this: distance, wet-season logistics and chronic under-investment drive high costs and long delays.

Homes have often been built without genuine community consultation, leaving dwellings that don’t fit local family structures, climate or daily life.

Closing the Gap commits all governments to improve housing. To get there, however, consultation is needed with remote Aboriginal communities themselves, as well as policymakers and experts, including those in preventive health. This should happen before any build or upgrade.

Too often consultation is skipped or rushed to save time and costs, resulting in houses that fail their residents and requiring frequent repair.

What’s the solution?

Addressing these inequities requires clear, measurable standards and accountable delivery:

• decision-making rights for residents and local communities
• locally based maintenance with guaranteed response times and transparent reporting
• sustained funding for new builds, maintenance and remediation
• community-led housing design that tackles structural crowding and the realities of remoteness and climate change.

Most importantly, there should be increased reliance on local service providers operating in these regions. These teams already have community trust and should be the first call, not the last.

As well as housing, health care should also be co-designed with communities to include a strong focus on prevention, primary health care, community engagement and capacity-building for local health services. This also requires greater funding and support.

Ultimately, listening to communities is the most important way forward. The culture and uniqueness of remote Aboriginal communities thrive despite challenges, but people shouldn’t have to contend with conditions that wouldn’t be accepted elsewhere in Australia.

As a local Elder emphasised during our conversations:

You need to be healthy, kids need to be healthy. We don’t want them to get sick, they’re the future, the future of our communities.

Stephanie Enkel, Postdoctoral Researcher, The Kids Research Institute Australia; Asha Bowen, Team Lead, Healthy Skin and ARF Prevention, The Kids Research Institute Australia; Hannah M.M. Thomas, Postdoctoral Research Fellow, Skin Health, The Kids Research Institute Australia, and Rachel Burgess, Social Scientist and Aboriginal Senior Research Fellow, The Kids Research Institute Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

So far in 2025 (as of May 1), 70 cases of measles have been notified in Australia, with all states and territories except Tasmania and the Australian Capital Territory having recorded at least one case. Most infections have occurred in New South Wales, Victoria and Western Australia.

We’ve already surpassed the total number of cases recorded in all of 2023 (26 cases) and 2024 (57 cases).

Measles outbreaks are currently occurring in every region of the world. Most Australian cases are diagnosed in travellers returning from overseas, including popular holiday destinations in Southeast Asia.

But although Australia eliminated local transmission of measles in 2014, recently we’ve seen measles infections once again in Australians who haven’t been overseas. In other words, the virus has been transmitted in the community.

So with measles health alerts and news reports popping up often, what do you need to know about measles? We’ve collated a list of commonly Googled questions about the virus and the vaccine.

1. What is measles?

Measles is one of the most contagious diseases known to affect humans. In fact, every person with measles can infect 12 to 18 others who are not immune. The measles virus can survive in the air for two hours, so people can inhale the virus even after an infected person has left the room.

Measles predominantly affects children and those with weaker immune systems. Up to four in ten people with measles will need to go to hospital, and up to three in 1,000 people who get measles will die.

In 2023, there were more than 100,000 deaths from measles around the world.

2. What are the symptoms of measles?

The signs and symptoms of measles usually start 7–14 days after exposure to the virus, and include rash, fever, a runny nose, cough and conjunctivitis. The rash usually starts on the face or neck, and spreads over three days to eventually reach the hands and feet. On darker skin, the rash may be harder to see.

Complications from measles are common, and include ear infections, encephalitis (swelling of the brain), blindness and breathing problems or pneumonia. These complications are more likely in children.

Pregnant women are also at greater risk of serious complications, and measles can also cause preterm labour and stillbirth.

Even in people who recover from measles, a rare (and often fatal) brain condition can occur many years later, called subacute sclerosing panencephalitis.

3. What’s the difference between measles and chickenpox?

Measles and chickenpox are caused by different viruses, although both commonly affect children, and vaccines can prevent both diseases. Chickenpox is caused by the varicella zoster virus, which is also transmitted through the air, and can cause fever, rash and rare (yet serious) complications.

The chickenpox rash is different to the rash seen in measles. It often starts on the chest or back, appearing first as separate red bumps that evolve into fluid-filled blisters, called vesicles. Chickenpox can also appear later in life as shingles.

4. Can you get measles twice?

The simple answer is no. If you contract measles, you should have lifelong immunity afterwards.

In Australia, people born before 1966 would have most likely been infected with measles, because the vaccine wasn’t available to them as children. They are therefore protected from future infection.

Measles infection however can reduce the immune system’s ability to recognise infections it has previously encountered, leaving people vulnerable to many of the infections to which they previously had immunity. Vaccination can protect against this.

5. What is the measles vaccine, and at what age do you get it?

The measles vaccine contains a live but weakened version of the measles virus. In Australia, measles vaccinations are given as part of a combination vaccine that contains the measles virus alongside the mumps and rubella viruses (the MMR vaccine), and the chickenpox virus (MMRV).

Under the national immunisation program, children in Australia receive measles vaccines at 12 months (MMR) and 18 months of age (MMRV). In other countries, the age of vaccination may vary – but at least two doses are always needed for optimal immunity.

Measles vaccines can be given earlier than 12 months, from as early as six months, to protect infants who may be at higher risk of exposure to the virus (such as those travelling overseas). Infants who receive an early dose of the measles vaccine still receive the usual two recommended doses at 12 and 18 months old.

Australians born between 1966 and 1994 (those aged roughly 20–60) are considered to be at greater risk of measles, as the second dose was only recommended from November 1992. Australia is seeing breakthrough measles infections in this age group.

An additional measles vaccine can be given to these adults at any time. It’s safe to get an extra dose even if you have been vaccinated before. If you are unsure if you need one, talk to your GP who may check your measles immunity (or immunisation record, if applicable) before vaccinating.

However, as the measles vaccine is a live vaccine, it’s not safe to give to people with weakened immune systems (due to certain medical conditions) or pregnant women. It’s therefore important that healthy, eligible people receive the measles vaccine to protect themselves and our vulnerable population.

6. How long does a measles vaccine last?

The measles vaccine is one of the most effective vaccines we have. After two doses, about 99% of people will be protected against measles for life.

And the measles vaccine not only protects you from disease. It also stops you from transmitting the virus to others.

Phoebe Williams, Paediatrician & Infectious Diseases Physician; Senior Lecturer & NHMRC Fellow, Faculty of Medicine, University of Sydney and Archana Koirala, Paediatrician and Infectious Diseases Specialist; Clinical Researcher, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.