Read, who has also worked as a nurse in poor areas of London, says the teenagers from Werribee and Hoppers Crossing may not have spent much time in a family unit or school community "so they have basic gaps in their health care and knowledge".

The weekly classes – sexual health, mental health and basic physical health advice and check-ups – are held in a place called the Link Centre which hosts kids who should be in school but aren't. No tier of government pays for the centre. Everything comes from donations.

It is a classroom but also a defacto medical clinic that illustrates the depths of Victoria's chronic health crisis.

The City of Wyndham covers Werribee, Point Cook and parts of Laverton, Hoppers Crossing, Wyndhamvale and also new suburbs Tarneit, Truganina, Williams Landing and Manor Lakes. On the Social Health Atlas of Australia, created by the University of Adelaide, it ranks as the sickest place in Victoria.

The list of illnesses and diseases at extraordinarily high levels is awful: heart disease and diabetes, cancer, mental health, bad teeth, obesity, asthma.

All of these are at significantly higher levels than the state average. Type 2 diabetes is rising fast – health data shows 6.5 Wyndham people are diagnosed every week. Migrant and refugee health is also enormously difficult to manage in an area which is a magnet for new Australians.

The Department of Health estimates a quarter of women in Wyndham smoke. Only 2.5 per cent of men eat recommended amounts of vegetables despite Werribee South having 3000 hectares of market gardens. A state population health survey has shown 74 per cent of Wyndham people do not exercise.

It's sick, and getting sicker, while new residents pour in every day. One prominent GP told me this week that Wyndham was "a disaster waiting to happen", with not enough infrastructure to support all the people: "a basket case".

Wyndham grew by more than 10,000 people in the year from mid-2013. Every week, 60 babies are born and every day nine new residents  move into the booming suburb of Tarneit, where there is one medical centre, one being built and a new one finished but not open.

Dr Don Fraser has been a GP in the region for 25 years and  practises from a clinic at Hoppers Crossing. He says new clinics are popping up like mushrooms but his patch is still "underdoctored".

Near Tarneit, in Truganina, one of the suburb's brand new medical clinics sits among unfinished estates and roads  under construction. In Wyndhamvale,  primary healthcare company ISIS bought land  from a farmer – "just paddocks and horses", says chief executive officer Terry O'Bryan – to build a clinic. The new Wyndhamvale train station opens in a fortnight.

This is how places like the Link Centre become unofficial safety nets. For her health classes,  Read uses an adolescent psychosocial assessment tool called HEADSS, an acronym for Home, Education/Employment, peer group Activities, Drugs, Sexuality, and Suicide/depression. It's used internationally but in Laverton means that she tries to pick up health issues holistically before they become a burden on a system already bursting at the seams.

This week was sex education – infections, contraception, consent -- and domestic violence. "If anything brings up issues just let me know," she tells them. Several see her privately afterwards for untreated genital infections.

"When a young person of 15, 16, 17 comes in to see you," she says, "you need to think about everything, not just that they had sex. There are a lot of gaps in knowledge. I ask what the most common sexually transmitted infection is and they all say AIDS, which is a real concern. There's a lot of education that needs to be done."

The problems, as always, are money and politics. Read's program is funded federally through the South Western Melbourne Medicare Local which is about to be subsumed into a new super-region called the North West Melbourne Primary Health Network, covering not only the western suburbs but the CBD and as far north as Kilmore.

From the beginning of July, the 61 Medicare Locals in Australia – a Rudd Labor idea – become 31 Primary Health Networks, with the whole of Victoria administered by six.

There are fears within community health that good projects that are already under way will not be able to continue. South Western Melbourne Medicare Local chief executive officer Gaylene Coulton says further stages of the projects in Laverton would have continued the health interventions that had already begun.

Federal Health Minister Sussan Ley, says existing "frontline" services will be "transferred to the PHN purchasing environment". Some Medicare Local staff will keep work with the new PHNs – but in Wyndham, the office moves from Hoppers Crossing to Carlton.

Last year the Medicare Local gave out federal money for grassroots health projects, including at Laverton for nutrition, anger management for men, diabetes screening, fitness classes and sports programs for migrants and refugees.

A second flashpoint and the subject of a bitter stalemate between the federal government and Victorian health minister Jill Hennessy, whose seat is in the western suburbs and covers several suburbs in Wyndham, is over a health scheme funded by both tiers of government called Healthy Together Victoria.

Labor under Kevin Rudd and then Julia Gillard put $30 million into 14 Victorian local government areas deemed most at risk of escalating chronic disease. It was part of the National Partnership Agreement for Preventative Health.

After being scrapped in last year's brutal federal budget, the Napthine state government appeared to have  struck a deal with Canberra to keep it going. A state Labor source says, as far as they knew, there was an agreement to keep the scheme in Victoria alive but they were told, after winning the election in November, that the deal no longer applied.

"The funding was cut without consultation or warning," Hennessey says.

The Victorian government will keep funding – for several years – four small modules including one in Wyndham getting healthy food and drinks to 60 sports clubs. But it has not yet budgeted beyond that. Federal health minister Ley says she expected Victoria to pay for more. "I acknowledge that Healthy Together Victoria is not a priority for Minister Hennessy."

The former Healthy Together Victoria co-ordinator for Wyndham City Council, Georgie Hill, says the program was in 47 early childhood facilities, 19 primary schools, seven high schools and 38 workplaces, and had reached 28 per cent of Wyndham's population.

"We continue until the end of the year but beyond that we leave all those organisations we have established close relationships with no ongoing support or reduced support," Hill says.

"To prevent obesity and effect long-term health change we need longer than three years of funding. It is a really disappointing situation. The many changes of government have not helped our cause."

Wyndham mayor Peter Maynard says Healthy Together is a world-leading preventative health program and cutting it is "short-sighted".

"They've run cooking and vegetable growing courses and established exercise programs and walking and cycling groups," he says. "Local community members won't get the support they need to make small changes for a healthier lifestyle."

The mayor gets a sweat up most weeks  thanks to a grassroots health program run by the Western Bulldogs footy club, who have big support in Wyndham.

That it is left, in part, to a sports club to run preventative health in a very sick part of the world's most liveable city is strange and instructive, but that's how it is out west.

As a direct response to alarming health statistics and shortage of services, the club began their "Sons of the West" program for men last year. It has tripled in size this year and holds talks on nutrition, diabetes, domestic violence, cancer and gambling, as well as exercise classes.

It is free, not restricted to club members, and is based on a program club leaders saw at the Liverpool Football Club in the north of England, another troubled low socio-economic region with endemic chronic disease issues.

"We were looking at low life expectancy, high rates of smoking, high rates of men with sedentary lifestyle," says the Bulldogs' Troy Daniel, who works on the club's community projects. "It was all pretty daunting. There are some pretty dire health statistics in our part of the world."

Graeme Ball, 59, has lived all his life in Werribee. He is a meteorologist; his father died of a stroke at around the age he's at now. Ball has three kids and seven grandchildren and he reached 100 kilograms – " A big gut," he says – suffered migraines and was medicated for high blood pressure.

"I needed to change," he says. "I was a couch potato eating Tim-Tams."

In a year with the football club's program, he's managed to lose 20 kilograms,  walks 14 kilometres every day,  and is eating less.

However in Tarneit, Indian migrant Prasad Amirneni, who works in a Hoppers Crossing plumbing store, is still reeling from the news he has diabetes. He is 40. It started with constipation last year, he tells me. Then X-rays and tests, and a diagnosis.

"I wasn't exercising," he says, "and I was eating anything and everything, eating takeaways for lunch. Now I eat veggies, my wife packs up a lunch each day."

He was 100 kilograms and has lost 10 kilograms by using an exercise bike and a real bike.

"I have two daughters," he says.

His GP in Truganina, Dr Anil Cheeti, says migrant health is complex with many subtleties beyond basic issues such as language and cultural differences. Startling community profiling data shows that Mandarin and Hindi speakers increased by more than 2000 per cent in Wyndham between 2006 and 2011. That means in 2011, 3200 people spoke Mandarin and 3100 Hindi.

To even think of owning a bicycle is a giant step for many migrants or refuges, the GP says. Where an Australia-born family might have three or four bikes – and use them – a new Australian family may not think of it as good exercise.

And so, according to the combined Western Community Legal Centres, diabetes is at "epidemic" level. They told a Senate inquiry into affordable housing last year about those 6.5 new cases diagnosed every week in Wyndham, and that supermarkets in so-called "food deserts" could be up to 10 kilometres from residential areas.

Food mapping by the council reveals Wyndham has 192 fast food outlets against 34 fresh food shops; that's nearly six takeaways for every fresh food outlet, a higher rate than even other vulnerable, low-socio-economic areas in the LaTrobe Valley, Geelong and Bendigo.

Dr Don Fraser hired nurse Sam Read to work from his Hoppers Crossing practice last year because her holistic ideas about healthcare for adolescents impressed him. A drop in the ocean, perhaps. But the right approach, he thought. She has since been able to outsource herself to places like the Link Centre in Laverton.

"We are in a very challenged area for healthcare needs," he says.

The hospital waiting lists for uninsured, public patients in a low socio-economic area are, he says, "atrocious", especially for pregnant women, children, diabetics and the mentally ill. Some patients wait 18 months. "Firewalls, I call them. Firewalls. Impossible to get through."

Don't get him started on mental health. "It is an absolute joke out here." He says youth mental health organisation headspace has a clinic in Werribee but many kids fall through the cracks.

"Mental health is a write off." There are mental health specialists in Wyndham, he says, but "they cherry pick the walking worried well. If anyone is really sick, they don't want to know."

"Part of me says he is right," concedes Liz Burgat, the director of clinical programs for headspace in Wyndham. "It is really hard. This is a huge growth area." The local headspace clinic has been open a year.  "We are trying to fill a gap in a service system that did not exist before."

She says the service has treated 600 "complex" young people. The most difficult cases are sent to specialists "but they are struggling to meet demand in the area too".

Sam Read, meanwhile, will continue at the Link Centre in Laverton trying to stop unwanted pregnancies, sexually transmitted diseases, family violence, anxiety and depression. She will also keep spreading  information about nutrition, exercise and how to be healthier and live a bit better until the money runs out or is taken away.

Fast vs fresh

Wyndham

• 34 fresh food outlets (6.3% of total food outlets) compared to 192 takeaway food outlets (35.2%)

• 5.6 takeaway food outlets for every one fresh food outlet

Latrobe City

• 24 fresh food outlets (8.6% of total) compared to 89 takeaway food outlets (31.9%)

• 3.7 takeaway food outlets for every one fresh food outlet

Geelong

• 68 (3.8%) fresh food outlets compared to 377 (21%) takeaway outlets

• 5.5 takeaway outlets for every one fresh food outlet

Bendigo

• 29 fresh food outlets (7.1%) compared to 139 takeaway food outlets (34.2%)

• 4.8 takeaway food outlets for every one fresh food outlet

Source: City of Wyndham

City of Wyndham – snapshot

Area: 542 square kilometres on the western fringe of Melbourne. Werribee and Hoppers Crossing are currently the biggest suburbs.

Population: 199,715 (at June 30, 2014)

Growth: 5.6% (10,604 people) in the 12 months from  June 30, 2013. Fastest growing area in Victoria; third fastest in Australia.

Migrants: 33.6% of residents born overseas (5% in India; 2.4% in the Philippines)

Source: City of Wyndham