Far from the facilities and comforts of the city, a small but highly dedicated group of health care professionals and volunteers work to ensure the people of the bush have access to quality medical services. With ingenuity and commitment, these outback.
By Pamela Robson and Kirsty McKenzie
When Bryan Connor was studying at the University of Glasgow’s prestigious medical school, he envisaged the years ahead as a suburban general practitioner (GP), treating coughs and colds, dispensing antibiotics and hormone replacement therapies, and referring patients with more complex problems to a battalion of specialists. He considered the prospect of coming home in the dark, winter evenings to sit comfortably by the fire, do the odd crossword, read a John Grisham novel or watch The Bill on television before going to bed to prepare for another routine day. But he didn’t like what he saw, so he did something about it.
In need of a challenge, Bryan applied for registration in Australia as an International Medical Graduate (IMG), which meant he had to work in a rural or remote area of need. That is how he ended up as the sole doctor in the small north-west Queensland town of Richmond, serving about 2000 people scattered over an area of 30,000 square kilometres. For the record, that’s half the size of Scotland, bigger than Wales and twice the size of Northern Ireland.
Over the past seven years, Bryan has delivered scores of babies, plastered broken limbs, cut out skin cancers and stitched up lacerated muscles as part of his daily rounds. He is regularly called out to emergencies, which are often life-threatening injuries resulting from car crashes or station mustering accidents. He finds himself sewing up wounds caused by dog bites or, more often, feral pigs. He is a psychiatrist, dermatologist, cardiologist and surgeon to his patients, and they love him for it. It’s about as far from the life of the average suburban GP that Bryan can get.
When his time was up as an IMG and he had the luxury of opting for life in the city or by the beach, Bryan decided to stay on, and then moved even further west – by about 287 kilometres – to the slightly larger town of Cloncurry (population 3500). The reason? There are three GPs and they can share the burden of the 24-hour on-call roster. Quite simply, Bryan is hooked on country living. He is the closest possible thing to the traditional family doctor as immortalised in A Country Practice or Dr Finlay’s Casebook – the type of medico who has all but disappeared from the city and suburbs, but who most people would love to have.
Offer Bryan a suburban practice where he can work part-time and sip a latte or go shopping and there’s just no contest. His stamping ground is among the cattle stations of northern Australia, which can be as isolated as any Antarctic field base. Here, he has to rely on personal initiative. He is the supreme generalist in an age of specialisation – and he wouldn’t have it any other way. He is passionate about making a difference to the lives of the small fragmented community he serves. He spills over with praise for the people of the bush who, he argues, deserve the same standard of health care as the people of the city. They put up with so much more; they are uncomplaining, loyal and decent. The doctor-patient relationship is very close in a small community, where the family doctor can make a big difference to people’s lives. That’s the key to what keeps most rural doctors in the bush.
Rural GPs are a feisty lot. They have to think on their feet, accept being on-call all the time and, importantly, have the self-confidence to deal with almost anything that comes along. They are the doers of this world, the types who naturally rise to challenges; none of them are bystanders in life. Talk to a few of them and sooner or later they’ll say something like ‘you only get out of life what you put into it’ or ‘you have to like having medicine intrude into your life’ or ‘country GPs are immeasurably happier than their urban counterparts’.
Bryan Connor has just been named the Royal Australian College of General Practitioners’ (RACGP) GP of the Year, partly because of his efforts to attract new GPs to the bush and then supporting them when they get there. The problem is that, while Bryan and many other rural GPs can’t think of a better or more satisfying way of life, the bush has difficulties attracting and retaining young health professionals. “In the past, there have been too many young people who were daunted by the prospect of hard work, no let-up and isolation,” Bryan says. “We’re showing them that being a GP in a rural or remote area can be infinitely more satisfying than life in the city where much of the time you never really get to know your patients.”
Bryan says education is the key. “We bring undergraduates here and let them see that it’s not just all hard work – they won’t be left on their own,” he says. “I think in the past a lot of rural doctors felt overwhelmed and undervalued. But there are changes taking place, and they’re all for the good. There is more emphasis being placed on training and supporting rural doctors. I’m optimistic that we can bring more people out here who are better trained and will stay. I can see the rebirth of the country doctor.”
There’s plenty of evidence to show that those living in non-metropolitan areas are likely to be in worse health than those living in the city or suburbs. For indigenous people, the situation is even more dismal with health standards far below the rest of Australia.
Although 30 percent of the Australian population lives in rural or remote areas, only 22pc of male GPs and 17pc of female GPs practise there. A recent survey conducted by Access Economics for the Australian Medical Association (AMA) highlighted critical deficits in psychiatry, obstetrics and anaesthesia. Also in short supply are nurses, midwives, dentists, physiotherapists and other members of the allied health professions. The health woes of the bush are also due to the gradual but relentless shrinkage of health care facilities like country hospitals and maternity units that has shadowed the depopulation of country towns since the 1970s.
The shortage of health workers isn’t confined to the bush nor is it an exclusively Australian phenomenon. Around the developed world, people are living longer, technology is advancing and demand for health services is ever on the increase. At the same time, there is an undersupply of medical personnel, and they are also getting older. The average age of a nurse or GP is well into the 40s and creeping closer to retirement age with each year. Countries such as the UK and US have already started cranking up their tertiary training programs.
Every state in Australia is struggling to meet demand for doctors, nurses and allied health professionals. Many people trace the shortages back to a Federal Government decision to slash medical places at universities a few years ago. According to the government, even with the new places created in the previous budget, it will not be until 2016 that shortfalls will be addressed because it takes many years to train a doctor or nurse.
But once doctors and nurses are trained there comes another hurdle – state governments will have to be able to afford to employ them. Right now, when medical workers in the UK graduate, the national health system can’t find the funds to pay them. London’s Daily Telegraph recently reported that the extra money pumped into training health professionals had provided skilled graduates who were now working in McDonald’s, bars and supermarkets, or moving overseas. And the country that most were moving to? Australia. Indeed, more than half of the doctors working in the bush are from overseas. In Queensland, where the state government is still dealing with the fallout of the Jayant Patel case – the Indian-trained US surgeon linked to the deaths of 17 patients at the Bundaberg Base Hospital – and where the shortage of rural doctors has been particularly serious, Premier Peter Beattie has travelled to the UK for a couple of intensive recruitment campaigns.
When a town is facing tough economic times, there tends to be an exodus of business owners and professionals who opt for the financial security of urban areas where there are better prospects. This includes GPs and other health workers. Governments have typically responded to fiscal restrictions by cutting back services in the less populated, outer areas to concentrate funding on centralised facilities in larger centres where they are most efficient. It makes sense; a larger central hospital can deliver more sophisticated but costly services more easily, whereas a series of small hospitals can each offer only a limited, more modest range. However, it also means rural people have to spend more money and time on travelling to those services. As one GP puts it, governments are simply moving the costs of health care on to the patient. Pregnant women are being forced to travel hundreds of kilometres to give birth because the maternity ward in their town has been closed, while cancer patients have to travel long distances for ongoing treatment.
According to the Rural Doctors Association of Australia (RDAA), if a patient in the bush is diagnosed with cancer, they are up to 300pc more likely to die over the ensuing five years than if they lived in a well-off city suburb. Former RDAA president Dr Ross Maxwell, a GP who has been serving the south-east Queensland town of Dalby (population 12,000) for the past 17 years, says many rural patients can’t have a cancer diagnosis and treatment close to home and therefore in a timely manner. It is this lack of access that creates poor cancer outcomes in the bush. “Obstetrics and emergency facilities are among the biggest worry, and there’s a serious shortage of specialists like psychiatrists and dermatologists,” he says. “Up to 30pc of all our calls are about mental health problems and up to 70pc of those patients have a diagnosed mental health disorder.”
The RDAA also wants to see the Federal and state governments communicate with each other and coordinate rural health care delivery. According to the association, the Federal Government has been introducing very useful support measures to maintain the procedural work force in rural areas, but state governments have been closing hospitals in which these proceduralists work. This is illustrated by the fact that 130 small rural maternity units across Australia have been closed in the past 10 years. It wants substantially more government funding for patient and carer transport and accommodation if diagnosis or treatment requires people to travel to larger hospitals in the cities. It is also lobbying for financial incentives that will keep doctors in the bush, such as additional locum support and bigger loadings paid for after hours and on-call work.
But, like Bryan Connor, Ross Maxwell believes the satisfaction he gets from the job outweighs the problems. “I really enjoy the people,” he says. “It’s a wonderful privilege to be able to live and work with a community; to get an insight on how people deal with the problems in their lives, how they cope in adversity. It’s like a three-dimensional jigsaw. I feel very fortunate being able to make a difference in some small way. I guess that medical practitioners in the cities have a sense of satisfaction, but I believe it’s more powerful, more intense, in a small, isolated community.”
Ross says training is critical to keeping doctors in the bush as it equips them to deal with the rigours of remote practice and then they are more likely to stay.
More places have been added to the key medical schools around the country. A new medical school has been established at Queensland’s James Cook University – Australia’s only new medical school in 25 years and the only full medical school in Queensland’s far north. A survey of the first cohort of James Cook medical students showed 64pc would be seeking internship positions in non-metropolitan areas after graduating.
Both the Australian College of Rural and Remote Medicine (ACRRM) and the RACGP run fellowship courses that dovetail with mainstream medical studies. ACRRM was formed 10 years ago out of a conviction that rural GPs needed their own organisation. About 600 GPs broke away from the RACGP, which they believed was too urban-focused. ACRRM now has more than 2000 members and an active executive.
In June 2006 the Council of Australian Governments (the body responsible for coordinating national policy across state and territory governments) recognised rural medicine as a generalist-specialist discipline under Medicare. This was an important milestone for the rural doctors who had been lobbying for the right to have the GP generalist recognised as a classification and for GPs to have accredited training
in subjects such as obstetrics, anaesthetics, surgery and emergency medicine – normally the preserve of the specialist colleges.
The states are now recognising the need for high-level generalists, with Queensland Health introducing the Rural Generalist Program, otherwise known as ‘Country Gold’. This is the result of a good deal of hard lobbying by people including Associate Professor Dennis Pashen, vice-president of the ACRRM and director of the Mount Isa Centre for Rural and Remote Health. Dennis, a former GP from Ingham in far north Queensland, has been stirring for a better deal for remote doctors – and, ultimately, their patients – for many years. The Mount Isa centre is part of James Cook University and one of a series of centres in places including Broken Hill, NSW, Alice Springs, NT, Geraldton, WA, and Whyalla, SA, which were started in the mid-1990s by the government’s Department of Health and Ageing. It acts as a support centre and provides accommodation for more than 200 medical, nursing and allied health students training across 700,000sq km of remote Australia. It has a skills laboratory to help train students in procedural and emergency medicine, a library and a research unit.
ACRRM recently won an Australian Primary Health Care Research Institute grant of $1.8 million to study the role of generalists and what it will take to successfully develop a future generalist workforce. Dennis says that, without proper training and recognition, rural communities have little hope in attracting and keeping health professionals. But he also says that changes to the way health services are delivered are crucial.
It’s a sentiment shared by Dr Chris Mitchell, the vice-president of the RACGP and chair of the National Rural Faculty. “We keep hearing that we need more doctors,” Chris says. “It’s all about ‘workforce, workforce, workforce’. But the situation is far more complex than that. Yes, we have an acute shortage of doctors, nurses and other medical personnel; we have an ageing population and an ageing medical workforce. But, realistically, we’re not going to be able to find the numbers we need. We need a bigger workforce just to keep pace with where we are at today, yet future demand will be greater still. We can’t stand still. If we just keep doing what we are doing now, the wheels are going to fall off.”
According to Chris, who is part of a multi-doctor practice near Lismore in northern New South Wales, not only are more people needed, but resources must be used carefully too. “We also need to expect that nurses and other practice staff will do some of the jobs that doctors do today,” he says. “Some allied medical professionals will also need to be able to do a wider range of things. Our practice nurses are already taking some of the roles currently provided by podiatrists and dieticians.”
Many general practices are becoming one-stop shops providing services from acute fracture care to cardiac rehabilitation, while an increasing range of chronic disease management is expected to take place at practices in the next few years. “Increased specialisation does not necessarily mean we’ll get better results,” Chris says. “In fact, there is extensive literature to show the more we invest in general practice care the better the results for patients.”
The RACGP runs the four-year Fellowship in Advanced Rural General Practice course. It has been shown over the years that 70pc of those GPs who participate in the course will stay in the bush. It includes a 12-month stint of advanced rural skills training in subjects such as anaesthetics, obstetrics, emergency medicine, mental health and Aboriginal and Torres Strait Islander health. Participating registrars chose a mix of training to meet the special needs of their community.
In his role with the college, Chris sees that each state is looking at different solutions. For example, New South Wales has funded procedural training programs and has also identified mental health and emergency medicine as priorities. “New South Wales has funded supernumerary positions for hospital registrars so that country hospitals, which are often under extreme financial pressure, get a free, fully-funded registrar,” Chris says. “South Australia has developed a really good package and is supporting rural doctors through incentives such as providing locums while the doctor is away from his or her practice because of training. In Victoria, they have a ‘hospital in the home’ program. This is about keeping the patient at home with good monitoring and support care. This has special benefits for country people. The Federal Government funds a really wonderful program, which gives financial support to cover costs of locums, flights, etc. to enable rural procedural GPs to leave their practices and travel to do 10 days’ training a year.” With new techniques constantly developing, this support helps keep skills in the bush.
An autopsy or two before breakfast isn’t what you’d call a typical start to the average day, but for Dr Nigel Buxton, the forensic pathologist for central Queensland, it’s just what he does. Whenever there’s a homicide or suspicious death, it’s Nigel they call to the crime scene. He is the real life version of Quincy, McCallum or Leo Dalton, who have appeared in television police dramas.
But while television has transformed the forensic pathologist into a hero, Nigel is far more down-to-earth. Most mornings he’s at the Rockhampton Mortuary before starting his ‘day job’: leading the scientific team at Sullivan Nicolaides Pathology (SNP) in Rockhampton. SNP is one of the largest practices covering remote Queensland and the Northern Territory, and Nigel concentrates on anatomical pathology, supporting the city’s hospitals and medical practices reporting on surgical cases.
He’s only one of eight forensic paediatric pathologists in Australia, and his patch stretches from west of Winton to Mackay in the north and Agnes Water in the south. The police may call him out at any time, day or night, often to a car crash or farm accident, sometimes a sudden infant death, a suicide or even a murder. Weekends can be busy.
Nigel loves being a country pathologist. It’s hard work, but he enjoys life in a smaller community. “You get to know the rural general practitioners as well as everyone on the police investigation teams,” he says. “In the city, you can be working with a lot of people – many you’ll never see again. Here, we’re a team. We know how each other works. It helps with the job.”
Counselling the bereaved can be stressful but, after 30 years as a pathologist, he’s learnt to deal with it. “You usually talk to the rural families by telephone,” he says. “This always makes it harder for everyone including the pathologist since you can’t react to expressions when the information you are delivering is hurting people. Also, in rural communities, you frequently know the family of the person who has died suddenly, and this brings in a personal factor. Talking to people about the death of a child is especially difficult. But I try not to take the emotional stuff home with me. I play some classical music, go for a walk and recharge.”
Pathologists are the detectives of the health profession. Without an accurate test result, delivered as speedily as possible, the GP or specialist often can’t confidently embark on a treatment program for their patient. In an emergency, this can be critical. SNP’s Toowoomba laboratory manager Greg McKee is responsible for making sure the test gets through come hell or high water.
Greg’s area takes in Winton, Longreach, Augathella, Quilpie, St George, Warwick, Dalby, Roma, Miles, Lockyer Valley, Gatton and Laidley. SNP has six blue-and-white Toyota Echoes that hurtle around the areas close to Toowoomba but, in the more remote parts, Greg has to call on a range of sometimes unusual transport – especially in an emergency. “We have to make sure the samples are taken by the nurse or collector to coincide with the courier runs,” Greg says. “If you leave a blood or urine sample for more than 24 hours, a test could be rendered useless. We’ve had to make use of all sorts of transport. Many samples come into the Toowoomba lab where we have three pathologists, but often it’s quicker to fly something from a more remote area direct to Brisbane where there are 50 pathologists and about 600 scientists.”
In the past, Greg has used a school bus service between Surat and Roma and a waste transport service from Dirranbandi to St George. “When there have been roads closed by floods and only big vehicles can get through, a road train has brought the esky through,” he says. “We even had someone swim across once with the esky.”
Greg will sometimes phone the police, ambulance or even the town newsagent for assistance. “The newsagent in a small country town will usually know if someone is going some place,” Greg says.
Analysis results are then usually sent through to the GP or hospital electronically via a secure-data transfer service. “If it’s urgent, we’ll get it through,” Greg says.
Governments across Australia are introducing the concept of the nurse practitioner to ease the doctor shortage. These are highly qualified nurses who take on some of the tasks conventionally performed by GPs. Yet there are plenty of nurses in remote areas who would say they’ve been doing these jobs for years – and a lot of other jobs too.
Nursing in the remote outback is an entirely different experience to the job of rural nurse in a country town in Victoria or Tasmania where backup from colleagues is available. According to Rod Wyber-Hughes, the director of the Council of Remote Area Nurses of Australia (CRANA), about 70pc of remote area nurses are working in isolated Aboriginal communities, often in the interior of Australia – some of the most isolated places on earth. They provide almost all the health care in the remote areas.
They are an exceptional group – they have to be in order to survive. They could be living with an indigenous community in the Gibson Desert, on an island in the Torres Strait or in a tiny fishing township on the north coast of Western Australia. They deal with everything and anything that comes along. Often they’re working in dangerous situations. They make life or death decisions as a matter of course – and there’s no one close by for help. Communications with the outside world can be infrequent and unreliable. They live with nature’s extremes: cyclones, floods and tremendous heat. Each of them has to be multi-skilled, independent and physically and mentally resilient. If they can’t develop a mental toughness, they don’t last.
According to Rod, there are about 5000 nurses working in the outback. The typical remote area nurse is older than those in the city and predominantly female – although there is a higher proportion of male nurses in remote areas compared with the cities. She is often single or divorced – although some people bring their partners.
Rod Wyber-Hughes is a remote area nurse himself. He “fell into it” about 10 years ago when he travelled north from Sydney with English wife Tracey, who is also a nurse. They worked at the Doomadgee Aboriginal Community in far north Queensland then did six months at the tiny Yuendumu Community 290km north-west of Alice Springs. After that they based themselves in Alice Springs and raised a family of five while Rod worked for the Ngaanyatjarra Health Service travelling around remote communities in the Gibson and Great Victoria deserts. “We’d put in huge distances; it was often about a 3000km round trip on dirt tracks,” Rod says. “In the summer, we’d start early because of the heat and we’d set up the clinic. We’d see everything from flu to serious illnesses. We’d be resuscitating kids dying from dehydration in the heat and managing old people with strokes or heart problems.”
CRANA runs a 24-hour support and debriefing service, which is a lifeline for nurses out in the field under strain from the myriad of traumatic situations they can face. This could be physical or sexual assault, dealing with the victims of all-too-frequent road accidents or being with a dying child, or it could be a build-up of many smaller difficulties and dilemmas. Rod says nurses provide about 90pc of the health care in the remote areas yet they get about one percent of the budgets allocated for support. “We’re against single-nurse posts,” he says. “Ideally, you need two or three nurses in a community so they can share the on-call burden. The nurse is everything to a small community. There are no days off; it’s easy to get burnt out. We believe it’s unacceptable for nurses to go into dangerous situations. This could be rendering aid to a victim in a domestic violence situation when the perpetrator is still around – they think the nurse is taking sides by treating the patient. We’ve seen many nurses bashed in these situations. And there are no police to call on. It could take days for the police to arrive.”
Some conservative sections of the medical community have been wary of upskilling nurses to take on doctors’ tasks, just as some are about GPs doing the things that specialists would normally do in the city. But Rod disagrees. “We’re not creating mini doctors, we’re about making maxi nurses,” he says.
CRANA’s training programs are so popular that they’re running 30 courses this year. “We teach trauma management – what to expect and what to do in the event of an accident – and another topic is maternal emergencies,” Rod says. “Most people start the courses petrified and come out feeling terrific. When they find themselves at a traffic accident or delivering a baby by the side of a road, they can function more effectively. People feel so much more confident.”
Nurses find they either love it or they hate it and don’t stay. “We have communities with a 600pc turnover in nurses – that’s six people leaving in a year,” Rod says. “We also have nurses who have been working in a remote area for 10, 15 or 20 years. Part of the nurse’s job is to educate people about how to have healthier lifestyles. A small success in this area can make a big difference. The best nurses don’t go into a community saying ‘I’ll show you what to do’. If you are going to make a lasting impression you have to work with the people, engage them and explain how they can change their lives. It’s an incremental process.”
As a nurse for the Sisters of Mercy, Mary-Jane Lynch had little idea what she was letting herself in for when she volunteered to relieve a colleague for six weeks at Balgo Aboriginal Community in Western Australia’s Great Sandy Desert. That was 14 years ago, and Sister Mary-Jane has been nursing in remote communities pretty much ever since.
Raised in Geelong, Vic, Mary-Jane did her general training and midwifery qualifications at Melbourne’s Mercy Hospital for Women. She was working as a midwife when she took the initial posting to Western Australia. “I’d always imagined I’d end up somewhere that would be difficult for a nurse with a family to go to,” she says. “I thought that would be overseas, but after six weeks at Balgo I knew I loved the life and it just felt right. So I asked for another remote posting and I ended up back at Balgo where I stayed for five years.”
Mary-Jane then spent four years at “Ringer Soak” (Gordon Downs) near Halls Creek before she took her current posting at Ngallagunda on Gibb River Station, 370 kilometres north-east of Derby, where she has been for the past five and-a-half years. As well as running the clinic in the Aboriginal community that, depending on the time of year, numbers between 30 and 60 people, she also looks after the Dodnun Community, which is about 40 minutes away by four-wheel-drive.
Mary-Jane, who is “40-something”, usually works 12 weeks on call, around the clock, then takes a two-week break. She says she has become something of a ‘Jill’ of all trades. As well as providing regular health care and education, emergency treatment and supervising medical evacuations, all sorts of tasks ranging from mending a broken bore to fixing the generator can fall to her. Most of the time she has access to a landline for communications with doctors at the Royal Flying Doctor Service (RFDS) base in Derby but, after big storms, it can go out and she’s left with a satellite phone, which works “most of the time”.
During the wet season, the Gibb River Road becomes impassable and the community can be isolated for up to four months. Occasionally, when the river is in flood, patients have to be ferried across by boat or medications carried across the river by strong swimmers. “We are supposed to get a mail plane once a week, but that depends on the state of the airstrip,” Mary-Jane says. “Last Wet was a big one and the strip wasn’t safe, so we went a month without a plane. Fortunately we didn’t need to have an evacuation during that time because it would have been by helicopter. There’s a flat area, which is a sort of a basketball court, that we use for a helipad.”
The task of driving the airstrip to assess the depth of the wash-outs and its viability for landings is also part of Mary-Jane’s job description, as is maintaining the 35 lights that have to be set out along the strip if a plane needs to land at night. Before ‘the wet’, the community focuses on getting pantries stocked with tinned goods for the inevitable periods of isolation. “Fresh food is always a luxury, but particularly so during the wet,” Mary-Jane says. “However once the rivers run so do the fish, so at least we have plenty of fresh fish to eat.”
With diabetes and heart disease two of the major health concerns for the community, Mary-Jane admits that ensuring a healthy diet is a constant challenge. She’s hopeful of establishing a vegetable garden after the rains and says that several members of the community are highly motivated to make it a success. She says she looks forward to lots of fresh fruit and salads when she hits the ‘big smoke’ of Broome or Derby.
Time in the city is certainly treasured. “A couple of times a year I go down to Melbourne to catch up with family and friends, whom I miss dearly,” she says. “I love being able to go out for a coffee or a nice meal, have a proper haircut and buy nice clothes. Your level of appreciation for small things goes up when you live up here, but most of the time I wouldn’t have it any other way. Because we’re a small population, anything that happens impacts on the whole community, so there’s a strong sense of everyone pulling together. I feel like I’ve still got a lot of energy and, while I can, I’ll stay here. I do believe it’s my calling to be here.”
Lifesavers of the bush
In the past two years, Adelaide retiree Wayne Griffith has had many painful hours to reflect on why his life was spared in the bushfire that tragically killed his wife Judy and grandchildren Star, aged three, and Jack, two. On January 11, 2005, Wayne and Judy were visiting their daughter Natalie, son-in-law Darren and two grandchildren on their farm near Port Lincoln, SA, when the disaster occurred. Fireballs engulfed the two vehicles in which Wayne and his family were trying to escape the fires that were raging across the Eyre Peninsula. Although they were only 50 metres from a dam, Judy and the children were incinerated in one car while Wayne, who was trapped in another vehicle just metres away, was powerless to help and sustained severe burns to 75 percent of his upper body.
“I’ve had some very dark days since,” Wayne says. “But even when I’ve been in the depths of depression, one thing has stopped me from doing myself in. I think of the wonderful people of the Royal Flying Doctor Service [RFDS] and the sacrifices they and others made to rescue and save me. The only thing that has kept me from suicide on more than one occasion is the thought of the money and resources that went into saving me, and how it might impact on the doctors and pilots and nurses who put so much effort into my recovery.”
Although fire surrounded the tar-sealed strips of Port Lincoln Airport on the day of the Griffith family tragedy, the RFDS plane came in under the smoke and landed on a gravel runway for Wayne’s evacuation to Royal Adelaide Hospital. He spent two weeks in intensive care and another two weeks in the burns unit. While the painful memories will never leave him, he says his physical recovery has been remarkable. He has recently been able to shed the ‘second skin’ that he had to wear 23 hours a day to reduce the scarring. “Now that I’m better able to deal with it I’m helping out talking to burns victims about my experience and recovery and becoming involved with a burns support group at the hospital,” he says. “I’m also involved in fundraising for the RFDS because it is an extraordinary service staffed by extraordinary people. There must be a reason why I was spared and I think perhaps the reason is so I can spread the word about the good work lots of quiet achievers are doing every day.”
Wayne’s medical evacuation was one of more than 45,000 patient contacts the Central Operations division of the RFDS made in 2005/2006. One of the service’s four sections, the base covers an area of more than 2.3 million square kilometres including most of South Australia and the Northern Territory, and parts of Queensland, Victoria, Western Australia and New South Wales. During the most recent financial year, Central Operations’ doctors and nurses logged up 13,700 consultations by phone and radio; saw 25,000 patients at clinics on stations, mine sites and remote roadhouses; and transported more than 6800 patients from isolated locations to city hospitals.
The RFDS as a whole, which includes some 23 bases spread across the vast waiting room that is remote and rural Australia, travelled more than 20 million kilometres and addressed the needs of more than 237,000 patients, 34,000 of whom were transferred to major hospitals for a higher level of care. This is keeping alive the notion of the ‘mantle of safety’ for outback residents and visitors envisaged by the Reverend John Flynn. Reverend Flynn became the first superintendent of the Australian Inland Mission (the ‘bush department’ of the Presbyterian Church) in 1912. By 1928, the first missions by his aerial medical service had begun in Cloncurry in northern Queensland as a one-year experiment.
While the RFDS receives Federal, state and territory funding for day-to-day operations, funds for the purchase and medical fit-out of its aircraft comes from donations and sponsorships. With 50 aircraft now in the fleet, including 19 Pilatus PC-12s worth some $6.5 million each, all converted for RFDS use, that’s a lot of fundraising. But it’s necessary, with growing numbers of travellers in remote parts of Australia meaning demand is constantly increasing and there are higher levels of expectation of access to high standard health care.
Today, primary health care is almost as important to the RFDS as the emergency response for which it is so famous. “The RFDS brings immunisation clinics, women’s health clinics and all sorts of other routine health checks and education to outback people,” Central Operations’ publicity officer John Tobin says. “The real measure of us doing our job properly is if we can identify a problem before it emerges. In that sense, the people we don’t have to transport to hospital are as important as the ones we do.”
This story excerpt is from Issue #51
Outback Magazine: Feb/Mar 2007