Tim’s time with the Doctor may lead to rural practice

P3_Tim in Broken Hill

Tim in Broken Hill.

For University of Wollongong student doctor Tim Roach, a 12-month stint in Broken Hill was a ‘fantastic experience’, bringing him into contact with a diverse range of challenges.

Additionally, it has encouraged him to consider returning to rural practice after he graduates.

Tim also spent over eight weeks working in Wilcannia and participated in five RFDS SE Section remote clinics.

“There was a real educational benefit in seeing patients who live in these rural and remote places and who don’t get to see their GPs as often as they would like,” Tim said.

“And the main thing in participating in RFDS clinics is you get to see the difficulty and challenges in treating patients who are so far away from specialist care.”
Tim said he found Broken Hill a great place to live. He enjoyed socialising with other medical and nursing students.

“And I did all the touristy stuff as well.”

But it was the exposure to medical conditions not as common in city areas that Tim found so interesting and challenging.

“You see people presenting with things that you wouldn’t normally see in an urban area, where patients are much closer to their doctors.”

One example was Orf disease, a viral condition humans contract after being in contact with an animal suffering from scabby mouth.

Tim said he also enjoyed being involved in an emergency scenario at Broken Hill Airport.

“The responsibilities and expectations on being a doctor, even a junior doctor, are very high.

“There’s so much to learn and not much time to learn it in, to be honest.

“I felt my time in Broken Hill was really well utilised … the diversity of experiences was terrific. I am now thinking more seriously about practising in a rural area.”

People living in rural and remote areas are more than five times as likely as those living in major cities to travel more than an hour to see a GP, according to the Australian Bureau of Statistics.

The RFDS SE continues to work closely with a number of organisations in training the next generation of rural health workers.

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Helping people stay well in Wilcannia

p3_Wilcannia Hospital

Wilcannia Hospital.

The RFDS SE Section conducts three clinics a week in the small Central Darling town of Wilcannia.

Held at the multipurpose centre, a GP and other specialists see patients every Monday, Wednesday and Friday.

The RFDS senior medical officer for primary care, Dr John Wenham, says the team departs Broken Hill Base about 7.45am, making the 196km trip in about half an hour.

Indigenous people comprise about 80 per cent of the 700 people who live there.

Indigenous men in Wilcannia have a life expectancy of less than 37 years and women less than 43 years, according to a 2009 study of the town published by the Indigenous Law Bulletin.

Patients present with a variety of problems, but John says the RFDS teams see a prevalence of skin problems, diabetes and cardio vascular disease associated with smoking and diet.

John says our future service delivery in Wilcannia is focused on providing continuity of care.

“We see it as a good place to be involved in, where the health needs are so extensive.

p3_ John Wenham removes stitches from Deanne Pearce at Wilcannia.

John Wenham removes stitches from Deanne Pearce at Wilcannia.

“The challenge for us is always to find better ways to engage with our patients.

“With Indigenous patients, it’s always important to put in the time to gain their trust. The relationship is key, as is the continuity of our people on the ground.”

John says the RFDS can see up to 23 patients each day, with 16 on average, with doctors and other medical staff always happy to extend the length of appointments if necessary.

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When landing, watch out for emus

P6_Captain Magnus_Badger.Senior pilot Magnus Badger has been flying with the RFDS SE Section for 25 years.

Since joining us in 1988, he has flown 13,000 hours to towns scattered across the South Eastern Section, an area the size of France.

Originally from Adelaide, it wasn’t until later in life, when he was attending Prince Alfred College, that piloting became a real career option.

“My father always had a pilot’s licence and always flew a plane and I always thought I liked it.”

Magnus earned his pilot’s licence and took a job flying tourists around the Flinders Ranges for the Wilpena Pound motel.

“They had their own airplane and I’d fly that for them, mainly around Wilpena Pound, Arkaroola and various places to the north of South Australia.”

At 28, he started work in Broken Hill at the Royal Flying Doctor Service base at the airport.

A typical clinic day sees Magnus sign on at 6.45am to read the clinic manifest and organise the flight plan for that day.

He will check the weather and arrange fuelling while the engineers do their daily inspections of the planes.

The crew of eight – usually two doctors, a women’s health nurse, mental health workers and sometimes others – fly out at 7.45am.

“We could go out, say on a Wednesday, to Wilcannia and drop a couple of people off there – a doctor and a nurse perhaps – and then go across to White Cliffs with a doctor or dentist, and then go up to Wanaaring or Hungerford or somewhere like that and drop some people there.

“When the Hungerford clinic is finished we’ll make our way back the same route.”

There are days, however, when things move at a more brisk pace, when there is an Outback accident, a fall from a motorbike or someone suffers a heart attack in a remote location.

Flights are usually controlled and problems are few and far between. He says there is some pressure but he keeps a level head.

“Occasionally we’d get the aircraft bogged on wet airstrips. I’ve run into some emus once, hit a couple of kangaroos but no major damage.”

In the fairly little spare time he gets, Magnus takes regular trips back to Adelaide where he owns a house at Eastwood with wife and former RFDS doctor Elaine and daughter Sally.

But he says when he retires he’d like to buy a plane and travel further afield.

“I’d like to do trips around Australia. That would be good.”

By Kurtis J Eichler. Originally appeared in the Barrier Daily Truth, Broken Hill. Reprinted and edited with thanks.

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Dee’s snakebite episode

P4_A scene from the Flying Doctors TV series.

A scene from the Flying Doctors TV series. (Photo courtesy of http://www.crawfordsdvd.com.au.)

For many Australians who live in cities, their only experience of the Flying Doctors is the long-running TV series of the same name.

The Flying Doctors hit Australian television screens in 1985 as a three-part miniseries. It was an immediate success and was relaunched as a regular series that ran for more than 200 episodes.

For Sydney-based marketing consultant Dee Mills, the show was compulsory viewing as a child.

“I just loved it,” Dee, 37, recalled. “I loved the characters and the fact that it was set in the Outback.”

3. Dee and Jaxon, now thriving.

Dee and Jaxon.

But for the new mother, the show became reality when she was bitten by a snake while visiting relatives on a sheep station, outside of Brewarrina.

Dee, her husband, James, 35, and new baby, Jaxon, had just arrived at Gilgoin – a sprawling and isolated property in north-west New South Wales.

It was 42 degrees, the air conditioning was on and everyone was watching the cricket.

“I had left some magazines in the car,” Dee recalls. “I thought I would quickly dash out and grab them. It’s snake country so normally we would wear closed shoes. I’m paranoid about snakes.

“But because I was only ducking out I borrowed a pair of my auntie’s thongs. I was sort of creeping along, looking for snakes. Big mistake. I should have been stomping across the lawn.”

When Dee accidentally trod on an unidentified snake, it bit her on the foot.

P4_The lawn where Dee was bitten

The lawn where Dee was bitten.

“It was like a bee sting. I was doing the high jig and the snake was doing figure eights underneath me while I tried not to step on it again.

“Because they had the air conditioning on in the house, no one could hear me scream. You’re supposed to stay immobile, of course, but I had to leave that spot, and leave the snake. I had to run up to the window and bang on it and say ‘hey, I’ve just been bitten by a snake’.”

Dee’s family fitted her with a compression bandage and called triple-zero.

The situation was further complicated because Dee was still breastfeeding young Jaxon.

“That was my main concern. Just tell me if I can breastfeed my child or not because it was really hot and we had to keep the baby hydrated.”

Everyone waited anxiously to see if Dee would begin suffering symptoms.

Meanwhile, an ambulance was dispatched from Brewarrina and Dee, husband James, the baby and members of the family drove out to meet it.

At Brewarrina Health Service a swab of the bite area confirmed that Dee had been “probably” bitten by a non-poisonous variety of snake – but the protocol for any bite victim is overnight observation.

“The hospital was not equipped if something began to happen so I needed to get to the next biggest hospital, which was Dubbo. That’s when the Flying Doctor was called.”

Dee said she had watched the television show as a child and was a “massive” fan.
“When I was stretchered out of the back of the ambulance at Brewarrina and saw the plane I was going on, I was really excited.

“Then I thought, hang on, I’m not on a scenic tour here. I felt guilty to be honest, because I didn’t feel sick and I know the Flying Doctor relies on grants and donations and does really important work.”

P4_Dee, husband James and Jaxon.

Dee, husband James and Jaxon.

Dee and baby Jaxon flew to Dubbo where the Base Hospital kept her overnight for observation. Husband James, driving from Gilgoin, arrived to join them early the next morning.

“You would be surprised at how many of friends say ‘oh my God, was it like the TV show?’ I think it was a cultural icon in its day.

“I felt bad because I didn’t feel I was a needy patient. My aunt and uncle at Gilgoin, however, are quite isolated. They know how important the service is.

“I certainly wasn’t in a life-threatening situation, although it could have been. But my respect for the RFDS, their professionalism and the job they do in Outback Australia has certainly been confirmed.”

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Outback ride cut short by fall

P1_ Peter is transferred to the RFDS aircraft.

Peter is transferred to the RFDS aircraft.

Veteran motorcyclist Peter Fargey doesn’t know how he was suddenly thrown from his motorbike while riding in the New South Wales Outback.

He has been a regular rider since the 1970s, and almost all that time has been without a major incident.

But this changed during a trip with a friend earlier this year.

Peter’s BMW F800 hit a patch of “bulldust” near Louth, 99 km south west of Bourke. He was catapulted off his bike and suffered extensive leg injuries.

Along with stray livestock, road-trains and motor vehicle drivers dozing at the wheel, “bulldust” can be a major hazard for Outback riders.

Peter explains it as an accumulation of fine dust that drifts into potholes, making them virtually invisible.

For Peter and fellow motorcyclist Steve Lear, the trip was to have been a week-long “follow your nose” journey, a meandering exploration of the northwest corner of the state.

Steve, in fact, had already taken a tumble off his bike the day before, but without injury. So both motorcyclists were riding with caution when the accident happened.

Additionally, trucks were undertaking maintenance on the road they were on, so both riders were especially vigilant, Peter recalls.

“It was about 10 in the morning … I’m not quite sure what happened.”

p1_ Peter waits for help.

Peter waits for help.

Peter says when he came off his motorcycle about 40 km south of Louth, he had no mobile coverage. Friend Steve continued to ride on, unaware of his friend’s accident.

Peter lay beside his bike for about 20 minutes, alone and in increasing pain, before a couple in a campervan arrived.

By this time, Steve had returned. Peter was loaded into the front seat of vehicle and its driver offered to ride his bike back to Louth.

“I still had no idea what was going to happen once we got to Louth,” Peter says.

Meanwhile, things were rapidly getting worse. By now, Peter was in increasing pain.

He says the Louth publican’s wife, a former nurse, checked his blood pressure and heart rate and then mentioned the possibility of an evacuation by the Royal Flying Doctor Service (RFDS).

“I thought that’s for sick people,” Peter says. “And I wasn’t sick. I’d just broken my leg.”

An ambulance crew arrived from Bourke. They lifted Peter out of the campervan and prepared him for the airlift.

RFDS Broken Hill doctor Catherine Dillon had taken the call but as the on-call aircraft was already on assignment, a plane was dispatched from Dubbo Base.

Pilot Craig Nethery and flight nurse Brendon Kiley were on board.

“Our main goal was to ensure a comfortable flight for Peter,” Brendon recalled.

“And certainly transporting a trauma patient by air means we must be very thorough in our clinical assessment on the ground and try to mitigate the risk of complications in flight.

“For example, a subtle chest injury may become quite serious once we are at altitude due to changes in air pressure.

“We constantly monitor a patient’s respiratory status and can lower the cabin altitude and/or implement supportive measures as required.

“Pain relief prior to moving a patient, appropriate spinal care and splinting of injured limbs in case of unexpected turbulence are equally important.”

P1_ Heading for safety.

Heading for safety.

After loading Peter, the flight flew to Wilcannia, about 240 km south, to collect a second patient who had broken her ankle.

Peter was transferred to Broken Hill hospital where his leg was placed in a temporary splint. And from there he was transferred to Adelaide Hospital on a second RFDS flight where he underwent extensive surgery. This included the insertion of pins and a plate in his leg, plus 57 stitches.

Peter called RFDS staff “a tremendous bunch of people”.

“I now have a great appreciation of the kind of work done by the RFDS and their dedication to service. This is a phenomenal service.”

Pictures courtesy of Steve Lear.

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Curry in a hurry raises funds

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On the road in India means meeting the unexpected.

Two RFDS supporters have raised just over $4,500 by undertaking a wild trip across India in a motorised rickshaw.

Agricultural consultant David Brown and business owner Peter Cain paired up for the odyssey from Shillong in the far north east down to Jaisalmer in Rajastan.

“It was by far one of the biggest adventures I’ve done,” said David, who has visited more than 30 countries.

“India is just massive, and teeming with people. The roads are pretty crazy … giant potholes and truck drivers coming towards you on the wrong side.

“Physically, it was relatively uncomfortable. We did pretty big hours. When we clocked up 250 km in a day, we’d be starting at 5.30 in the morning and going to six or seven at night. But the constant stimulation helped.

“You’d be uncomfortable as hell then you would see something that would totally take your mind off it. It was pretty cool.”

The pair chose to support the RFDS as well as a charity in India.

David said the family business was Reola station, about 120 km north of White Cliffs in north-west New South Wales. The 178,000 ha property boasts one of the biggest wool sheds in the world, accommodating the shearing of 3000 sheep and the pressing of 95 bales of wool a day.

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All dressed up and a long way to go.

“We’ve relied heavily on the RFDS over the years,” David said.

“I’ve been a patient with them a number of times and we’ve gone to RFDS clinics.

“We’re not accident-prone by any stretch but we operate a family property and whenever there is a problem, either with family or the people we employ, it’s good to have the RFDS to call on.

“And I was a pretty regular RFDS patient as a kid. I fell out of a tree once and got a big stick stuck in my leg. The RFDS came and stitched me up on the airstrip at our neighbour’s property.

“In another incident I got a nasty gash in my leg again. We’d been working with goats and one of them stuck me with its horn.

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Peter and David (right) with a local.

“It sounds a bit silly but it was a three inch cut in my leg. It warranted a trip to Broken Hill with the RFDS.”

David said he and Peter had many adventures during their India trip, which lasted just over 10 days. The rickshaw suffered “heaps” of mechanical problems.

“There was always someone along the way who could fix it for a handful of notes. If they can’t help out then they know 10,000 friends who can.”

In one Indian town an impromptu tour by a local teacher ended up with Peter addressing a school assembly of several thousand children.

The pair aptly called their trip “Fifty Shades of Curry” and by starting before their Australian departure, Peter managed to eat 50 curries in 50 days.

P7_Repairs on the run.

Repairs on the run.

“Over there, of course, you have curry for breakfast, lunch and dinner,” David said.
For their next adventure, David and Peter are considering a rickshaw run in Indonesia.

If you have an idea for a great way to raise funds for the RFDS or if you’d like some inspiration please call our Sydney office on (02) 9941 8888.

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Flying Doctor clinics – a vital part of Outback communities

RFDS women child and family health nurse Jacqueline Noble cropped

Jacqueline Noble.

My name is Jacqueline Noble. I’m the RFDS women’s and child family health nurse.

In remote areas there are usually no doctors and no nurses. The most basic health facilities can be hundreds of kilometers away.

That’s why Flying Doctor clinics are such a vital part of the local community.

The RFDS runs weekly, fortnightly and monthly health clinics on station properties and in remote townships across far north western NSW, as well as in parts of south western Queensland and north eastern South Australia.

Cover letter_Keith and Jenny Treloar at the Wiawera clinic.

Jenny and Keith Treloar.

At Wiawera, a station property close to the border between NSW and SA, Jenny and Keith Treloar have hosted Flying Doctor clinics since the 1950’s.

That’s where I first met Barbara Ponton.

Barbara, 43, and her husband, Craig, had just taken over the Bordergate Truck Stop near Cockburn.

They had moved from Bribie Island in Queensland with four of their six children.

Barbara was still breast feeding her youngest, Rosie, but had a general feeling of being unwell. During a well women’s health check session, we discovered she had dangerously high blood pressure (HBP).

HBP is often called the silent killer. While some people will experience symptoms such as nervousness, sweating, difficulty sleeping or facial flushing, HPB can be a symptomless condition.

For many people, the next stage is a heart attack or a stroke.

As the RFDS women’s and child family health nurse and midwife, I regularly visit 17 clinics across a territory covering 640,000 sq. km.

And while I love to fly, it’s the ongoing contact with remote families that really makes my job special.

Apart from helping Outback women prepare for birth, my role extends across the range of women’s and children’s health – Pap smears, breast awareness, child health checks and immunisation, advice and information around antenatal and postnatal care.

The next time I saw Barbara was for a Pap smear. But again, all was not well.

She had lost weight and was again generally feeling unwell. We suggested Barbara have further tests and a subsequent scan revealed a cyst on her ovary.

It was sitting next to her bowel and in a three-month period had grown to the size of a softball. Barbara underwent immediate surgery to have it removed.

It’s lovely to see Barbara and her family now, and see them all so well.

Three of the Ponton’s children are students of the School of the Air, avoiding a 200 km twice daily drop-off-and-collect commute for their parents.

Cover letter_ Barbara and Craig Ponton, with their daughter Rosie.

Barbara Ponton with her husband, Craig, and their daughter, Rosie.

And when I see Barbara at one of our clinics, she always greets me in the same way.

“Jacquie,” she says. “You saved my life.Twice.”

I often think back to John Flynn’s ‘mantle of safety’ philosophy, that extraordinary vision he had to make sure Australians living in remote areas have access to healthcare.

Living somewhere beyond the reach of normal medical care takes a special kind of courage.

Residents of rural and remote communities continue to show poorer health outcomes than residents in metropolitan centres.

Potentially preventable hospitalisations occur at more than twice the rate in remote Australia compared to major cities.

Last year our clinics result in more than 40,200 patient contacts across our region.

Working for the RFDS is a humbling experience.

Every day we make a real difference to the lives of people in Outback areas. That’s why our work is so important, and why we rely on your help.

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