NERCHA - Women's health in the Isa
Kristy Palmer reflects on her Rural and Remote Health Elective. After experiencing brief glimpses of remote health care in the Northern Territory and Far North Queensland during my journey as a medical student, I was curious to explore women’s health in a remote context. On a previous visit to Tennant Creek, NT, I was amazed at how lack of human resources in obstetrics forced all the pregnant women in the surrounding community to travel over 500km to Alice Springs, sometimes a month before their due date to safely deliver their baby. Antenatal care was scarce and disjointed, and babies would be brought home to their community (which the mother may have lived in all her life, and have no relatives or social support during her time in Alice) on the Greyhound bus.
This prompted me to travel to Mount Isa (1800km+ NW from Brisbane) with James Cook University’s Mount Isa Centre for Rural and Remote Health, to see an example of remote obstetric care in my home state, Queensland.
I was shocked to see patients from as far away as Mornington Island in the Gulf of Carpentaria, delivering in the outback mining town of Mount Isa as their local centre. The logistics of access to reliable transport meant many scheduled appointments were missed, delayed, or women came in during labour with little history of antenatal care. With an Aboriginal population of around 25% it was an education in cultural awareness and walking a mile in someone else’s shoes.
My last day in Mount Isa ended at 7pm after leaving the operating theatre for removal of a woman’s ruptured ectopic pregnancy to manage a teenage girl from a surrounding community who was experiencing a post-partum haemorrhage.
She had no family members with her, no father of the child present, and was left clutching her newborn baby whilst the doctors stopped the bleeding and stitched her wound.
English is not her first language and she very timidly asked (after such a long ordeal) if she could have something to eat, for the first time that day.
Contraception advice favours long-acting methods as it may be many months once a woman leaves Mount Isa before she has access to a pharmacy. In the children’s ward nearby I saw the list of diagnoses that seemed more appropriate in a third world country than contemporary Australia – crusted scabies, osteomyelitis etc.
Amongst this I was blown away by the hospitality of the townspeople, staff, and students at the hospital. Though the work can be challenging and the days can be long everybody approaches the challenge with flexibility, a commitment to teamwork, and a sense of humour. I particularly enjoyed the opportunity to travel 300kms to Julia Creek for the Dirt N Dust Festival to camp under the stars, watch my junior doctor friends compete in the triathlon, and unwind at the rodeo. Sadly I missed out on entering into the World’s Best Butt Competition!
The opportunity to attend a remote clinic visit with the Royal Flying Doctor’s Service was also an unforgettable experience. To talk with people in the field who come from such diverse backgrounds to share a common goal of reducing the barriers to accessing healthcare in remote areas was incredibly valuable. All I had to do was walk into the reception area of the RFDS, fill out paperwork and I was airborne the next day!
I am grateful to the Mount Isa Centre for Rural and Remote Health (MICRRH) and James Cook University for helping me with the logistics of making my stay practical, and to my UNE’s rural health club NERCHA for partially funding the elective and making it financially viable for me. I would encourage other health students interested in going rural to get involved with NERCHA and utilise the opportunities they provide.