Dr Tanya Davies
Darwin based GP, Dr Tanya Davies, had previously worked as a locum in remote and rural communIties around Australia, but after 3 years in the city decided to give RAHC a call and get back into the bush. During her placement with RAHC Dr Davies spent a couple of weeks working in remote clinics around Katherine and shares her experience with us here.
How did you originally begin working in Indigenous Health?
I've always been interested in doing work with communities that don't have a lot of access to healthcare. That's why I did medicine and I always imagined that I would go overseas and work in international aid. Some friends were working in Indigenous health and I did a locum at Galiwinku and I loved it. I did a couple more locums and just got hooked by the community, the people, by the experience, by what I could contribute, by the team work. I got hooked very quickly.
What made you contact RAHC?
I've done quite a lot of years of locums but I was working in the city for about 3 years and I wanted to do another locum. I tried to organise it myself and struggled a bit, so I just rang RAHC and they made it happen. It was really good, I went to a community I had worked in before and RAHC just facilitated the whole thing and made it really easy.
What type of work did you do on your RAHC placement?
It's the sort of work that is pretty standard across the Territory. Remote work in the communities can be a single-doctor position with a few nurses and Aboriginal Health Workers and other staff at the clinic. And it's general medicine so you can see anything, whether it's chronic disease or acute care, women's health, men's health or child health; you sort of get to everything at once. It was two weeks and I certainly got to cover a lot of subjects in that time, but I had a great team, with lots of people working together so you certainly don't feel alone, that's for sure.
Did you feel that there is less support in remote clinics than in the city?
No, not at all: I've done some work in rural Australia, in four different states, and I actually feel like I have more support in remote clinics than I do in other places. You have the people on the phone: specialists in emergency have helped me, and you have the specilalist paediatricians - everyone on the end of the line. They have travelled out to the communities, and they know what situation you are in, they understand the health problems you're seeing - that you don't see everyday - and you have access to all those people, all the public health people and they give you a back up for public health issues. As long as you can pick up the phone there is lots and lots of support around.
How do you find working with the Aboriginal Health Workers?
The Aboriginal Health Workers are amazing. They are trained in such a wide range of subjects, and they see all the patients. They can see acute patients, or chronic disease patients, they do a lot of translation as well as cultural explanations, they're the person you go to - all remote staff go to - when you are not sure how to handle a situation. The Aboriginal Health Workers will tell you who is the correct relationship person to speak to about a certain situation, who to get advice from, what's the best way to deal with a particular situation if something is not happening the way it could or should and what is the best way to facilitate that and how to address the issues that are there that you may not have realised. They can identify the barriers or issues to give health professionals the help that they need - they are an amazing resource.
How did you find your RAHC experience?
The Regional Coordinator actually drove me down to Katherine so I didn't have to catch the bus. Nothing was too difficult and RAHC just said, "Yep, we'll organise it!". It was actually a really short time frame of only a couple of weeks but they organised re-instating my provider number. They insisted I have all my paperwork, obviously I had to provide all my registration, insurance and all those sorts of things, but they just facilitated it and made it happen in a very short time frame so they made it very easy.
How are remote clinics different from those in the city?
It's definitely a lot different from down south or in the mainstream. The services work very hard on a very limited budget. The clinics usually have most of the equipment that you need and sometimes you can have really quite good equipment, resuscitation devices, all the equipment that a day clinic would need. The burden of disease is challenging, as everyone knows there is the "Close the Gap" campaign with 17-20 years difference in life expectancy and you see that on a day to day basis.
You see very young people with diabetes, young people with heart disease, renal disease in very young people on dialysis, it can be very confronting but the spirit of people out bush is phenomenal. People don't sit down and say 'Woe is me', they always want to make a difference. In our society we tend to think, "Oh, I'm sick what can I do?" but they look after the rest of their families, their extended families, kids and grandkids. The burden of disease is high but the spirit is also very high.
What are some of the most interesting situations you have been in while working remotely?
There have been a few! I've seen car rollovers, I've delivered babies, but yet again in every single one of those incidents I had someone at the end of the phone, I had the nurses coming in even at night when they were not on-call, people coming to the clinic to help, including the Aboriginal Health Workers. You end up with lots of the community, if it's a serious problem everyone chips in. So I've got a range of stories but there has always been lots of back-up in every case and I have all good memories and experiences.
What would you say to other health professionals thinking about working with RAHC?
Just do it there is no day like today. I think it is something that once you have done it you get hooked. You find a way to do it. RAHC can facilitate it, do all the various paperwork that needs doing, they can talk to you about all the different options you have to work in. You can talk to people in the Territory. There are a range of places, from remote places to town-based places like Katherine, Tennant Creek or Alice Springs. You can work in a place with only a couple of doctors or a place on your own, so you may be in a place as the only doctor but there will be lots of nurses and Aboriginal Health Workers.
Those places I actually think are a more amazing experience because you are a lot more engaged with the community when you are remote and I would definitely suggest people do that. The experience of being in the community for a few weeks, on the weekends going to a local church service which might be in the local language, you might be taken fishing or hunting with the Aboriginal Health Workers or other local people. It's quite an amazing experience, so do it!
Would you like to do another RAHC placement in the future?
Oh, I would love to. I'd have to organise it with my current employer but absolutely I'd love to do another one and I've got to tell myself to just do it!
