First Impressions

The Land: red, dry, unvarying, roads long and unchanging.

Yet astonishingly different.

Hardy.

Loved and used.

Worn and resilient.

 

Community: population about 3000

50% indigenous.  40% bogan and the rest are pretty cool people :)

an IGA, a woollies, a pub, a gym/swim facility.

People: proud of their community. Proactive and resourceful.

Sharing of stories, wisdom. Generous.

Laid back, welcoming, inviting. 

December 11th-14th Mowanjum Health Day

My last remote trip. Things are winding down, everyone’s getting ready for Chrissy. It’s nice seeing the school decorated but things are much the same, still a challenge and still kind of depressing. One of our aims as a department is to work on health promotion because 1:1 level doesn’t seem very effective. No one in remote communities does their physio exercises let alone exercise in general. Obesity is such a problem and poor general health but people just don’t know about it. And it’s so hard to educate, 1) because there is no interest and 2) it’s difficult to get a message across due to lack of understanding each other’s languages. So we are trying to figure out the best way to get our message across, how do people want us to deliver the information so that they understand it and so that the can be interested in their own health. It’s more difficult than it sounds. There was a health clinic day in mowanjum last week. Mowanjum is a community close to Derby. The even was organized by the Mowanjum nurse and different groups came to set up a little stall – community health, DAHS (aboriginal health service), allied health, a quit smoking/drugs group etc. We were there an hour late but still a few hours before anyone rocked up- all set up and nothing to do. We weren’t really sure what to expect but our ITA (indigenous therapy assistant) said “It’s another bunch of white fella telling them what to do- why should they come?” So we got it wrong… again. Finally (after a few health workers drove out door knocking) a woman and her child came. The poor things were a bit bombarded and didn’t know how to respond. But when the ITA took her around, she interated a little more. Racism goes 2 ways… “Proactive” is a word that doesn’t seem to be in the vocab list. A few people wandered in, took the freebies and free food and sat around chatting to each other. Then we heard news that an elder had just passed away in the community so we all had to pack up and leave… We tried to ask people if they knew us and what we did but it was a bit of a waste of time to be honest. I don’t know why we keep trying. Is it a duty? I’m confused. And frustrated. Yet I keep wanting to help people and make changes and do the best I can – which is a common trait among health professionals. And perhaps this is our problem…

December 5th - 10th Broome Time again

Broome time again yay! On Friday I drove down and participated in a community event with a friend called “The Broome Splash n Dash”. It started at 5pm with a 5k run and it was still flipping hot! But knowing the swim was the next part pushed you that little bit extra so you could jump in the water sooner. But after the 500m swim I was still sweating and red in the face. We both ended up coming second in our gender groups- not a bad effort. Then we rewarded ourselves with delightful Japanese – 3 courses num num num. I was supposed to stay the night in a hotel room with another friend but sadly she unexpectedly had to fly home so I had the big bed and the lovely room to myself. In the morning I woke up and ran down along cable beach with all the other joggers and walkers and early rises. The sun beat down but I didn’t risk cooling off in the ocean with the possibility of lurking irrakanji – not that it would cool you off much, the water is like a hot bath at this time of year. So back to the hotel for a swim in the pool. Then out to coffee and breakfast at my favorite Broome café. I met some more Derby friends then and we did our chrissy shopping and I spontaneously bought myself a beautiful willy creek pearl for Christmas. Back to the pool. Then a pre-dinner drink at the Mangove which provides delightful views of the ocean and sunset. Dinner is booked at the nicest restaurant in town. A few jugs of sangria later we move on to a nice ambient cocktail bar for cocktails and delicious desert. Broome weekends are really just excuses for degustations and coffee. Sunday morning we are picked up at 7 for our big day of fishing! We are taken out on a big boat to a secret location in the middle of the ocean- no land is in sight. We are given rods and bait… “Now what do we do?” The other group of people were keen fisherman and were reeling in fish left right and centre- red emperor, giant somethingorother- just shit loads. And we couldn’t catch a thing! I reeled in a Samson and something else but it was too big so they had to be put back  We kept at it though – in between Matso’s ginger beers. At the end of the day we had one little fish- so the other group made sure we didn’t go hungry and they gave us 5 more fish to bring home! So nice. And that night we cooked up a storm and everyone came over to our little house and we bought chippies and it was all a big chaotic fun.

Nov 25th- Dec 4th It was the mangoes :(

So it wasn’t ring worms but an allergy to mangoes! It is terribly sad because I had great plans to make mango desserts and delicious things and now I cannot touch the poisonous things! The disease kept spreading and I ended up on antihistamines, oral steroids, oral antifungal, steroid cream, anti fungal cream and I think that’s it… It has subsided a bit finally but is still there… So last week was spent itching and in ED and at the pharmacy and by the weekend I was over it! On Friday night was the White Ribbon Day Football match between Derby and the next small community. White Ribbon Day was in commemoration of violence against women. We sat out and watched the boys play- some in bare feet, some wearing just one football boot (on their kicking foot). We had picnics and a free BBQ and it was cute. Saturday night was Thanksgiving dinner. My oh my there was a lot of jolly delicious food again- including 2 huge turkeys. We were all assigned a dish to make and given the recipe to follow by our Australian-American speech pathologist. The dinner was set up in a courtyard between 2 houses with gorgeous tables set up, fairy lights and music. It was very pleasant and we have been eating leftovers all week. On Monday I managed to jump aboard an RFDS flight up the cape to One Arm Point. The view on the flight was breathtaking. Departing the mud flats of Derby surrounding the jetty and moving on to fly over blue water. After the blue come beautiful islands with surrounding turquoise waters. The landing strip looks to be about a meter from the ocean on all sides but we land safely in our mini plane. Apparently sometimes you can even see turtles swimming as you land and take off. Whilst the RFDS doctors saw patients at the clinic I wondered down to Lombadina’s beach. It was a hot hot long sandy walk and it felt like the water kept getting further and further from me but eventually I reached it and it was glorious. The perfect colour, the perfect temperature. There was not a person or another live thing in site! So I swam and read a book and found some shade and after an hour or so headed back to the clinic. On the way back home I was told that there was a resident croc sighted residing at the beach at the moment…. Thanks for not telling me earlier!!

Ring Worms? Nov 24th

What a nice relaxing Derby weekend it has been again. I haven’t done much that is for sure. And earlier today I was a bit annoyed at not having done much but this evening I was relaxed and I went for a walk and I could take as long as I liked and I didn’t have to be anywhere and that felt nice. So I’m no longer feeling annoyed at not having done much, rather I feel appreciative of where I am and what is happening around me. On Thursday last week we had a planning day. The whole day was dedicated to reflecting on the events in allied health this year and sorting out what needs to be worked on for next year. Everyone has fantastic ideas on how to improve small issues and big issues and on just to improve even if something is not an issue. It was all very exciting because I could see that things can happen and will happen because the team is so enthusiastic and this made me want to contribute and put forward ideas and offer to help with projects. I won’t lie- it definitely made me feel like I want to stay and work toward these projects through next year. But I’m sure there are many places that need projects worked towards and I will find another I can contribute to and get excited about. It is a very nice feeling to love what you are doing and be surrounded by a team of people who also love what they do and are dedicated to it. It is inspiring and positive. Friday night we made homemade pizzas and watched Downton Abby- brilliant. Saturday Jess and I ran the first physiotherapy antenatal class and this was exciting and fun and the start of another positive! Saturday arvo and Sunday arvo I lounged around the hospital pool reading and cooling off. We partied Saturday night and dealt with it Sunday morning. I slept in until 10.30!! I felt so guilty of wasting the precious morning but it was necessary in order to function for the rest of the day. And I have ring worms. Yep. It’s gross. They are all over my arms and back and I look like a leper. And I am itchy and it’s horrid. But it is apparently easy to fix so I’m lucky I have not anything worse for there are by far worse things I could catch here I am sure. Ready for another week. It is going too too quickly but I need to stop worrying about the future and live in the now where it is fun and happening. Goodnight.

First Camping Trip - Middle Lagoon

You know you’re in the Kimberly

When you rock up to work on a Friday

And your workmates are excited and they casually say

We’re going camping this weekend

Knock off at 3

We’re heading somewhere great

Just wait and see

Pack a backpack

We’ll sort your gear

Just bring togs

And a slab or two of beer

You know your’e in the Kimberly

When a 4WD is the only way

When you bump, jump and slide

Over red dusty dirt all day

You know you’re in the Kimberly

When it costs seven bucks for water at a take away store

When there’s no such diet as vegan, organic or raw

When you order a decaf, skinny soy latte

And the dude looks blankly-

“What the hell did you say?”

You know you’re in the Kimberly

When a net and mat can be called bed

No blanket, no roof

Just something to rest your head

You know you’re in the Kimberly

When the sky is printed with a billion shiny dots

And you gaze up at them from your swag

As dreams slowly occupy their spots

You know you’re in the Kimberly

When you wake at 5 cos it’s hot and light

You walk, swim and eat

Before the sun’s reached height

You kayak the blue calm water

Of a lagoon untouched untainted

And wonder through animal tracks

And rocks that are fossil-painted

You know you’re in the Kimberly

When you’re in the middle of nowhere

And someone brings a satellite dish

To watch the granny free to air

You cook up a fresh catch

And all add something to share

Crabs, macky, spuds

Feed masses with more to spare

I know I’m in the Kimberly

I didn’t know what to expect

My adventures are beginning

As I learn to live and respect   

Fitzroy Crossing

We depart early morning for a drive to another community. Two and half hours later and work has begun. The long standing rotator cuff disease, the post op ACL, the chronic back pain, the developmentally delayed child all wonder in and out. At the end of the day we head to our lodge for the night and it’s like stepping into a different world. There is a pool and a restaurant and clean sheets to sink into. The next day I wonder just after sunrise and return sweaty though it’s only 6.30 so a dip in the pool before brekky on the verandah. Then to work. Today we have a home visit to a chap with multiple comorbidities. He stays in bed most of the day but word has it he’s been having difficulty walking so we have been called out to review him. Jess gives me a run down on procedures along the way. When visiting an aboriginal community, one will either toot and wait for someone to come out of the house, or speak loudly from the fence until someone comes out. We do not get out of the car if there are “cheeky” dogs around. We do not do home visits alone. We then ask if we are allowed to come in, and if welcomed through the gate, we ask again at the front door if we can come inside. Only then do we enter the house. Bob (names have been changed for confidentiality) is not keen to get out of bed for us today but he is pushed by his wife and eventually walks with us and a provided frame around the house. He then plonks down and starts eating breakfast. We wait until he is finished to continue our assessment. After providing a walker and lots of education it’s time to move on, It’s hot outside and not much cooler inside the house so we are glad to return to the comfort of the car’s air conditioner.

Next up we visit the Guwardi nursing home, which is home to about 25 residents. Jacko is getting along using his feet to push his wheelchair slowly but surely. There’s music playing and all the residents are sitting outside. The workers are wearing orange and yellow Hawaiian shirt uniforms and it’s nice to see that most of them are Aboriginal.

After Guwardi we go on a mad hunt for a patient who was supposed to come to the clinic for a teleconference with Perth specialists. He is not to be seen… so we head back for a long ride home. 

A typical day in Derby

Sun rises at about 5 am. I get a sprinkle of light through my blinds. The fan is gently whirring providing the perfect waking breeze. 5.30 I get up and start the day with a jog or yoga. 5.30 is the perfect temperature outside. There are an abundance of walkers out on the jetty path- some of whom I recognise as my patients- but the rest of the town remains asleep. By 6.30 the sun starts to become more prominent and I am sweating. Breakfast outside overlooking the marsh and I take my time easing in to the day. Off to work at 8 and the air is already thickening.

The morning at Derby Physiotherapy usually starts with a coffee. Women’s exercise class to follow. It’s hard to discharge the regular comers from the service but even harder to get the patients who need it, to start. The women who do come love the socialising and they love a chat. They like to tell me where they’ve worked, lived and what they’ve done in their lives. It is always astounding.

Then there’s morning tea, a patient to see or more likely a patient to chase if they haven’t turned up for the appointment.

Men’s exercise class happens later in the morning. Bushie wears no shoes, the same flouro vest and doesn’t come without his akubra- ever. Bushie had a stroke last year which has left him with a non-functional arm and unable to work. Despite this he has a great dry sense of humour but I’m not sure I understand his jokes half the time.

Hamish is a fisherman and the loveliest chap. Only in a country hospital can you swing past your patient’s house at lunchtime on a Friday to borrow some lines for your weekend fishing trip…

Greg has one leg double the size of the other and wears some serious bloodstones to exercise in. He says he’s preparing for the wet.

Lunchtime comes early enough but you’re hungry enough. And conversation is usually excited planning for the next weekend camping.

On a Thursday arvo there’s a hydro class at the local pool. The pool is definitely not “hydro” standards as it’s 28 degrees and we have to keep telling the local kids to keep out of the class area. But the ladies love it- it’s another excuse for socialising and free entry to the pool to keep cool in the hottest part of the day.

Tuesdays are an early morning flight with the Royal Flying Doctor Service (RFDS) on a very small 8-seater plane to service Fitzroy Crossing. The flight back is rocky and hot as you hit thermal pockets because the plane has to fly below a certain altitude due to its size.

In a single day, your caseload may be paediatric developmental disorders, antenatal, postanatal, on the wards, in Emergency, at the IGA (yep), at the nursing home, video conferencing, neuro, orhto, musculoskeletal, amputations, cardio… anything and everything.

As you step outside the air conditioning in the afternoon, the heat is all consuming and 43 degrees in Derby is suffocating. Friday arvo is POETS (piss off early tomorrow’s Saturday) so we head off to Scott House where the finance workers sell UDLs, wine, beer, cider and we have a drink around the hospital pool. Other weeknight post work activities include squash, swim club, jetty walks, mixed netball, volleyball. If someone is in town for a few days eg the dietician from Broom- there will be a dinner: a marsh dinner, pot luck dinner, fish and chips on the jetty with the sunset or one of the three restaurants in town. And Thursday night is karaoke night at The Spinny…

There’s also cricket, golf, fishing club, Hash House Harriers (a drinking club with a running problem), 5am boot camps, group pump classes at the town hall…