Remote was exactly what Jasper Lawson wanted in his JFPP experience and you can’t get much more remote than where he’s just finished his second placement. Kalkarindji is a small dusty community about 500km south of Katherine in the Victoria Daly District and home to about 350 people. There is a clinic, police station, council building, school, shop, arts centre, and a whole lot of wide-open spaces.
“I always wanted to go to the NT because it feels like what Australia really is, it’s so removed from other states”. But more than being out in the middle of nowhere, the placement was attractive to Jasper because it helped him pursue his quest for understanding the inequities of health between Indigenous and non-Indigenous Australians. “Due to the social determinants of health, many patients had multiple comorbidities. This is something we learn about at uni but living within a community has allowed me to have a greater appreciation of these issues”.
When asked about his first impressions of Kalkarindji he said it was the teamwork of the health professionals in the clinic. “I’ve never been on a medical placement where teams work so well together and are communicating every day as equals. In larger hospitals that doesn’t always happen, and the hierarchy is stronger. Aboriginal health workers are seen at the same level as the nurses and similar to doctors. Everyone’s view is valid, everyone is discussing and giving their input and I really enjoy that”.
A typical day on placement for Jasper started with feeding the dogs. “I offered to feed the dogs which I did each morning and then I would have my own breakfast and be at the team meeting in the clinic at 8am. We would chat about the emergency cases from the night before and key tasks for the day. These meetings were great because they showed the collectiveness between allied health workers, nurses, Aboriginal health workers and doctors all working together.
“I would usually be with the doctor but if the patient didn’t want me to be there, or if there were other procedures I could be involved in, I would do those. For example, I took patient histories, observed nurses or allied health professionals, took blood samples, gave vaccinations or sutured or cleaned wounds with the Aboriginal health worker. A highlight of my most recent placement was being educated by specialists from Darwin on the how to interpret echocardiograms.”
Being remote was not a big deal for Jasper who said the most challenging thing so far was not having Wi-Fi on his first placement! Nonetheless the emotional and logistical support was amazing, and he assured other students not to worry about being remote. “Sue and Lyndsay need to be commended and I can’t speak more highly of them. They are so good at navigating their way through all the potential issues and they work really well with Katherine West Health Board.
“There were weekly chat sessions where you could ask questions about issues that you’re facing and be involved in sessions where you can talk about it with other students. They were very useful and worthwhile especially for those that didn’t have a lot of experience working remote. If there was anyone who was worried about doing the program because of how remote they are – they shouldn’t be”.
Spending time in community has made Jasper more aware about disparity in health between Indigenous and non-Indigenous Australians. “Being on placement has made me a lot more aware about the impact of social determinants of health particularly due to living in a remote community. Often specialists in Darwin would assume medical imaging could be completed within minutes and a telehealth session could be attended shortly afterwards. However, it can take up to three days for a patient to get imaging, as they need to catch a bus to Katherine and stay overnight. This is further complicated by wet season which can close off highways.”.
In 2-5 years’ time, Jasper sees himself continuing on the same trajectory of remote medicine. “Eventually I do want to work in remote Aboriginal communities. I find it interesting and more engaging. Remote communities are beautiful, and the culture is incredibly strong with most people speaking English as a second or third language. Working remote in NT will allow me to support communities who often find it difficult to retain doctors. I want to work in the tropics in the NT or northern Australia and I would like to also look at working with Doctors without Borders”.