Well, we’re now back in Alice arriving five days ago and feels kinda strange not to be traveling, talking with folk about CRANA and listening to their concerns.
On the way to Menindee following the river from Bourke spotted a couple of parrots ñ the Mulga and Blue Bonnet.
The Emus colour was different from around there too rather than being grey-blue-green they were rust-coloured.
There were lots of wildflowers mainly purple, yellow and white with the greenery. The last wee bit had obviously missed out on the rain as dry as.
Wilcannia reminds me a little of Kalgoorlie and Coolgardie in WA, as I mentioned to Lenny, with the stone buildings a kinda grandeur of former days or plans of a bigger town in the future than turned out to be.
Again being a weekend day just dropped off the package of info at the hospital and will make contact soon.
Menindee has a good feel about it I reckon and lakes nearby add to that. There are also orchards in the area.
Did a bit of a double take when out walking to see a guy on a unicycle!
With the announcement three days prior to us getting there that White Cliffs health facility 95kms or so to the north was to close, naturally there was a huge concern about this at Menindee health centre for the 300 or so people of White Cliffs and the ramifications of this.
From there we followed the highway back over three days. Again, I apologise to Nepabunna, Leigh Creek, Maree, Oodnadatta and Marla for not spending time with you as anticipated. Donítí feel good about that. Will be in touch.
We DID get to visit and share with 30 health facilities though, over two and a bit weeks and more than 7000kms! Thanks to everyone for making us feel so welcome. It was great to be able to meet and spend time with you.
Thatís it folks. Cheers
Author Archive for Blog Manager
Just left Bourke after a couple of nights there and heading to Wilcnnia via the river road, Louth and Tilpa. Plan on being in Menindee tonight.
Learnt there is just now only a nurse at Wanaaring on Wednesdays and with time running out, decided to not head to Tibooburra unfortunately and therefore White Cliffs as well. Donít feel that good about it and was looking forward to seeing that country but howeverÖapologies to those there and will be in touch when I return to Alice which will be the 5th at the latest.
Since last writing visited the Walgett AMS which is very impressive and was told gets frequent visitors because of that. The CEO is Christine Corby, who is also the chair of the AH&ARC as well as having been inducted into the Aboriginal Hall of Fame as well as having an Order of Australia Medal. We didnít get to meet her as she was away, but spent time with the Practice Manager Kylie Gilmore, who told us Walgett AMS has a list of achievements including the first two AHWs trained as assistants with the local pharmacy, three awards for the Menís Pitstop, coinless condoms and AHW of the Year. However they still have trouble recruiting staff as elsewhere.
Went on to visit the hospital too of course, and met with two RNs, missed the Health Service Manager as she was away at a funeral. Again as elsewhere there are concerns about maternity services.
Lightening Ridge was next and what a shift, shops and signs galore and busier than usual with the Opal Festival on. At the Community Health Centre missed the Health Service Manager so as with a few places since and to come left the package and will get in touch back in Alice to talk through things.
At the hospital the Nurse Manager Liz Greaves had time with us when obviously very busy. She gave us a good insight to the community. Interesting. Here too there are recruitment issues even with itís attractiveness. Usually there are three thousand people living in the area but at this time of year it swells to ten thousand so naturally impacting on a whole range of things in the community. Sheís noticed more Indigenous people moving to the area because of the service access. There is no public housing and there is an increasing need for housing with the movement of people and there are many living in situations without running water, electricity or sewerage. There are extremes in demographics with those who have made much money and those at the other extreme. We saw a couple of examples of housing from the past in the town and the first wee hospital.
Next stop was Goodooga to Martha an RN from NZ whoís been there 4 Ω year and two AINs Belinda and Penny. Goodooga was seriously under threat of closure being announced in July last year to take effect at the end of the roster. Two reviews were done and earlier this year saying that it shouldnít be closed down and in fact should have increased staffing. Then in May they were told it wouldnít be closing. Needless to say there was a huge outcry from the community who worked to keep it open.
To Brewarrina or Bre as itís called in these parts. Arrived at sunset and ran into a Peter Tregonning, who I wasnít familiar with but some of you may well be as he was part of the early days of CRANA. Not long finished two years at Wanaaring and now at Bre. He spotted the car. He was the one who told us of the lack of service at Wanaaring at the moment. Again going to have to get back to the Bre folk. The last week or so have learnt of several services we didnít know about till we arrived in the area. Was told three of the Bre staff are going to the MEC in Bourke in a couple of weeks. Not surprised with the level of concern about maternity services.
The drive that day took us through some interesting country with clay/salt pans and vegetation obviously very tolerant to such but also swampy looking when rain was about which it had been recently so green plus.
Bourke, well got all the tyres replaced apart from the spares. Came across a market down by the river ñjust a lovely spot. Bourke has some lovely old buildings that I wandered about looking at with Ness while waiting on the car and Lenny took a rest.
Didnít realize Fred Hollows was buried here in Bourke. Thereís also a stone wall at the Sydney side entrance to town commemorating his eye/vision work where Bourke played a big early part in his career. Interesting grave of which the photo should be on the blog at some stage soon too.
Think thatís it for now again Cheers V
At Walgett after spending yesterday with staff at Cunnamulla Hosptial and Lenny with seven AHWs at the Multi Purpose Centre there. Then the Frontier Services Bush Nursing Post at Bollon followed by several staff at the St George Hospital. Today it was Goondir AMS in St George, Mungindi and Collarenebri.
Adele Leeds the DON at Cunnamulla praised the ENs there as highly skilled and talked about how the nurses all have portfolios. Joined staff at morning tea and met with a paramedic there as well for the first time on the trip and spent time talking with him about the relevance of CRANA to people in his field. He mentioned that ambulance staff tend to be on the outer rather than being included with other health staff generally he felt.
Charmaine at Bollon is in a single nurse post and like a couple of other remote nurses we’ve met on this trip lives on a property some way out of town when not working.
St George Hospital and PHC unit are very well resourced. Again met with several of the staff who were saying the last twelve months the area has had good rain after about five years of drought. Needless to say this will’ve had all sorts of effects on the community.
Goondir Health Service were suffering with having many of their staff away with the flu.
Mungindi were really appreciative of our visit as it was said they don’t get a lot of visits. Border issues certainly come into play again here! One of the RNs Sarah also works at nearly Dirranbandi so was able to tell us a little about the facility there. We passed on CRANA packs for her to share with the staff there and also Goondiwindi where she has worked previously.
At Collarenebri (with it’s fancy pink kettle) sat with member Nicole Lawler firstly, followed by three agency nurses and then the two resident community nurses. With a population of about 550, relatively new Multi Purpose Centre and two doctors as elsewhere people here don’t necessarily see themselves as remote. With us elaborating on CRANA’s definition of geographically remote &/or professionally isolated and what the organisation has to offer, I think people there too may access aspects of CRANA’s programs more in the future.
Lots of native pine trees (presumably Callitris)on the roadside yesterday. Occurred to me also that we have seen very few reptiles in our travels. Birds: saw a group of White-winged Choughs today and still groups of Apostlebirds about too.
More cleared land today and evidence of cotton on the roadsides today.
We’ve now visited with 25 health facilities, done just under 4500kms and it’s only day 11!
Catch ya. Vicki G
At Cunnamulla.
Back to when I last wrote on the road to Birdsville a couple of days ago.
Ross met us at the relatively new expansive health centre right next door to the old one which is open for visitors still. I remember a few years ago Kirsten and Jo were the nurses working out of the old building and doing a presentation on their work. Know Ross from Kintore in the late ë90s but hadnít seen him since so good to catch up. Bev arrived that night too as about to take over from him. They do six weeks on and three off. The Diamantina Council owns the health service and North West Queensland Primary Health Care, which is part of the Division of GPs cover the staffing.
Theyíve got the famous Birdsville races coming up soon when the town which usually has a population of about 80 swells to several thousand and going by the tourist stats this year, already itís expected to have an even bigger turnout. Ten extra nurses, two doctors, twenty police and I think 70 extra bar people are part of it all!
Visited the famous pub of course, certainly has character.
Back to Windorah, calling in to see Susan again. She had one of the old local characters with her whoíd lived all his life in the area.
The drive to Quilpie was green as ñ just lovely. Still coming across Emus and now goats.
Weíve crossed a number of the well known kind of legendary rivers on this trip, some more than once. Names like Georgina, Diamantina, Barcoo, Cooper Creek, Bulloo, Paroo and now Warrego. Still a good bit of water about too which is great to see for all sorts of reasons.
At the Quilpie Hopital this morning met the staff at morning tea. Theyíd had a rough day yesterday.
Had a new grad just started who said itís difficult to find a grad placement. There was a nursing student as well. Theyíre light on senior RNs and trying to grow their own. Only one agency nurse at the moment. Had a good yarn with a few of them. As elsewhere relief to get away for training is an ongoing issue.
Thargomindah to Karen a reliever whoíd seen the new CRANA ad on TV as others have. She was telling us that Thargomindah was the third place in the world to get electric light after Paris and London. Apparently one of the fellas involved in developing it in London came there in the 1860s!
Next Bollon, St George and Mungindi on the border.
Wrote this yesterday. Mobile range and internet access where we’ve been the last four days has been limited hence the delay in posting this.
Literally on the road to Birdsville from Bedourie on Sunday and obviously not driving myself at the mo, Lenny is.
Just had a couple of hours with Jeannie the reliever at Bedourie who has also worked a lot in the NT so connections in common.
Last wrote from Barcy as the locals call Barcaldine. Before leaving there two days ago met with Mark the DON, who also showed us around the extensive facility saying that one of the biggest issues is growing their own nursing staff and they have an ongoing program with local school kids to help try and change this to a degree. Lenny luckily spent time with Andrew the Acting Aboriginal Health Coordinator. The local Indigenous population tends to access the local the Aboriginal Corporation run by the Red Cross he said.
Headed off for what we found to be the delightful Blackall Hospital with itís ground level, curved, verandah-surrounded structure! Frankie the new DON there is a member and like everyone just lovely to meet and spend time with these folk. She said at the moment they were managing staffing levels with only one agency nurse and she attributed a lot of this to the flexibility of the staff. One of the nursing staff we met was up with her husband from Victoria for a while and has done the same in various places in the NT
Thereís looking like big changes in the area with coal and gas reserves having been found.
About 40 kms before Isisford came across a wee bearded-type dog obviously lost. Felt like picking him up and taking him to town but no room and maybe the owners would be back. Didnít take a drink but didnít feel too good looking back in the mirror to see him standing looking bewildered after the car.
Not long after that came across eight Australian Bustards, having also seen a group of four the previous day. Most Iíve ever seen that I can recall ñ just pairs in the past. They have a real arrogant air about them.
Isisford PHC centre again an old building that is apparently being slowly replaced. They still had a big-wheeled canvas ambulance stretcher in their historical area. Alex the Barcaldine-based reliever had just taken over from Phillip the current resident DON that day. Like other single nurse posts very reliant on the OSO for cleaning and ambulance driving during the week.
The Yellowbelly Fishing Comp was about to start for the weekend..
The stop for that night was Jundah another 200kms heading out to the Longreach road. Lots of green, emus again, and kangaroos mainly Euros and Greys as well as sheep and cattle. The jump up and forest at sunset just before our destination was beautiful.
Sue met us outside the extensive garden and PHC complex and then after unpacking we were off to the local pub for tea with her hubby Dennis too. Meeting some of the locals including a lady born in the area and apart from holidays still there at 81. We met an English backpacker working there as we did at Bedourie where there is also a woman from Paris. Apparently advertising is done in the cities to attract these workers.
One of the big changes in the area is the cancelled Russian kangaroo meat exports, as there are a considerable number of shooters in the area. Needless to say this will have a domino affect on the surrounding areas.
Left crossing the Thompson River like many waterways weíve crossed still with water in it and travellers fishing and staying for various lengths of time and several years in a row according to locals.
SoÖ to yesterday we left Sue after a pikelet morning tea and headed to Windorah to Susan a reliever and her three dogs. She has worked remote for years in Queensland including the Torres Strait and Gulf. Learnt about FROGS from her = Flying Remote OBs/Gynes Service!
To today, and itís our slowest one so far with under 200kms to Birdsville staying at the health centre there. Like all roads so far really interesting and changing country - grassland, gibber and wetlands with Darter, a Yellow Spoonbill, Pelicans and such. Which reminds me at the motel last night the Fairy Martins had built amazing nests under the eaves and were flat out this morning circling, ducking and diving.
Long day tomorrow going to Quilpie but thatís ok will get to connect with them the following morning before heading to Thargomindah then Cunnamulla.
You know weíve come across some amazing trees between Boulia and Winton that Iíve heard also grow south east of Alice and also 12km north of Birdsville. Apparently the only known three patches of Acacia peuce, a wattle harking back to the Ice Age. Yet another amazing thing Iíve found out on this adventure. Very slow growing and resistant to fire.
Catch ya
Hi again this time from Barcaldine. Almost have to stop and think where we are as moving from place to place quite quickly. Feel like I’d like to stop and overnight at each place we visit really!
Had the Corellas waking us at Boulia (is it really only yesterday morning!?) as at Alpurrurulum sunset and sunrise. Today though at Winton it was Galahs.
Had a lovely chat with Katrina and her partner Chris at Boulia. Unfortunately the Aboriginal Healthworker Lawrence was away. It seems that the Boulia Shire Council is really pro-active with the local Inidigenous population as far as employment goes and other aspects of peoples’ lives.
It also seems there’s a move of folk back to Boulia from Mt Isa because of the expenses, gambling and alcohol but this is creating housing issue at Boulia.
As we were leaving Boulia spotted quite a bit of water in the river to the east ( sorry don’t have the map in front of me to tell you it’s name) with Pelicans and lots of Black Cormorants.
Driving to Winton there is an extensive range of mesa or table-top shaped hills that are quite beautiful and originate from the ancient expansive sea that used to exist over much of the land. There is also a species of tree which like the mesas that it was said the only other place in the world that these occur is in South America!?
We didn’t get to meet with Jenny the Director of Nursing at Winton till this morning as she was tied up but met several other staff yesterday afternoon including Elsa who said one of the issues for health staff at Winton was a beach - quotable quote I reckon! As in other visits said I didn’t have a magic wand in my back pocket to oblige.
Learnt of another term alongside cultural awareness, sensitivity, safety, security, comfort, competence there’s responsiveness.
Last night Lenny and I yarned with Sue Witten a CRANA member and two agency nurses from New Zealand near Wellington and the West Coast of the South Island.
There is fantastic accommodation for staff at Winton which we have photos of and will post on the blog when we get to it. The gardener is also doing a fantastic job there too and at Muttaburra. Speaking of which I haven’t been to since 1988 with my ex and parents and at that stage there was a degree of angst I remember about the Kiwis and there use of wide-toothed combs for shearing. The sheep in the area have decreased somewhat since that time, being replaced by cattle. However as we walked into the pub for lunch with Karen the relieving nurse between Muttaburra and Boulia, there was a Kiwi joke shouted across from one side of the bar to the other. Then at Aramac not long after this, one of the residents of the lovely nearly 100 year old elevated hospital asked if we were there to work.
Can understand the question in view of the reliance on agency nursing staff. In my response he obviously picked up that I was a Kiwi and said in his German accent about the sign at a NZ airport asking fo the last peron leaving to turn off the lights! Agency staff is not the main issue confronting Aramac though, the main threat is the possible/probable closure of their hospital with the decision due in September. It like Hughenden and threats to Julia Creek and Charters Towers also aparrently they would be downgraded to single nurse post, primary health care facilities. Leaving there felt pretty down actually.
Did see quite a few Emus between Muttaburra, Aramac and Barcaldine as Karen at Muttaburra told us, and a mob of cattle with two women drovers including a young German. They were going from Tambo to Lake Nash! Didn’t get to ask the reason.
Don’t want to compromise people’s postions with regard to issues shared but will list these soon when I get a break in the traffic so to speak. Having very long days but just great to meet and yarn with folk.
Catch ya. Vicki
To see photo’s of Vicki & Lenny’s Trip : http://albums.crana.org.au/crana/vicki-lennys-trip-photos/
Well, sitting at Boulia with it’s wide streets and post Camel Cup W/E. Got in just after sunset with those amazing colours of outback Australia of green and orange after sunset to the west then the pink and blue in the eastern horizon that grows across the sky - the coming of the night. Then stars.. beautiful big sky country eh, are we who spend time out here ever so lucky!
Anyway leaving Alice yesterday just as the sun was rising was great to see a big flock of RTBCs which any other birdos out there will know to be the Red-Tailed Black Cockatoo.
To work…(?) up the Sandover Highway stopping at Ampilatwatja then Alpurrulum for the night. Have been up that road three times before when working short term but haven’t been that way for seven years. It’s lovely. The store then was the best I’d ever come across and still seemed to have joy, music and several Indigenous staff which is great to see.
At the mighty Georgina River just east of Alpurrurulum where there is still lots of water there was a big flock of Straw-Necked Ibis and two Brolgas flew over as well.
The track(s) to Uranangie are tricky to work out but got there. Talked with the relatively new publican and her opinion is that there isn’t enough access to health services of this small community of 20-60 folk. She also advised us to take the south road to Dajarra rather then the north road. Lovely drive as she said it was and Dajarra itself has a lovely setting in a range of hills not on the map. Very cute health centre and accommodation there too. It was pointed out that like many others there are serious health issues in this community, which is 95% Indigenous.
Will leave it at that for now. Visiting the health centre staff here before east to Winton. There’s an old stone house here too that I just might check out, some of you may be aware of me doing stonemasonry in ‘06.
There’s already a pattern of issues for remote staff which is not a great surprise to me. You’d like to think there has been some postiive changes to them though!
It’s great having Lenny to share the trip with along with trusted muttley Ness.
Good night.
Well, we’re nearly ready to head off on Monday morn early- well on the work front anyway, on the home front will need to largely happen over the weekend. Plan on being away for two and a half weeks.
First stop Alpurrurulum 700kms to the north east of Alice up the Sandover and Alyawarra country, up close to the Queensland border.
Then it’ll be Dajarra followed by Boulia, then Winton. I’ll have my laptop and mobile with me so if anyone wants to make contact that way please don’t hesitate: vicki@crana.org.au or 0400252602
Will keep you posted over the two and a half weeks or so and Amy is working on the map as I write.
Look forward to meeting up and yarning. Cheers for now Vicki
Vicki Gordon
CRANAplus Remote Support Officer
I went to the launching by Malandirri McCarthy the Minister for Children, Families and Child Protection, of the NT Suicide Prevention Action Plan 2009-2011 here in Alice Springs recently, with Mark Millard and Gary McFarlane from Bush Support Services.
As the plan says there are a range of complex and connected factors at play when considering suicide. These include mental health problems, drug and alcohol misuse, inadequate education, lack of meaningful or any employment, cultural or sexual identity issues, poverty, sexual physical or emotional abuse, problems with family and the law, grief loss and trauma.
Many of you of course will be more than aware of this and the numbers of people involved.
Suicide is one of the three leading causes of death for those 14-34. (Bertolote et al 2003). Males were almost four times more likely than females to die this way. There has been a drop however from 2720 in 1997 to 1799 in 2006.
In the Indigenous community the rates are at least 40% higher than the national average. The statistics can be a bit tricky with the influence of under-reporting, differences in reporting methods and with the Coronerís involvement this affects the length of time. The ABS reported that in 2006 suicide accounted for 4.3% of all Indigenous deaths compared with 1.3% in other Australians. Suicide in Indigenous populations was virtually unheard of prior to the 1960s. With the increase since then the distribution has been uneven in both time and place.
In the NT the rate has increased markedly since the mid 1990s with a peak in 2002, which is against the national trends. For the period 2002-2006 the rate was 22.4 per 100,000, which is more than double the national average at 10.4 per 100,000. (ABS 2008). Remote Indigenous males, young urban Indigenous males and non-Indigenous males 25-45 in an urban setting appear to be at higher risk than others. It needs to be remembered too though that these differing rates compared to the national level need to be viewed in the context of the higher proportion of Indigenous people, the higher male to female ratio, a younger population and high rates of known risk factors such as alcohol and drug abuse, crime and domestic violence.
In some Indigenous communities there are increasing rates of cannabis use too, which is of concern.
The NT Strategic Framework for Suicide Prevention (2003) is based on the Australian Governments Living for Everyone (LIFE) Framework (2000). This was reviewed in 2006 and a revised Framework was released in 2007. The NT Action Plan has retained the original key action areas of the NT Strategic Framework for Suicide Prevention and matched these where possible against the revised LIFE Framework for consistency and coordination. There are a range of responses across many different areas. One of the aims is to provide culturally appropriate programs that support community response to the high rates in Indigenous communities.
In each Action Area Enhancing Existing Initiatives and New Initiatives are included looking at various government departments and services/agencies but principally the Dept of Education and Training and Dept of Health and Families
Action Area 1: Promoting wellbeing, resilience and community capacity across the NT
Action Area 2: Enhancing protective factors and reducing risk factors for suicide and self-harm
Action Area 3: Services and support within the community for groups at increased risk
Action Area 4: Services for individuals at high risk
Action Area 5: Partnerships with Indigenous people Enhancing Existing Initiatives
Action Area 6: Progressing the evidence base for suicide prevention and good practice
Some of the themes:
ï The dissemination of information, training and resource development including those that are culturally appropriate
ï Increase of the workforce and expertise
ï Support services for the homeless, bereaved, victims of violence, prisoners and first responders
ï Cross-sectoral collaboration, partnerships, increased co-ordination and whole of govt approach
ï Increased cross-cultural understanding and engagement
Some of the initiatives:
ï Headspace which sounds like a good one stop shop for youth
ï Menís Sheds
ï Wellbeing officers in govt. primary schools
ï Counselors in middle and senior schools
ï Reducing Bullying & Empowering Bystanders package for schools
There is a lot written of programs already in existence many I was unaware of.
Just have to hope this all translates well at the grassroots level.
For more details: www.health.nt.gov.au/Mental_Health
Vicki Gordon
CRANAplus Remote Support Officer
vicki@crana.org.au
I went to the National E-Health Strategy Forum information session in Alice Springs last week and thought Iíd share some of this with you. I certainly learnt a lot about whatís happening in this regard and kinda wondering if much is generally known out there hence me putting this together.
As remote health workers itís well known how quality and continuity of care is compromised without ready up-to-date access to health records.
Peopleís mobility, language and cultural differences affect this of course, and as they say in the information package, this can and does lead to frequent re-admissions, duplication of interventions e.g medications or immunizations and gaps in care. In addition, adverse events related to allergies can only be avoided when they are known about.
If records and information are more easily available clinicians are able to spend more time with the patient and the patient doesnít have to continually retell their story as they know it.
An external evaluation of the trial of eHealth NT in 2004 said that providers, health care managers and consumers unanimously supported the concept. The main three areas of need were identified as being being, Hospital Discharge Summaries, pathology results and Current Health Profile.
Shared Electronic Health Record (SEHR), Electronic Transfer of Prescriptions (ETP) and Secure Electronic Messaging Service (SEMS) are elements with the process being easy fast and secure. No doubt there are some teething problems initially. The SEHR is integrated into local clinical information systems whatever they are and at the end of a consultation there will be a tick box to send the information to the SEHR.
ETPs at this stage are unique to the NT and apart from anything else help get over illegibility problems.
SEMS can include discharge summaries and reports, test results and current medications and notifications such as appointments, referrals and management plans between services.
There is more information available regarding the choice not to send sensitive information to the SEHR if desired by the patient and other matters.
An elibrary and elearning strategy are part of the package.
It was reported that once trained productivity is much the same.
At this stage 80% of rural and remote Territorians are registered with 61 participatory sites involving 2400 health staff integrated into day-today service delivery. The registration process of Aboriginal people was done in a culturally appropriate way it is said.
The Anangu Pitjantjatjarra Lands of northern South Australia are also participating and the Kimberley in WA as well as Queensland are looking to being introduced as well.
The Australian Health Ministers commissioned Deloitte to develop the National Strategy with key stakeholders in early í08 and they endorsed this in December.
After starting off with radio at Walungurru (Kintore) NT in the late ë80s itís amazing!
You can find out more at www.ahmac.gov.au for the National Strategy. This includes provider information and frequently asked questions as well as the Implementation Roadmap. For more details on the NT and cross border areas and an example of a SEHR view go to www.ehealth.nt.gov.au
Hope you find this useful and helpful.
Cheers,
Vicki Gordon
