Doctors beat tyranny of distance
When help is too far away, the hospital comes to the patient, writes Ashleigh Wilson
‘‘HE’S not complaining, but it’s been a tough few years for Muriel James. From her home in Lightning Ridge, a small mining town about 800km north-west of Sydney, the 72-year-old great-grandmother has been forced to travel long distances to seek treatment for everything from knee reconstructions to eye surgery. You name it, I’ve had it,’’ she said. In March, James and her partner Don Johnson underwent surgery to remove cataracts from their eyes in the nearby town of Bourke, a three-hour drive away. Travelling out of town for treatment has become unsettlingly routine, though it remains a necessity for residents of Lightning Ridge.
But earlier this month, the specialists came to them, performing much-needed eye treatment all day for residents of this 7000-strong town well-known to tourists for its opals.
‘‘ Oh mate, it’s marvellous,’’ said Johnson, 79, after reading out the letters on an eye chart stuck to the wall. ‘‘ The Government should do things like this out here with all the specialists.’’
The Outback Eye Service, created eight years ago to continue the pioneering work of the late Fred Hollows, treats about 1200 patients each year in four remote NSW towns.
The work is vital, with many residents reluctant to leave town for medical attention, regardless of their condition. But constant challenges remain to meet the rising costs of providing such a service, and resources are stretched thin.
The eye program depends on the Royal Flying Doctor Service, which flies teams of ophthamologists, optometrists and other eye specialists to Lightning Ridge and other towns every two months.
The service celebrates its 80th anniversary this year, having started out in 1928 in the north-western Queensland town of Cloncurry. But as its operations expand, the RFDS has struggled to meet the additional costs of providing a service off the beaten track.
The RFDS is currently negotiating a new funding agreement with the commonwealth that would include additional money for buying and maintaining aircraft. Soaring petrol prices and strong demand for doctors in rural areas have increased pressure on the organisation, which treats more than 240,000 patients per year.
Indeed, the figures involved are huge. For the year ending June 2007, the RFDS’s 47 planes travelled 21,714,595 km across some of the nation’s most isolated areas. They performed 35,089 aerial evacuations, or an average of 96 per day, and conducted 12,247 health clinics, or an average of 34 per day.
But there’s more to the service than evacuations alone. Primary health care makes up a large part of the RFDS, with GPs, nurses and specialists travelling to remote clinics for regular check-ups.
The service also boasts the nation’s only ‘‘ flying dentists’’, based in Broken Hill. Before a second dentist was employed in February this year, Lyn Mayne worked at 178 dental clinics across NSW in the year to June 2007, treating 1468 patients.
There’s also a Rural Women’s GP Service operating in NSW, Victoria and Tasmania, offering a range of medical services for women in remote areas, including cervical cancer screening, breast examinations, diabetes, menopause and psychological issues. Over that same period, the 26 female GPs treated 4294 country women at 44 locations.
And then, of course, there’s the outback eye program. At Lightning Ridge this month, as 25 patients waited patiently for their turn, ophthalmologist Michael Hennessy was clear about the need for regular visits by specialists.
He has been coming to town for 13 years, before the outback eye program officially began, so he knows the area and its people. Problems relating to glaucoma, diabetes and cataracts make up the bulk of his work.
But Hennessy says it is often a ‘‘ big deal’’ for patients to have to travel to nearby towns such as Bourke or Dubbo, let alone Sydney.
‘‘ A lot of people haven’t left here for a long time,’’ he said. ‘‘ And it’s the most disadvantaged and isolated community in NSW.’’
One patient was recently evacuated to Sydney with the team for immediate surgery after visiting specialists noticed a perforated
‘ cornea. At that critical stage, the patient could have lost their eye if no action had been taken. ‘‘ When it gets to that stage,’’ said Sydney optometrist Kyriacos Mavrolefteros, ‘‘ hours are what matters, not days or weeks.’’
The demand was reinforced by one patient, 77-year-old Evelyn Fields, who said she would have left her cataracts untreated if specialists did not come to town.
She had surgery in March at Bourke, where hospital facilities are more advanced, but had her check-up this month at Lightning Ridge. Her home is in Goodooga, a short drive from Lightning Ridge, and she admits that having to travel long distances would have made her think twice about seeking treatment.
‘‘ I probably would have gone blind instead,’’ she said.
James and Johnson still need further work on their other eyes, but recent surgeries by Hennessy have already improved their sight without the cost of travelling to a major city for treatment. For about an hour, James and Johnson wandered between the specialists having their eyes checked. Everything, it seemed, was progressing well. And the fact they did not have to travel long distances again made the experience far easier to bear.
‘‘ You can take the country out of a girl, but not the girl out of the country,’’ said James. ‘‘ I love the open space out here, the trees. And as for your sight, that’s something you can’t do without. If you can see, you’re on the top of the world.’’
Oh mate, it’s marvellous’: Muriel James and Don Johnson at the Lightning Ridge Primary Health Care Centre