Doc­tors beat tyranny of dis­tance

When help is too far away, the hospi­tal comes to the pa­tient, writes Ashleigh Wil­son

The Weekend Australian - Travel - - Health -

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‘‘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.’’

Pic­ture: Sam Mooy

Oh mate, it’s mar­vel­lous’: Muriel James and Don John­son at the Light­ning Ridge Pri­mary Health Care Cen­tre

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