RURAL REMEDY
SUPPLYING HEALTHCARE IS JUST THE BEGINNING FOR THIS GP
Dr Kate Armstrong is on a medical mission in Colville
Kate Armstrong was recently asked by a fellow GP, “Why aren’t you burnt out?” It’s a good question – life is so full-on for the rural doctor and mum of three that it wouldn’t be a surprise if it all became overwhelming.
She’s the only doctor covering an area of about 250 square kilometres in the northern Coromandel Peninsula. Her clinic in the small settlement of Colville has 700 registered patients, spread throughout the region, but in summer the population of the area swells to between 8000 and 10,000 thanks to all the holidaymakers who flock there.
“In summer none of the locals come to see me unless it’s an emergency because we’re pretty much operating as an A and E clinic for people on holiday,” explains Kate (48).
She is also a St John ambulance service volunteer, spending about 50% of her time on call. During that time she stays in Colville because her home, 50 minutes away in Port Charles, near the very top of the peninsula, is up a windy, steep road and it takes her a long time to get anywhere from there.
As part of St John, she attends everything from cardiac arrests to car crashes, alongside a team of women who also volunteer their time and skills. “We set up the service ourselves 11 years ago and in that time, we’ve never missed a shift,” she tells. As if that’s not enough, Kate is also involved in a project to raise money for a groundbreaking multi-purpose health, education and wellbeing centre in Colville.
“Yes, it would be easy to burn out, but part of the reason I don’t is because I love what I do,” tells Kate. “There are a lot of challenges being a rural GP covering a large area, but that makes things exciting, and I never know what each day is going to bring.”
Growing up in Auckland, she considered medicine as a possible career, inspired by her mother and grandmother who were both nurses. But a passion for sport – she was a top water polo player – meant her grades weren’t great and her career guidance counsellor told her, “Sorry, you can’t be a doctor.”
At 16, Kate made the New Zealand water polo team and spent several months travelling around Europe in a double decker bus, competing in countries such as Italy, Belgium and France. Afterwards, she decided to stay in England with friends of her parents, where she completed a diploma in horticulture and landscaping, and in between working for a landscaper, she travelled.
On a trip through Africa in an overland truck, Kate found herself watching two nurses in the group she was with who were helping others when they got sick and had an epiphany.
“After five years away, I suddenly thought, ‘I want to go home and become a doctor.’”
Even though she’d left school at 16, she managed to get into the University of Auckland to do a science degree because her horticulture diploma was recognised as a qualification.
“To start with, I really struggled, but the science faculty was amazing. They took me from a crying wreck after the first chemistry session – what the heck was I supposed to do with sodium chloride? – to someone who got As at the end of the year.
“I got the marks I needed to get into medical school but I wasn’t offered an interview. I was devastated but wasn’t going to take no for an answer, so I wrote to every person on the selection committee and badgered them into giving me an interview until I got in.”
Inspired by the doctor
her grandmother had worked with in Masterton, Kate was keen on becoming a rural GP. Meeting her husband, Richard Campbell, in her third year at university sealed the deal – he owned land in the remote northern Coromandel, which is where they wanted to live.
As well as doing hospital training as part of her medical degree, Kate gained extra qualifications in obstetrics, general practice, gynaecology, paediatrics and emergency medicine, and worked in rural communities in Northland and the Coromandel while she was a student. “That helped to give me the confidence to go into the middle of nowhere and practise medicine.”
At the end of her fifth year at medical school, she had her first son Dorian (now 21). Richard became a stay-at-home dad and took the baby to wherever Kate was working so she could breastfeed. He did the same thing when their second son Locky (16) was born and Kate was working as a locum.
Shortly after having Locky, Kate began working on Great Barrier Island, alternating one week on, one week off with the GP there, Dr Ivan Howie.
In 2003 she decided to set up a community health centre in Colville along the lines of the one on Great Barrier Island. With a staff of three – a local nurse and Richard’s mum and sister – she initially worked out of the local hall.
“We stacked up piles of chairs and put curtains over them to create private areas. My mother-in-law was on reception and she’d have the radio going so people couldn’t hear too much of what was happening. Richard and some local builders then built me a mobile clinic to put next door that I could use as my surgery.”
Kate quickly found that many of her patients were “hippies” who weren’t fond of orthodox medicine and would often refuse to do things like take antibiotics. So she did even more study, this time in complementary medicines, so she could cater to them. She now practises integrative medicine, combining orthodox and complementary treatments.
The Colville Community Health Trust was set up to pay for infrastructure, which means equipment and other assets are owned by the local community, not Kate. The trust gets its money from grants and fundraising events such as deep winter swims and raffles.
Kate and her team now work out of a rented house that is better than the hall but still not fit for purpose.
“We decided to raise money for a purpose-built health centre,” Kate explains. “A while back, an architect came to see us to talk about what we wanted, and he said to me, ‘What’s the real vision, Kate?’
“I’d had ideas about something bigger than just a health centre but I hadn’t been brave enough to tell anyone about it. Because of that encouragement, I spoke out about what I had in mind and now the health trust has joined together with another group, the Colville Social Service Collective, to create the Colville Project Charitable Trust.”
As well as building a wellbeing and education centre to house everything from the GP and district nurse through to A&E and social services, the Colville Project wants to provide
accommodation for visiting professionals and students, and also housing for the elderly and people with disabilities.
Kate’s also hoping the project can fund training for some unemployed locals to provide services for elderly people. Plus they’d like to build houses for skilled people who want to move to the area but haven’t got anywhere to live, as well as provide recreational facilities and training for young people.
It’s a very ambitious project and so far a quarter of the $670,000 needed to buy 32 hectares of land in Colville has been raised, along with $170,000 towards building the wellbeing centre.
“It takes up a lot of my time but I am passionate about it,” says Kate, adding that being involved in something that will not only help locals but may end up being a model for other rural communities in New Zealand helps to keep her energised.
Another reason why she hasn’t burned out is the support from Richard, their children – they also have a daughter Isla (10) – and his extended family.
“They look after me every step of the way; they make sure I get enough sleep. They’re amazing,” tells Kate.
When she is not on call for St John, she can truly relax at home because they have no
TV, Wi-Fi or landline phone and poor cellphone reception. Regular massages, a weekly yoga class and getting out in nature also keeps stress at bay.
“But one of the main reasons I can keep going is because of the connectedness I feel with the community,” says
Kate. “Every single day I get something from my interactions with my patients that helps me personally.
“Sometimes it is literally a gift – we get given smoked fish, crayfish, mussels, vegetables, homemade sourdough bread.
“I really care about them and I want them to be well. I love being a rural GP and I get so much out of it. I know this is what I’m meant to be doing.”
‘ It would be easy to burn out, but part of the reason I don’t is because I love what I do’