Help from above
As the Royal Flying Doctor Service celebrates its 90th year, it’s honouring its past while looking to the future.
The Royal Flying Doctor Service celebrates its 90th year.
“IGOT FLOWN OUT by the Flying Doctors once,” says Kerrizita Jimbid ie, a re sident of t he Yakanarra Aboriginal community, 31 hours drive north-west of Perth in the Kimberley, Western Australia.
“We were coming back from night hunting and I got bit by a death adder on my second toe. His teeth got stuck in my foot. My grandfather had to drive me to the airstrip. My mother and grandmother were with me – they try to keep me awake, saying, ‘Count the stars, Kerrizita.’”
It worked. Kerrizita stayed awake until the Royal Flying Doctor Service (RFDS) landed at the nearest airstrip to take her to hospital about 340km away in Broome, where she was treated with antivenene and soon recovered.
These are the kind of emergencies that spring to mind when we think of the Flying Doctor: snake bites; accidents with farm machinery; kids falling from horses; vehicle smashes on remote highways. It was these sorts of crises that first prompted Reverend John Flynn to create the RFDS 90 years ago in 1928.
It all began a decade before, on 29 July 1917, on a remote WA cattle station when stockman Jimmy Darcy, 29, suffered internal injuries after his horse fell during a cattle stampede. He was taken 80km on a dray to the nearest town of Halls Creek, where the postmaster, who had no medical training whatsoever, performed emergency surgery with a penknife, following instructions relayed via Morse code from Dr Joe Holland in Perth.
The country was shocked by the dramatic events and followed the story via newspaper as Dr Holland made the 2800km trip from Perth, travelling by cattle ship, Model T Ford, horse and foot, to save Jimmy’s life. But when he finally arrived, it was only to discover that Jimmy had died a few hours earlier.
The tragedy tugged at Australians’ heartstrings and highlighted the need for an outback medical service. It also gave Lieutenant Clifford Peel, a medical student and pilot, an idea. Peel was a fan of Rev. Flynn, who’d been appointed head of the Australian Inland Mission in 1912 and was intent on providing medical care, as well as spiritual sustenance, to people in remote locations.
Knowing of Flynn’s dream of creating a ‘mantle of safety’ for outback communities, Peel wrote to him suggesting he use planes to fulfil this mission. Flynn finally succeeded in bringing this inspired idea to fruition in 1928, when a plane leased from Qantas took off from Cloncurry, Queensland, with the very f irst f lying doctor on board. Flynn had created the world’s f irst aeromedical service.
That f light – and all those in the decades that followed – shaped Australia as we know it, an accomplishment that earned Flynn a spot on our $20 note. The provision of medical care has enabled families to live, work and prosper in remote locations, helping forge the spirit of Australia – one that’s rooted in the outback and the bush.
The populating of outback Australia by farmers has had more concrete outcomes, too. “If you think of food security,” says Marcus Wilson, manager of the RFDS Broken Hill base, “the majority of our primary producers can live and work where they do because of the Flying Doctors.”
None but the boldest of women took their families to live in the outback before that mantle of safety was established.
Even today, life here isn’t easy. Tracey Hotchin, who lives in the New South Wales town of Tibooburra, 330km drive north of Broken Hill, says, “The RFDS wants you in Broken Hill six weeks before your baby comes. But they pick people up if something goes wrong, of course.” And it’s not just for birth that she has called on the RFDS – it’s the bumps and scrapes that are part of any childhood. “Having the comfort of the RFDS when you’ve got kids in the bush, knowing you can speak to someone within 10 or 15 minutes, it’s reassuring.”
Back in Yakanarra, it’s a similar story. Trevena Kylie is attending the RFDS weekly GP clinic to have her 18-month-old son, Junior, vaccinated. Along for the trip are her other kids, the oldest of whom is Jemima, 19, herself expecting a child. Trevena explains: “You have your babies in Broome or Derby – Perth if you’re really sick.”
Keeping families safe in these remote communities has always been a large part of the RFDS remit. And now, 90 years after that first f light, the single fabric-and-wood plane has given way to a sleek, high-tech f leet of 69 customised aircraft that makes the RFDS the third largest airline in Australia. Its 1500 staff, who work across all 23 bases, toil busily to keep those planes in the sky, which costs the RFDS $350 million each year.
CHRIS DENING SITS surrounded by screens in the comms room at the RFDS Broken Hill base, the nerve centre of the service’s western NSW operations. One screen shows where each plane is in real time, and one tracks the weather. She juggles the phone and the radio
and keeps the whole operation running. “Some days there are no [emergency] retrievals,” she says, “and sometimes there are four in one day. The most common incidents are motorbike accidents – that’s mostly in the tourist season, March–November. Often there are quad bike accidents, too, when they’re mustering on stations. Or cars crashing into wildlife – emus are in abundance round here at the moment.”
Beside Chris’s high-tech station lie older machines, outdated by the march of progress. The base even still has one of Alfred Traeger’s pedal radios, the invention of which allowed people in remote communities to summon the RFDS.
Even the most extreme examples of country resourcefulness are giving way to modern efficiency. “The f laming dunny rolls are going,” Marcus Wilson says, going on to explain that when RFDS planes have to land at night on remote airstrips (mostly on cattle stations) that aren’t equipped with lights, “we had to soak toilet rolls in diesel and light them, and put them every 10m on either side of the airstrip. We did that as recently as last year. Now most airstrips have Ef lares, which are LED lights.” These emergency night landings and daring rescue missions have always been key to the work of the RFDS, but it’s the more humdrum work of GP clinics and patient transfers that keeps rural Australia’s heart beating.
Dr Servaas Terblanche of the RFDS Broome base explains: “Primary care is the most effective way to spend our budget – retrievals are always more expensive than clinics, so if we can prevent some of these conditions that lead to retrievals, that is more value for money.”
As a GP with specialisms in obstetrics and anaesthetics, Servaas loves working in remote areas. “This is general practice in the most raw way you can imagine,” he says. “It’s great getting into the communities and really getting to know people.”
The RFDS runs a weekly clinic in Yakanarra, sending out a GP and a nurse, often accompanied by a specialist. (It was optometrist Stephen Copeland on the day we visited.)
The two-hour f light we took from Broome to get to the remote community and speak to its locals, including Kerrizita Jimbidie, underlines the ‘tyranny of distance’ that still rules WA. Every half-hour or so, we f lew over a tiny cluster of buildings surrounded by trees, with straight red roads angling out into the bush. A couple have dirt airstrips of the kind that the RFDS uses for emergencies.
“We had to soak toilet rolls in diesel and light them, and put them every 10m on either side of the airstrip.”
After landing in Yakanarra, we see the airstrip building – barely more than a shed – is dedicated to Sister Gail, an RFDS nurse who worked in this community for decades. A rattletrap vehicle transports us along the bumpy road to the town, which consists of the health clinic, a shop, a school and houses.
The shop serves as a meeting place – partly because it has the only phone service and wifi in town – and its verandah is dotted with people using the microwave, emailing on their phones, or sitting with friends.
As Patrick Berringal sits in the clinic waiting room to see Servaas, he ref lects on the RFDS: “In the city they put you on an appointment [to see a doctor], and you have to wait – here they do it quicker. The Flying Doctors do a lot here. They come every week.”
The most common ailments in Yakanarra, Servaas says, are diabetes, hypertension and asthma. The people in the waiting room chat in the local language, Walmajarri, but they switch quickly to English to recount tales to us of RFDS rescues and everyday care.
“I’m seeing the eye doctor today,” Lavinia Vanbee says. “And I’ve had physio before – I had a bad back.”
Vicki Moora has an abiding impression of being f lown out to Derby when she was battling severe asthma: turbulence. “It was a bit shaky in the air,” she remembers.
When we visit the RFDS Broken Hill base – 2190km away in NSW – we f ind Wednesdays are ‘W-days’: there are GP clinics in the outback towns of Wilcannia, White Cliffs and Wanaaring. Pilot Magnus Badger has just taken off on the W-clinic run, and Chris in the comms room is monitoring his progress.
“Magnus calls in when he gets to Wilcannia – that’s half an hour [f lying time] from here,” she says, stopping to pick up his call. Afterwards, she rings ahead to his next stop at White Cliffs to tell them he’s 15 minutes away. “Can you do a roo run, please? Thanks.”
The necessity of the roo run (where a local drives along the airstrip to clear it of wildlife before the plane lands) becomes clear when I speak to Broken Hill base aircraft engineer Malcolm Esling. Despite these efforts, though, problems still occur. “We’ve had two roo strikes in the past 12 months,” he says. “Well, three if you count the plane that hit two at once. One took out half an engine.”
Malcolm is one of 10 engineers at the Broken Hill base, and the rolling maintenance they perform is vital: “This environment’s harsh on aircraft,” says base manager Marcus.
“Without us,” Malcolm says of his team of engineers, “they’d be the Walking Doctors.”
IT’S EASY TO STEREOTYPE the country towns that the RFDS services as tightknit communities of good people all pulling together. But in the case of Tibooburra in north-western NSW – population 134 – it rings true. “It’s a bright little town,” says long-time resident Barney Dail, 93. “Everyone comes in and boils the billy with you.” Proving his point, he has a word for each person who passes as we yarn outside the clinic doors. “How are ya? How you keeping? When’s the rain coming?”
The rain question is all too crucial. With the entire state in drought when we visit in August, the RFDS mental-health services are more in demand than ever. Its services range from GP consultations to visiting mental-health specialists, telehealth services and emergency air transfers for people in crisis.
Rachel Hill can testify to how tough droughts can be. She grew up on a station outside Tibooburra and now lives at Waka Station with her husband, Bodie, and sons, Ethan, 9, and Edward, 6, both educated via the School of the Air. Rachel says of the drought, “It’s hard to know what to do. On our station we have about 3000 sheep, but not many cattle now. There’s a f low-on effect – if there’s no rain, there are no lambs, and no income for the next few years.”
Rachel’s mum, Tracey Hotchin, owns the Two Storey pub (the sign out the front says Tibooburra Hotel, but its nickname stems from classic outback logic: the only other pub in town is single storey). The RFDS is so embedded in Tracey’s life that she struggles at first to articulate what it means to her: “You take it for granted until you actually start talking about it! I don’t know life without the Flying Doctors. It’s just part of life for us – it’s an accepted fact that that’s how our medical system works.”
But soon she’s recounting various rescues the RFDS has undertaken for her family members. “People ask how you cope living out here,” she says. “I believe we’re well looked after by the Flying Doctors. The service we get is great. That’s what makes living here easier – it is the reassurance of everyday. The emergency response is amazing, but for general medical things, they’re always there too.”
It’s true the Flying Doctors are woven tight into the warp and weft of rural life. Everywhere you turn, someone has a tale to tell of lives saved, crises averted, and worries allayed by the
RFDS. And the communities they serve help them, in return. On every bar is a fundraising tin, on everyone’s lips a story of how they did a sponsored ride or walk, or a silent auction, to keep their beloved doctors f lying. Barney has a glint in his eye as he tells of how his turn as an artist’s muse helps raise cash for the RFDS. “There’s a mural on the wall of the Family Hotel, that’s the pub I used to own. Clifton Pugh the artist painted me riding bareback, and it’s a gold coin donation to the RFDS if you want to take a picture of it.”
Vivienne Fazulla, the head nurse at NSW Health’s Tibooburra clinic, from which the RFDS operates its GP clinics, explains the glint: “And you’re in the nude, aren’t you, Barney?”
He nods as the corners of his mouth twitch with a wry smile: “I was in me prime.” Barney first went droving at the age of 12. “Saddle and swag, that’s my home,” he says, explaining that he’s relied on the RFDS on several occasions. “I’ve had a few f ly-outs – mostly from getting hurt with the horses. I got a knife through here.” He lifts his hand, a long white scar winding through its lines. “It twisted and came out here. That was a Flying Doctors job. They took me to Broken Hill. They took me to Adelaide, too, when I needed two stents put in.”
Along with GP clinics, patient transfers are another key element of everyday RFDS activities.
Throughout his life, painter, author, TV and radio star and bushman Jack Absalom has raised hundreds of thousands of dollars for the service. The outback is central to both his existence and that of the RFDS. Now aged 91 and as robust in spirit as ever, if slightly frailer in body, Jack is being transferred in an RFDS plane from Broken Hill to Adelaide hospital for tests. “I could have climbed in there, saved all this messing around,” he jokes as nurse Leisl Moffat and pilot Drew Withers use the stretcher loader to lift him from the airstrip into the plane.
For all his decades of outback adventuring, this is the f irst time Jack has used the RFDS. “But I’ve donated and raised money for them,” he says. “The RFDS is so important for the bush – by 10 o’clock tonight, this plane could be 1000 miles away picking up a little girl who’s fallen off her horse and got hurt. It’s a godsend.”
Despite the accolades, the RFDS doesn’t rest on its laurels. At the Broken Hill base, Dr Justin Gladman is testing out an innovative telehealth program. Doctors have been conducting remote consultations via mobile or satellite phone for decades, but this new equipment involves a machine that will be set up in clinics with no doctor.
A nurse facilitates the use of the machine’s various attachments – cameras and lights, tongue depressors, a mole-scope – to
With the entire state of NSW in drought… the RFDS mental-health services are more in demand than ever.
assist the doctor on the other end of the video consultation to make a diagnosis. “It’s like Skype or Face Time,” Justin explains, “but patients just get emailed a link when they get an appointment – they don’t need to set up an account. It’s a great addition to the face-to-face clinics. For example, Ivanhoe has a couple of clinics a week – this is for the patients on properties who can’t get there on those days.”
Remote consultations work in conjunction with that RFDS staple, the medical chest. Essential since the service’s earliest days, the chest is stocked with numbered medications, some that need prescriptions and some that don’t. Australia is scattered with more than 2000 RFDS medical chests, located in accessible places ranging from homesteads and cattle stations to schools, Aboriginal communities and mine sites.
OUR TWO WEEKS with the RFDS end the same day as the Outback Air Race does. This 12-day race from Brisbane to Broome is held every three years in August to raise funds for the RFDS. “You do what you enjoy and it’s for a good cause,” says Geoff Glanville, a member of Team Carry-On. “We need more awareness for the Flying Doctors, particularly among city people. It’s an iconic Australian institution.”
The race’s youngest participant, Jordan Phan, 10, is in total agreement: “My school motto is, ‘Never see a need without doing something about it’. That’s what made me want to help. And the Flying Doctors do great things.”
Each time it’s run, the Outback Air Race raises half a million dollars. Impressive as that f igure is, it pales into insignificance when compared with the $350 million required each year to keep the doctors f lying.
“At a function the first night of the race, an RFDS guy gave us a presentation and showed us a picture of an engine. He said, ‘That engine costs a million dollars’,” captain of Team Carry-On John Kearney says. “So all this fundraising the race does, it’s great, but it only pays for half of one engine! That’s why the awareness it raises is just as important.”
The RFDS runs on donations from the general public, as well as Commonwealth funding. In March, then prime minister Malcolm Turnbull announced a funding boost of $84 million to the RFDS for mental-health and dental care.
Another source of funding is the contracts the service fulfils for remote healthcare: with the state health services and with private companies who need to keep their workers healthy.
Even more than the money, it’s the people who keep the RFDS f lying. We meet numerous people who have retired from the RFDS, then returned to work because they just can’t stay away.
The service attracts people with fascinating backgrounds: Marcus Wilson was an army medic for 14 years before spending 10 years in Afghanistan doing aeromedical retrievals. His colleague Lauren Cooney, primary health manager of the RFDS south-eastern section, worked all over the world with Médecins Sans Frontières for years, both as a nurse and in emergency and operational management.
In WA, Dr Edi Albert works for the RFDS out of the Broome base, as well as lecturing in remote and polar medicine at the University of Tasmania and fitting in regular working visits to Antarctica.
After a busy corporate career at Coles-Myer, Sue Williams returned to her home town of Broken Hill and is now the RFDS business manager for tourism. “It is a really rewarding job,” she says, crystallising what draws this eclectic mix of people to the service. “I wanted to give back to the community and get job satisfaction. So what better place than the RFDS?”
It’s the people who make the RFDS what it is: both the dedicated workers and the resilient, hardworking folk they help.
“The RFDS safety network only works because of the sense of community in the bush – people might not get along but they’re there if push comes to shove,” Marcus says. “That’s the definition of mate ship, tome .”
And those people are ready for the next 90 years of fulfilling Rev. John Flynn’s vision and safeguarding the outback.
AUSTRALIAN GEOGRAPHIC would like to thank the Royal Flying Doctor Service and all those featured for their generous assistance with this story.