OUTBACK CLINICS IN RURAL AND REGIONAL AREAS
National Rural Health Commissioner Professor Ruth Stewart consults with all rural and remote peak bodies to improve the health of those who live outside urban centres. Prof Stewart chairs the network of the 80 general practice respiratory clinics which are the vaccination hubs for rural and regional communities. They are as remote as Cobar in NSW, Kununurra in Western Australia, and Longreach in Queensland. Here she speaks with Jane Hansen
Q How do the GP respiratory clinics (GPRC) work?
A There are 80 GPRC and they have been chosen to fill gaps in places where there isn’t a vaccination centre. The states and the commonwealth are pulling together to get people vaccinated.
The respiratory clinics were set up very rapidly. For example, I recently visited Emerald in central Queensland and they put that together in three days. For a program rolled out very, very quickly, it has done surprisingly well.
Q Some communities, such as the East Pilbara, have only 22 per cent with one dose and 12 per cent with two doses. In the local government area of Grant in east South Australia, only 14 per cent have received one dose and 5.7 per cent two doses. Is it access or a supply issue in these areas?
A It’s both an access and supply issue, but also an issue of will. I think some rural people think ‘We don’t have Covid out here’. Particular remote communities think that – but all they need is one person with the Delta variant to move through their community and it is gone. People will be infected very rapidly.
Q Is that what happened in Wilcannia, NSW, where one in six now has Covid? A What has happened in Wilcan nia illustrates very sadly the message I want to get out.
People living in rural and regional Australia, if you are not vaccinated yet, you’ve got to make an appointment and get vaccinated. You can’t think ‘I live in the country and think I am safe from Covid’ – nobody is safe from Covid unless fully vaccinated.
Q Are the vaccines actually available in rural and remote communities?
A They are and they aren’t. We’ve had lots and lots of AstraZeneca vaccine and it is an excellent vaccine that gives good immunity but people have been scared off it because of discussions about the TTS clot issue, but it is a very rare syndrome and we do actually know how to treat it. I encouraged my 25-year-old son to go off and get it, but you just need to understand what the risks are, know what the signs are and line up for whatever vaccine you can get as soon as possible.
Q What have been some of the hurdles?
A In rural and remote areas, we are always challenged by workforce. And because Covid vaccine is new, there was a concern early on what the risks were so there was greater concern on having doctors present when people were being vaccinated. That is still the case, but we have developed more ways of vaccinating under the supervision of doctors, so there is that safety valve.
Q Western Australia seems to have the lowest vaccination rates in rural and remote areas. Why is that?
A Remote communities were initially given AstraZeneca because you didn’t have to freeze it – you could put it in an Esky and drive or fly out for a couple of hours to a remote community and it could be stored in their fridge for a few weeks, all good. Then came the announcement of AstraZeneca being preferred
for those ov over 60 – that changed to who should get ge AstraZeneca, and remote communities had to stop the planned rollout and begin to develop develo one of Pfizer.
Q What role has vaccine hesitancy played in vaccinating the Indigenous population?
A If you are from a community where in your mother’s childhood children were removed from the community because ‘this is the best thing for you’ says the man from the government, you remember that more than any other message, so when 50 years down the track someone says there is this horrible disease and we want to jab this in your arm, you need to have a careful conversation with that person.
Q What is at stake in rural and regional?
A Any community that doesn’t get over the 80 per cent of vaccination will be exposed to very high levels of infection. And if there are an increased number in the community with comorbidities, it is more likely people will die.