Care when – and where – it counts

As anyone who lived through the Spanish Flu epidemic of the early twentieth century knows, the COVID-19 pandemic is far from the first time the world has faced a collective health emergency. What’s more, the Flying Doctor has a long history of protecting Australians during such emergencies. During the late 1960s, when a second wave of polio was sweeping through Western Australia, pilot and RFDS flight nurse Robin Miller was at the forefront of the country’s response. She recognised that while the polio vaccine had been available since the mid-1950s, many West Australians living in remote areas were still unvaccinated, and therefore highly vulnerable.

Combining her nursing and piloting abilities, Robin began a radical immunisation program, flying solo to isolated communities to deliver vaccine doses dripped onto sugar cubes. It was this distinctive process of vaccine administration that earned her the nickname, the ‘Sugarbird Lady’.

While Robin’s is undeniably an impressive story, it is not altogether unique. Over the years, countless RFDS doctors, nurses and health care professionals have shown the same dedication to our most vulnerable, including during the COVID-19 pandemic.

Right across the country, RFDS became involved in a number of COVID-19 vaccination clinics to help boost Australia’s vaccination rates in remote communities. Here in Victoria, we supported our local health partners at more than 40 pop-up clinics in nearly every pocket of the state. We went north to Robinvale and Irymple, west to Nhill, Goroke and Harrow, east to Cann River and Gelantipy and into many more towns in between, as we helped administer COVID-19 vaccines and assist at testing centres.

Nestled amongst rolling green hills, on the edge of the famous Snowy River National Park, the East Gippsland town of Buchan doesn’t immediately fit the brief of your stereotypical Flying Doctor community – there’s no red dirt, no burning desert, no surplus of snakes, sharks or plate-sized spiders. However, the beauty of this picturesque region hides an alarming reality.

Buchan lies within Victoria’s alpine region, and is therefore naturally very hilly. There's only one road in and one road out of town. When it's snowing in this area, locals need to put crampons on the wheels of their car as it can get very slippery, and the roads can be quite dangerous as they’re so windy. As a result, it can be rather difficult to access bigger towns, making Buchan a fairly isolated community.

This separation from big centres means that Buchan locals can’t easily reach their nearest hospital, which is located in Bairnsdale – and it’s even worse for the surrounding townships. For people in the town of Wulgulmerang, for example, it’s an hour and 10 minutes to Buchan, and then another 45 minutes on to the Bairnsdale Regional Health Service.

“We do have a doctor come in one day, every three weeks. And we have a range of other visiting services to the clinic,” says Anne Brewer, a registered nurse working at the Buchan Bush Nursing Centre. However, when emergencies happen or when specialist treatment is required, locals are more than 70km from help.

In addition to its isolation, Buchan is also a town steeped in trauma. During the Black Summer bushfires of 2019/20, the community was devastated by the blaze that tore through the Buchan Valley. Twenty-four homes were lost in these fires, and tragically one life.

Anne and her husband were among those who lost their home on the night of 30 December, 2019. While Anne evacuated early that morning, her husband stayed behind to protect their house. At 3am the next day, Anne received the news that her house was gone and that her husband was seeking shelter at the recreation reserve, along with many other community members who had stayed behind. Soon after, Anne lost contact with the town, and those hours of not knowing what was happening and if everyone had survived were hardest of all.

Over the months that followed, the Buchan community banded together to rebuild and recover, but then, COVID-19 reached Victoria. Not only did this force community activities to halt once again – thereby further impacting the mental wellbeing of locals – but it also interrupted the construction supply chain, hampering the rebuilding of homes.

Then, in addition to all of this, Buchan and much of the East Gippsland region has also had to endure a particularly damaging flood season this year, as well as the bizarre occurrence of an earthquake this past September. Few communities have been so completely tested as Buchan, and yet when you venture into town, the resilience and strength of the people is still extremely palpable.

While in many ways the health care sector has been busier than ever since the outbreak of COVID-19, some services were forced to temporarily shut down. Our Dental service was one such casualty. However, adversity is known to breed creativity, and the pandemic in some ways presented as many opportunities for our staff as it did obstacles.

When RFDS Victoria travelled back to Buchan to provide locals with the COVID-19 vaccine in November, among the cohort of our staff who made the journey was Dannielle Dookhit. By trade, Dannielle is an oral health therapist working within our school dental program, but when her regular work halted, she was able to adapt her skillsets to meet the health needs of the community.

“Because of COVID-19, schools have been in lockdown for quite a few months, so we haven't been able to do any of our clinical work,” says Dannielle. “So instead of just doing nothing and sitting around, when the opportunity came up for dental practitioners to expand our scope and start doing vaccinating, I was really keen to participate in that program.”

In early September, legislation changed to allow allied health professionals to work in vaccination clinics.

“[The change allowed us] to diversify our skills and support the health care workforce to deliver the vaccines, as the state government needed to ramp up the rollout,” says Dannielle. “So after some training and a practical test, I was able to get out on the road and visit those smaller communities to provide the vaccine.”

Ian Fellowes is another Flying Doctor team member who was unexpectedly able to broaden his skillset this year. When an injury forced him to take time out from his normal job within our Mobile Patient Care (MPC) service, he eagerly put his hand up to work at the Buchan pop-up vaccination clinic instead.

“In a normal day with MPC – if there’s such a thing as ‘normal’ – I work in either the Sale or Bairnsdale branch from 7 o'clock in the morning and finish at about 5 o'clock in the evening. What happens in between is all part of the mystery of the job. It could be transporting a one day old, a 101 year old or a palliative patient, or going to someone's house and rescuing them off the floor, and everything in between.

“I’ve worked a lot of jobs, so this [vaccination clinic] is just adding another arrow in my quiver really, which I'm happy to do.”

This pop-up clinic in Buchan is only one example of the many clinics RFDS Victoria has supported over the past 12 months, but the success of every clinic has been the same. This is because building strong, mutually beneficial partnerships is at the core of what we do at RFDS Victoria, day in, day out. 

Much of the Flying Doctor’s success is based on partnering with local health services to tap into local knowledge and community trust. In many cases, our role is to offer an area of expertise, to fill gaps or provide further support in times of need.

“[The Flying Doctor] doesn’t come in and take over. They will work alongside us,” says Anne. “It's them assisting every step of the process.”

And for communities like Buchan, our commitment to this type of localised service model is essential, as it means the town can rely on us for continuity of care.

“There are a lot of services that do come in, and they're here and then they're gone,” says Anne, noting that this is where a lot of community distrust in external services can stem from. “If [these services] are going to be here, they need to be here long term. It's one of the question I ask counsellors if they're coming in and want to provide a service: Are you here for five minutes, or are you here for five years? And often they'll say my contract finishes in six months. Well, I'm not interested. If you're going to be here offering psychology services, we need to know that you're here for long enough to actually identify the patients and treat them and have an outcome – not come, get them halfway there and then dump them.”

As the Flying Doctor is committed to the long term health of the communities we serve across Victoria, our services are designed with this sentiment in mind: we operate under a sustainable business model, ensuring that our services are impactful now and into the future.

While almost 23 months have passed since that first case of COVID-19 was confirmed in Australia, there is still no definitive finish line in sight for the pandemic. The world may be opening back up, with interstate and international travel no longer things of memory, but the virus and its impact will be present in our daily lives the foreseeable future. However, whatever the New Year brings, our mission will remain the same as it always has: to ensure that great health care is accessible to all, no matter where you live.

Watch the full story below