Women’s Health - Western Operations
RFDS (Western Operations) is contracted by the Commonwealth Department of Health and Ageing to provide a female GP service to designated towns throughout WA. The Rural Womens GP (RWGP) program is designed to improve gender choice of GP to women living in rural areas.
The program provides patients in designated rural areas with access to doctors of female gender on a regular visiting basis (up to once a month), for a full range of general practice services. The visits are in partnership with local GPs who host the visiting doctor and provide the local infrastructure.
Over 5000 patients access the RWGPS in Western Operations in any given year at over 54 designated locations. The service currently employs 17 experienced female GPs.
A Day in the life of an RWGPS GP
Providing Services in the East Pilbara
The following is an account of a recent trip conducted by Dr Susan Downes.
My visits with RWGPS to the East Pilbara, Western Australia, are once a calendar month but there is a cycle with trips ranging from two to five days. We try to avoid the female biological four-week cycle, by scheduling the trips between three and six weeks apart.
All the visits start with collecting equipment, shopping and packing the day before the trip. Then up at 0400hrs, taxi at 0415hrs, arrive at the airport before 0500 for the 0530hrs flight to Newman with the miners, arriving about 0715 all going well. There are three different scenarios form here on. I do two days in the GP clinic in Newman every month, but alternate months I also visit either Jigalong for two days or the distant communities trip of Parnngurr, Kunawarritji and Punmu over three days. These four alcohol-free aboriginal communities are cared for by the Puntukurnu Aboriginal Medical Service (PAMS). Needless to say the manager of the WA RWGPS, Ms Donna Fahie, has to be vigilant with the forward planning of flights, accommodation, vehicles, and cognisant of the need to coincide some trips with RFDS flights from Port Hedland to hitch an initial ride to Parnngurr. It can be fraught with complications. All it takes is a funeral or protracted Lore process and we have to think and adjust quickly to make the best of the visits. There have been occasions where we have managed to do clinics in Newman and all four of the Aboriginal communities in the one trip, and still seeing approximately 100 women, all with last minute adjustments.
The Jigalong trip is greatly aided by the manager of the PAMS, meeting me at Newman Airport and handing over their 4WD for me to drive the two hour mostly dirt-road to the Jigalong Clinic. It is a wonderful drive in good weather with five creek-crossings. Flash-flooding and blow-outs of tyres do occur to add spice to the trip but the wildlife and scenery make up for this. I usually arrive at the Clinic around 10 a.m. Women are often waiting, becoming impatient and so keen to be seen that it is a joy to arrive there.
We know each other well and have gained mutual respect over the eight years of my visits. An acceptable quiet and secluded room is set up for mothers and babies and we get to work the minute I am able to unpack and set up, often with women already agitating in the room.
Most of the work as expected revolves around PAP, breast and STI screening plus antenatal and postnatal care, but there are other general issues that often lead to the diagnoses of diabetes, renal failure, and thyroid problems. Infertility, both primary and secondary, frequently needs investigation, along with the great need for contraception education and procedures. There are no appointments and no breaks and by about 6pm (14hrs since starting this day 1000ks away by taxi, plane and 4WD) I am really tiring. But there is magic to come that keeps me awake. Dinner cooked by Dr Randolph Spargo, the resident GP, is superb. We chat about his long experiences in Aboriginal health and our shared locations, colleagues and patients. We marvel at the changes and the contrasts over time. We are particularly thrilled with the RFDS’s newly acquired portable ultrasound which has enabled dating scans in early pregnancy, and provides the basis for antenatal planning and most importantly, to ensure that women travel to their place of confinement at 36 weeks, and not having to rely on emergency RFDS transfer in labour. I sleep well that night and the clinic starts next morning at 0800 and we work until the demand subsides. Mostly I am driving back to Newman at dusk. Camels, cattle, kangaroos and emus are plentiful entertainment to end the two day trip to the desert. The comfortable motel room is welcome and the next two clinic days are in Newman before flying home, exhausted but fulfilled.
Dr Susan Downes, RFDS Western Operations