...good health and wellbeing in rural and remote Australia

Magazine of the National Rural Health Alliance Number 44 August 2012

Art for fitness in Canowindra

Frontier Services turns 100

A ‘right’ view of politics!

Rural health gets its own TV channel

Aboriginal and Torres Strait Islander readers are advised that this newsletter may contain images of people who have died. The National Rural Health Alliance (NRHA) is a collective of national organisations which represent the consumers and providers of health GOOD services in rural and remote Australia. The Vision of the National Rural Health Alliance, as the peak non-government rural and remote health HEALTH organisation, is good health and wellbeing in rural and remote Australia. AND WELLBEING IN RURALAND REMOTE AUSTRALIA

PHOTO:2 ARTHURPartyline MOSTEAD August 2012 Partyline August 2012 3 IN THIS ISSUE: EDITORIAL IN DEFENCE OF POLITICS 5 Editorial: In defence of politics 48 Allied health rural and remote 7 Baby steps to universal dental scheme practitioners 50 Ground-breaking advances in 8 The long and winding path to equal now thankfully seems likely, both the disability care international point-of-care testing olitics is too important to be left P Federal Cabinet and the Coalition 11 Judith Adams: a true friend of rural 52 Equipping the future rural health only to politicians and the media. Shadow Cabinet support the proposal Australia 54 International Aassociations of To judge from reports seen and heard that there be a national disability 12 Why rural health placements need a Patients’ Organisations Conference dose of the used car salesman 55 Editor’s breakfast from other countries, Australia is not insurance scheme, there will indeed 13 Health Heroes campaign 55 2011 Mentors of the year the only place in which contemporary be one. politicians are not admired or trusted 14 From paddock, to plate, to waistline 56 Notice Board This is how politics works. This is and in which the occupation they 16 TV channel dedicated to rural health 58 Making a commitment to a bright how important it is. And given the pursue is invested with scant public begins broadcasting future critical nature of the decisions made by credibility. 18 Rural mental health services affected 60 The city or the country Cabinets (which, in the Westminster by funding cap And yet politics is so important. Much system at least, are comprised entirely 20 The Gonski Review of Funding for is made in this new ‘information age’ of elected politicians), how can it Schooling of the democratisation of information be that the public generally is so 22 The Outback Oral Treatment and (which in some parts of the world uninterested in and scathing about the Health (TOOTH) Program p.38 has democratised whole nations). processes and the people of politics? 24 Rural health – the good, the bad and But in countries that are already the balance Many people in Australia were democratic people can exchange as 26 Calling all doctors politicised by the events of November much information as they like without 11, 1975. As with conscientious 28 Don’t be a witness, get into fitness! changing anything unless their objection and football grand finals, 30 Celebrating Frontier Services: A views are mediated by politics. The century of helping remote Australia families and other social groups were Australian public can write whatever 32 Beginning your eHealth journey riven by that historic and dramatic they will in their blogs and by other political event. On one side were those 34 Broadband for all Australians social media but, until the next time who thought the Governor General 35 Rural Placebook they get to vote, many of the decisions had no choice; on the other, those who 36 Walwa Bush Nursing Centre that affect them are made by small 37 Summary of Indigenous Health groups of men and women who provide 38 Finding confidence in Goulburn Base the government of the day. Hospital p.34 40 Defence for bone health Take for example the current situation relating to a National Disability 41 Indigenous clinical health practice p.30 resources Insurance Scheme. No matter how many 42 Safety in the rural workplace debates there are about it, and however 44 Supporting allied health professionals much information is exchanged, what in rural and remote Australia matters are the decisions made by 46 Kel’s Chemist - my journey to opening Federal and State cabinets and by their a community pharmacy in rural NSW equivalent opposition groups. So if, as

Partyline August 2012 5 are used in order to abbreviate the herself, trying to form a government discussion, on the understanding that that was not ‘Labor’ but ‘coalition’ or they connote something appropriate to ‘hung’ (now seen for some reason as a most readers!) pejorative). There are several acid tests of the Politics deserves to be seen through a natural disposition of political better lens than that provided by most commentators. None has been more of Australia’s media outlets. It should telling than their attitude to Julia be credited with what it can do every Gillard and the carbon tax. Some day to make lives better or worse. It Members of the Alliance Council meeting with Mark Butler, Minister for Mental Health and Ageing at Parliament House. publicise or sloganise the ‘broken deserves and needs a good reputation, promise’ line because it supports their with many more members of the public political persuasion; others emphasise keen to support it and to be involved were outraged that the Party with the These days the differences between the the totally transformed situation in it. majority in the Lower House was no major political groupings in Australia - in which the Labor Leader found longer the government. as elsewhere - are much narrower than in earlier periods. This could be given What was it about the dismissal of Prime a negative spin, by saying that it merely Minister Whitlam which stimulated reflects the pragmatism of parties who such widespread involvement in what Baby steps to universal dental scheme want to be in power and therefore was (‘merely’) a political event? And move to the middle ground. Or it may ‘A healthy mouth for every Australian’ why did it divide people so decisively be given a positive spin, by saying that was the catch-cry of those present at and arouse such passionate response? if both sides of politics agree on most of Dental Policy Forum in Canberra on If it was a catalyst for the public’s the important issues, then it is indeed a 15 August. People from 80 health greater interest in politics, what are civilised and safe political situation in consumer and provider organisations the potential events which might which we find ourselves. came together to agree on how best soon have an equivalent effect on the to secure better dental health care in that, in the meantime, the additional children of those who were divided in What proportion of Australians have Australia. resources promised by the Federal 1975? an active interest in politics? If half Government should be provided as are uninterested, meaning that come Those at the meeting were appalled Did The Dismissal create new political entitlements to those in greatest need. election time they are disinterested, it at the stories told about children and interest or was it merely a lightning This includes low and middle income might be fair to hypothesise that the young adults with numerous decayed rod around which pre-existing families, Aboriginal people and Torres other 50 per cent are divided three and missing teeth; encouraged by political inclinations clustered? And Strait Islanders, and people in rural and ways: one third left-ish, one third right- the commitments made in this year’s what factors determine such natural remote areas. ish, one third undecided. It is hard to Budget; and determined to continue inclinations? Perhaps political watch programs like the ABC’s Q&A to work together for a much-improved There was strong agreement on the predispositions are determined on the and even Insiders (much better political national oral health system. need for a greater focus on oral health basis of people’s views about the role journalism than the former) without promotion, including through public of markets, governments, compassion Because governments are being being struck by the predispositions health measures relating to fluoridation and/or the redistribution of public fiscally conservative, it is understood of the people who are selected as and food and nutrition. resources. (Surely they are not that there will need to be ‘baby steps’ commentators. Which of the panellists determined by the personality of the towards what most of those at the A communiqué from the Forum is on Insiders has a genuinely open and political players?) meeting see as the ultimate goal: a available at www.ruralhealth.org.au balanced view as between ‘left’ and universal scheme for oral health for all ‘right’ (these old-fashioned labels Australians, funded through insurance. NRHA All of those at the meeting accepted 6 Partyline August 2012 Partyline August 2012 7 PHOTO: STEVE LOVEGROVE The long and winding path to equal disability care

and stroke. In 2004-05 around 21,800 those with a disability, and in positive that continuing rehabilitation is his year’s Federal Budget committed T people nationally were admitted to developments like the National required to maximise the chance of the $1 billion to support the first stage hospital with TBI: 40 per cent due to Disability Insurance Scheme. patient returning to the fullest possible of a National Disability Insurance falls, over 30 per cent due to motor level of independence and quality of Scheme (NDIS), an insurance- When it comes to care for rural people vehicle accidents and 16 per cent due life. based approach to disability care and with a disability, there is a high degree to assault. support. Agreement between the of variability between jurisdictions. An example of the special consideration Commonwealth and several States The rural-metropolitan differential is In more remote areas, especially, it is that needs to be given to rural issues followed fast on the heels of the related to gender. Rates of disability difficult to provide the more specialised relates to the launch locations COAG meeting on 25 July. in rural women are similar to rates clinical therapy and support needed currently being considered for the for women in metropolitan areas, but following discharge from hospital. NDIS by COAG. A launch location Some 6-7 per cent of the Australian Australian males are 1.2 times more in a single geographic area would not population has a severe or profound After a severe traumatic brain injury, likely to have some sort of disability be an appropriate test of its potential activity restriction due to disability. such as from a motor vehicle accident, (and 1.2 to 1.4 times as likely to have effectiveness for people in more remote The prevalence of disability is higher the patient is likely to be transferred a severe or profound disability) if they areas. A trial of rural effectiveness in rural and remote areas, meaning to a large metropolitan hospital for live in a rural or remote area. Similarly, should test each step in the rural that the prevention, treatment and trauma care and subsequent inpatient the latest data show that males from person’s rehabilitation journey and not management of disability are of brain injury rehabilitation. This assures Inner Regional areas were 1.26 times as focus solely on the area in which the particular relevance to people in those them of the best quality of care at this likely and males from Outer Regional patient lives. areas. stage of their patient journey, even 1.62 times as likely to have an ABI though they may be isolated from Special consideration should be given It follows that some of the causes of compared with those in Major Cities. their own community and family to the rural and remote characteristics disability are more common in rural For this reason rural advocates and by a considerable distance and for a of each of the NDIS building blocks. areas than the major cities, such as disability advocates (such as the considerable time. They include a national approach to accidental injury and acquired brain National Rural Health Alliance and choice and control for people with injury (ABI). Thirty-two per cent of But the main service challenges come the Rural and Remote Special Interest disability; eligibility and assessment; the population lives outside Major when the patient is discharged from Group of the Australasian Faculty of quality safeguards and standards; and Cities, compared with 38 per cent of the major hospital and steps down to a Rehabilitation Medicine) are vitally workforce and sector capacity. those with ABI. The major causes of smaller facility and is then discharged interested in the current situation ABI are traumatic brain injury (TBI) to go home. It is at these later stages relating to care and treatment for

8 Partyline August 2012 Partyline August 2012 9 PHOTO: STUART ADAMS

Attention should also be given to the potential role of information technology Judith in providing rehabilitation services, and means of ensuring the sustainability of Adams: disability support services in areas with sparse populations and overcoming a true friend of the difficulties in recruiting specialist workers for disability care in rural and rural Australia remote areas. In this service area as in others, fly-in specialised services have to be well-planned and managed in Judith’s work on various parliamentary n our successful multicultural order to build local capacity. I committees - along with her grassroots immigrant nation there is of course campaigning - was legendary but she The proposed National Disability nothing surprising about one of always found time for the personal Insurance Scheme (NDIS) will our heroes being ‘foreign’. But such touches and the close contact which hopefully be supported by both sides was Judith Adams’ passion and made her so well loved. of politics and eventually by even commitment to rural and remote areas the recalcitrant States. Although of Australia that it might be a surprise We shall fondly remember Judith challenges relating to sparse populations to some to know that she was in fact Adams and regard her work, and will undoubtedly remain, a universal born and raised a New Zealander. the way she did it, as a benchmark person-centred disability support in advocacy on behalf of rural and One only had to observe the memorial scheme, funded through insurance, will remote communities. service at Kojonup or read the reduce some of the inequity currently condolence speeches in Parliament experienced by people with a disability to have a clear understanding of the who live in rural and remote areas. esteem in which Judith was held. And Above: Late Senator Judith Adams, former Liberal Senator for Western Australia, with NRHA although she had other enthusiasms, her two dogs on the family farm at Kojonup such as for the wellbeing of Australia’s in the Great Southern region of WA. armed forces, it was primarily her Below: With Judy Harris, Kathy persistent advocacy on behalf of the Kirkpatrick, Sue Wade, Bruce Harris people of rural and remote Australia and Louise Lawler in Canberra, 2009. The NRHA’s Position Paper: Achieving the best possible outcomes for people with for which she was best known and acquired brain injury who live in rural and remote communities demonstrates the most admired. substantial interplay required between health services, both metropolitan In the pages of Partyline we do not PHOTO: LEANNE COLEMAN and regional, and the community-based disability support system. The paper wish to compete with the national quantifies the incidence and prevalence of rural brain injury, identifies key commentators who have said so much aspects which help to describe best practice, and considers the extent to which and so well about Judith’s national the issue may be amenable to a policy response. It summarises some of the contribution. From the point of view differences in access between metropolitan and rural/remote areas and confirms of the National Rural Health Alliance, that the National Disability Insurance Scheme (NDIS) and the National it was a privilege to have had Judith Injury Insurance Scheme (NIIS) have great capacity to improve the situation. Adams involved with our work before www.ruralhealth.org.au (under Publications) she became a Senator, and a blessing and a great advantage to have had her continual support once she stepped 1010 PartylinePartyline AugustAugust 20122012 into that national role. Partyline August 2012 11 rural health rotation guidelines were a potentially harmful incident during workshopped at the 2010 SARRAH remote area placement in Aboriginal Conference and the 2011 Breathing Why rural communities in Central Australia from New Life Conference. There is however Health 2006–2007, often due to administrative a need for further research at this critical or supervision issues. These potentially time in training capacity, when we can Heroes health harmful incidents did not however expose more students than ever before to placements always lead to an overall negative rural health. experience, with many students To understand what sells students on campaign seeing them as powerful learning rural health, we could undertake surveys, need a dose opportunities (Patel, Underwood, we could run further workshops … or we ealth Heroes is an Australian Nguyen, and Vigants, 2011). Knowing could just open a dating service in each H Government campaign which of the used this, there should be examination of rural clinical school so that students may encourages Aboriginal and Torres what students and supervisors want, make use of their cars for more than just Strait Islander secondary school car salesman driving. students to take up jobs in health. Rural health service isn’t a ‘lemon’ but Information is available on hundreds sometimes a specific placement can be. of different health jobs, as well as I bought my first car recently so The problems that can occur on rural a range of training and support that I could undertake a rural health placement, or with a newly purchased options for Aboriginal and Torres placement. Whilst shopping around, I second-hand car, are part of the inherent Strait Islander students. There is encountered a range of slick salesmen, risk. Ensuring that placements deliver also material for students and career with movie star good looks. The way what students and supervisors want, helps advisers and an inspirational ‘Genie’ they eventually sold me on a Mazda sell that risk as adventure and that is why comic book. got me thinking about what sold me we need a national set of guidelines on on a rural health placement. After PHOTO: CHRIS TIMMS optimal rural placements. For more information or to order all, the choice to train rurally was far resources visit more central to my future than the Chris Timms www.australia.gov.au/healthheroes purchase of a car that “had only been Senior Community and Advocacy or email [email protected] driven on Sundays to Church”. Now, Would you buy Rep 2011, NRHSN rural health isn’t a used car or a ‘lemon’, but it should be sold with ‘used car a used car salesman’ enthusiasm by promoting the from this man? outstandingly positive rural placement 2012 National Indigenous and training experiences of current and Health Conference past health students. Many Pathways, One Outcome Research has demonstrated that doctors so rural health can be ‘sold’ as a career 5–7 December 2012 are more likely to enter and stay in genuinely, and without resorting to Watermark Hotel in the Gold Coast rural practice if they have a positive ‘winding back the odometer’. www.indigenoushealth.net exposure to rural medicine during their training, or if they or their spouse are Currently many rural health placements of rural origin. But a recent Medical deliver a fantastic experience and Journal of Australia article reported drawing the best aspects from these to that one in six students experienced create a national set of guidelines could help to optimise experiences. Optimal 12 Partyline August 2012 Partyline August 2012 13 From paddock, students and about 10 per cent of Despite advances in modern farming unemployed and low income earners practices, weather and climate are experience food insecurity (ie not still major factors in determining to plate, enough food). And this in Australia in agricultural productivity. Many of the 21st century! the future effects of climate change are unclear, but Australia’s south west to waistline With 7 per cent of the burden of regions are most likely to experience disease due to high body mass, 7 per the greatest decline in rainfall by 2070. n 17 July, the Australian Government are overweight or obese, with rural cent due to high blood cholesterol, and O Agriculture is currently exempt from released a Green Paper Towards a residents about 10 per cent more likely 2 per cent due to low consumption of paying a tax on carbon emissions, but National Food Plan for Australia. This is than others to be classified as such. In fruit and vegetables, the contribution it is a major emitter, and it may only the next step towards a National Food addition, rural residents are more likely of poor dietary choices to avoidable be a matter of time before this changes. Plan – hopefully bolstering both our to have high blood pressure and high disease and death is clearly substantial. ability to produce food and our healthy cholesterol. Although much of the It is estimated that, since 1960, global As well as feeding ourselves, Australia’s consumption of it. food we eat is produced and processed marine biodiversity has decreased by as farmers and fishers feed roughly another in rural Australia, the cost of nutritious much as 29 per cent. Forecasters predict On the same day, AIHW released 40 million people outside Australia. foods is about 30 per cent higher that the ocean’s supply of seafood could Australia’s Food and Nutrition, which With a 77 per cent increase in the outside metropolitan areas. be depleted by as early as 2048. It is provides many of the statistics in the value of the world demand for food recognised that marine biodiversity Green Paper, and describes much of Ninety per cent of people living in expected by 2050, and strong growth needs to be restored through interest to the rural observer. metropolitan areas normally travel in the number of ‘middle class’ people sustainable fisheries management, less than five kilometres to shop at in the Asia Pacific region, there will Food is particularly important pollution control, maintenance of their regular supermarket, while 23 per be increasing pressure and opportunity for people in rural Australia; its essential habitats and the creation of cent of people living in regional areas to expand this capacity to feed others. production, transport, processing and marine reserves. By some international travel more than 10 kilometres. As This expected increase in production storage provide work and income for standards Australia’s fisheries compare well as higher transport costs involved could have substantial indirect health many, and how we consume it has a in distributing food to regional areas, well, but many challenges exist. substantial influence on our health. benefits for people living in rural and a lack of access to transport may limit remote Australia— through its effect It is extraordinary to think that A critical health issue is how much food choices for rural consumers to in bolstering incomes and therefore Australians waste, on average, 361kg of food we eat and of what types. People smaller local stores with higher prices. choices. food every year. That’s a kilo each per in rural areas tend to eat slightly more day (or 20 thousand tonnes nationally Many people who have restricted However there are ongoing challenges vegetables than those living in cities, per day), much of it going to landfill – physical or financial access to healthy for sustained and increased food their fruit intake is similar, cereal and that’s just rubbish! food resort to eating unhealthy but production arising from climate fish intake lower, and their meat intake more affordable food options. A small substantially higher. Sixty-eight per change, fuel and fertiliser prices, and NRHA percentage of people including 24 per the sustainability of fisheries. cent of males, 55 per cent of females cent of Indigenous adults, some recent Have your say about Australia’s food and 25 per cent of Australian children migrants, 13 per cent of university future – read the Green Paper www.daff.gov.au/nationalfoodplan/ process-to-develop/green-paper and become involved. You can contribute by attending one of the 24 public meetings or by making a written submission.

14 Partyline August 2012 PHOTO: ARTHUR MOSTEAD Partyline August 2012 15 remote areas of Australia. Anyone The website has more than 120 can purchase equipment to access programs that are available to view TV channel VAST but in areas where terrestrial or to listen to at no cost. DVDs television is not accessible the of the programs are also available dedicated government is subsidising the cost to for purchase - and these are a great install a satellite dish and set-top box. teaching resource. to rural VAST currently reaches 75,000 The Foundation’s satellite network households, and this number is of more than 670 ‘receiving sites’ health begins expected to grow to more than located around Australia is still very 250,000 by the end of next year. active which means that Rural Health broadcasting Education Foundation programs can Some programs are webcast still be viewed at community health on the Aurora Digital satellite simultaneously with the live satellite any readers will know of the centres and hospital staff rooms as M system that carries VAST (Viewer broadcast, meaning professionals can Rural Health Education Foundation always. Access Satellite Television). The watch and participate in the program as the ‘satellite people’, the group Rural Health Channel will continue from their home or work computer. To register with the Foundation that broadcast live satellite television to broadcast the Foundation’s to receive notices of upcoming programs on Tuesday nights. With All programs are recorded and professionally accredited programs programs (delivered by satellite and/ the recent launch of the Rural Health uploaded to the Foundation’s website as well as other health education or webcast) as well as to receive Channel, viewing options have been where interested people may view or programs and information - thus information on available DVDs, extended to more locations and listen to them at any time. extending the Foundation’s service to online videos or podcasts, go to viewing times. With broadcasts on the wider community. www.rhef.com.au/register/ and every weekday - both afternoon and follow the prompts. evening sessions - remote and rural The VAST system has been set up as health professionals are offered up to part of the Government-mandated conversion from analogue to digital 24 hours a week of health education View the Rural Health Channel television. television, to provide television via satellite to people who cannot receive The Rural Health Channel is a Tune into Channel 600 terrestrial television, mainly those dedicated free-to-air health channel living in ‘black spots’ in rural and A satellite dish and a digital VAST set-top box are required to access the Rural Health Channel. If you do not have access to VAST in your Above and left: Senator Stephen home or at your local clinic or centre, Conroy and Federal Health Rural Health Education Foundation Minister Tanya Plibersek satellite viewing sites across Australia officially launching the Rural have access to VAST and their set-top Health Channel at Parliament boxes have recording capabilities. House on 26 July 2012. To locate a viewing site near you visit the webpage www.rhef.com.au

16 Partyline August 2012 Partyline August 2012 17 PHOTO: ARTHUR MOSTEAD

The most recent Australian Institute Ainslie also believes MHNIP can be considered as a safety net of Health and Welfare report on for those who may fall through the cracks of other treatment Rural mental Mental Health Services in Australia providers, particularly people with mental health needs who highlighted that the majority of are also struggling with addiction and dependency issues, health the rural and remote mental health whose care is often traded between agencies. workforce is made up of mental health Despite the real benefits of this program, in the May Budget nurses. Just 10.5 per cent of FTE services the Government announced that its funding will be frozen at psychiatrists work in rural, regional 2011-12 levels. According to figures from the Department of or remote communities, compared Health and Ageing, the program has helped around 45,000 affected by with approximately 30.3 per cent of in 2011-12 with demand for services growing as more health FTE mental health nurses. Through professionals and consumers become aware of the program. funding cap the MHNIP, people with severe and But with the Budget decision, GPs, psychiatrists and mental complex mental illness have been health nurses not already working under the program will able to access specialist mental health be unable to start delivering this service, and the services nursing care and ongoing support already operating are unable to expand. It goes without saying that access within their community. to health services is problematic in The MHNIP is also having a beneficial effect on the mental Ainslie Ivin-Smith, a credentialed rural areas, and access to mental health nursing workforce outside metropolitan areas. The Mental Health Nurse based in rural health services in rural areas is even Australian College of Mental Health Nurses estimates NSW, believes the MHNIP reduces more so. But over the last five years, around 40 per cent of credentialed Mental Health Nurses the risk of the stigma people may feel specialist mental health nursing delivering MHNIP services are located in rural and regional when accessing psychiatric care at the services have been gradually growing locations. in rural, regional and even remote mental health centre. Instead they areas of Australia. These services can receive expert treatment in their Elizabeth Martin, a credential Mental Health Nurse working have been established with the support trusted local GP surgery. under the MHNIP in Broken Hill and a mental health of a Medicare funded program called academic at Sydney Medical School, thinks the effect of the Mental Health Nurse Incentive the freeze will be significant. “This is a huge rural mental Program (MHNIP). health issue. It effectively freezes the areas in which I work to just two to three sessions a week, leaving the community The MHNIP was established in the without appropriate service levels. This has nothing to do 2006 COAG Mental Health Package with community need and, yet again, we are disadvantaged to provide specialist mental health by our difficulties in recruiting to rural areas. This freeze will services and coordinated care in stop us from taking advantage of extending our capacity if primary care settings to people with a new Credentialed Mental Health Nurse moves into our severe and complex mental illnesses. area.” Under the program, mental health consumers can access a specialist The Australian College of Mental Health Nurses is calling mental health nurse who works with on the Government to rethink the funding freeze to ensure them to manage their symptoms, people in all parts of Australia can access appropriate services coordinates their care and connects in a timely manner. To learn more about the campaign, go to them with the other services they need, www.acmhn.org/news-a-events/mhnip-freeze-campaign.html while helping them establish social and family support systems. Kim Ryan CEO, ACMHN

18 Partyline August 2012 Partyline August 2012 19 big project of the 21st century is surely From Kotter’s research, location - place sustaining the modern world. - matters and the way teachers and The Gonski Review of school leaders are currently trained Gonski rightly argues, “Australia’s undervalues it, certainly with regard to schools, government and Funding for Schooling rural places. non-government, should be staffed with the very best principals and By re-directing very modest funding teachers, those who feel empowered from the annual schooling allocation An opportunity to improve rural education? to lead and drive change, and create plus collaborating with philanthropy, opportunities for students to learn final year pre-service teachers could in new ways to meet their individual have the choice of a fully funded long time now. However, attracting needs”. semester-length rural placement. This hat quantum of funding should would cost around $16,000 per student. W and retaining top educators to live and For this to be the reality for be available for schooling, from what For a similar cost, current and aspiring work in country locations continues to rural families, their children and sources, how should it be distributed, leaders could take a purpose designed be a major issue for education systems, communities, serious changes have to and what should individuals, the wider post-graduate rural leadership study irrespective of employment incentives. occur in the way teachers and school public and governments reasonably program with expert leadership leaders are prepared and selected. expect from the expenditure? These It is time to radically change the way coaching. are some of the questions which teachers and educational leaders are JP Kotter (2002), a Harvard expert Medicine has led the way with underpin the report from the Gonski prepared for working and living in on change, has consistently found extended rural placements for students Review of Funding for Schooling. rural schools and communities, and the that “people change what they do less through rural GP programs to address Gonski Review provides both the basis because they are given analysis that Policy about funding for schooling in major health service problems. There and the resources for doing this. shifts their thinking than because they Australia, and in most other countries, have been some very good results. are shown a truth that influences their is highly contested. As is the case for The report has a heavy focus on Why not the same with education? feelings”. health, when it comes to applying ‘education of the individual’ with a finite resources to infinite demands for comparatively light touch for ‘education John Halsey education, there are no simple answers for community’. As well, there is a Sidney Myer Chair of Rural PHOTO: LEANNE COLEMAN - just better approximations, better very persistent focus on education for Education and Communities, fits. On the question of resources, the building an economically competitive Flinders University Gonski Report argues that an extra $5 Australia, but the report is virtually billion is needed in schools funding. silent on education for a sustainable Australia. I find this particularly The report is available at: The Report argues that “resources alone disturbing given the mountain of www.deewr.gov.au/Schooling/ will not be sufficient to fully address evidence we now have about growth ReviewofFunding/Documents/ Australia’s schooling challenges… and consumption patterns and their Review-of-Funding-for-Schooling- new funding arrangements must impact on survival. Final-Report-Dec-2011.pdf be accompanied by continued and renewed efforts to strengthen and reform Sustainable rural communities matter Australia’s schooling system” (emphasis because they are integral to the Kotter, J. P. & Cohen, D.S. (2002). The Heart added). Gonski emphasises that it is wellbeing of our nation, and indeed of Change; Harvard Business School Press. high quality teachers and leaders who the world. When was it ever different? have the most impact on students’ If the big project of the 20th century learning. We have known this for a was building the ‘modern world’, the

20 Partyline August 2012 Partyline August 2012 21 The TOOTH program will not only Dr Hendrik Lai reports on some of the provide clinical dentistry but, in cases he has seen: order to help people in these remote “Last week I treated a young girl who lives The Outback Oral communities, will provide training, in Bourke… she was just two years old education and support, so that future and needed 15 fillings. A four year old Treatment and Health generations of children won’t need to boy needed six extractions. Then I saw have their baby teeth filled and young (TOOTH) Program a young man of 26 whose teeth were so people can reach adulthood without badly decayed they all had to be extracted having to wear a full set of dentures. – all of them.” Through collaboration between RFDS, was shocked when I started work on the he Royal Flying Doctor Service Charles Sturt University, University With the support of the Gonski T TOOTH program and found that the level (RFDS) South Eastern Section (SES), of Sydney and Griffith University, the Foundation and Investec Bank, the of tooth decay for some people in remote in partnership with the Investec TOOTH program provides a unique RFDS’ South East Section aims to communities is worse than anything I Foundation and the Gonski Foundation, opportunity for dental students to secure funding for the program from saw overseas. I had no idea how bad has undertaken to deliver a new oral work alongside Dr Hendrik Lai at the NSW and Australian Governments things were, and not just in Aboriginal health service in north west NSW to appropriate clinics. It is hoped this and transition to a full government communities either; the problem extends address the poor and deteriorating oral will encourage and prepare them to funding within three years of operation. right across remote parts of western New health in some of our most remote and continue their careers in the areas of South Wales. On average the children we Lyn Mayne vulnerable communities. most need. are seeing in these vulnerable communities have over five times more dental disease than their peers in metropolitan Australia.” This innovative funding model, combining corporate sponsorship, private philanthropy and funds from RFDS donors, will enable our dentist Dr Hendrik Lai, and Dental Therapist, Rebecca Hovington, to deliver 128 dental therapy clinics for children and PHOTO: RFDS 128 dental clinics to address current gaps in dental health care provision in these remote locations. Dr Hendrik Lai joined the RFDS South East Section in March 2012 and says: The TOOTH program will provide oral health care and education to “I’ve worked with the United Nations the communities of Lightning Ridge, and International Stabilisation Forces in Bourke, Goodooga and Collarenebri East Timor and the Solomon Islands, so which have been identified as some of I know what conditions are like for people the most disadvantaged in the state. in disadvantaged areas. One thing I never expected when I came back to Australia Clinics began in March 2012 and are PHOTO: RFDS was to find that such conditions exist right provided on a regular basis to these here at home - in our own back yard. I communities.

22 Partyline August 2012 Partyline August 2012 23 PHOTO: JULI COFFIN

Rural health – the good, the bad and the balance

The National Healthcare Agreement double the rate of places available in of its key focuses. From 1 July 2012 ith the release in June 2012 of its W is therefore a rock on which rural and Very Remote areas. This serves as a the Australian Government assumed third annual report on the National remote people, and those who work reminder of some of the rural challenges operational responsibility for Home and Healthcare Agreement, the COAG with and for them, can build their case for the aged care reform agenda now in Community Care (HACC) services Reform Council has again done rural for equivalent access to health services train. There is great variation across for people over 65, except in Victoria people a big favour by publishing a and ultimately equal health. And these the nation in terms of demographic and Western Australia where current special supplement to the report that recent reports from the COAG Reform shifts, with some areas growing too co-funding arrangements will continue. examines progress towards meeting the Council provide the most authoritative fast, others slowly declining, and still State and Territory Governments targets for people living in rural and evidence that the job is not yet done. other affected by ‘sea change’ and ‘tree will continue to fund and administer remote areas. change’ trends among retirees. HACC services for people under 65 The deficits faced by people in rural This special report demonstrates the and for Aboriginal and Torres Strait and remote areas are evidenced in The proportion of people using inequality experienced by people in Islander people under 50. such things as low birth weight babies, community care increases with the more remote areas and reminds us cancer survival rates, end stage renal remoteness, perhaps reflecting unmet These and related issues were that, in our federal system, it will take disease, preventable hospitalisations need for residential aged care places. discussed at the 2012 National Aged action from all governments to remedy and care for the elderly. But continually Older Australians in remote areas Care Conference held 6-7 August the situation. highlighting what some call ‘the case wait in hospital ten times longer for at the Adelaide Convention Centre The context for these annual reports for the rural deficit’ is a double-edged residential aged care than those waiting (www.conference2012.agedcare.gov.au). is that Commonwealth, State sword, given the significant advantages in Major City hospitals. Continued attention needs to be given and Territory Governments, with of a life in rural areas and the challenges People in rural and remote areas also to the workforce challenges and higher the Australian Local Government of recruiting professionals of one sort have much lower rates of hospital costs of delivering aged care in rural Association also at the table, have and another to them. separation (half to one-third) for and remote communities. agreed that “the healthcare system It is important for rural and remote subacute services (eg rehabilitation, will strive to eliminate differences in NRHA advocates, including the Alliance, to palliative care, geriatric evaluation and health status of those groups currently pursue a middle path between the rural management, psycho geriatric care), all experiencing poor health outcomes deficit and the personal, professional of which are highly relevant to older relative to the wider community”. It and community benefits of a rural people’s quality of life. goes on to acknowledge that these lifestyle. The COAG Rural and Remote particular groups include Aboriginal A recent update on the Commonwealth’s Supplement and the Alliance’s media and Torres Strait Islander people, The Reform Council’s report shows aged care reform process, Living Longer, release on it are available at people living in remote areas, and that access to residential aged care Living Better, describes helping older people in socio-economically places worsens markedly as remoteness Australians to stay at home as one www.ruralhealth.org.au disadvantaged areas. increases, with Major Cities having

24 Partyline August 2012 Partyline August 2012 25 DID YOU KNOW? CALLING Snapshots from the MSOD Data As of June 2012, the Project? is tracking more than 20,000 participants ALL including bonded, rural, Indigenous and international students, John Flynn and RAMUS scholarship holders and DOCTORS students undertaking RUSC, RCS, UDRH placements. 18 per cent of commencing and 14 per The MSOD Project is the world’s The data and the results of research cent of graduating medical students ot another survey, I hear you cry as N first nationally coordinated project using the data are used by the indicated that they would like to yet another email lands in your inbox for tracking medical students through Australian Government to inform practise in a rural and regional location. with an invitation to take part in some medical school and into prevocational medical training programs and study or another! It promises (don’t Of commencing students 53 per cent of and vocational training. Through workforce planning for the creation of they always) that it will only take a few respondents who identified themselves Medical Deans (the peak body of the a sustainable medical workforce into minutes of your time and it is vitally of rural background indicated they Deans of all the medical schools), all the future. (The MSOD Project was important! would like to practise in a rural and Australian and New Zealand medical funded by the Department of Health regional location compared with 9 per So, how does the busy and harassed schools are involved in the project and Ageing from 2005 to 2011 and is cent of respondents who identified doctor decide whether to answer both as stakeholders and participants. currently funded by Health Workforce themselves as not being of rural a questionnaire or not in these Australia.) The project commenced in 2005 and in background. circumstances? 2011, for the first time, surveyed doctors For more information about the MSOD 19 per cent of respondents identified If you felt that the outcomes of the who had reached the Postgraduate Year themselves as coming from a rural survey might lead to more doctors in 3 stage of their careers. Over the years Project please look at the website: background. rural areas, would that make you more a lot of data has been collected about www.medicaldeans.org.au, or if you have kindly disposed towards completing it? medical students’ backgrounds, their any questions about the Project please email 27 per cent of graduating students who career intentions in their first and [email protected] indicated they would like to practise in The data collected through the last years of medical school, and their a rural and regional location identified Medical Schools Outcomes Database placements during medical school and Meanwhile, if you see the MSOD general practice as their first preference and Longitudinal Tracking (MSOD) their intern year. Questions like, ‘Do Project logo attached to an email for future medical practice. Project is used, among other things, placements affect career intentions?’ requesting that you fill in yet another for evaluating medical educational Just under 7 per cent of MSOD and ‘Is a medical student from a survey, please don’t hit the delete programs aimed at increasing the participants at postgraduate year 3 rural background more likely to work button! The MSOD Project will be recruitment and retention of a rural indicated that their primary place of in a rural setting after graduation?’ surveying interns at PGY1 and doctors medical workforce, and provides other work was outside a capital city or major have already been investigated by at PGY3 later this year. information used in medical workforce urban centre. researchers using the MSOD data. planning. Penny Harvey

26 Partyline August 2012 Partyline August 2012 27 as well as work by professional artists. Over 200 visitors viewed the artworks and each one was invited, for a small fee, to vote for their favourite picture. Don’t be a The people’s choice award went to Bobbi Angelini of King Kong climbing frame Orange whose entry was Carpe Diem WITNESS, - Seize the Day. The painting (pictured) metres wide and 710 metres long) is for sale via the gallery or the artist. is put down. The second stage of get into In addition to the community implementation will be installing fundraising and donations, the local the equipment into the exercise FITNESS! Cabonne Council is contributing sites. There will be five pieces of $60,000 worth of work to the project outdoor fitness equipment in each of the idea and it was tagged with the - and the dream will start to become a three organ shapes. The equipment wo years ago, when Julie Middleton T slogan Don’t be a witness, get into fitness! reality in Spring when the path (2.5 is double-sided and designed for two was employed as a dietitian running people to exercise together. nutrition-based fitness programs for The plan provides a fitness path Canowindra Community Health, she for walking and cycling around the PHOTO: HELEN HAYNES In the lung shape there will be a King had the dream of making it easier for perimeter of the Canowindra oval. Kong climbing frame, a special piece of people to exercise. There will be fitness equipment at equipment being built for the first time four different stages along the path, in Australia, which is good for upper When a new fitness path was proposed, with each exercise area in the shape body work and likely to be of interest the Canowindra community embraced of a bodily organ - heart, lungs, kidney to the users of the nearby skate park. and liver. Each area will promote the PHOTO: LEXIA SMALLWOOD The final stage of the project will be message of looking after our organs to landscape the surrounds with native to reduce lifestyle diseases and raise plants and grasses and locally sourced awareness of the great potential value boulders. This will beautify the area of organ and tissue donation. and entice people to use and enjoy The community set about organising a the facility in line with the overall range of activities to raise the $200,000 aim of increasing the number of local needed for the project, including a community members of all ages who ball, raffles, progressive dinner, car can exercise in a safe and accessible boot sale and an art competition. The environment. art competition attracted 26 entries Julie Middleton is no longer working which were displayed at the River Bank as a dietitian - she is an enthusiastic Gallery in Canowindra for six weeks. volunteer on the Canowindra Fitness Children’s art was well represented Catherine O’Brien (Gallery Director) and David Bobbi Angelini, people’s choice winner of the Path Project. Isbester at the River Bank Gallery, Canowindra. Canowindra community art competition.

28 Partyline August 2012 Partyline August 2012 29 100 years Celebrating Frontier Services: A century of helping remote Australia

this remarkable man. The people t is time to celebrate 100 years of I who work and volunteer for Frontier progress for the aims of Frontier Services Services provide pastoral support, aged Rosemary Young – pictured in the National Office with clocks showing and to celebrate the continuing hope care, community care, health services, the times in all the States where Frontier Services operates. and resilient spirit of those who live family support and child care across 85 in remote Australia. One hundred per cent of Australia’s remote regions, emotional support to 15,000 families She learnt Yolngu Matha, a local years ago, Presbyterian minister John from the tip of Cape York to the west a year. Pauline Wardle, Manager of Indigenous language so that she could Flynn (1880-1951), established the coast of Tasmania and the isolated Community Care at Frontier Services, communicate better with her clients Australian Inland Mission in order to Kimberley region. when asked for her opinion about in East Arnhem Land. “Learning the give some much-needed support to working with Frontier Services, said language is a way to connect with the people living in Australia’s remote Those working in Frontier Services that she was “in awe at the variety and people - and with dementia it is really places at the time. programs understand that progress in the health of remote Australians is creativity” of her fellow staff members important to make that connection,” John Flynn was a minister interested in not just about health services, but also “who work extremely hard to ensure she said. When asked about receiving spiritual welfare but he also aimed to about social and economic services, their clients in rural and remote areas the award, she said that she was just provide a network of pastoral support education, better housing and cultural of Australia have access to the same doing her everyday work: “What we do, plus medical care, and he moved with understanding. All these factors have services as those in the major cities”. we do naturally. Every day is different the times, leaping with alacrity on new and we are not sure what challenges we an impact on the health of individuals Another staff member, behaviour technology, using radio and aeroplanes are going to have, but we do it because and on the communities in which they advisor Stephanie Charlesworth, won as they were developed, in order to we love it. It is extremely rewarding live. a national employee Award last year meet the challenges of distance and to see someone whose life has changed for her commitment to improving isolation. Sir W Hudson Fysh, the Through the Outback Links program, because of some intervention you have the quality of life for people with founder of QANTAS, wrote that families in remote areas who need made.” dementia in the Northern Territory. “Flynn the Dreamer … was a practical special assistance during difficult man when the time came for action”. times are linked to volunteers who lend their time, energy and skills to John Flynn’s organisation gradually provide a helping hand. Twenty-one developed into Frontier Services, Patrol ministers give practical and which has sustained the spirit of

30 Partyline August 2012 Partyline August 2012 31 There are many ways to get involved in celebrating this historic year: you can host your own Centenary Great Outback BBQ, a Frontier Services Sunday, a historical display or activity Beginning your eHealth journey in your community or anything else you can think of. Everyone is invited, News from the Department of Health and Ageing from near and far, to the celebration at the Dallas Brooks Centre in Melbourne on 26 September. You can also log on to the Centenary section able to communicate with the eHealth Australians living in rural and remote of the Frontier Services website at rom banking online to our interactions F record system, allowing them to add areas will benefit from the eHealth www.frontierservices.org/centenary with health care, technology touches information. With patient consent, record system, as they often have to keep up to date with the latest the lives of every Australian every day. news on events across Australia to other healthcare organisations will be to travel great distances for health celebrate the achievements of this When you visit your doctor, get a blood able to access that health information care. The system will allow easy and wonderful organisation which does test, or have a prescription filled, your securely, online, letting them spend secure transfer of information between good for so many people. information is uploaded into some form less of their precious time looking for healthcare professionals, helping to of electronic medical record. However, missing information. In an emergency, improve coordination of care. For For further information or to buy a none of this information is easily shared having quick access to the information patients, being able to access their copy of the book At the Very Heart, or available to you. in a patient’s eHealth record will help health information online will save and other memorabilia celebrating medics in those seconds that count the time and travel costs, especially in The personally controlled electronic the Centenary or for resources most. combination with broader eHealth health (eHealth) record system will to host your own celebration, initiatives such as Telehealth. contact Kate Higginbotham at make the sharing of this information [email protected] or on easier. (02)8270 1361. The eHealth record system will enable Australians can register for an eHealth record either by the secure sharing of health information phone (1800 723 471), by post, or at a Medicare office. between your healthcare professionals, while allowing you to control who can access your eHealth record as you go other of three, Rachel Batchelor, sees the through your health journey. M benefits of an eHealth record. She notes the If you choose to register for an eHealth difficulty that can be involved with trying record, you will be able to enter to remember each child’s immunisations, demographic and basic information allergies and reactions to medications. With about your health, such as details of another child on the way, Rachel appreciates allergies and medications. You will also the coordinated care approach that an eHealth be able to keep private notes for your record presents her with. “An eHealth record own use. means I wouldn’t have to give a detailed As clinical software is upgraded over description of my child’s history every time we see a new health practitioner, and I’d have Pauline Wardle with Paul Staines at Old the coming months, doctors, nurses and Timers Aged Care Service in Alice Springs. other healthcare professionals will be more confidence the children were getting the PHOTO: DOHA best possible treatment.”

32 Partyline August 2012 Partyline August 2012 33 The NBN Co Discovery Truck

BROADBAND Rural Placebook FOR ALL AUSTRALIANS City girl goes bush

The two technologies are being rolled irstyn has recently moved from coastal city life to a pastoral property near Charleville he NBN Co Discovery Truck has K T out independently, with the fixed where she works as a governess. Her facebook posts reveal her developing impressions been travelling around Australia wireless build to be completed first. of life in the bush. informing communities about the This means many remote communities National Broadband Network. In in Australia will have access to the rural and remote areas of Australia the NBN before suburbs in major cities. number one question the team gets The Long-Term Satellite service is asked is “will my home or business be Kirstyn: Kirstyn: due to launch in 2015 and the fixed connected to the NBN?” April 14 at 8:59pm April 19 at 3:21pm wireless rollout is already underway in via mobile via mobile The NBN is a national upgrade a number of areas. of Australia’s telecommunication NBN Co’s Interim Satellite Service Kayaking ... and people think I get This status update was going infrastructure and will give 100 (ISS) is available now to some bored out here … silly people ... to be about me being on my per cent of Australian homes and Australians in remote areas. The ISS opens...but, alas, it is not :-( businesses the ability to connect criteria have recently been extended to high-speed broadband service. to include eligible schools, health Earlier this year NBN Co announced Friend: clinics and local council facilities such a three year construction rollout I’m sorry...what happened? as public libraries around Australia that plan that is available online at don’t have access to metro-comparable www.nbnco.com.au. Residents can broadband services. This change is enter their post code to see where they Kirstyn: expected to broaden the eligibility for sit within the rollout schedule. It’s The police station was the ISS to better meet the educational important to keep in mind the NBN Kirstyn: closed. Apparently it is and health needs of people living in rollout is a 10 year project so if your May 19 at 9:48am only open on Mondays :-( country and outback areas. area has not been included in the via mobile initial three year rollout plan it doesn’t For more information on eligibility mean you’re not getting the NBN – it Friend: please go to If you try contacting me in the next just means your area will be part of the Does this mean that crime rules www.nbnco.com.au/satellite week and can’t get onto me, it’s next phases of the rollout. the streets the rest of the week? or call 1800 883 488. not that I’ve fallen of the face of To achieve national coverage NBN Co the earth; I’m just near Cloncurry. NBN Co has a Discovery Centre in is using three different technologies - Kirstyn: Melbourne and a Discovery Truck Fibre, Fixed Wireless and Satellite - to The town is so small that travelling around the country so reach everyone, including the most the job of a criminal is if you are interested in seeing new remote areas of Australia. only available 1 day a applications and learning more about week ... he has to have a second NBN Co’s fixed wireless rollout will be the NBN please book in a visit to job just to be able to survive... completed before our fibre optic rollout. either facility at www.nbnco.com.au/demo-facilities 34 Partyline August 2012 Partyline August 2012 35 range of health promotion programs, district nursing and palliative care Walwa Bush Nursing Centre services, community transport, home and community care, meals on wheels, planned activity group, falls prevention family came to be too difficult for the alwa is situated in the North classes, QUIT smoking and solution W GP employed to replace Dr Dave, and East of Victoria, 110 kms up river based counselling, health education he left after only a year in our employ.” from the closest regional centre of and chronic disease management, out Albury-Wodonga. It has a population The WBNC was then faced with patients, 24/7 emergency department, of around 100 in town and 1500 in providing no medical services or accredited x-ray department, the surrounding areas although the filling the role with a succession of community capacity building and actual patient base is bigger than this locums while continuing to search community development programs. as individuals travel to Walwa from for a permanent full time GP. They “We still hope to find a permanent Dr Ledwoch, a regular locum at Walwa. surrounding towns to access services. chose the latter, and since July 2011 a GP. But in the meantime the locum number of GPs have provided services, Health services in the township of model is a fabulous way to continue to spending anything from one week to excellent facilities in the workplace. Walwa are provided by the Walwa provide access to medical services for three months working in the centre. “A She said, “The software is just right for Bush Nursing Centre (WBNC) and our isolated community,” Sandi says. number of those locums have returned,” the type of clinic and the surroundings the Walwa Medical Centre (WMC). Sandi reports. “They all report being Dr Barbara Hoare has recently spent are picture perfect. The staff are Prior to 2002, these two facilities very happy here and feeling very well time at Walwa and her experience as talented and committed and all wear provided distinct services from two looked after which is reflective of our a first timer was one of “delight”. She many hats. They are governed by a different sites in town: the WMC overall philosophy.” said people appeared receptive to her very committed and competent board, with 1.5 GPs provided general approach of providing information to and the community is clearly very practice and pharmacy services; and It can be difficult for the community help them look after their own health proud and grateful for such a service in the WBNC provided acute bed based having so many different GPs. Sandi and avoid prescription medication as a remote part of the country.” And will hospital services. In 2002 the WBNC says that some patients have expressed much as possible. Dr Barbara felt well Dr Barb be going back? “Absolutely!” underwent a complete redevelopment. frustration about having to “tell their received by the community and found This included closing the acute beds story” over and over each time they and redeveloping the infrastructure attend a new practitioner. “But the and the entire service base. The positive side is that you can get a second, redevelopment included purpose even third and fourth opinion without Summary of Indigenous Health built medical rooms, with the view to having to go anywhere else,” she says. relocating the medical practice to the “It’s also been a valuable learning The Summary of Australian Indigenous • population same site as the Bush Nursing Centre. experience for our nurses. Although health 2011 is now freely available • births Subsequently, the Bush Nursing they all have advanced assessment on the Australian Indigenous • deaths Centre purchased the medical practice skills and are able to manage most HealthInfoNet website. It provides a • common health problems and salaried the GP role in an attempt emergencies, working with different plain language summary of the most • health risk and protective factors. to improve ability to recruit GPs into locums has brought a new range of recent indicators of the health of Indigenous people. The Summary aims www.healthinfonet.ecu.edu.au/ the future. skills and experiences that our nurses uploads/docs/summary-2011.pdf have benefited from.” to make this information available to In 2010 long standing GP, Dr David all people, including those without a The HealthInfoNet makes relevant high Hunt, retired after 33 years in Walwa. The Walwa Bush Nursing Centre specialised knowledge of the health quality knowledge and information “We thought we had filled the role,” says provides a vast range of community field. The Summary uses information readily accessible to policy makers, CEO and Nurse Practitioner, Sandi health and wellbeing services including from the most up-to-date sources to health service providers, program Grieve, “but sadly, separation from a gym with personal trainers and a help create a picture of the health managers, clinicians, researchers and of Australia’s Indigenous people with the general community. 36 Partyline August 2012 information on: Partyline August 2012 37 Finding confidence I was blown away with the of people and medical conditions and in Goulburn professionalism and passion of the nurse each person was on a journey that we educators. They were truly interested could support them through. The staff Base Hospital in ensuring that we were learning remembered our names and were very from every one of our patients. I was committed to building our skills and As a third year nursing student with s nursing students we all have those guided through a patient’s diagnosis, confidence as a health professional. I A limited acute care experience I was days on placement where we feel like what their body was doing, why they would definitely recommend going constantly being reminded that I would we are getting in the way of our RN were on the medications they were, rural to other health students. be part of the hospital world very soon or taking too long to learn the ropes. what I should expect in their recovery and I wasn’t sure how I was going to get It’s that awkward moment when we and how to identify the signs if they Ely Taylor more prepared. That’s when I decided accidently break a Heparin vile or were starting to deteriorate. It was Third Year Nursing Student at to go rural. clumsily invade a sterile space and we priceless first hand knowledge. As it is the University of Canberra start to feel like we may never make Goulburn Base Hospital is the referral a smaller hospital we saw a wide range it. You know it’s part of learning and hospital for the Greater Southern it happens to everyone but the feeling Area Health Service in NSW. It has

Al And Torres sTrAiT Aborigin Hips islAnder HeAlTH scHolArs Puggy Hunter Me Morial ScHolarSHiP ScHeMe

are you an aboriginal or torreS Strait iSlander PerSon?

 who is currently studying or wanting to study an undergraduate course in a health related field at TAFE or university  who needs financial assistance for study costs. You may be eligible for an Indigenous health scholarship worth up to $15 000 per year for full time study. Apply online at www.rcna.org.au Closes 16 Sept 2012 Goulburn Base Hospital

freecall 1800 688 628 lingers. So it’s when your RN tells you approximately 120 beds and medical, [email protected] that “it’s going to be ok”, or confides surgical and psychiatric wards, an RCNA www.rcna.org.au that they too “have done that before”, intensive care unit, operating rooms that things start to look up and you and an emergency department. It also Puggy Hunter Memorial Scholarship Scheme (PHMSS) is funded by the Australian Government. remember why it is you are studying so has community and outpatient services. RCNA, Australia’s peak professional nursing organisation, is proud to partner the Australian Government as the fund administrator for this program. hard to be a part of this great profession.

38 Partyline August 2012 Partyline August 2012 39 What is reassuring though is that the many medications, lack of perceived rural patients with hip fracture have protective effect and medication side increased their vitamin D use from 46 effects. per cent to 79 per cent and calcium Make no Innovative attempts to make tablets from 61 per cent to 81 per osteoporosis screening more accessible cent between 2005 to 2009 compared in the country include mobile bone with the city dwellers whose calcium density screening service in regional bones about it and vitamin D use remained fairly South Australia and more research to constant (69-79 per cent). Further, the enable local chemists to have low-cost gap in supplement use between urban portable ankle ultrasounds to assess and rural patients was narrowed. This ural seniors fracture risk. R reflects an increase in health awareness are prone to under-treatment There among country people. More innovations like these and for osteoporosis. Although rural further promotion of bone health and are national Additionally, both rural and Australians have a lower fracture falls prevention services in the rural subsidy schemes to encourage urban patients stopped taking rate, those of them who survive a hip and remote areas would go a long doctors to identify and treat osteoporosis. bisphosphonates one year after their fracture are less likely to be aware of way towards reducing rural inequality However, a person’s residence in rural fracture for a variety of reasons, leaving their pre-existing osteoporosis and also in fracture prevention from minimal regions was associated with lower use them prone to fracture recurrence. less likely to comply with osteoporosis trauma. treatment than their metropolitan of osteoporosis treatments before they More than two-fifths of rural patients counterparts. suffered from a hip fracture. Prior to a had no ongoing prescription for the Dr Michelle Lai fracture, rural WA residents were 65 medication after hospital discharge Consultant Physician and A recent study at Royal Perth Hospital per cent less likely to have used vitamin (43.2 per cent for rural as compared Geriatrician, Royal Perth Hospital titled Under-treatment of osteoporosis in D, 60 per cent less likely to have used with 31per cent for urban). Otherwise, regional Western Australia looked at the calcium and 46 per cent less likely to both rural and urban patients reported The original study is available at importance of geographic differences have used bisphosphonates than urban similar reasons such as having too http://onlinelibrary.wiley.com in osteoporosis management among residents The findings echo a previous in the Australasian Journal on 1130 patients who presented to the study, which found that Australians Ageing, 2012. 31(2): p. 110-4. tertiary centre for hip fracture after outside capital cities are less likely minimal trauma in WA from 2005 to to check their bone density. At the 2009. time of the WA study, eligibility for a Indigenous clinical health practice resources Hip fracture is a costly but potentially Medicare rebate for bone density scans The Australian Indigenous and will provide a reliable up to date preventable complication of was widened to include all healthy HealthInfoNet website now features resource to keep health practitioners osteoporosis. Besides vitamin D seniors aged 70 and over and those at a searchable database of its health updated and informed. This and calcium supplements to replace risk of bone loss, such as those on long practice resources. This makes it easier comprehensive searchable literature micronutrient deficiencies, early term steroids and those who suffer from to find the clinical resources which about Aboriginal and Torres Strait intervention using osteoporosis certain chronic diseases. are needed by health practitioners Islander health can be accessed at medications, such as bisphosphonates One year after their fracture, only working in Australian Indigenous www.healthinfonet.ecu.edu.au/ and strontium, can effectively reduce two-thirds of rural patients continued health. This valuable resource key-resources/practice-resources fracture risk in those who have proven to take calcium and vitamin D for health practitioners contains bone loss or those who already suffered supplements and were 11-15 per cent information about clinical guidelines, from a minimal trauma fracture. less likely to do so than those living in toolkits and manuals. The searchable metropolitan areas. database will be continuously added to

40 Partyline August 2012 Partyline August 2012 41 Lack of funding and lack of staff workplace violence makes it difficult were seen as the two biggest factors to gauge whether workplace violence Safety inhibiting the ability of employers to is more prevalent in rural and remote respond to workplace violence. locations, as opposed to urban locations in Australia,” said Ms Johnson. in the rural “Addressing issues that cause stress and anxiety, as well as other workplace “It also makes it difficult to work out workplace safety concerns, is one way in which what strategies and initiatives are PHOTO: LEANNE COLEMAN employers can help their staff remain actually reducing the incidence of longer in a more remote area,” Ms workplace violence.” “The survey and the review aimed to Johnson said. ong hours and isolation are key The next component of the project is L increase our understanding of the factors in the safety of rural and remote The review of the literature identified to develop a national framework for incidence, prevalence and impact professionals. Health professionals, the need to develop reliable practical cooperation on workplace of the violence experienced by teachers and police working in rural mechanisms for recording workplace safety both within and across sectors. professionals delivering key services and remote areas often feel vulnerable violence in each sector, as well as across in rural and remote workplaces,” said to violence in the workplace when different locations in Australia, and to Jenny Johnson, RDAA CEO. working alone in isolated settings and evaluate violence prevention strategies working unsociable hours. This is the “This work provided an overview of and initiatives to discover what works finding of a recent survey of more than current strategies and initiatives to best in particular environments and The report on the findings of the survey, build safe workplaces and of their situations. and the literature/documentation review, 600 rural and remote professionals. is available online at effectiveness. The survey was carried out as part of “The lack of any system to formally www.rdaa.com.au at Quick Links the Working Safe in Rural and Remote “The results of the survey showed that and uniformly record incidences of Rural Doctors’ Association, Australia Australia project. The project is respondents generally accepted that a collaborative effort of the Rural there is a level of risk which comes Doctors Association of Australia from working in these jobs or in (RDAA), Australian College of Rural these locations. Working long and and Remote Medicine, Australian unsociable hours and working alone Rural Placebook Nursing Federation, Police Federation in isolated settings were identified as City girl goes bush of Australia, the Queensland Teachers’ contributing to feelings of being unsafe Union and CRANAplus and is funded in their workplace. Kirstyn: Kirstyn: by the Australian Government’s “All respondents also reported feeling June 4 at 6:10pm July 27 at 6:11pm Department of Health and Ageing. increased stress and anxiety resulting via mobile via mobile The project aims to seek solutions to from concerns about workplace That sad moment when you think the problems of workplace violence violence.” Has a fully functioning TV...with it’s payday but then realize it’s not for health workers, police and teachers the ability to record!!!!! (Well Most suggestions from respondents on til next week...That sadder moment in rural and remote Australia by you would be excited too if how workplaces could be improved to when you’re excited about it being promoting and facilitating a whole-of- you’d only had 7, 9, ABC and prevent workplace violence related Friday afternoon but then realize community response. SBS for the last 5 months...) to improved training (particularly you’re working tomorrow...And the The first step in the project has been in managing violent and aggressive saddest moment of all when it’s your to conduct a survey and a review of behaviour), enforcing existing policies mum’s birthday and you’re not there available literature and documentation. and improving work practices. to give her a great big hug! :-(

42 Partyline August 2012 Partyline August 2012 43 Supporting allied health allied health professionals, and A major professional development comparing supply with demand. and networking event for rural and professionals in rural 4. Increase the current range remote allied health practitioners and remote Australia of scholarship programs and will be the 2012 National SARRAH incentives supporting allied Conference, to be held at the Hotel health professionals and students Grand Chancellor, Launceston, practising or wishing to practise Tasmania from 20 to 23 September. in rural and remote Australian The conference subthemes include cultivating champions, confident ervices for Australian Rural and communities. There is a clear S competent clinicians, celebrating client Remote Allied Health (SARRAH), is lack of equity evident when these With an ageing population and centred care, chronic conditions and the peak national body representing strategies are compared against increasing burden of chronic disease coordinated care, creating community rural and remote allied health the range and volume of programs the demand for allied health services capacity, and curious and captivating professionals working in both the available to doctors and nurses. will continue to rise. Consequently, conversations. public and private sectors. SARRAH is playing a leading advocacy SARRAH’s representation comes from role for allied health professionals a range of allied health professions practising in rural and remote Australia. including but not limited to: Audiology, Earlier this year SARRAH endorsed Dietetics, Exercise Physiology, four key priority areas for action by Occupational Therapy, Optometry, the Commonwealth Government: Oral Health, Orthotics and Prosthetics, Pharmacy, Physiotherapy, Podiatry, 1. Develop and implement a Psychology, Radiation Science, Social national rural health policy Work and Speech Pathology. which is underpinned by a rural and remote health plan. During 2011-12, SARRAH continued Workforce and health system reform, These allied health professionals have to work collaboratively with each of allied health models of care, research, significant roles and provide a range of 2. Appoint a national Chief Allied the 36 Medicare Locals which have education and training and consumer clinical and health education services Health Officer to sit alongside rural and/or remote geographical centred care will be the focus of to individuals who live in Australian the Chief Medical Officer and coverage across Australia to develop a attention for the conference delegates. rural and remote communities. Allied Chief Nurse positions. This strategic alliance in areas such as: health professionals also work in new position should develop • advocacy and support for allied other human services areas such as policies which contribute towards health professionals practising in education, disability, aged care and implementing a multidisciplinary rural and remote Australia; Join us in Launceston to celebrate “Rural child protection and family welfare approach on delivering health and Remote Practice: Totally Wild!”. systems. services across Australia. • linkages to resources and 3. Develop an allied health evidence communication tools including Registrations are now open and for The allied health professional, database to inform strategies websites and e-bulletins; and further information please visit the especially in rural and remote areas for workforce development, SARRAH website: www.sarrah.org.au • promoting access to development across Australia, is required to adapt to especially in rural and remote and networking opportunities workforce shortages and is well versed areas. Workforce data must be for allied health professionals in the interdisciplinary and team collected on a national and including the availability of the approach to health care, especially for regular basis using a consistent Commonwealth Government’s management of chronic disease and to methodology including both scholarships programs. improve health behaviour. registered and self-regulating

44 Partyline August 2012 Partyline August 2012 45 of my partner made the decision for me, and we decided to take the plunge Rural Kel’s Chemist - my and move to this beautiful town. The doors to ‘Kel’s Chemist’ opened in Placebook Journey to opening a June 2005 after a lot of hard work, City girl goes bush community pharmacy including remodelling the existing space. We were very fortunate that the in rural NSW community pitched in to help, along During the remodelling with my family - it was still a hard slog Kirstyn: to change the pharmacy in just one July 6 at 4:46pm month. via mobile asked if he was interested in moving as believe that community pharmacists I I thought it might be just the kind of Support for taking up ownership of a play an important role in the rural I hit an echidna :’-( Kinda glad it job I would enjoy – working for myself, community pharmacy was provided and remote primary care team by wasn’t a kangaroo but I also wish I living in a great place to raise children by the Pharmacy Guild of Australia, providing a range of health services had learnt how to change a tire :-( as a member of a small community and of which I am now a member. In to the community. I first decided to being able to really know my customers. particular, there was an emphasis on be a pharmacist when I was in year 11 supporting people to practise in rural at high school (no need to mention Considering ownership of a community and remote Australia, and because of the year!). Needless to say that there pharmacy in a rural area was a big this, I am now a member of the Guild’s was a bit of a gap between finishing decision for not only me, but my family, Community Pharmacies for Rural my HSC and making it to Pharmacy; and in the first instance I needed and Indigenous Australia (CPRIA) I completed a Bachelor of Science in to ensure I had the support of the Advisory Group which addresses rural, the meantime. community… so we visited Mungindi. remote and Indigenous population In 2000, I was the recipient of the Mungindi is on the New South Wales health issues relevant to community Aboriginal and Torres Strait Islander and Queensland border, divided by the pharmacy. Pharmacy Scholarship through a Barwon River. It is the only border I would encourage students in senior scheme administered by the Pharmacy town in the Southern Hemisphere school to consider pharmacy as a Guild of Australia. After completing with the same name in two states and profession, especially Aboriginal Kirstyn: my pharmacy degree at the University has a population of approximately People and Torres Strait Islanders, as July 23 at 6:29pm of Tasmania, I undertook my intern 700 people. To confuse things even it has been a rewarding journey. I via mobile year in Darwin before returning to my further, the ‘central business district’ am a health professional with my is located in NSW, but there are two home town of Tamworth. I spent the own business, and as a community So stoked! I’m going shopping Police stations, one in each state. next year and a bit working in Quirindi pharmacist in a rural location, I know I tomorrow!!! AND my iPad is The Schools, with the exception of and Werris Creek. am contributing to my community, and due to arrive! You have no idea the Community Pre-School, are in My journey to ownership began when I in return, my growing family has been how excited I am...especially NSW, and the hospital is situated on heard a plea on ABC radio in December welcomed and I have no plans to leave about the grocery shopping! the Queensland side. This makes it 2004. The community of Mungindi in the foreseeable future! interesting during State of Origin! were, in their words, “left in the lurch” Kellie Beckenham and wanted to find a pharmacist. After The support I was shown by the hearing this I spoke to my partner and community and the encouragement

46 Partyline August 2012 Partyline August 2012 47 knowledge and skills enhances communities. With their wide range health care for people living outside of skills, knowledge and experience, Allied health rural and remote practitioners metropolitan areas. allied health practitioners can support communities to determine health With as many as seven million people approaches, can actively work with Podiatrists, Perfusionists, Psychologists, living in rural and remote Australia, llied Health Professions Australia individuals to change their behaviour A Social Workers, Sonographers and and around 70 per cent of Australia’s (AHPA) supports quality healthcare to improve their health, and can work Speech Pathologists. AHPA’s member Aboriginal and Torres Strait Islander for rural and remote Australians. with those who are ill or injured to organisations represent approximately people living outside the major cities, AHPA advocates for improved regain their health and function. 45,000 health professionals. It is allied health practitioners have access to allied health services for all estimated that 10 per cent work in significant contributions to make to Many allied health professionals are Australians, as good healthcare is about rural and remote Australia. their health and AHPARR strongly happy to testify that working in rural effective teamwork amongst a range supports the NRHA vision for equal and remote Australia is rewarding and of providers in collaboration with Nicole and her AHPARR colleagues health by 2020. exciting. They talk about the the individual or community. Allied also promote an awareness of rural and health professionals are needed just as much in rural and remote regions of Australia as in the cities, to contribute their specialist skills and knowledge to help individuals maintain or regain health. Allied Health Professions Australia Rural and Remote (AHPARR) is the subgroup of AHPA working hard at representing the rural and remote views of AHPA member associations at a national level. Its convenor, Nicole O’Reilly, an occupational therapist in Darwin, participates actively in Left to right: Amarjit Anand, Audiologist, doing otoscopy; Nicole O’Reilly providing remote health issues within AHPA and the National Rural Health Alliance occupational therapy services in the Northern Territory; and Anne Leversha, hospital its member organisations and the wider activities on behalf of AHPA. She pharmacist, displaying a Rural Health Week award for the Gippsland Region. community. For example, whilst many is supported by Amarjit Anand, an incentive schemes and payments are audiologist, Maria Pritchard an offered to doctors and nurses, allied orthoptist and Anne Leversha a health professionals – the third pillar Just over a year ago Rural and Regional environment, personal lifestyle hospital pharmacist. of health care providers – miss out Health Australia was established in benefits as well as the broader range Collectively AHPARR speaks for all on much needed support to relocate the Department of Health and Ageing of professional experiences that are 15 allied health professions which to rural and regional positions and, and is working to strengthen rural and possible there compared with urban are part of AHPA: Audiologists, most importantly, to remain there. regional health policy. AHPA supports practices and they are every bit as Chiropractors, Dietitians, Exercise Thus AHPA has been advocating the NRHA call for a National Rural satisfied as their urban counterparts. Physiologists, Occupational Therapists, for improved support for rural and and Remote Health Plan - and sees a Lin Oke Orthoptists, Orthotists and Prosthetists, remote allied professionals as it knows key role for allied health in improving Osteopaths, Hospital Pharmacists, that access to their range of specialist the health status of rural and remote

48 Partyline August 2012 Partyline August 2012 49 g advances in breakin testing ound- int-of-care Gr onal po rnati inte will be conducted on the Siemens oint-of-care (POC) testing P DCA Vantage point-of-care device is pathology testing performed in remote Indigenous communities in on-site by a trained operator in a countries including Canada, South clinical setting at the time of patient qualifications in the fields of nursing, by the International Centre. They Africa, Thailand, Papua New Guinea, consultation. The test results enable an health science, medical science, can then select a further 9 units the Solomon Islands and New Zealand. immediate, informed clinical decision medicine, nutrition, paramedic science, from specialty streams designed to The Centre is looking to partner with to be made, potentially contributing Indigenous health or public health. complement and enhance the core international universities or diabetes topics; these specialty topics are to an improved health outcome for The Graduate Certificate in Global organisations that have strong links delivered by the International Centre the patient. Point-of-Care Testing is unique in with their remote communities. and its collaborating Flinders partners that it will enable students to gain The Flinders University International - the Centre for Remote Health, the As its first major teaching initiative, a formal postgraduate university Centre for Point-of-Care Testing was Flinders Human Behaviour and the Centre is offering a Graduate qualification in POC testing. The established in 2011 to: Health Research Unit, and the School Certificate in Global Point-of-Care course is taught by scientific and of Nursing and Midwifery. These • deliver advanced research and Testing as an 18-unit, fully on-line, academic staff skilled in delivering specialty streams cover areas including teaching programs in the field one-year part-time postgraduate community-based POC testing models remote health, Indigenous health, of community-based point-of- qualification. in ‘real-life’ field situations in Australia primary health care, chronic disease care testing to an international and overseas, and is strengthened by its The Graduate Certificate in Global management, disaster management audience; and interconnectedness with other related Point-of-Care Testing will provide and infectious disease. • build the capacity of rural and advanced level preparation for Flinders University teaching modules. remote communities globally to practising health professionals and Students enrolling in the Graduate Mark Shephard, Heather Halls develop and sustain innovative, recent graduates from Australian and Certificate must complete 9 units of and Lara Motta quality-assured point-of-care international backgrounds wishing core topics on POC testing delivered testing solutions. to specialise in POC testing at local, national or international levels. In terms of research, the Centre has Particular emphasis will be placed on developed an international POC preparing students for working within testing model for diabetes management a multidisciplinary health care team called the ACE Program (ACE standing For further information on the ACE Program or the new Graduate Certificate in rural, remote or Indigenous primary for ‘analytical and clinical excellence’). in Global POCT, please contact: Associate Professor Mark Shephard, Director, care settings in their country of origin. In this program, POC testing for Flinders University International Centre for Point-of-Care Testing, Flinders haemoglobin A1c (HbA1c) and The course is particularly relevant for University, phone 61 8 8201 7555 or email [email protected] urine albumin:creatinine ratio (ACR) health professionals or graduates with

50 Partyline August 2012 Partyline August 2012 51 Equipping the future rural health workforce with skills to thrive in the bush

The NRHSN has not only been busy he students of the National Rural T promoting the priorities to stakeholders Across the country, Rural Health wellbeing among members through Health Students’ Network (NRHSN) and decision-makers, but has also been Clubs have been offering members the other initiatives including running are passionate about improving the actively working with all 29 Rural opportunity to attend a Mental Health Mental Health Week events and health workforce and health outcomes Health Clubs to help achieve local First Aid course to develop these distributing its popular student mental for rural and remote Australians. outcomes in the five national priority skills. By making the training more health guide, ‘When The Cowpat Hits Comprising over 9,000 university areas, ultimately supporting the future widespread and accessible to health the Windmill’, written by students health student members across 29 health workforce of the bush. students, the Network hopes that it for students and recently developed Rural Health Clubs at universities may help reduce the stigma of mental in partnership with beyondblue: the throughout the country, the Network One great example is the work being illness and encourage future health national depression and anxiety initiative. includes students from medicine, done across the country by Rural professionals to actively pursue greater A copy of the guide and the 2011-2012 nursing and a range of allied health Health Clubs on the Network’s mental health literacy. The course has NRHSN National Priorities Paper can disciplines. National Priority 3: Mental Health Training for all health students. The been attended by medical, nursing and be found in the Publications section of The NRHSN undertakes a number NRHSN believes that promotion and allied health students, and has become www.nrhsn.org.au of initiatives to encourage students training in mental health is integral to a popular annual event on many Rural to pursue careers in the bush, while Teena Downton and Mitchell the development of resilient, healthy Health Club calendars. also providing an important voice on Milanovic and confident practitioners for a Rural Health Clubs also actively issues that directly affect the future National Rural Health sustainable rural health workforce. support good mental health and rural health workforce. The 2011-2012 Students’ Network Furthermore, students who are NRHSN National Priorities Paper, equipped with practical knowledge and developed in consultation with basic skills to manage their own mental Network members, outlines the health and the health of those around student perspective on five key issues them will be valuable assets to rural for improving the health workforce for and remote Australia, where mental rural and remote Australia: illness is a major challenge. 1. Rural and remote At a national level, the NRHSN is training pathways calling for more research into the 2. Aboriginal and Torres mental health challenges experienced Strait Islander Health by health students undertaking tertiary 3. Mental health training study. At the local level, the NRHSN for all health students believes that training health students in mental health will support greater 4. Ensuring Medicare Locals levels of mental wellbeing during deliver for the rural and their training and importantly in their remote health sector future careers so they are less likely to 5. Regional development and experience professional burnout. health infrastructure

52 Partyline August 2012 Partyline August 2012 53 PHOTO: LEANNE COLEMAN Editors’ breakfast International Associations of Patients’ Organisations Conference The founding and current honorary Editors London – 17-19 March 2012 of the Australian Journal of Rural Health caught of illness and disease risk factors than up with each other in Glenelg at the 3rd Rural n March this year I attended the I those in major cities. This is because and Remote Health Scientific Symposium. 5th Global Patients Congress of the rural residents have poorer access to Founding Editor Desley Hegney (right) has International Association of Patients’ goods and services, and educational returned to Australia and recently took Organisations (IAPO) as the delegate and employment opportunities, as well up a post at Curtin University in Western for the Health Care Consumers’ as having lower levels of income. The Australia. Current Editor David Perkins (left) Association (HCCA). The congress discussion was animated. People were has prevailed upon Desley and the other two was held in London from 17 to 19 able to provide similar examples from previous Editors to each write a guest editorial March 2012 and the theme was their own countries, and they were in this, the 20th year of publication of AJRH. Achieving Patient-Centred Healthcare: surprised about some of what they Desley’s is in the current edition (August 20:5). Indicators of Progress and Success. learnt about Australia and its health IAPO (http://www.patientsorganizations.org) system, especially in regard to rural is a unique global alliance representing and remote areas. It was interesting patients of all nationalities across all that in the same conference session a disease areas and promoting patient- Canadian told about the situation in MENTORS centred healthcare around the rural and remote Canada; the parallels world. IAPO’s vision is for patients and convergence between the two OF THE YEAR throughout the world to be at the countries was truly remarkable. 2011 centre of healthcare. A patient is Dr Olga Ward and Dr Jenny Wray were joint winners of the RAMUS Mentor of My presentation, Patient-Centred defined as a person with any chronic the Year Award for 2011. The Award recognises their outstanding contribution to Healthcare in Rural Communities, disease, illness, syndrome, impairment the Rural Australia Medical Undergraduate Scholarship (RAMUS) Scheme and was developed through discussion or disability. The members are the inspirational support they have provided to the RAMUS scholars they have with NRHA staff and was based on patients’ organisations working at the mentored. wonderful materials they provided. international, regional, national and The congress attendees who saw the local levels to represent and support materials which I took with me were patients, their families and carers. Based in Perth, Dr Olga Ward works with the very impressed with the publications. I Royal Flying Doctor Service, regularly flying At the Congress I presented two believe that NRHA were pleased that her much loved plane ‘Pinky’ to rural towns in sessions, one of which was a case study HCCA chose to use them as a case Western Australia. She has participated in the of the National Rural Health Alliance study for this important international RAMUS Scheme as a mentor since 2004. of which HCCA is a ‘friend’. congress. The presentation was well received and generated much The main thrust of my presentation was discussion. to provide an overview of the state of Dr Jenny Wray, of Narooma NSW, has been a rural health in Australia, and explain Caroline Polak Scowcroft mentor in the RAMUS Scheme since 2005. She why, on average, people living in rural also received the RACGP GP of the Year award areas have shorter lives and higher levels in 2011.

54 Partyline August 2012 Partyline August 2012 55 I O National Continence NOt CE B AR Helpline (freecall™) 1800 33 00 66 Incontinence is experienced by one in four Australians over the age of 15 years, making it one of the biggest health issues facing the nation. However, many people are National Stroke Week– Healthy Living reluctant to discuss the problem. 10-16 September Network For confidential advice about bladder or bowel weakness phone This year’s Stroke Awareness Week has the theme of ‘1 in 6’… because 1 he Healthy Living Network the National Continence Helpline T (freecall™) 1800 33 00 66. The in 6 people will have a stroke in their (HLN) is a registration portal Helpline is a free service staffed lifetime. Stroke Week packs are available Connecting Up that provides a list of activities, by continence nurse advisors who for groups and individuals wishing to providers and programs in can provide referrals, resources and help raise awareness of stroke risk. A new directory for Australian your local area. The Healthy information about government non-profit and charity organisations Communities Initiative aims subsidies for continence products. www.strokefoundation.com. to support Local Government au/national-stroke-week d The Helpline is a valuable resource Australia’s non-profit organisations Areas in delivering effective enrich the community - culturally, for Australians living in rural or community-based physical activity remote parts of the country who socially, economically and and healthy eating programs. It have limited access to health environmentally - and provide also supports communities in professionals. Information: assistance and support to those who developing and reviewing local www.continence.org.au are vulnerable. The aim of Connecting policies that promote healthy Health benefits of Up is to help these organisations to lifestyle behaviours into the future. climate action do what they do better so that the Australian community benefits. The HLN supports the Healthy Our Uncashed Dividend: The Health Communities Initiative by listing Putting People First Benefits of Climate Action, produced We are keen to engage non-profits the quality programs and service in partnership between the Climate in rural, regional and remote areas providers that have been registered The 4th Australian Rural and Remote and Health Alliance (CAHA) and The as they play a particularly important and assessed against the Healthy Mental Health Symposium, themed Climate Institute (TCI), and supported role in supporting individuals, families Communities Quality Framework “Putting People First”, will be held by the Australian Medical Association and communities disadvantaged by standards and criteria. All healthy in Adelaide from 19-21 November (AMA) and Australian Healthcare distance from service centres. All living programs and service 2012. Keynote speakers will address and Hospitals Association (AHHA), organisation listings are FREE! Make providers are invited to apply recent developments and future outlines the evidence that there are sure your non-profit is listed! for registration and promotion. initiatives including the benefits of substantial health benefits associated Registration will be provided the implementation of the National with strategies to reduce emissions. Enquiries welcome: Broadband Network, the impact on www.caha.org.au www.connectingup.org/directory free-of-charge until June 2013. Information: e-health programs, and the establishment www.healthylivingnetwork.com.au of The Australasian Centre for Rural and Remote Mental Health. For information: anzmh.asn.au/rrmh/

56 Partyline August 2012 Partyline August 2012 57 together in teams comprised to replicate and extend the successful of whichever professionals ones where they are already known. are present, this gives rural and The National Rural Health Alliance remote areas a head start in the is seeking abstracts for presentations MAKING A COMMITMENT laboratory of health service design. to be made at the Conference on Despite these advantages, on many positive approaches to the prevention, TO A BRIGHT FUTURE fronts the health of people in rural management and mitigation of and remote areas is poorer than the negative aspects of health and and recreational services are only what is experienced by the residents wellbeing in rural and remote areas. he communities and T available at a distance. And even in of Australia’s major cities. There They are seeking abstracts about case businesses of rural and remote this technical age, communications are continues to be the need to build on studies of solutions, home grown Australia have a bright future. poor: phones that drop out, narrowband the natural advantages of rural areas - success stories, and health system They are home to many of both the internet, poor public transport, and the close interpersonal connections, and workforce redesign that has been traditional and the newer industries challenging reception for radio and TV. the resilience and creativity, the achieved. driving the nation’s growth: single-minded focus on an agreed First-time paper presenters can receive agriculture, forestry, and tourism; and These are the conditions in which purpose, and the presence of some of assistance on their abstract from the mining and resources - including the rural communities have learned to the best institutions and personnel in Conference organisers. The online renewable energy sector. be resilient and in which some of the Australia’s health sector. most innovative approaches to service portal is open for the submission of And rural Australia is a great setting for th delivery have been hewn. And this is The 12 National Rural Health abstracts until 1 October. Guidelines work as a health professional. There is true just as much in the health sector as Conference in Adelaide next April and all other information are a sense of community, a broad scope of in any other. Through the University will focus on the positive aspects of available via www.ruralhealth.org.au professional practice, and fewer stress- th Departments of Rural Health and the health and health services in rural, (go to ‘12 Conference’). inducing traffic jams, queues and turf Rural Clinical Schools there has been regional and remote areas. No more wars (reflected on the back cover). genuine decentralisation of a significant evidence is needed of the worse health But at the same time there are of portion of the human and physical statistics in rural areas. Instead there is To keep in close touch you can course deficits in the Bush. Physical infrastructure for health education, enough confidence and knowledge to follow conference developments infrastructure is stretched and often in teaching and research. When added build new approaches and new service on Twitter by using the relatively poor condition. Some health to the ‘needs must’ imperative to work systems where they are needed, and #ruralhealthconf hashtag.

Editorial details

Partyline is the magazine of the National Rural Health Alliance, the peak body working to improve health and wellbeing in rural and remote Australia. The Editorial Group for this Partyline was Lexia Smallwood (Editor), Gordon Gregory, Penny Hanley, Helen Hopkins, Andrew Phillips and the friends Advisory Committee. Articles, letters to the editor, photographs, poetry and any other contributions are always welcome. Please email these to: [email protected] or send to: Lexia Smallwood, Editor, Partyline, PO Box 280, Deakin West, ACT 2600; Phone (02) 6285 4660; Fax (02) 6285 4670.

The opinions expressed in Partyline are those of contributors and not necessarily of the National Rural Health Alliance or its individual Member Bodies. The Australian Government Department of Health and Ageing provides the Alliance with core operational support. Partyline is distributed free. To subscribe, email your contact details to [email protected] Partyline is also available online at www.ruralhealth.org.au

ISSN 1442-0848 58 Partyline August 2012 Partyline August 2012 59 The city or the country

Pity the man who pounds the streets picking up his latte; Concrete, fumes and neon lights imbedded in his psyche. Pity the man in the traffic jam, noise and air pollution; Seeing his kids for an hour each day, the family’s an illusion. Joy to the man on this great land breathing in life’s richness; Open spaces, open minds, communities of comfort. Joy to the man who says “G’day” to his neighbours when they’re passing; A helping hand, a problem shared, solutions in the making. More joy to the soul, more friends for life, more beauty in the vistas, More joy to the children running free, more joy to our brothers and sisters. More heartbreak when the orchards die, the crops and stock are waning, More heartbreak when the river runs dry, more heartbreak when it’s raining, More heartbreak when the price goes down, for grapes and wheat and cattle; The love for country gets us through despite the growing battle The city or the country, we need them both for sure, But give me the country every time ’cause it always gives you more.

Pamela Stagg (“reflecting on my 20 years living in rural South Australia…”)

PHOTO: STEVE LOVEGROVE

www.ruralhealth.org.au