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Opening your eyes to another world

In its effort to close the gap, the Australian government is keen to attract more people to work in indigenous health. Here, one nurse shares her experience working in the field.

Working in remote Australia providing desperately needed ear, nose and throat care has been a life changing experience for nurse Fiona Wake – and for many of her young patients.

Darwin-based Wake is the clinical manager for Remote Area Health Corps (RAHC), an Australian Government funded program that recruits and supports urban-based health professionals to undertake short-term placements in remote communities in the Northern Territory. As part of this role, Wake undertakes clinical placements to keep her skills up to date and ensure she is keeping in contact with people on the ground.

Recently she undertook a placement through RAHC as a teleotology nurse in remote communities in the Central Desert, the Barkly and Katherine regions and East Arnhem Land.

Her teleotology placements were part of the Australian government’s response to Closing the Gap in indigenous health outcomes through the funding of programs to provide outreach ear, nose and throat services to remote communities in the Northern Territory. This initiative aims to improve ear and hearing health in Indigenous children and increase access to services in the territory.
Wake worked in a team of three alongside an audiologist and an administrator and undertook remote consultation with an ENT specialist. The team worked closely with the local health clinics to deliver a range of services including teleotology consultations, manually cleaning ears, taking otoscopy photographs, collecting data and, finally, treating any ear disease.

Wake describes her experience as “incredibly rewarding” and recalls the case of a young boy whose father said was uncontrollable.

“He said ‘he is such a bad boy, he doesn’t listen, he is bad at school, he is naughty’. We had a look in his ears and he had big holes in his ear drums. We tested his hearing, and discovered that he couldn’t hear. We treated his ear disease and then surgically repaired the holes in his drums,” says Wake.

“When I returned to that community some months later, I immediately recognised the father with a big smile on his face. He said to me, ‘He is a different boy, so happy, listening all the time, doing so well at school.’ And when I met the boy again, it was like meeting a different child – he was smiling, listening, happy, and said he was loving school.

“We have been able to give that boy another chance – because if he couldn’t hear at school, at home and with his friends, he was going to struggle to learn and interact.

“These are the precious moments that inspire you – that make you feel that you have been part of making a difference.”

Wake says that her first experience of working in indigenous health was in the Top End. She felt privileged to work with the local people and assist to deliver improved health outcomes.

She admits to having been confronted with situations where she was overwhelmed by what she didn’t know.

“As a health professional you are faced with challenging and chronic health conditions. There’s heartbreak but you get involved, do what you are trained to do and you really feel you are making a difference. You feel blessed somehow.”

“It was a massive learning curve but there is incredibly good education and support from a variety of sources to help you along your journey. Apart from the committed and experienced remote staff, educators and support staff, there are also excellent manuals that give clear guidelines about how to work and deliver services in a remote environment.

“The community members and clinic staff provide fantastic support – everyone is eager to help you and are keen to teach you. They give you some space and they recognise this is new for you – but they also give you the time to learn.”

Wake was so moved and motivated by her experience of going to the Northern Territory for a short-term placement as a nurse that she decided to make the move north long-term and took the job with the RAHC. As clinical support manager, she now provides daily support to nurses undertaking similar work throughout the territory and finds that her own experiences enable her to do that with empathy and technical clarity, replicating the impact of her own experience amongst many others.

“Sometimes I just pinch myself that this is my job – meeting people, seeing Australia like I never would as a traveller, having the opportunity to work and help the local communities while learning about their culture,” she says.

“Sometimes what I experience has been so far removed from what I previously knew or understood. I have met inspiring people who challenge who I am and what I believe. I am just learning every day. The more I learn the more I realise I need to learn. The challenge of looking beyond my own beliefs and priorities has, I hope, allowed me to become a better, more understanding person.”

Wake sees one of the main challenges of delivering Indigenous health care as being able to explain to the communities why health measures should be embraced.

“What we are trying to do health-wise needs to make sense to them,” she says.

“With English most commonly a second language in remote Indigenous communities, we have to take the time to explain and educate so people can actually understand the health challenges they are facing. We need to communicate not just through words but through pictures, demonstrations and illustrations.

“Aboriginal Health Workers and other community members are key to this process. I’ve noticed in my work with ear health that some of our greatest successes in compliancy to treatment is when an individual or group in the community support the health measure.”

Wake says an enriching and humbling part of this work is witnessing the strength and passion of people who hold the communities strong and the commitment of the elders who hold onto tradition and also embrace change for the health of their children.

“They stand up for what they believe in and in many ways are keeping the communities together,” she says.

These experiences inform her work supporting the placement of RAHC health professionals in the Territory. Wake is passionate in encouraging others to work in Indigenous health.

Her advice?

“Do it – go with an open mind,” she says. “You can’t fix everything. It is just one step at a time. Do a bit of research on Aboriginal culture so that you don’t get a massive shock when you get out there.

Organisations like RAHC have reading materials on culture and community profiles that anyone can access on our website www.rahc.com.au.

“You need to understand it is going to be different and you are going to be challenged at a number of levels, especially culturally, but you won’t be sorry, at least I wasn’t... it changed me and I believe for the better.

“The rewards far outweigh the challenges. It is an incredible experience – a privilege to work in communities and provide care.  I now see my future in Indigenous health. I love working in Indigenous health.

“If you want a challenging career – maybe you are a bit tired of the same old coughs and colds. This will blow you away. Every day you learn something different. Your eyes are opened. It is another world.”

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