Editorial: Pulling together to manage climate and health disasters

Rural, regional and remote communities are least supported by Australia’s healthcare system, yet they and their farmers, businesses and families bear the brunt of climate-related disasters.

Yet, as weather conditions become more extreme and the frequency and intensity of bushfires, drought, floods and biosecurity threats grow, rural health services are becoming sparser. This trend is illogical.

That’s why the Alliance is intensifying calls for the Australian Government to introduce a new National Rural Health Strategy that demands climate change and disaster preparation are included in all aspects of rural health research, policy planning and legislation.

Relentless COVID-19 pandemic outbreaks and disasters in recent years have also taken a huge toll on the rural health workforce. That’s our focus for Issue 79 of Partyline. We asked our rural, regional and remote communities to let us know how health organisations, service providers and practitioners have been adapting and innovating to continue providing high-quality rural health care under such trying conditions. How are practitioners and health professionals coping and what strategies are being employed to support the rural health workforce as they deal with layer upon layer of external threats and challenges?

Clearly, the challenges have been immense and, as the Office of the National Rural Health Commissioner (ONRHC) notes in this issue, the mental health and wellbeing of communities has been adversely impacted. Subsequently, demand for all health services has increased, already existing rural workforce shortages were exacerbated by border closures and health professionals are fatigued.

It’s pleasing then to see highlighted in this issue that the Black Dog Institute has developed The Essential Network (TEN) for Health Professionals online, which offers ways for health professionals to prevent and manage burnout.

More than ever, disaster demands that in afflicted areas, allied health professionals, nurses, rural generalists, general practitioners and specialists work together, a matter the ONRHC also addresses in this issue. Speaking of stepping up, the story of how Monash Rural Health medical students took on roles during Victoria’s Pandemic Code Brown earlier this year, joining surge workforces and vaccination clinics as well as providing in-home treatments, shows that when the chips are down, having all hands on the wheel helps ensure health services continue to be delivered.

Telehealth has also risen to the fore during the pandemic, with a range of disciplines reporting its increasing use. For example, Queensland and West Australian hospital pharmacists are now able to provide cancer care support for patients online with the support of metropolitan-based specialist oncology pharmacists. Dietitians Australia reports an organisation called Desert Dietitians in Alice Springs and a similar service in the Pilbara are ensuring rural and remote dwellers have online access to good care. Kultchafi, too, is now offering its ancient Aboriginal and Torres Strait Islander healing process, called Healing Circle Work, online to expand its reach.

Yet for all its upsides – its capacity to bridge geographic gaps and smash accessibility barriers – telehealth’s success will be limited if rural, regional and remote health services are understaffed, warns the InsideOut Institute for Eating Disorders. It piloted specialised training for family-based treatment of the eating disorder anorexia nervosa (AN) via telehealth to clinicians in rural health services. Its aim was to see this treatment extended into the homes of young people with AN in rural areas. Of the 19 therapists it trained, only seven remain in the project, thanks to COVID-19, bushfires and flood.

In this issue it’s also inspiring to hear how, during COVID-19 and other disasters, primary and allied healthcare services have adapted, responding in very localised ways to very localised circumstances when needed. The Pharmacy Guild of Australia writes that rural, regional and remote community pharmacists found themselves delivering medicines by jetski and boat during floods, as well as collaborating with other pharmacies to share stock and providing credit when people had lost wallets and credit cards in the havoc.

Disaster or not, the story of two physiotherapists who took their mobile service on the road, providing one-on-one and in-the-home face-to-face services in remote areas where outpatient services had been withdrawn, is a pointer to possibilities.

My thanks to all contributors and advertisers and especially to our Friends of the Alliance for their continued support. Remember the Friends photo and poetry competition is now open and will be judged by delegates at the 16th National Rural Health Conference in Brisbane on 2–4 August, so get those creative juices flowing or brave the elements – if you live in places like Canberra – to take some shots of our unique rural Australian landscapes!

There are six stories in this issue of Partyline that are authored by presenters at the upcoming event, giving a flavour of conference offerings. Or read details of our keynote speakers – you are bound to feel compelled to join us.