The National Rural Health Alliance (the Alliance) fact sheet on the allied health workforce demonstrates the mal-distribution of the allied health workforce across Australia, with remote and very remote areas experiencing the lowest workforce supply compared to major cities.
However, living and working in a rural and remote place can provide many individual and community social, cultural and economic benefits. These benefits often get missed if we only focus on the numbers.
This story provided by Ruth, a remote area pharmacist, highlights the challenges faced in rural and remote areas. But this is also a story that shows how a health professional can make the most out a challenging situation, turning it into something positive and worthwhile.
In 2017 I took up the post of Pharmacist Manager at a Pharmacy – in Tropical Far North Queensland. I travelled almost 3000km north from NSW to Cooktown with my family. I had no idea what to expect. At that point I had been a qualified Pharmacist for 18 years. I had worked in the UK and in Australia, in both city and country locations, but nothing I had ever done could have prepared me for the experience I gained in this Category 5 [very] remote location pharmacy.
Cooktown is about a 4-hour drive north of Cairns. You can get their by plane or by road, if you have a suitable 4x4 off road vehicle. Cooktown has a supermarket, bank, two schools, a medical centre, a small hospital and a small variety of pubs and clubs. During the dry season the population booms as travellers drive and camp their way up to the tip of Australia. In the wet season the population sits around 2500, according to the 2016 census.
The pharmacy is a typical pharmacy, its well-stocked and a happy place to work. We dispense scripts, offer over-the-counter advice, provide vaccinations, NDSS, staged supply, dosing, and community Webster packs. This is the same for other pharmacies however, we have our unique experiences.
Our pharmacies service 5 very remote Indigenous communities ranging from one to twelve hour drive on dirt roads. We provide 100 support visits twice a year as well as weekly Webster packs. That means checking around 1000-1200 Webster packs a month. They are sent via road and plane each week, resulting in a very tight schedule for me and my staff.
We interact with nurses and doctors at the clinics and medical centre. Everyone is on first name terms, you get consulted every day, your opinion and professional knowledge and experience matter. You matter. You are part of the team that looks after these Indigenous communities. That feeling of a sense of professional belonging is amazing. You are not just the person who “Sticks a label on a box”. When you call up the doctor due to a mistake, enquiry or query you aren’t put down, your knowledge and opinion are highly valued.
There are serious challenges: in the wet season it is hot, you get cut off, there are cyclones, but it’s all part of the experience and you learn to adapt. The working hours are long. I was the only Pharmacist there, but for the long hours you get an amazing sense of achievement.
So as well as visiting all the clinics, putting faces to names and voices, and doing all the other work, you get the chance to experience the remoteness. The family loves it too!
I was also lucky enough to be asked to participate in the IMERSE trial run by Griffith University in collaboration with the Pharmacy Guild. This involved the provision of Medicines Talk to Indigenous people with a chronic condition. I provided this service to 70 patients from Hopevale and Wujal Wujal communities. It was an amazing experience for me and for the patients, who had very little or no contact with a Pharmacist in their lives. It created bonds and left lasting impression for myself, the patients and the Aboriginal health worker.
After almost 2 years working in Cooktown, I can without a doubt say it has been the most eye-opening and professionally rewarding experience of my career, and without a doubt has also given my family an experience to remember.
It is likely that Ruth’s story resonates with many of her peers working in rural and remote areas. It puts the experiences of remote area allied health professionals in perspective: on one hand the poor road networks; the rough landscapes; the tight schedule for a small team can prove challenging, but on the other hand the sense of achievement, the adventures and the wonderful community spirit make it all very satisfying.
The lower supply of the allied health workforce in rural, regional and remote areas can have deleterious consequences on the health and wellbeing of people living in these areas. Increasing the allied health workforce can ensure more positive health outcomes for recipients of care. It is also a great support to the allied health workforce who more often than not, love working in rural and remote areas.