rhino ramblings semester 2 2011

RHINO Ramblings: Semester 1 May 2011

In this Issue:

• Opinion: Communication with Australian

Aboriginals: Experiences and Lessons of a Medical Student + other articles.

• The Run down on all Semester 2 Events

including: Rural High School Visits, Vibe Alive Festival and More!

• Meet the Exec and Faculty Reps for 2012!

• How you can get involved in the upcoming

year!

RHINO Ramblings November 2011

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1. About RHINO……………………………………. 3 2. Contacting RHINO……………………………….3 3. From the Editor………………………………......3 4. Presidentʼs Report……………………………….4 5. Meet the Exec……………………………………5 6. Past Events……………………………………….7 7. Opinion……………………………………………9 8. How to Get Involved……………………………10 9. Placement Stories……………………………...13


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Club RHINO is the James Cook Universityʼs student rural health club. Founded in 2000, it aims to promote rural health issues and opportunities within the all health disciplines of the university. RHINO provides numerous rewarding activities for its members that are both fun and educational. These include trips away to rural locations around North Queensland, guest speakers from around Australia and the world, skills nights, social events, conference attendance and lots more!

Club RHINO School of Medicine and Dentistry James Cook University TOWNSVILLE QLD, 4811. Phone: (07) 4781 4712 http://www.clubRHINO.org.au If you have any questions, please contact your RHINO Discipline Representative (see later for details)

Join Us on Facebook! Just search: Club RHINO or click the Facebook logo.

Welcome to the second (and greatly delayed) instalment of the RHINO Ramblings for 2011. Firstly I have to apologise as some articles from events this semester were delayed and thus will be not be included until the next edition. That being said, RHINO has had a busy semester with its members becoming involved in a wide range of events and activities. Events included two sets of Rural High School Visits, The Vibe Alive Indigenous Festival, Welcome back drinks, The Gala Dinner at Harveyʼs Range and Mental Health week. RHINO also had the pleasure of funding some members from a number of faculties to attend the RDAQ Conference in Cairns and CRANA Plus Conference in Perth. In the upcoming year, RHINO is looking to expand its presence in both Townsville and Cairns. RHINO meetings are now open to all members, with the hopes of increasing the voice of interested students who may not hold an official position. The increased numbers of new members, especially in exec roles, has already lead to an influx of fresh ideas about new RHINO events, activities and means of improving experience in rural health issues. An example of such is the establishment a program to involve Dental students in remote area clinics, in a similar fashion to Rural health clubs down south. On top of reports on past events, articles on rural placement and information on how to get involved, the Ramblings now features an opinion section, which contains interesting articles on Rural/Remote and Indigenous social and health Issues – Enjoy!

– Ben Dickson Ramblings Editor

RHINO Publications Officer


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Incoming Presidential Report First of all, I would like to say a big THANK-YOU to RHINOʼs outgoing president and precious jewel – Ebonney Jackson for her tremendous efforts that have raised Club RHINO profile through membership, events and health promotion. I am very privileged to be provided the opportunity of leading RHINO alongside a team of dedicated committee and subcommittee members. I would love to hear from all of our members and work together to organize and run events that suit your needs. At the handover meeting in Innisfail, we celebrated the strengths of RHINO and worked on overcoming the challenges we have faced. I have no doubt that RHINO will accomplish all the goals set out with the contribution of the members. In 2012, RHINO aims to increase membership and student involvement across all disciplines but especially allied health and nursing. We aim to run numerous skills night, assist students in attending conferences and therefore increase sponsorship from local businesses and national stakeholders to make all of this possible.

The events calendar for 2012 is full of events with opportunities to get involved and reap the benefits of the resources available for RHINO members. The campus will again be buzzing next year with Oʼweek activities at both Townsville and Cairns. Some other events lined up include the RHINO Townsville Gala Evening in first semester and the MD skills night. Our meetings will be now open for all RHINO members to attend at both Townsville and Cairns campuses via video conferencing. We are also planning to hold some meetings outside university at places such as Fasta Pasta with special meal rates. Our goal is to reach out to each and every one of you. We want to not only hear your ideas but also provide you with early rural experiences and formal guidance to make the right career choice in either rural practice or metropolitan areas. I look forward to working with you and for your interests in the coming years! All the best for the upcoming festive and holiday season.

– Surabhi Khosla RHINO President


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Incoming 2012 Committee President Surabhi Khosla

Vice–President (Townville) Jerry Abraham-Alex

Vice–President (Cairns) Mark Davidson

Treasurer Ben Dickson

Secretary (Townsville) Nicole Leather

Secretary (Cairns) Nicole Milham

Senior NRHSN Representative Sigrid Theodore

Junior NRHSN Representative Christopher Myers

Publications Officer, Ramblings Editor Jessica Cutting

Sponsorship & Merchandise Officer Kate Laffey

Membership Officer Samantha Carmichael

Indigenous Representative Ravi Widanapathirana

RDAQ Representative Corinna Smith

Medicine Representative (Townsville) Justin Azzopardi

Medicine Representative (Cairns) Tasciana Gordon

Dentistry Representative (Cairns)

Corbin Barry Stevie Dilley Olivia Neate

Pharmacy Representative Morgan Groves

Speech Pathology Representative Clancy Conlon

Occupational Therapy Representative Lucy Seiler

Nursing Representative (Cairns) Penelope White

Physiotherapy Representative Ankur Verma

WE WANT YOU! We are still looking for representatives for:

• Nursing • Social Work • Sport and Exercise Science • Psychology

To apply, email Surabhi Khosla: [email protected]


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A big Thank You to All the Exec and Committee members who worked very hard this year to make RHINO so successful! President Ebonney Jackson

Vice–President (Townville) Surabhi Khosla

Vice–President (Cairns) Corbin Barry

Treasurer Mark Davidson

Secretary (Townsville) Kate Laffey

Secretary (Cairns) Nicole Milham

Senior NRHSN Representative Jerry Abraham Alex

Junior NRHSN Representative Sigrid Theodore

Publications Officer, Ramblings Editor Ben Dickson

RDAQ Representative Keith Hall

Membership Officer Jaimie Aslanidis

Sponsorship Officer Lindsey Ziegler

Indigenous Representative Ravi Widanapathirana

Medicine Representative (Townsville) Nicole Leather

Medicine Representative (Cairns) Lachlan Gordon

Dentistry Representative (Cairns)

Olivia Neate Raje Manickam

Occupational Therapy Representative Lucy Seiler

Speech Pathology Representative Laura Maltby Carly Davis

Pharmacy Representative

Morgan Groves

Nursing Representative Christine Conyers


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Vibe Alive 2011 Festival Report After many months of planning, RHINOʼs participation in the 2011 Vibe Alive festival in Townsville was a success. Vibe Alive is an annual festival targeted towards primarily Indigenous Australian youth (from between year 4 and 12), with workshops and stalls in sports, dance, music, education, health and careers, as well as being a wonderful opportunity for their representative schools to win prizes as part of a friendly competition held over the two days. A concert with various performing arts demonstrations ran throughout the day, and participants had the chance to meet some inspiring Indigenous role models involved in numerous organisations. In 2011, the festival was held in Bendigo, Kalgoorlie, and in Townsville on June 1 and 2. In partnership with three and two volunteers respectively from the rural health clubs of the University of Tasmania (Rustica) and the University of Western Sydney (RUUHWS), RHINO organised the activities component of the health workshop located at the stall held by the National Rural Health Students Network (NRHSN). The volunteers on both days applied wrist plaster casts to children visiting the stall, measured blood pressures, had an array of medical equipment (such as surgical retractors, kidney dishes and stethoscopes) and anatomical models on display and handed out free, fresh fruit, health-related comics, health careers information and merchandise (such as stickers and notepads) from our respective rural health clubs. On the ground was a blank canvas and visiting participants had the option of decorating it with numerous coloured markers, responding to the statement “I am healthy because.” The aims of the activities were to promote healthy eating, demonstrate some of the roles of health professionals, provide educational material and encourage careers in health. Most importantly however, an essential outcome of the participation of rural health clubs at Vibe

Alive was in encouraging discussion and awareness of health in general, by stimulating thinking in the participants about why their health is important and curiosity as to the wonders of the human body and medical science. Responding to the commonly asked “What does this do?”, in reference to a piece of unusual medical equipment or an organ in the body, provides an ample opportunity for this. The participating children, their supervising teachers and the volunteers from the rural health clubs enjoyed the festival. The relaxed atmosphere of the festival allowed for greater interaction with children in discussing their health, as well as being fun to aid their participation in our activities. I would strongly encourage anyone with an interest in Indigenous health, paediatrics and public health in general to be involved with the NRHSN stall in future appearances at Vibe Alive.

– Ravi Widanapathirana Indigenous Affairs Representative

Mental Health Week Recently RHINO, in collaboration with JCUMSA and SANTÉ hosted Mental Health Week – five days of activities aimed at raising funds for three Australian Mental Health Organisations: Head Space, SANE and FASSTT (Forum of Australian Services for Survivors of Torture and Trauma). RHINO hosted a bake sale as well as stalls for finger painting and bubble blowing, allowing students to muck around and chill between class. The Mental Health week was very successful, raising significant funds for charity and creating a fun vibe around campus.


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Rural High School Visits This semester RHINO undertook our rural high school visits around the Mackay and the Whitsunday region. The towns visited this semester included Glendon, Mirani, Sarina and Proserpine State High School. The team consisted of a combination of five second and third year medical students as well as one speech pathology student. The group members all came from diverse backgrounds, each person brought their own set of experiences, which allowed us to provide a broad perspective on health and university. At each high school the team spoke with students from grades 9 through to 12, each group was different in size ranging from 15 up to 75 but overall the team was very well received and the students actively engaged in both the presentation and hands on activities. The presentation had a strong focus on health as a career, but also dealt with aspects of moving away from home and financial support at university. The hand on activities were definitely a highlight of the presentation, these included things such as plastering, testing reflexes, blood pressure taking a speech pathology activity demonstrating swallowing disorders. Overall the visits were a success, many of the students we spoke to were already considering a career in health and we were able to discuss the advantages of a health profession to the students that were unsure of what to do after high school. For myself the trip was not only an opportunity to meet and encourage young people to consider a career in health, but it also allowed me to visit rural communities and meet with locals and discover their opinions on rural health. The trip was thoroughly enjoyable and I would encourage people from all disciplines to go if the opportunity arises.

– Simon Baker-Jones

RHINO Member

The RHINO Rural High School Visit Team

Sam Turner discussing university life with a class.

Simon Baker-Jones teaching a student to take blood pressure


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Communication with Australian Aboriginals: Experiences and Lessons of a Medical Student Doctor: DO YOU KNOW WHY YOU ARE SICK? Patient: Yes Doctor: ITʼS THE GROG ISNʼT IT? Patient: Yes Doctor: TELL ME, WHAT IS IT THAT IS MAKING YOU SICK? Patient: … Yes A 50-something year old seemingly-deaf indigenous lady was being yelled at by the doctor in a loving attempt to explain to her why she was having repeated seizures. She had reappeared in the middle of the doctors ward round at the Mareeba Hospital, after having been gone for several hours. The doctor was not going to risk missing talking to her, so we went outside for a chat. She sat with her head stooped and she was not maintaining eye contact as hard as the doctor tried. Her eyes were watering and I could not help wondering if she was crying, although she said she wasnʼt. We did not know whether she understood what the doctor was saying. As the conversation progressed, she appeared to understand more. The next step was to assess if she would be compliant if the doctor prescribed her with anti-epileptics. This interaction was a big deal for me. It was really hard to communicate with this lady. The doctor was getting understandably frustrated. Maybe she did not respond because he was a bloke? Maybe because there was no relationships and trust between them? There did not appear to be a respect for the doctor, although she sat and listened to him, which showed a care for her health.

The weekend before this, I was chatting to a very experienced doctor, who has worked at Kowanyama, an indigenous community in North Queensland. I was expressing my upset at the catastrophe of the indigenous health crisis that I had learnt about at uni and now was seeing at Mareeba. I questioned her as to what she thought was the ʻanswerʼ. After, admitting that Jesus alone can bring true healing to those who are his on the final day, she said that as health professionals we need to realise that indigenous people are firstly humans, just like us ʻwhite fellasʼ. She said that they should not be treated ʻspeciallyʼ but just like our other patients, with love and respect. From this comes the interest in understanding the cultural differences and a desire to provide health care culturally appropriate.


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One difference I have noticed is it can be harder to build the strong doctor-patient relationship with the transient culture of some Aboriginal people. I think this means that we need to modify the way we ensure compliance. Namely, not majorly on trust, but more on reason. By explaining how the drug works, why they are sick and why they will get better if they do this. Then not matter what doctor they go to, it will be the same.

The issue is though, that explaining takes time, which the average rural doctor is already stretched too far for. Maybe, it can start with us! As students on rural placements, we could spend time without the doctor talking with indigenous patients and trying to understand their culture. We could explain why their medications are important to take, explain why there are sick, explain who you are, that you care for them and that the doctors are here to help. RRITH has not prepared for this, but the theory never has the same learning value as experience.

– Sara Fraser RHINO Member

WANT TO GET MORE INVOLVED IN RHINO?

• Become a Member: To become a member of RHNO click here Note: RHINO Membership is now online, so even if your already a member, you still need to sign up online.

• Join a Sub-‐Committee: If you would like to help organise upcoming events, simply email our President: Ebonney Jackson, to find out how you can become involved. [email protected]

• Apply for a Position: Elections for positions each year run early in semester one – so look out for emails around then. We are still looking foce discipline representatives for Physiotherapy, Sport and Ex. and psychology. To apply email: Ebonney (see above for email)

• Attend an Event: RHINO always has upcoming events, so stay on the lookout for emails and posters around your faculty! For the upcoming events at the moment, see the upcoming events section.


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Wouldn’t It Be So Much Easier If We All Lived in Cities? The idea that costs for almost everything would be lower if we all lived in cities, at face value, seems like an financially feasible suggestion. Regardless of a countryʼs economic system, healthcare is a very expensive service, and funding the health system is often one of the largest expenses of a government (and personal) budget. Considering the high overheads of medical care, there are many unsurprising reasons why health policy is metro-centric and why it seems that is fiscally viable to undersupply the needs of rural and remote Australians. Nevertheless, we only have to be reminded of the importance of the country to Australiaʼs heritage in order for us to think beyond the dollars, and realise why Australia is thankfully a leader in servicing rural populations.

Why do we spend so much money on rural medicine, when people could move to Brisbane, where there are plenty of doctors, CT scanners and endoscopes? Compared to similar “essential services” such as water and energy, which can be easily centralised, automated and dispersed across vast distances using cables and pipes, it is the human involvement in healthcare, through the use of lengthily-educated health professionals, while being absolutely paramount in caring for patients, that makes it so costly, particularly in Australiaʼs post-manufacturing economy where labour is expensive. Additionally comes the cost of maintaining hospitals, subsidising medicines and purchasing (often expensive) medical equipment, such as beds and defibrillators. Costs are great enough in metropolitan medical practice; now imagine needing to provide these services to localities from a hundred to a thousand kilometres away from the city tertiary hospitals. Firstly, living costs are higher in the country, away from the warehouses and ports of the cities; likewise are labour and material costs, so more money is needed to build and maintain rural health facilities. Outreach services require regular transport to-and-from the urban hubs, and city-based staff may have to be paid more to encourage them to work in rural areas. “Why should I pack up my belongings and work out in the desert for a few months, and leave my coastal, temperate urban home, where most Australians live anyway? Canʼt they come to me?” From an Australian perspective, imagine if everyone lived in his or her state or territoryʼs capital city. Goods would not have to be sent over enormous distances (imagine the fuel savings from a single road-train from Brisbane to Mount Isa), so theoretically, myriad items, from paper towels to plasma televisions, would be cheaper for everyone, and the costs of living would rationally be more affordable for everyone.

Are You an Online Member Yet? RHINO has recently moved its membership database online. So even if you became a member is previous years, you will still have to sign up online to stay part of RHINO. Just Click Here, or follow the prompts on our website. Http://www.clubrhino.org.au


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The cities are hubs of international trade, and in a globalised world, you can purchase the same items in New York and Nairobi; goods could be more efficiently imported and exported if the majority of consumers and producers respectively lived in the cities. The internet and faster instant communication networks could allow for most of a mining company to be based in a city office, allowing them to easily liaise with other corporations and flying their workers to and from transient mining towns, negating the need for them to move to the country. Similarly, health services and health professionals could more efficiently serve a large population if everyone lived in the capital cities, instead of funding for running expensive aircraft for outreach services and paying higher salaries to recruit professionals to the bush With advances in permaculture, sustainable agriculture and genetic engineering, food could possibly be grown in patches around urban agglomerations, and fish is already farmed in industrial-sized ponds in metropolitan outskirts. In a more environmentally-conscious world, popularity for fibres such as hemp and bamboo may reduce the demand for wool, and even livestock stations could be theoretically spread in belts through and around the cities, negating the need for large open pastures, which both academically and economically, are viewed as unsustainable. Australia is already one of the most urbanised countries in the world, and most of the developing world is also shifting towards an urban life. Democracy generally always supports the majority; envisage the power of the majority in hearing about potential tax cuts that could eventuate if governments did not have to fund the expensive rural services. Life in the country, in spite of being the home for many Australians and being a symbol of stoicism, may become as archaic as life on the savannah. So why do we keep caring about the country? All cities in Australia were initially small settlements, some being penal colonies, and in the early colonial days, the relationship

between bourgeoisie and educated Britain and underclass, criminal Australia may have been similar to the contemporary relationship between the cities and the country. That very Australian quality of supporting the underdog and respecting the bruised and battered toiler, has not been buried under popularised Euro-American-Capitalist vogues of luxury, convenience and affluence. Moreover, there is much history and culture that stems from rural Australia. From the Man from Snowy River and Slim Dusty, to bush poetry and folk heroes such as Ned Kelly, as well as countless stories of the Dreamtime and Aboriginal art have their home in the country. Some of Australiaʼs most successful businesses, such as BHP Billiton and Qantas, have origins in Broken Hill NSW and Longreach QLD respectively, and the Royal Flying Doctor Service, the worldʼs first aerial medical service, is an organisation that is respected by many, with its founder, John Flynn emblazoned on the twenty-dollar note. The laid-back, egalitarian culture of Australia has privileged the idea that everyone gets a fair go, and this value is a key reason why the needs of rural Australia still feature in the work of the healthcare system and its professionals. Indeed, servicing the medical needs of rural Australia is and will always be expensive and time-consuming. Nonetheless, while there will always be a struggle between choosing between the needs of the metropolitan majority and the rural few, the spirit that citizens on both sides of the Great Dividing Range have in aiming for a united good surpasses the most convincing economic proof.

– Ravi Widanapathirana RHINO Indigenous Representative

If you would like to contribute and be featured in upcoming issues, please email our publications officer and Ramblings editor for 2012 Jess Cutting: [email protected]


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Biloela Outreach Service My name is Lucy, I am a third year occupational therapy student and also your occupational therapy representative in RHINO! I have just finished my first seven week placement of my course. It was in community health services in Biloela QLD. The service is typical of rural practice; flat out and generalist. The occupational therapy service caters to paediatric development delays, adult disability, adult rehab, hospital and community outpatients and outreach services. As a result, everyday is vastly different and at least once a week I get to travel out to one of the outlying towns. The outreach and the driving was one of my favourite parts of this placement. Seeing the changes in the country has been a highlight of the placement.

Outreach service often lends itself to interesting situations. My supervisor and I did a home visit out to a property. We were on the grass beside the veranda measuring it up for a possible ramp to be installed. I looked around and saw a snake a few metres behind my supervisor! Not just any snake, but a nicely sized eastern brown. Needless to say we all jumped, and had it not been for my quick reaction to shout “Snake!” it may have been a little more interesting! Rural practice has been a challenge. Managing the demand of occupational therapy services and the lack of staffing, facilities and funding has been interesting to see. Itʼs been a great experience to see the challenges that rural practitioners face, and some ways to try to deal with them, without causing burn out. I have to give some thanks to RHINO and the JCU course for providing me with support and education to help overcome some of the challenges that this placement has presented me with. I canʼt wait for my next one to start!

– Lucy Seiler Occupational Therapy Representative


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Adventures in Kerang Part 2 The speedometer indicates our progress at 110km/hr and I for one, know fully well the luxury and simplicity of cruise control – after all, my journey from Melbourne to Townsville took just over two days with only two stops overnight! As we pull into the garage, there is a sigh of relief that signals the end of our road trip adventures and the inception of another – for the two other men that have accompanied me, theyʼre back home and looking forward to their mumʼs home cooked meals; for me – Iʼm here to spend two weeks as part of my rural placement and I too, anticipate the culinary delights of the Sherriff household! My mentors are Drs Dianne and Lindsay Sherriff who work as rural GPs in the rural town of Kerang, in northern Victoria. Dr Lindsay Sherriff was the recent recipient of the Peter Graham Cohuna Award at the Rural Medicine Australia Conference 2010, in Hobart that recognized his dedicated commitment and service alongside his wife, Dianne, to their community – they truly are the ʻJack and Jillʼ of rural medicine! This is my second visit to Kerang, as part of my John Flynn scholarship where I stay with the Sherriffs as a member of their household. My placement revolves around the Kerang District Hospital and the Fitzroy Street Medical Clinic, both of which cater to the needs of Kerang and the surrounding towns accounting for nearly thirteen thousand people or more. My first day emerged with the sound of chirping birds and a vista of glistening leaves as the sunlight filtered through. I was excited at the thought of what lay ahead, and one thing was certain – you learn more that you anticipate in the company of the Sherriffs. This placement was no exception! Our ward rounds commence at 8.30am and this incorporates patient visits, meeting with family members who may be present, and medication review. On conclusion, we head to the clinic for the remainder of the day, unless one of doctors is

on-call and the hospital requires their expertise, urgently. Just as Tom Sawyer met his match in Huckleberry Finn, I found a fellow medical adventurer in Johanna, a third year medical student from Monash University, who is local to Kerang. Together, we made a formidable team (or so we thought) and tried our best to make light our mentorsʼ work by engaging in patient history and vital signs before the detailed consult ensued. Our mutual interest and fascination with Obstetrics was catered to by numerous antenatal consults during which we learned to measure uterine length, estimate gestational age and use a foetal ultrasound to hear the heartbeat of the foetus. We also had the privilege to be part of a normal delivery and were taught how to support an infantʼs head as it made its painful (for mum) yet triumphant and jubilant entry into the world we define as our own. Needless to say, we were on cloud nine after the whole ordeal. Both our mentors found it amusing that the slightest hint of Obstetrics got our fullest attention and brought about a gleeful delight that was evidenced by ʻHermesʼ feet, ʻDonnabellaʼ eyes and opera styled laughter whenever we shared learning experiences and bloopers from our exposure to obstetrics thus far at medical school.


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The spirit of adventure was bustling in the surrounding air, and adrenaline levels made a sudden surge as I expressed no hesitation when asked if Iʼd like to go for a swim and a water ski session in the recently flooded Lake Meran. For a north Queenslander like me, it felt obscurely odd yet refreshing to be swimming in this cool, placid lake that had a mystical stillness about it. To be repeatedly told that these waters were free from ʻsaltiesʼ and witnessing scores of families enjoy a splash in the lake was reassuring in that I knew I would not be witnessing a croc version of a scene from the movie Jaws, here in northern Victoria! The people of Kerang always make available new learning opportunities for us, students, by presenting with conditions about which we have limited knowledge, have only read about in textbooks or have absolutely no clue about! Needless to say, it is always a steep learning curve with the Sherriffs, and Iʼm always amazed about the manner in which learning sessions with them seem to etch themselves in my memory – for which I am truly blessed and grateful. Saying goodbye to the members of the Sherriff household and the clinic staff is always hard, but I know Iʼll be back for part three of the ʻAdventures in Kerangʼ tetralogy! Till then, I wait patiently, learn more about the complexities of the most intricate piece of engineering known to mankind, and discover subtly how I can contribute invaluably to rural medicine in the future!

– Jerry Abraham-Alex RHINO Vice-President (TSV)

Share Your Story! Have you been on a recent rural placement, in or outside of Australia? If so, why not share your stories and photos with the RHINO community, and have it published in the next edition of the RHINO Ramblings! Just Email Ben Dickson [email protected]

rhino ramblings semester 2 2011

Documents

rhino meetings

new rhino events

club rhino school of

rural health issues

rural health clubs

rural placement

social events

past events