Rural Health West

Cultural Immersion brings weekend of learning and connection

The inaugural Bush Medicine Cultural Immersion weekend, organised by the Kimberley Health Professionals Network (KHPN), has given participants a deeper understanding of Aboriginal culture and connection to Country.

Held at Neem Campground on the Dampier Peninsula, the immersion provided a unique and enriching experience that blended practical knowledge of bush medicine with personal stories from Aboriginal Elder, Mena.

Travelling in convoy, the 21 participants made their way to the campground, setting up camp before embarking on a guided on-Country walk.

“Mena guided the group through significant cultural sites, including a Stolen Generation kids bush camp, a shell midden, and a well that local Aboriginal people were forced to dig,” said KHPN Coordinator Sara Hennessy.

“Along the way, she introduced various plants used in bush medicine.”

The afternoon concluded with a swim at the mouth of the lagoon, followed by a barbecue dinner where Mena shared her story as a child of the Stolen Generation.

The impact of the Stolen Generation:

The removal of Aboriginal children was a policy enforced by various governments from the 1910s to the 1970s, claiming it would save the children from a life of neglect. The children removed during this time are now known as the Stolen Generation.

Many Aboriginal families have experienced inter-generational trauma due to the damage and hurt experienced by parents or grandparents who lived through this period of history.

Mena’s story provided a moving and deeply personal element to the weekend and helped participants develop a deeper understanding of the lasting effects of this policy, many of whom had not previously heard a first-hand account from a
child of the Stolen Generation.

Understanding connection to Country

“I have lived in the Kimberley for more than 10 years and have walked on Country with Traditional Owners from around the region, but with Mena’s guidance I felt like I was seeing the bush for the first time,” said Jenni Lowe, Coordinator for the Kimberley Aboriginal Medical Service (KAMS) Wellbeing Informed Care program.

“The array of useful/medicinal plants all around us blew my mind. Listening to Mena’s knowledge, passion, and deep respect for the healing power of Country was truly moving.

“As a health professional, I felt privileged to learn a bit about the ways Aboriginal people have been doing things for so many generations.”

The idea for the immersion came about after a chance meeting between Mena and local doctor Angi Vico. Angi felt Mena’s expertise in cultural and bush medicine would be a perfect fit for a KHPN event.

“Angi told me she had met an amazing lady who knew a lot about bush medicine and asked if I would be interested in involving her in a KHPN event,” Sara said.

“Mena and I met later that same day, where we talked for hours and came up with the idea of the immersion.

“The immersive aspects of the weekend gave the group a really rich experience which has given them insight into traditional bush medicine and connection to Country. We’ll definitely look to hold more on-Country events,” she said.

The Kimberley Health Professionals Network is a collegiate network of health professionals who provide care to the rural communities in the Kimberley region of Western Australia.

Similar networks operate across Western Australia with the aim to provide health professionals with better support and greater opportunities to network, upskill, share information and collaborate in a local supportive community environment.

To join your local network visit ruralhealthwest.com.au/hpns

Congratulations to the Aboriginal Health Council of Western Australia - AHCWA , our partners in the Ear Health Coordination program for the launch of their animated Simon Says Series.

The Simon Says print mini stories and now animation, provide education and key messages on healthy ears.

Take a look at it here:

AHCWA | Ear Health | Simon Says: Lets Talk About Hearing Loss

An invitation to all community members, including health and education professionals, parents, sporting club members, students accompanied by a supervising adult, etc, to attend this FREE evening education.

Come along to learn about what va**ng means for you and your community, including the impact on someone’s health and what is being done to curb this new generation of to***co products.

This session was created in response to local health professionals' insights and frequent patient queries. It aims to provide balanced, evidence-based information on va**ng—not to promote any particular stance, but to equip the community with accurate facts.

Wednesday 13 November 2024
6.30pm – 8.30pm Katanning Leisure Centre
Registration required but FREE
https://ruralhealthwest.eventsair.com/rhw-community-ed-va**ng/reg

From numbers to narratives: Keisha's story

“The statistics you read about Aboriginal health aren’t just numbers to me; they represent the real lived experiences of my family, my community, and myself.”

This powerful statement from Ballardong Noongar woman and medical student Keisha Calyun -Clarke underscores the growing recognition of the importance of self-determination for Aboriginal people in shaping policies and programs that support them.

It also encapsulates Keisha’s decision to pursue a career in health.

Keisha’s introduction to the health sector began with her role as a project officer on the Mappa project, which maps health services available in rural and remote communities.

“Working on Mappa, I began to understand the social determinants affecting health and the disparities my people face.

“When I first entered the health sector, I was shocked to learn that conditions like rheumatic heart fever exist in Australia and disproportionately affecting Aboriginal people in rural and remote areas.

“I found this deeply troubling; our community deserves better,” she said.

Witnessing the positive outcomes achieved by the Aboriginal Community Controlled Health Services (ACCHS) sector, she believes that health equity for First Nations people is possible.

“It is important to me to do all that I can to help make the positive changes that are needed,” Keisha said.

This belief inspired her decision to pursue medicine.

Now in her third year of medical school at Curtin University, Keisha finds the journey challenging yet rewarding.

“I won’t sugarcoat it – it’s been very tough. It is very demanding with a lot of content to learn in short periods.

“I have coped by knowing my learning style and playing to my strengths. I am also fortunate to have an amazing tutor, an Aboriginal doctor who has guided me throughout my medical studies and ensures I am on the right path,” she shared.

The camaraderie among Aboriginal medical students has proven to be a crucial support system for Keisha.

“There is a great bond between all the Aboriginal medical students, and we all support each other to get through,” she said.

“The first three years of my degree have been theory work; the final two years will be hands-on learning full-time in hospitals.

“I am looking forward to my clinical years and recently accepted an offer to complete a year at The Rural Clinical School of WA in Broome.”

In 2022, Keisha attended the 10th Biennial Pacific Region Indigenous Doctors Congress (PRIDoC) in Vancouver, an event aimed at sharing knowledge and successes from various communities to improve Indigenous health globally.

“It was an incredible experience, gathering together Indigenous doctors and medical students from Australia, Aotearoa/New Zealand, Taiwan, Hawaii, the USA and Canada.

“It is an important event for all Indigenous medical students where we not only receive important mentoring from Indigenous doctors but learn valuable lessons that we will never learn in a university classroom,” she said.

As a future medical practitioner, Keisha hopes to make a direct impact on the health journeys of individual Aboriginal people by being a trusted doctor who works hand in hand with her patients.

She also envisions herself working in public health and advocacy, remaining focused on her goal to work closely with her community and contribute to achieving health equity for Aboriginal people.

“My goal is to work closely with Aboriginal people and communities and make a direct impact on individual people’s health journeys,” she said.

AHCWA Executive Manager – Public Health and CQI Kim Gates said the organisation was privileged to be part of Keisha’s journey.

“She is going to make a difference to improving Aboriginal health outcomes in WA,” Kim said.

“Her commitment to supporting other Aboriginal people to do the same is to be commended and we are very proud of her achievements."

Crikey, we are at the 2024 Rural Medicine Australia Conference in beautiful Darwin.

If you're around make sure you say hi to our friendly GP Locum Program officer Guy. We promise he won't bite, unlike the 🐊! 🤣

Nurturing hope in the Kimberley

After earning her Bachelor of Nursing, Andy Fowler kick-started her career in the city and spent a year as a nurse in Scotland. However, the loss of her best friend at age 23 profoundly reshaped her professional path.

“At the time I was working in paediatrics, nursing children with cancer and after the death of my best friend to cancer, it became pretty difficult to continue that line of work,” Andy said. At the suggestion of her parents, Andy returned to the family farm to heal, which led her to work alongside her mum at a nearby rural community mental health service. “There was a position there they had been unable to fill for over six months, so they were willing to take on a junior clinician,” she said.

“Surrounded by a small, experienced team, very generous with their knowledge, I got my first real taste of working in mental health.” This initial three-month stint in mental health nursing set her on a new trajectory, focusing on supporting individuals with mental distress and substance abuse issues. “It became my area of interest,” she said.

Andy eventually moved to the Kimberley where she has worked for the past 13 years, spending 10 years as a community mental health nurse in the government system and more recently, working for a not-for-profit organisation in a counselling role.

The need for advanced mental health training
Mental health issues are a critical concern in the Kimberley region. Injury, including su***de and self-inflicted injuries, is the leading cause of burden of disease, followed by mental health issues. Seven per cent of the population has been diagnosed with anxiety, and eight per cent with depression, with 10 per cent scoring high or very high psychological distress using the Kessler 10 scale.

The Kimberley region’s high rates of su***de, self-harm, and psychological distress reflect deep-seated issues rooted in historical, social, and economic factors. Addressing these requires comprehensive, culturally sensitive approaches to mental health care.

Impact on the community
Against this backdrop, Andy recently completed training in Eye Movement Desensitisation and Reprocessing (EMDR).

EMDR is an evidence-based psychotherapy approach found to alleviate distress associated with traumatic memories. It helps patients to process traumatic memories and can be life changing for people with Post Traumatic Stress Disorder and others with significant trauma. “The organisation that I work for has a generous annual personal development allowance which I had used up previously doing some preliminary training in EMDR. However, I realised there were limits to my knowledge when it came to people presenting with more extreme experiences of complex trauma which is common where I work.”

Andy accessed a grant through the Health Workforce Scholarship Program which enabled her to develop enhanced EMDR skills, a critical extension in a region where complex trauma is pervasive. “The most recent training I have completed was an Advanced Eye Movement Desensitisation and Reprocessing (EMDR) course on structural dissociation, led by EMDR pioneer Roger Solomon,” Andy said. “The training blew my mind, opening doors to a whole new area of learning and ways of working.”

“The knowledge gained from this course has significantly enhanced my ability to support people with severe trauma and dissociation, making my work more effective and impactful.”

Andy’s story highlights the critical need for more mental health training and resources in the Kimberley, which can help reduce the burden of disease, improve community well-being, and foster resilience in a region facing significant challenges. Despite the challenges of her work, Andy feels privileged to live and work in the region.

“Every day, I hear stories of strength, culture, courage, and resilience of the people of the Kimberley and those who have chosen to make it their home,” she said. “Living and working rurally, I have experienced a slowing down; life has gotten simpler and quieter which has allowed me to forge lifelong friendships with like-minded individuals and find solace and wonder in the bush.”

The Health Workforce Scholarship Program provides funding support for rural health professionals working in primary care to access additional training and development. Two funding rounds are held each year – typically in September and March.

For more information visit ruralhealthwest.com.au/programs/health-workforce-scholarship-program

Wangkatjungka unveils vibrant basketball court refurbishment, inspiring community spirit and healing Kimberley Aboriginal Medical Services - KAMS is excited to celebrate the refurbishment of the Wangkatjungka community basketball court, an inspiring example of what can be achieved through community-led initiatives.

Guided by the vision of local leaders, Elders, and young people, the revitalised court—complete with a beautiful mural reflecting the community’s cultural identity—now serves as a vibrant space for connection, health, and social and emotional wellbeing.

This project was made possible through a strong partnership between the Wangkatjungka community, KAMS, Marninwarntikura Women’s Resource Centre, House of Darwin’s HoopDreams Initiative, and Gayaa Dhuwi (Proud Spirit) Australia.

Read more here: https://tinyurl.com/5n6zf6hy

Wangkatjungka Community celebrating the launch of the basketball court. Image source: House of Darwin.

New Allied Health Grads – looking for a unique way to kickstart your career?

WA Country Health Service's Transition to Practice (T2P) program offers invaluable support and real-world experience you won’t find anywhere else.

T2P helps you make a smooth transition into life and work in the bush, giving you the confidence and skills to thrive in rural and remote communities.

Ready to take the next step? Click the link below for more information.

Allied health grads – we’ve got your back 💪

Our Transition to Practice (T2P) program is a great way to gain experience you wouldn’t get anywhere else.

T2P provides instrumental early-career support to new grads as they make the transition to live and work in the bush.

Read more: bit.ly/3wz68bT

Therapy in remote Pilbara

Puntukurnu Aboriginal Medical Service (funded by Department of Primary Industries and Regional Development) is making significant strides with its community-led and co-designed Jiji Program, which delivers occupational therapy and speech therapy to remote Martu communities such as Newman, Nullagine, Jigalong, Punmu, Parnngurr and Kunawarritji.

Tarin Dempers, a senior occupational therapist at Puntukurnu Aboriginal Medical Service (PAMS), explains the importance of using a culturally relevant, community-led approach to service design and delivery. “The program has been co-designed with Martu. This has been possible through building deep relationships, holding conversations in the Pilbara red dirt, employing Jiji support workers and using a ‘brain map’ and regulation tools,” Tarin said.

“This unique approach integrates neuroscience, polyvagal theory, and child developmental theory to address trauma, healing, and regulation for children, families, and the community.”

Co-design and community-led models are vital in ensuring that healthcare services for these remote communities are not only effective but also sustainable. By involving the community in the development and implementation of these programs, it builds trust, enhances relevance, and empowers local people. This is particularly important in First Nations communities, where understanding cultural context and fostering community ownership can lead to more profound and lasting impacts.

The Jiji Program’s success is evident in its reach and engagement. With more than 80 children referred, 59 enrolled, and 40 actively engaged in therapy, the program emphasises family-based therapy within a community development model. “This approach ensures capacity building, job creation, and sustainability,” Tarin said.

Empowering Martu women, mothers, and carers to become Jiji support workers ensures that knowledge remains within the community and that therapy is both relational and meaningful.

“One of the women I work with said, ‘When we heal, we can help children heal’,” she shared.

“It provides space for resourcing and regulation from trauma, fostering healing within the community.”

Despite significant challenges for healthcare delivery in the Pilbara, Tarin’s dedication is steadfast. “Communities serviced by PAMS are often accessible only by 4WD or small planes, with some, like Kunawarritji, being approximately 800km from Newman and accessible via unsealed roads,” she said. “Newman is the major service town in the region, dominated by the mining industry. The limited access to healthcare services, including occupational therapy, speech therapy, and paediatricians, underscores the importance of the Jiji Program.”

Tarin’s journey to the Pilbara began after a life changing trip to rural WA. “I went to Kalbarri on a holiday and fell in love with the red dirt,” she said. “The vibrant landscape captivated me. I think as soon as my feet hit the Pilbara red soil, I was hooked.”

Tarin sought a role that would allow her to leverage her academic background, while immersing herself in the desert, both professionally and personally. “I completed a Master of International Development through RMIT University in Melbourne, where my thesis was a participatory evaluation project with people with leprosy and other disabilities in Tamil Nadu, India,” she said.

“This experience cemented my desire to work within a community development model, recognising the importance of understanding and exploring Australian contexts, roots, and knowledge within remote communities.”

For those considering a career in rural health, Tarin suggests jumping right in. “The skills and tools I’ve developed, the deep belly laughs, and deep sorrow I have found in the desert make this work so special.”

“Learning from Martu, learning to sit and listen and be still, to unlearn everything I thought I knew about relationships, trust, and healing – the deep connections and sense of purpose I have found have made it all worthwhile.”

Beloved Wiluna doctor hangs up stethoscope, leaving remarking legacy behind

Wiluna general practitioner Toby McLeay hung up his stethoscope after 25 years at the Ngangganawili Aboriginal Health Service. The beloved doctor (affectionately known as Dr Toby) has dedicated his career to Aboriginal healthcare and rural medicine and is very much missed by colleagues and his patients.

Child and Maternal Health Community Nurse Manager and colleague Victoria Salerno said Dr Toby’s tenure at the medical centre showed his dedication to the craft.

“He was committed to his patients and the staff that have worked alongside him,” she said.

“He was always the one person who staff have been able to approach with questions and issues, and he never shirks his responsibility of imparting his wealth of knowledge onto the next generation of medical professionals in Wiluna.” “

His commitment showed us all just what a difference one person can make to a community such as Wiluna.”

According to Victoria, Dr Toby’s talent included being able to develop strong doctor-patient relationships, with his strong connections enabling him to influence outcomes and behaviours.

Dr Toby will also be remembered for some of his incredible initiatives including the establishment of Communicare and the introduction of “Dr Toby’s Healthy Food Choice” labels at the local store.

“His strong community connections enabled him to implement these initiatives and were also evident in his everyday interaction with the community,” she said.

“Dr Toby looked after three generations of one family in our remote area, and gained the highest level of respect from these families over the years.”

“We thank him for paving the way to a better healthcare model for all remote communities, just by following his professional lead.”

Leaving behind memories of captivating travel tales, including trekking through the Flinders Ranges or enjoying croissants at a sidewalk café in Paris, Victoria said these would now become a cherished part of Dr Toby’s legacy.

The community is now reflecting on the better healthcare model he helped establish through his professional leadership.

“Dr Toby is missed by many and remembered by all,” she said.

“He made a positive impact on many lives and his name, will be whispered by many, for many years to come.”

Today is World Menopause Day 2024

The theme for World Menopause Day 2024 is Menopause and Menopause Hormone Therapy.

While menopause and its treatments, such as hormone therapy, are well understood in some regions, in other parts of the world, they remain misunderstood, under-discussed, or even controversial.

It's important to promote awareness and advocate for women's health.

To learn more, visit: https://www.menopause.org.au/health-info/world-menopause-day/2024

Full house for Day 1 of the Northern Australia Regional Paediatrics Meeting in Broome today.

More updates to come.

Is you partner studying or undertaking some form of training?

Partner Education Grants offer financial support to PARTNERS of rural Western Australian medical and health professionals to assist with the cost of their training and education.

To see how they can get their slice of the pie along with FAQs head to https://ruralhealthwest.com.au/financial-support/partners-of-health-professionals/

Transforming Aboriginal healthcare through a yarn

The art of yarning in healthcare is bridging cultural gaps and fostering trust between Aboriginal patients and healthcare practitioners in the Midwest. Clinical Yarning is the brainchild of Professor Dawn Bessarab, Dr Charmaine Green and Dr Ivan Lin.

Through their collaborative efforts, they’re changing the way healthcare professionals engage with Aboriginal patients, ensuring communication is patient-centred, respectful and effective.

“Many years ago, Professor Dawn Bessarab developed a framework for qualitative research in Aboriginal health settings called Research Yarning,” Dr Ivan Lin said.

“This framework emphasised the importance of conversational and respectful dialogue in research, which inspired Dr Charmaine Green, a Yamatji elder, to adapt this approach for clinical settings. “The adaptation process started during co-teaching sessions with students in Geraldton, where Charmaine and I noticed some shortcomings in how healthcare students interacted with Aboriginal community members.”

“We were constantly prompting these students not to interrogate but to engage in friendly and conversational dialogue.” This observation led to the birth of Clinical Yarning, a model that integrates social, diagnostic, and management yarning into clinical practice.

“Traditional healthcare consultations often follow a rigid question-and-answer format, which can be off-putting for patients with previous negative experiences in healthcare,” he said.

“Clinical Yarning, on the other hand, encourages a more fluid and patient-led conversation. It comprises three key components: the social yarn, the diagnostic yarn and the management yarn.”

“A social yarn is the initial phase, which focuses on building a connection with the patient, recognising them as a person rather than just a health condition. It’s about making the patient comfortable and establishing trust.

“The diagnostic yarn is when healthcare providers gather necessary information through a conversational approach. It’s patient-led, allowing the patient to share their story and experiences in their own words.

“The management yarn is the collaborative phase which involves creating a care plan together, ensuring that health information is conveyed in ways the patient can relate to and understand. It often includes using metaphors and culturally relevant explanations.”

Ivan said Clinical Yarning borrowed from the traditional yarning processes, which made patients more comfortable leading to improved treatment. “It’s not prescriptive; it’s very much patient-led,” he said.

Since publishing their first paper on the model in 2016, Ivan and his colleagues have worked to integrate Clinical Yarning into various healthcare settings. “We have a partnership with WA Country Health Service (WACHS) Midwest to implement it across the region,” he said. “Both WACHS and WA Primary Health Alliance have been very supportive, and our e-learning program has been completed by more than 3,000 clinicians and students across Australia.”

Ivan believes Clinical Yarning is extremely important when working with Aboriginal people, something he personally saw when working on his PhD research.

“Continuity of care is crucial but that’s not always possible in remote areas, so it’s important to build trust. Building trust is incredibly powerful in changing people’s perceptions of healthcare. Good communication is fundamental to quality healthcare and can improve patient experiences, increase trust and enhance understanding of health conditions,” Ivan said.

“When completing my PhD, I interviewed Aboriginal people with chronic back pain which highlighted some of the communication barriers Aboriginal people face. “Aboriginal people much preferred to have a better relationship and yarn with somebody, which addresses some of the communication barriers. “It’s also something that can be changed relatively easily compared to the more complex systemic issues in healthcare.”

Ivan said he felt privileged to be working to develop Clinical Yarning. “The combination of clinical work, research, and teaching is fantastic, and it’s been a team effort all the way through,” he said.

“It’s been a partnership with First Nations and non-First Nations colleagues and working with inspiring people has been a highlight of my career.” Going forward, the team is focused on ensuring that the approach translates into positive patient experiences and outcomes.

“We’ve had a lot of good feedback from clinicians who like it and we are seeking a strong patient perspective in the next phase,” he said.

To learn more about Clinical Yarning visit www.clinicalyarning.org.au

🙌🙌🙌Rural doctor and educator Associate Professor Andrew Kirke was today inducted as a Life Member of Rural Health West in recognition of his long-time commitment to advancing rural health and his enduring support for the organisation.

Currently juggling roles as Head of The Rural Clinical School of WA (RCSWA) and working as a GP in Dalyellup, Andrew served on the Rural Health West Board of Directors from 2016 to 2022.

Andrew is a graduate of The University of Western Australia and undertook his GP training in Kalgoorlie, which nurtured his early passion for rural medicine.

Working as a procedural GP in the Goldfields and Kimberley before relocating to the South West, Andrew took on a teaching role with RCSWA in 2006. He became Head of RCSWA in 2019.

Under his leadership, RCSWA opened additional sites – in Collie and the Warren Blackwood region – and significantly expanded opportunities for rural-intent students to complete their final year of medical school in country locations.

Rural Health West Chair, the Honourable Tuck Waldron, said Andrew is a prominent voice in rural health and a strong advocate for disadvantaged communities throughout rural WA.

“Andrew is an incredibly generous contributor to rural health, actively promoting rural medical careers to the next generation of young doctors through his involvement with RCSWA and his previous role as the Chair of the Rural Doctors Association of Western Australia,” Tuck said.

“Andrew’s absolute commitment to forging new rural education and training opportunities have been absolutely vital in developing a new and growing generation of young doctors excited about rural medical careers.

“He has a strong social conscience, and always provided keen insight, context and compassion during Board discussions. He was a significant support to me when I commenced my term as Chair, with little prior exposure to the health sector.”

Andrew joins Emeritus Professor Max Kamien, Dr Felicity Jeffries, Dr Mal Hodsdon, Professor Geoff Riley AM, Dr Stephen Langford and Professor Tony Celenza as a Life Member of Rural Health West.

📷: Associate Professor Andrew Kirke (fourth from left), with members of the Rural Health West Board at today's Annual General Meeting.

L-R: Rural Health West Chair Hon. Tuck Waldron, Cr Liz Guidera, Karen Bradley, Associate Professor Andrew Kirke, Company Secretary Tanvi Haria, David Rigby, CEO Tim Shackleton and Matthew Tweedie.

WA Country Health Service had partnered with Puntukurnu Aboriginal Medical Service Aboriginal Medical Service and Menzies School of Health Research to trial cutting-edge technology aimed at eliminating Rheumatic Heart Disease (RHD) in the Pilbara.

Through the NEARER SCAN study, teams are working together to detect RHD, while empowering eight healthcare workers – including five Aboriginal health staff – with training in non-expert echocardiography.

Read more about it below: