Sunday, April 15, 2007
Yulumbu
A short week here after the 4 day Easter weekend. Many people are still "gone bush" and there is no school for 2 weeks, so the kids are out and about and people have gone visiting. Because it is autumn here (the Ozzies give me a very funny look when I call it "Fall"!) we are giving flu shots like mad. However, with the time of year we are having our first outbreak of respiratory viral illnesses, so I've seen a lot of sick kids and adults this week. A lot of people come in to be "just checked out" and get the Section 100 (free) medicine that an Aboriginal Health Service dispenses. Here in remote Australia, a package of 24 500mg generic paracetamol (equivalent to Tylenol) runs about A$ 5.00. Mums particularly have concerns about small children with fevers, as well they should, given the historically high death rate from sepsis for Aboriginal children. And then there are very high rates of ear infection, with it being very common to see ruptured eardrums draining pus in small children. The theory is this is due to high carrier rates of streptococcus bacteria species in the nose and throat, which invade during every viral illness. So we end up prescribing a lot of liquid Amoxycillin antibiotics.
But beyond treating sick people one by one, and doing opportunistic preventive care in a systematic fashion, a rural and remote doctor occasionally needs to become a public health officer.
Friday I was rostered for a remote flight out to the sister communities of Tirralintji and Yulumbu. These communities, about 35 km apart across the Fitzroy river are about 350 km due west of Derby. So we flew out of the Derby Aerodrome around 0730 and landed at Tirralintji first, where the morning was spent giving flu shots and doing some routine checkups. The people at Tirralintji told us that their relatives at Yulumbu had no water- their "bore" (well) went out around April 1st. In fact, two of the teen aged boys had walked across country and swum the crocodile-infested Fitzroy to visit their Tirralintji relatives after this happened. Otherwise the two communities had been cut off from each other completely for the entire Wet season.
We loaded up the plane again and took the 20 minute hop to Yulumbu, which is situated right on the river. Yulumbu has 23 people living in the community, 9 of them are small children and 4 are teenagers. One woman is pregnant. Most of the adults were older and a few very old (for Aboriginal people), with many medical problems. This community has historically found hygiene to be a challenge, but now all of them had now been without running water for 2 weeks. They had been carrying drinking and washing water out of the Fitzroy, which besides having crocodiles, is in the middle of cattle country. And overheated cows are fond of standing in the small streams and pools in the area, and contributing a nice load of manure into the water. It was clear that the people did not have the resources for- and therefore had not been- boiling all their water. The RFDS nurse and I were very concerned to hear that the estimate for repairing the bore pump was "sometime after Anzac Day" (which is April 25th). This would mean almost an entire month without water for this community, and surely this was an outbreak of dysentery just waiting to happen. The cost for a new pump was A$5000 so CAT had recommended that the old pump be pulled and repaired because it would save $2000.
Gail got on the satellite phone and called the Center for Appropriate Technology (CAT) office in Derby who told her that "the contractor was on annual leave for a week and there wasn't much that could be done". So she asked me to call them back. I explained that I was on the ground in the community, that the hygiene situation was terrible, how many small children were around, and that my assessment was this was an urgent health crisis. They told me they were "not aware the situation was so serious for so many people and they would see what they could do". They are on my call back list for Monday morning. We will see what happens.
It just strikes me that there is so little concern about this situation in wider Australia, at a time when the earthquake/tsunami relief for the Solomon Islands is on the news nightly. Australia has donated A$3 million for relief there, but can't find $5000 for a new pump for its own people. And $A5000 is a good deal when you consider the cost for each chartered fortnightly flight to the community was over A$3000. One RFDS evacuation for a dehydrated shocky child will be many times the cost of a pump.
Click picture above to see the album.
But beyond treating sick people one by one, and doing opportunistic preventive care in a systematic fashion, a rural and remote doctor occasionally needs to become a public health officer.
Friday I was rostered for a remote flight out to the sister communities of Tirralintji and Yulumbu. These communities, about 35 km apart across the Fitzroy river are about 350 km due west of Derby. So we flew out of the Derby Aerodrome around 0730 and landed at Tirralintji first, where the morning was spent giving flu shots and doing some routine checkups. The people at Tirralintji told us that their relatives at Yulumbu had no water- their "bore" (well) went out around April 1st. In fact, two of the teen aged boys had walked across country and swum the crocodile-infested Fitzroy to visit their Tirralintji relatives after this happened. Otherwise the two communities had been cut off from each other completely for the entire Wet season.We loaded up the plane again and took the 20 minute hop to Yulumbu, which is situated right on the river. Yulumbu has 23 people living in the community, 9 of them are small children and 4 are teenagers. One woman is pregnant. Most of the adults were older and a few very old (for Aboriginal people), with many medical problems. This community has historically found hygiene to be a challenge, but now all of them had now been without running water for 2 weeks. They had been carrying drinking and washing water out of the Fitzroy, which besides having crocodiles, is in the middle of cattle country. And overheated cows are fond of standing in the small streams and pools in the area, and contributing a nice load of manure into the water. It was clear that the people did not have the resources for- and therefore had not been- boiling all their water. The RFDS nurse and I were very concerned to hear that the estimate for repairing the bore pump was "sometime after Anzac Day" (which is April 25th). This would mean almost an entire month without water for this community, and surely this was an outbreak of dysentery just waiting to happen. The cost for a new pump was A$5000 so CAT had recommended that the old pump be pulled and repaired because it would save $2000.
Gail got on the satellite phone and called the Center for Appropriate Technology (CAT) office in Derby who told her that "the contractor was on annual leave for a week and there wasn't much that could be done". So she asked me to call them back. I explained that I was on the ground in the community, that the hygiene situation was terrible, how many small children were around, and that my assessment was this was an urgent health crisis. They told me they were "not aware the situation was so serious for so many people and they would see what they could do". They are on my call back list for Monday morning. We will see what happens.
It just strikes me that there is so little concern about this situation in wider Australia, at a time when the earthquake/tsunami relief for the Solomon Islands is on the news nightly. Australia has donated A$3 million for relief there, but can't find $5000 for a new pump for its own people. And $A5000 is a good deal when you consider the cost for each chartered fortnightly flight to the community was over A$3000. One RFDS evacuation for a dehydrated shocky child will be many times the cost of a pump.
 |
| Yulumbu |
