Carol Koffsovitz
Year 4 at Flinders University
Alice Springs, NT
Carole talks about her placement experience in the Northern Territory and tells GPSN members the many reasons why medical students should go out of their comfort zones and experience life out in the bush.
With renal disease so disproportionately effecting Northern Territorians, and the logistical nightmares associated with treatment, it was with keen interest that I embarked on a remote rotation at Alice Springs Hospital, the epicentre of renal medicine in Australia.
I have never been as warmly welcomed into a team as I was by the renal physicians at the hospital. This is likely due to the fact that it takes a certain type of person to work in a location like Alice Springs, and in a field like renal medicine. I was humbled by the extent to which the treating team was invested in each patient’s journey. The depth of knowledge that the treating team held relating not only to the complicated medical aspect of care, but also social, cultural, spiritual and emotional factors that coloured the experience for our patients, was overwhelming.
In an effort to gain a better understanding of the immensely convoluted social circumstances that our patients have to overcome to maintain adequate health, I paid a visit to Purple House, a local NGO that attempts to bridge this divide. The organization is the true definition of a grass roots organization, and it really works. In 2003, a group of Pintupi people from the Western Desert decided to tackle the dislocation and fear that those in the community had, when faced with renal disease. They auctioned off valuable paintings at Sotheby’s to raise the initial $1 million needed to establish the Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation (now say that ten times fast!), which has since spawned a number of remote dialysis clinics across the NT. The service is unique in that it not only attempts to maintain connection to country by keeping dialysis closer to home, it also normalized the process.
The Alice Springs facility (Purple House), is exactly what it says on the tin; a house! Actually, more of a home. There are no clinical posters around to make it seem medical. There is a big tree with lots of shade for yarning under, there is an enormous kitchen to make the vital cuppa, and there is a television so large it converts the dialysis lounge into a cinema. After having seen the NT government funded satellite dialysis sites, I was struck by the difference. Purple House felt far less confronting, far less sterile and far more like a service even I would be likely to engage with long term!
Seeing the true success of this community driven enterprise, I left Purple House with a full heart. Even though my visit was short, it was obvious that tackling the social aspect of renal disease in this way was the only way that long-term, complicated clinical medicine could have any impact. I highly recommend any student hoping to gain an appreciation for the Aboriginal health context, pay these folks a visit, you may even leave with some bush medicine, like I did!
As an aside, it was during this rotation that I finally articulated my true motivation behind enrolling in the MD course. Had it just been for the bog-standard reasons of ‘wanting to help others’ I could have stayed a nurse, but I realized that I needed to stimulate my brain, challenge (and surprise) myself with this vast world of medical knowledge that I so desperately wanted to explore. It seemed that renal medicine is the ideal mix of the ‘soft’ caring, social side that drew my bleeding heart to nursing in the first place, as well as the ridiculously complicated medical acumen required to truly understand human physiology.