My Rural Story | Week Nine | Janie Dade-Smith

AUSTRALIA’S RURAL, REMOTE AND INDIGENOUS HEALTH #MyRuralStory

Featuring Interviews from the brand new 3rd edition of Australia’s Rural, Remote and Indigenous Health by Janie Dade Smith

Share your rural experience now to win a copy of the book @ElsevierAUS #MyRuralStory

-Week Nine -

J anie Dade-Smith Professor of Innovations in Medical Education, Bond University.

JanieDade Smith

My name’s Janie Dade Smith and I was born in rural Queensland. I’ve lived in rural and remote areas most of my life, in Queensland and in the Northern Territory for 11 years. I worked as a clinician over on Bathurst Island which is a little island north of Darwin. I went over there as part of a rural placement actually, just for two weeks, and when I came back they actually offered me a job. I thought that I had such wonderful skills and that’s what they were attracted to. But, actually I realised that if you had a pair of shoes and a pulse they would have taken anybody because of the recruitment and retention problems in rural and remote Australia which I really had very little idea about. What I found when I was working there

though was there were some fundamental moments working there with kids who had all these sores on their legs and they used to come in and have their dressings done. I really realised that you could work clinically with one person at a time but, with education you could actually have an impact on 100 people in an hour and just how incredibly powerful that was. Then I moved into education and I worked in high schools teaching sex, drugs and rock and roll to young people. I then moved to Queensland and wrote the Queensland Aboriginal and Torres Strait Islander Health Worker Program which was another really fundamental turning point in my career, to do curriculum development but to also work for a community controlled health organisation and what that actually

@ElsevierAUS

involved. It was then that I realised how little I knew and how much I had to learn. That changed my life course in many ways. I’ve worked for the college of GPs for four years down in Melbourne and wrote their Aboriginal curriculum and have been really involved in that ever since. I also an my own consulting business for seven years but now I’m working at Bond University as a Professor of Innovations in Medical Education.

bit like doing a pap smear in Melbourne on a patient or doing one in a remote community. In a remote community that person might be your next door neighbour, your kid’s best friend’s mother, those sorts of things. So, it’s a very different context and the context changes everything about a normal situation. Rural and remote people see the world and know the world in different ways to metropolitan people. They are often more resourceful in terms of access to services, how they actually go about their daily living, those sorts of things. Distance isn’t seen as a problem, ‘oh, it’s only four hours drive down the road mate, it’ll be right’, that sort of attitude. That’s quite acceptable and they’re used to not having the same sort of facilities and access to services as metropolitan people have. I think as a rural person, I never thought that I was any different from a metropolitan person, I thought

What is different about working in rural and remote areas?

There are two main things. One’s about the content, the sorts of things everybody does to work as a doctor or a nurse or an allied health professional in a rural or remote or urban area and the other one is about the context. The context changes everything about a normal situation. It’s a

@ElsevierAUS

we were all just Australians. But, there’s a way in which people think about things and do things and the way in which people think about health and their health which is quite different in rural areas compared to metropolitan areas. People in rural and remote areas see their health as illness services, in terms of actually going to the doctor for example, whereas in metropolitan areas there’s a higher proportion of people that actually present for health prevention and health promotion services because there’s more of them. So, in terms of those health beliefs, people will often present late if they’re from a rural area. There’s a much higher incidence of women havingmastectomies for breast cancer instead of coming in and having radiation because it actually takes them away from their families for six to eight weeks. Whereas, by having the surgery, you’re only away from home for probably a week. So, there’s

a much higher incidence of that. It’s a very important aspect for their health. What advice would you give to students going on a rural or remote placement? Make sure that you have done your homework before you go. Find out about thingslikethesocialdeterminantsofhealth, what is the water supply like out there in a remote area? What sorts of things do you need to know about the community? Is there a community profile, for example? Some of these things are available on the internet. You can go in and find out; is there a police station there? How many police are there? How many staff are you going to be working with? What will your roll be? Find out all of those things. What are you going to be paid? All of those practical aspects of going into a job, but, also some knowledge about working with rural and remote people.

@ElsevierAUS

having an impact, was when I worked for the Queensland Aboriginal and Torres Strait Islander Health Worker Education Program. I wrote their curriculum which was the first one accredited in Queensland back in 1991. We used to go out into the communities and interview the students and we’d go out and teach the students in communities. They used to come in and we’d go out and actually run the programs. I think the generosity of spirit that we experienced in those communities was just overwhelming. It was humbling to actually be part of that process and to feel accepted as part of a remote community. They’d put on great big dinners up in the Torres Strait Islands with all that amazing coconut rice and all that fabulous food and they’d have dancing and just make us truly welcome. It was humbling to actually be part of that process and to feel accepted as part of a remote community when a lot of people in the Torres Straits speak English as a second or third language. It was a very satisfying experience, more than satisfying, it was a fundamentally changing experience to feel so accepted and to feel so incredibly inept at the same time about what we were doing.

‘Have an open heart, be willing to laugh at yourself because you

I think the second piece of advice that I’d give people is, if there are particular things that you really like then you should take them with you. Don’t expect that there’s going to be a coffee shop that has decaffeinatedlattesout therebecause, I can assure you, there won’t be. It’s probably, the bucket of Moccona, on a good day, or Nescafe on a bad day. So, you need to be able to take those sorts of things with you and be prepared for those sorts of events. I suppose the third piece of advice, especially for those going to work with Aboriginal and Torres Strait Islander people, is learn to stand back, shut up, listen and hear. Have an open heart, be willing to laugh at yourself because you are going to be in those cross cultural situations where you have no idea what’s going on most of the time. What has been one of your best experiences working in these remote communities? I think my best experience working in a rural, remote area in terms of actually are going to be in those cross cultural situations that you have no idea what’s going on’

@ElsevierAUS

What have you experienced in remote Australia that has changed your world view? I think one of the experiences that changed my life path and the way I viewed the world was when I was working in Bathurst Island which is a little island north of Darwin in the Northern Territory. I was working there with 10 Aboriginal Health Workers and a nun who was working there as a nurse at the time. I used to say to the Health Workers, it was very important to fill in the pink form in the chart because that helped with the discharge summaries, and to me that was very important, what was written down etc. Then one day the health worker said to me ‘would you like to go hunting, Janie?’ and I had my little daughter who was about four or five at the time. We all

jumped inmy car with buckets and things, there were 10 of us in a two wheel Suzuki. Off we all went, I had my white shorts on. Going hunting in the mud for crabs out at the beach and as we were walking behind them they were running over these mangroves and they turned around and said to me ‘too slow, go back’, and they made two of the children, the seven and eight year old come back with us. They made us damper, sitting there in the sun. They were very reluctant about actually doing it because they wanted to be out there with their parents, catching crabs, and they saw these people who had no ideahowto survive in this environment. It gave me a moment to reflect, to actually think, we could sit here with our white skin burning forever and never find our way back and it made me realise just how unimportant the pink form actually was.

@ElsevierAUS

Don’t be afraid to ask for help!

If you feel you’re outside of that and you don’t understand things look for help; look for a mentor, look to the leaders and ask for advice . “

NRHA National Rural Health Alliance NSW Rural Doctor’s Network RHWA Rural Doctors Workforce Agency Doctor Connect PHN Health Workforce Qld CRANAplus ARHEN

SARRAH NRHSN LIME Network Rural Doctors Association of Australia Rural Clinical Schools (RCS) Australian College of Rural and Remote Medicine

“

hare Your Story! We believe stories matter. Tell us about your experience living, working, learning or visit- ing rural and remote areas within Australia or New Zealand for your chance to win a copy of Janie Dade Smith’s new book.

Tweet It

@ElsevierAUS #MyRuralStory

Post It

Facebook.com/elsevier.australia #MyRuralStory

“

Send It

Email us!

Featuring Interviews from the brand new 3rd edition of Australia’s Rural, Remote and Indigenous Health by Janie Dade Smith

Share your rural experience now to win a copy of the book @ElsevierAUS #MyRuralStory Please note, the transcripts featured within this publication have been taken from live interviews. Any alterations have been made for the purpose of clarity and do not change the overall meaning of the speaker.

To find out more about this, and many other local Elsevier titles, visit elsevierhealth.com.au