My Rural Story | Week Three | Amani Savi

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

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-Week Three -

A mani Savi Registered Nurse. Fifth Year Medical Student - Bond University

Amani Savi

My name is Amani Savi. My background is that I’m a registered nurse. I worked in Mackay for five years as a registered nurse and it was there that I decided that I wanted to go back and do medicine. I’ve been at Bond University for five years, this is my final year as a medical student. Since I’ve been here, I’ve been contributing to my passion with rural and remote medicine by being part of the Rural Health Club. I’ve served as the Vice President, President and Treasurer. The Rural Health Club, here at Bond University, is reallyjust tohelptrytoengage students inwhat ruralmedicine isall about. Trying to get them to go out and network with doctors that live rurally, getting them to see a different type of medicine.

When I was a nurse working in Mackay, there was not one qualified Australian trained doctor in the entire hospital and I thought that was pretty poor. Considering Mackay is not even really that rural, it’s more regional and I thought, if we don’t even have Australian qualified doctors in regional areas, what have we got rurally? So, that was my big drive to come back and do medicine so that I could give back to the bush and help close the gap which is something I’m very passionate about. I’ve decided to spend my last year as a medical student in a town called Inglewood, which is a town three hours west, which for a lot of people seems a long way away. I think of it as just a bit of a stones throw away. It’s a town of 1,200 people, it’s a two

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GP town at the moment. It will be two GPs and a student when I’m there so I think I’ll get a lot more experience there. I’m the only student who’s taken up the opportunity in my final year to go rural, but I just think it will be fantastic. I’ll feel like I’m already there, I’ll feel like I’m making a difference. I’ll have started building community ties with an area that I would hope to go back to when I’m finished and I’ll still see everything that everyone in the city will see. In fact, I’ll probably see more. What is different about working in rural and remote areas? I think there are lots of differences between working rurally and working in a metropolitan area. I personally think there are a lot of advantages to working rurally, some would disagree. The biggest advantages I see for living in a rural area would be the fact that you’re part of a community. That sense of close-knit community. That’s a big draw card for me. It helps with the continuity of care with your patients. You’re actually able to look after your patients, not just fromwhat they present when they come into the clinic, but because you know who they live with, where they live, what their background issues are with the family; you’re able to treat them much more holistically. You obviously also see those same patients coming through the clinic, it’s

‘When I got there I had a real, oh my goodness am I still in Australia moment. It was like I’d landed in a third world country, it was just heart wrenching...’

not a GP bulk billing, in-out sort of situation, so I love that. I also love the fact that you make a real difference when you’re somebody of this profession in a small community. I love the fact that you don’t sit in traffic for three hours. I must admit that gives me more time to horse ride, so that’s a big plus. You can live in the city and be 5km away from the hospital, but be in traffic for an hour each way. That’s just wasted time to me. I’d rather be practicing medicine or spending timewithmy family. I guess because I lived rurally for those first few years of my life and, although I only have a few memories of it, they were the best memories of my life and I’d like to be able to recreate that for my daughter, so they’re the big drawcards. There are also disadvantages with working rurally. Sometimes your access to resources is not as good. Your ability to promote yourself within your chosen career can be somewhat stunted. But I think if you’re passionate to be there, and you’ve got the drive, then you’ve got

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the ability to continue your profession wherever you are. And I think it’s a big blessing that you can give to people in rural areas, and they can involve you in their personal life; so in saying that, that’s an advantage and a disadvantage. People will be your patients, but they will also be your friends so you do have to be able to draw that line between being their doctor and being their friend, but at the same time it’s such a privilege. What advice would you give to students going on a rural or remote placement? If a student was to come to me and ask me ‘what are the three things I need to know to go rural?’ I would say this: One, get involved in everything you can when you’re out there. Get involved in the local sporting club. Say yes to every experience, if someone says come and muster my cattle for the weekend, do it. That’s the best thing you can do, get

involved in the community. Because it’s the sense of community and that close-knit environment that’s a real drawcard for anyone who goes rural and if you don’t experience that, you’ve gone out there and missed out on that. The second thing I would say is take something to do in your quiet times, because there are going to be quiet times. There are no cinemas, there’s no bowling alleys, there’s no pub or clubs generally. So, take some creative writing, take some music, take some paint, do some artwork. Findyourself inthebushandactuallyspend that time learning to develop yourself. The third thing I would say is be on the ball with your clinical knowledge. You don’t have a lab down the road. You don’t have an MRI machine or a CT scan down the road. Your patients will have to travel maybe two or three hours to get to those types of things. So, be up to date on your clinical knowledge. Know how to diagnose from clinical signs, really listen to your patients and know how to

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do a good history because 80% of your diagnosing can be done from a history if you do it well. They’d be the three big things I’d tell a student going rurally. What has been one of your best experiences working in these remote communities? The best experience I’ve had in a rural setting is when I worked as a student on placement with a GP at St George. St George is a small town six hours from Brisbane and I was lucky to work with a GP who had worked in the town for 40 years. The best part of working with her was that I got to see how she approached her patients and their care. As an example, a patient came to see her who had amental health issue. Shewas not just able to treat that personwithwhat they toldher intheactual interview, shewas able to treat them from a holistic point of view. She knew their mother, their father, their brothers their sisters, and she was able to globally, in a way, look after this patient. And it just astounds me at the end of the day that we saw about 20 patients, every single patient had a different issue - there was not one issue that was repeated. So people who say when you go rural you only do the same thing over and over, they’re definitely wrong. Every patient we saw was different, but every patient we saw, she knew their background. She knew, they’re the teacher that worked at such and such and it’s been really tough

down at the school lately so that’s probably why she’s come to us with that problem.

The biggest advantages I see for living in a rural area would be the fact that you’re part of a community. That sense of close-knit community, that’s a big draw card for me . That ability to have the knowledge of how to treat her patient better and how to look after her patient, the ability to holistically look after them and the continuity of care that you could see she had for all of her patients. That was a big wow moment for me, that’s what really cemented my idea of being a rural GP because, you just can’t do that in the city and so that was a really big moment for me. What have you experienced in remote Australia that has changed your world view? Something that really changed my world view was when I was on placement in a little island called Elcho Island. It’s a little island off the top coast of Australia, about a two hours flight from Darwin. It’s a community of about two and a half thousand Aboriginal people and when

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I went there I was so excited. It was the first placement I was doing in a real rural Indigenous community and I was excited to see all the different health challenges that they face and the way that I was able to make a difference. However, when I got there I had a real, ‘oh my goodness, am I still in Australia?’ moment. It was like I’d landed in a third world country, it was just heart wrenching. It was so sad to see people who are Australians not having access to health care, not having the types of services that urban Australians have, and just being so far out of the way. So, yes it was a two hour flight away but there were hardly any fruits and vegetables on the island. The ability to have a nice house on the island, the ability to have clothes and shoes that were appropriate for the weather, all of those things were just lacking.

It really opened up my eyes to, oh yes, we really do have a gap and we have this Close the Gap campaign and it’s there for a reason, but we really need to be working on it a lot more than what we are. We can keep saying that we’re working to close the gap, but we really do need to be working to Close the Gap because it’s just not happening at the moment. So that was a real moment for me and I think that is, again, the reason I want to go rural because, not only do lots of Indigenous populations and communities not have access to health services, there’s also lots of farming and mining communities that also don’t have access. So, it goes across the board that we need more doctors off the east coast of Australia to go west and if I can be just one of those GPs that does that, then at least I’ll have made some difference.

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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