Harwood_Abby_Dr_Jul11_TNThe seasonal influx of tourists transforms general practice in the Kimberley, according to Kununurra GP Dr Abby Harwood.

Harwood_Abby_Dr_Jul11Dr Abby Harwood: “And of course, most people want to be seen by yesterday because they’re “only in town this afternoon. We’ve booked to go to the Bungle Bungles first thing tomorrow morning”.Every year, it comes. Sometimes, it starts with a trickle that gradually becomes a flood. Most years, it’s almost instantaneous, like somebody suddenly opened the floodgates. No, I’m not talking about the wet season but the influx of tourists that comes with the dry season.

Each year, the population of the East Kimberley doubles from April to September, with both tourists and seasonal workers. Suddenly, all free appointments are booked up by 9am. The number of walk-ins increases from non-existent to about twenty a day. And of course, most people want to be seen by yesterday because they’re “only in town this afternoon. We’ve booked to go to the Bungle Bungles first thing tomorrow morning”.

Grey nomads usually come with more complex medical problems, but they are much more relaxed with their time. They’re willing to change their itinerary to allow time for further tests or recuperation. Backpackers also tend to be more relaxed. It’s the in-between ones, those on tighter schedules but usually with lots of money, who can be a bigger logistical challenge as they don’t want to miss out on their luxury eco-tour. They don’t have time for chest pain! Even on holidays, there doesn’t seem to be any contingency built in.

Most of the time, it’s coughs and colds and repeat prescriptions for hypertension or hyperlipidaemia. As the first port of call for many people travelling to the West from the East, I often educate patients about the sparse facilities in WA or smooth the waters with the WA health system, as was the case with a lady on palliative chemotherapy on her final hurrah around Australia.

Occasionally, something nasty rears its head. For example, the woman who was experiencing shortness of breath. It turned out she had ascites from ovarian cancer. Unfortunately, the Patient Assisted Travel Scheme in WA only covers permanent country residents. And most grey nomads don’t think about getting travel insurance, so they end up having to finance their own way back home to specialist care. I vividly remember the older gentleman who had a heart attack putting up the caravan annexe. He had to be sent by RFDS to Perth, but his wife was forced to drive the caravan the 3,000+ kms to Perth on her own.

My approach to medicine changes, too. Every consultation has the questions “so how long are you in town?” and “which direction are you heading in?” prior to decisions being made about treatment. The next pharmacy outside Kununurra is Katherine, 500km to the East, or Broome, 1,000km the other way, so it’s no good giving someone a script for 5 days’ worth of treatment with a repeat if they’re going to be somewhere between Halls Creek and Fitzroy Crossing when they need to get their repeat filled. Consequently, a bit more time is spent on the phone to Medicare for authority scripts, but the gratitude is worth it. And it may prevent an admission at Fitzroy Crossing Hospital.

The best bit is learning about other people’s experiences … the places they’ve been, what they’ve seen, where’s the best fishing spot near Timber Creek. It’s all in a day’s work.

Ed. This article was provided through the assistance of http://ruralchampions.govspace.gov.au/.



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