This part of East Arnhem Land has been a battleground for the last week, against an enemy that is too small to see but is hard to beat. That enemy is Sarcoptes scabiei, otherwise known as scabies. All week, health workers have been visiting houses in communities, encouraging everyone to wash and dry their linen in the sun and to all apply a special cream from the neck down. Continue reading
I have an embarrassing admission to make. A while back I wrote a blog post called “Shaken by the experience”, in which I complained bitterly about the bumpiness of the Central Arnhem road. Subsequently, a friend joined me on a drive down a dirt track and asked through chattering teeth “What are your tyre pressures set on?”. Later on I checked – 40psi! I copped some deserved laughter and was left with a deflated feeling after letting some air out of all the tyres.
Happily, it is now much more comfortable on a dirt track!
When you see a doctor, do you expect to be able to explain your problem so the doctor understands it, get an explanation of what could be wrong, and a plan for investigations and treatment? For most people that would be a fairly basic expectation.
What if none of the doctors could speak your language?
I had an experience recently of meeting someone, and not being able to communicate at all. Neither I or the nurse could figure out what was wrong apart from the suggestion that abdominal pain was the issue. I think that my patient gave up even trying to communicate early in the piece – perhaps it was clear to her that we were never going to understand.
What if this situation involved giving informed consent for an operation?
I’ve heard that a survey of a hospital at one point in the recent past showed that about 60% of the inpatients did not know why they were there, or what their treatment was for. This is challenging to me. Language is so important. How can I expect to be a good doctor here if I can’t even communicate?
I’ve been challenged by the “Why Warriors” blog – you might be interested too in this article that discusses issues of communication and language for Yolŋu people.
Spare time in Nhulunbuy is great. There is so much to do, places to explore, people to meet and things going on. I guess a new place is always like that, but I’ve decided that there’s something special about here. This weekend has been full of fun highlights. The Nhulunbuy market was on Saturday morning, and it seemed the whole town showed up to check out the wares, stock up on Christmas presents and catch up on gossip. A local lady was making fresh Thai green pawpaw salad – lethal chilli but excellent. One of my work colleagues was spruiking frozen mango shakes, but they seemed to sell themselves without any trouble.
We explored Goanna Lagoon, a swimming spot with no apparent crocs at the end of a bumpy track. I’m glad to have a 4WD living here. As Victorians, we find it disconcerting to see a bushfire on the side of the road, but up here it’s a pretty normal thing.
It was great to join in the fellowship at the Uniting Church and have some good conversations there. This afternoon we capped off a great weekend with our friends who have recently acquired a yacht. It was a beautiful combination of water, wind and sun.
I reckon I could do a tourism ad for NT. Come and visit!
My first impressions of Nhulunbuy surprised me. After driving 12 hours on a red dirt track in the heat, the last thing I expected to see was someone running in the hot twilight air. I was amazed that anyone would have the motivation to strap on some running shoes and pound the baking footpath for fun. Subsequently I’ve found that the town is very keen on fitness, and being active seems to be the norm.
from foundingdocs.gov.au
Let me tell you a bit about where we are living. Nhulunbuy is a town of about 4000 people on the tip of Arnhem Land in the Northern Territory. It is often referred to as “Gove”, named after William Gove who was a WWII pilot killed in 1943. It is a mining town on land that is leased from the Yolŋu people, who are the traditional owners of this area. There is lots of bauxite here, and this is mined, sent on a long conveyor belt to a port, refined, and loaded onto ships to eventually become aluminium. This area has an important history about Aboriginal land rights, with the famous Bark Petition in 1963 opposing mining here. This was the first document recognising Indigenous people in Australian law. Although the court at the time allowed mining to continue, the case helped prepare the way for later recognition of Aboriginal land rights.
Nhulunbuy is a beautiful place. It is only a short drive to find sparkling water and sandy beaches, or camping spots with cool creeks and no crocs. There is a great sense of community here. In fact, there seems to be a club for everything! So far, I’ve heard of the Yacht Club, the Surf Club, the Triathlon Club, the Running Club, Mums of Preschool Kids, and I’m sure I’m just scratching the surface. There is an active community notice board on Facebook where lots of things are bought and sold and people comment about community issues. Everyone seems friendly and keen to involve newcomers.
I’ve been working out some of the quirks of living in a remote community, even one like Nhulunbuy that is so well serviced. Woolworths sells sausages, but not in the second half of the week as they come packaged from the barge and don’t keep that long. IGA is about twice the price for everything, but they sell fresh fruit and veggies on Tuesdays that are better than Woolies. You need a permit to drink alcohol – which is a good thing. The power goes off periodically if the mine needs extra electricity. It takes about 3 weeks for a parcel to get from somewhere else in Australia to here.
Sitting at the Yacht Club this afternoon, listening to live jazz music and watching the sunset over the boats, I felt lucky to be in this beautiful part of the world.
I’m basking in the Nhulunbuy moonlight presently, wondering if the power will come on soon.
Here in Nhulunbuy the power to the town is provided by the Rio Tinto mine. Which is great, but it seems that sometimes the power does go off due to a particular requirement at the mine. Today the power has been off since this morning, and the gossip is that it may not come on again until midnight. It’s been a hot day without fans or airconditioning at home, but there has been a lovely breeze blowing most of the day.
We decided it was definitely time to hit the pool this afternoon. I met the lady as she was locking the gate. “No power, no pump, no chlorine, no swimming” she explained. Made sense. The writing was clearly on the wall for the pool idea – or at least on the sign.
We headed down to East Woody beach, just past the golf club. The breeze was much stronger and it was beautiful in the shade. We met a local lady and had a good chat. No one seems at all concerned that the power is off, it just seems part of normal life.
Our gas has also run out, so I’ve been cooking on our little camp stove. I was quite happy to knock up a passable tandoori chicken salad in the dark, and had to take a photo to see what it looked like!
Us doctors seem to enjoy appearing mysterious and intelligent, so we often speak in secret codes that only other doctors understand, or write with such bad handwriting that only other doctors can decipher it. It’s a great strategy because it gives the impression of being clever without requiring any actual cleverness. Take the following example:
via newnurseblog.com
My point exactly.
Now, when a doctor like me moves to a place like Nhulunbuy, it is stressful. The language is different. All of a sudden, instead of familiar words like “choledocholithiasis”, “hypercholesterolaemia” and “adenoidectomy”, I’m faced with a host of new words. Words like “strongyloides”, “HTLV-1” and “rheumatic fever”.
These are diseases that I’ve read about in medical school but forgotten, because I’ve never really needed to know about them. Things are different up here though, and the challenging part is that many of these different diseases are ultimately diseases of poverty and disadvantage.
I’ve been thinking a lot about language lately. If it’s a challenge for me adjusting to a different medical vocabulary in a different part of Australia, how much harder must it be for Yolŋu people who don’t speak English when they interact with a doctor who doesn’t speak Yolŋu Matha?
Conversation while driving on the Central Arnhem highway is different to normal conversation. The few flat sections of road that allow for some casual chat are punctuated frequently by long stretches of teeth chattering, car rattling, spine shaking corrugations and bumps. I frequently felt compelled to glance in the rear view mirror to check if the spare tyre was still attached to the back – mostly because I was sure it wouldn’t be long until a puncture occurred. Some of the corrugations seemed deep enough to swallow the whole car, and I imagined a search and rescue team having to pull us out, crevasse style, with ropes and winches.
In reality, the drive from Katherine to Nhulunbuy was much better than I anticipated. It was never boring, with changing landscapes and frequent buffaloes or kangaroos on the road. It took us 12 hours to drive 750km, of which about 650km was dirt road. The river crossings were fun and the crocs seemed to be too lazy to laugh at our nervous examination of the riverbed before we drove through.
It was a relief to get to Nhulunbuy, not only to be driving on bitumen again. I think that we will enjoy being here.
Tomorrow is the “big trip” that Georgi has been talking about for a long time. She’s really keen to finally get to “Lulunbuy” as we keep promising she will soon. I don’t think that she knows exactly what she’s in for – 10 hours and 700km of bumpy dirt road.
The trepidation is increasing somewhat now that we are about to start this trip. I’ve heard a lot of different bits of advice, that usually starts with “watch out for…” or “don’t forget to…” or “whatever you do, make sure that you…” It almost seems like we’re about to fly to the moon in a rocket made of tin cans rather than drive a car from A to B.
Having said that, it will be an adventure. We’ll get up at 5am, drive the 100km of bitumen the have breakfast while we contemplate what’s ahead. I’m just hoping the corrugations and corners aren’t too bad, and the Goyder river has no crocs so that when I wade across to make sure it’s lower than the roof of the car I don’t get eaten…
What a joyous fruit is the mangosteen! A dark purple cannonball with a comical stalk, whose defences are soon breached by a firm squeeze that gives rise to the the pale fruity segments coddled in their velvet case.
They taste good too.
Some interesting facts about Mangosteens (from Wikipedia)
The Wandering Lintons 