PROVIDING 90 YEARS OF SERVICE TO REMOTE AND RURAL AUSTRALIANS
BABIES ON BOARD THE BIG CHALLENGE OF TRANSPORTING TINY PATIENTS
KING OF THE AIR
THE BEECHCRAFT B350 IS BIGGER, FASTER AND QUIETER
GROUND CREW
THE DONORS, SPONSORS AND VOLUNTEERS KEEPING THE FLYING DOCTOR FLYING V1 - BCME01Z01FC
2 | FOREWORDS
Keeping Flynn’s vision alive
MARK GRAY
Chairman
NINO DI MARCO
Chief Executive Officer
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n 1928, Reverend John Flynn first conceived the “mantle of safety” for Outback Australia. His incredible vision of an aeromedical service – one which would bridge the gap in access to medical care and shorten the tyranny of distance for so many people living in rural, regional and remote parts of the country – is now an Australian institution as relevant and necessary today as it was back then. Ninety years on, that enduring vision has not only been maintained but grown and fostered by an unquenchable drive to find more innovative ways to improve access to health care services for people in the bush. We are extremely privileged to hold the trust of those communities we serve every day and, in 2018, we consider ourselves immensely proud to be able to reflect on a rich history – one for which we owe
so much to so many. The Flying Doctor has a unique place in the hearts and minds of Australians, and this year we were humbled once again to be awarded Australia’s Most Reputable Charity for the seventh year running. This recognition is in large part due to the evergrowing army of loyal RFDS supporters. From the Outback pubs to local community groups, major corporate partners and thousands of individual donors – our gratitude for this extraordinary support is immeasurable. These people are our Local Heroes. Whether they be fundraisers, volunteers or someone who helps us in an emergency, we owe them a debt of gratitude and will be doing so again this year as we celebrate our 2018 RFDS Local Hero Awards. These awards will be held during our 90th birthday week, from May 13-19, alongside numerous other high-profile events to mark this special occasion. It is a simple fact that, without the support of our funding partners, we would not be able to carry out the work we do. Both the state and federal governments have entrusted us for many decades, providing the necessary funding support to keep our traditional primary health care services and inter-hospital patient transfer service operating, giving a lifeline to world-class health care to people no matter where they live in this great state. This funding enables us to deliver our renowned health care either by air, road or across the airwaves, whenever and wherever it may be needed. Our long-term corporate supporters, Ergon Energy
Retail, Brisbane Airport Corporation and QCoal Group, are, as always, unwavering in their support for our cause. They have been instrumental in not only our efforts to upgrade our aircraft and purchase the latest medical technologies, they have also gone above and beyond in advocating our service through their extensive customer and client networks, contributing millions of dollars to the Flying Doctor in Queensland annually. All this support would mean nothing, however, without a group of dedicated, talented and undeniably professional staff to fulfil our mission of patient care. Everything we do at the RFDS comes down to our patients and the quality of care on which we stake our reputation. Our medical officers, nurses, pilots, mental health and oral health clinicians, administration and support staff – almost 400 of whom work across our nine Queensland bases – are the face of the Flying Doctor. These individuals have helped to shape our wonderful history. They are also fundamental in carrying on Flynn’s legacy of the “mantle of safety”, by delivering the finest care to the furthest corners of our great state. They should all be deeply proud of what they do for more than 95,000 Queenslanders whose lives are touched by the RFDS each year. Finally, we would like to thank News Corp for giving us this opportunity to share some amazing stories and insights from the RFDS in Queensland and across the country.
We hope you enjoy the read.
From modest beginnings ...
N His Excellency the Honourable Paul de Jersey AC
Governor of Queensland
o organisation more perfectly symbolises the values of compassion, service and mateship than the Royal Flying Doctor Service. When the first aerial ambulance took off from Cloncurry in 1928, the pilot was flying a single-engine biplane named Victory. The name was appropriate because that tiny plane represented the victory of founder John Flynn’s vision for a “mantle of safety” over the Outback against the financial constraints of the Depression and the vast and unforgiving Australian landscape. From that modest beginning, the RFDS has grown into a unified medical service which both saves lives and improves the quality of life of people living in the bush. More than 336,000 times over the past year, the RFDS provided health care, advice and support through its clinics, aeromedical transports and telehealth consultations. Flynn once said, “If you start something worthwhile, nothing can stop it”. For 90 years, people living in the most remote parts of Australia have relied on the RFDS for emergency medical and primary health care, all delivered with the hand of friendship. I am immensely proud to be the service’s Patron in Queensland, and commend to you this splendid history of a homegrown icon and rural lifesaver, the Royal Flying Doctor Service.
T The Honourable Dr Steven Miles
Queensland Minister for Health
he Royal Flying Doctor Service and its rich 90-year history of service has become an integral part of the Queensland Government’s commitment to providing health care for people living, working and travelling in all parts of our great state. The RFDS is renowned for providing vital 24/7 aeromedical emergency care in some of our most remote communities. It also provides inter-hospital patient transfer services right across the state in a partnership with the Queensland government that stretches back more than 20 years. This service currently facilitates access for more than 10,000 sick or critically ill patients to and from Queensland’s major tertiary hospitals and specialist care facilities each year. The RFDS is a much-admired Australian institution. It has earned the community’s trust, and without its presence many people would find it difficult to access the health care they need and deserve. Congratulations on a magnificent milestone, RFDS, and for upholding your mission to provide the finest care to the furthest corners of Queensland.
www.flyingdoctor.org.au
Head of production: Bret Fisher Editorial: Lynn Cameron Features: Lynn Cameron, Jennifer Hullick Design: Bret Fisher, Chris Bowden Photography: Annette Dew, Steve Pohlner Publisher Published by News Corp SA, a subsidary of Advertiser Newspapers Pty Ltd, with the support of Royal Flying Doctor Service Central Operations. News Corp SA Custom Publishing, 31 Waymouth St, Adelaide SA 5000. All rights reserved. The production cost of this souvenir liftout has been funded through the kind support of publication partners, The Advertiser, SARAH Construction, Walter Brooke Associates, and RFDS corporate partners and suppliers advertising in this publication. Cover Dr Shaun Francis, flight nurse Di Nicholls-Bull and captain Barry Dawson at the RFDS' Cairns Base.
4 | HISTORY
Heroes of the health revolution How five magnificent men and their flying machine brought medicine to the Outback – and changed the face of history
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Anatomy of our $20 note The first RFDS aircraft, the DeHavilland 50 named Victory. A cross section of the pedaloperated radio invented by Alfred Hermann Traeger.
A compass The "where does it hurt?" body chart
RFDS founder Reverend Dr John Flynn.
Coledge Harland, a missionary to the inland people of Australia, riding one of five camels purchased by Reverend Flynn in 1913 for his Patrol Padres, who undertook mission work throughout Central Australia.
hen young Presbyterian minister the Reverend John Flynn first came to help with missionary work in Outback Australia, the culture shock must have been jarring. Flynn, born in 1880 at Moliagul, just outside of Bendigo, was essentially a child of the city, having been raised mostly in Sydney and Melbourne. His initial exposure to the often unforgiving nature of Australia’s remote regions was through romantic tales about the vast Outback, from when his father’s business partners mounted an unsuccessful venture in the far north. After leaving behind school teaching in 1903 to study theology at Ormond College in Melbourne, followed by a four-year course in divinity at Melbourne University, Flynn was ordained as a minister in January 1911. His first experience of working in remote areas came during his training, helping with the missionary work of other Presbyterian ministers in rural Victoria and South Australia. What he saw there was enough to spark the writing in 1910 of The Bushman’s Companion, “A handful of hints for Outbackers”, with minister Andrew Barber. The guide was full of first aid advice for everything from bandaging broken bones to treating snake bites, drowning and “fits”, as well as Bible scripture, hymns, the cost of postal services and a calendar. It was dedicated to “the stalwart men who are stoutly fighting, With the heat and the drought, and the dust-storm smiting ...”. In places where the churches were few and doctors even harder to come by, the Companion proved popular. But it wasn’t until his ordination in 1911 that Flynn came face-to-face with the real Outback, at the Smith of Dunesk Mission at Beltana, 500km from Adelaide in the flat, arid country north of the Flinders Ranges. While the residents now had pastoral care on their doorstep, there was little medical care for locals or travellers. His work for the church soon took him to Darwin, Katherine, Bathurst Island and Adelaide River, researching life in remote communities, and led him to propose and then head up the Australian Inland Mission to cater to the spiritual and medical needs of “Outbackers”.
The idea of making medical help airborne came years later in 1917, from pilot and medical student Lieutenant Clifford Peel, who wrote to Flynn. After hearing of too many people left to suffer or die because a doctor could not bridge the vast interior distances in time, Flynn ran a 10-year campaign for an aerial medical service. Vital funds for the idea came from a bequest from long-time supporter Hugh McKay, inventor of the Sunshine Harvester, whose charitable trust survives to this day. When Flynn met aviator Hudson Fysh, a founder of Qantas, the idea and the money came together in 192728 to become an aerial ambulance out of Cloncurry in Queensland, flying 50 missions to 26 destinations and treating 225 patients in the first year. The early pilots were taking genuine risks, flying in fabric-covered timber biplanes and navigating by landmarks and compass alone. If the plane went down, there was no radio to call for help. The lack of communications technology to operate the service effectively was solved by another Outback hero, Alfred Traeger, with his invention of a pedaloperated generator to power a radio receiver. By 1929, isolated station dwellers and townsfolk could call on the Flying Doctor to help them in an emergency. As the service grew and technology improved, Flynn’s aerial ambulance became the backbone of medical care in remote Outback locations. Transistor receivers later replaced pedal radios and the School of the Air was able to piggyback on the renamed Flying Doctor Service network from 1951. When it became the Royal Flying Doctor Service in 1955, it was being run by a national council out of bases in Broken Hill, Alice Springs and Port Augusta. It did so in the absence of Flynn, who attended his last council meeting in 1950 and died of cancer a year later. The service continued to grow, expanding to the modern service, working from 24 aeromedical bases and with 69 aircraft across the nation, and bringing Flynn’s dream of high-quality, rapid response medicine and health care to the bush.
www.flyingdoctor.org.au
The early pilots were taking genuine risks taking to the air in fabric-covered timber biplanes and navigating by landmarks and compass alone
Clockwise from left: Rev John Flynn (1880-1951) was a Presbyterian missionary who founded the Australian Inland Mission Aerial Medical Service, which became Royal Flying Doctor Service; After being rushed 2010km from Camooweal in a Qantas DH50 plane, a man who had been injured in a shooting accident is transferred to an ambulance in Brisbane during the early days of the Australian Flying Doctor Service; WW1 pilot Clifford Peel (standing and in his aeroplane The Bluebird) wrote a letter to Rev John Flynn suggesting the idea of the Flying Doctor service.
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Piñata Farms’ Gavin Scurr, left, and Stephen Scurr.
Support Piñata Farms in the Outback Car Trek outbackcartrek2018.everydayhero.com/au/pinata-farms
6 | TIMELINE
1932 The success of operations in Cloncurry, and the increasing public awareness of the service, results in a push for a national network of flying doctors. 1932 The Sydney Harbour Bridge opens and racehorse Phar Lap dies in California after being poisoned. 1933 Alfred Traeger invents a typewriter Morse keyboard, an accessory to the pedal wireless sets used widely until the advent of radio telephony.
1934 The Victorian Section of Australian Aerial Medical Services is formed, in 1934. Using donations from the public and church philanthropists, they provide aeromedical and other health services to the remote Kimberley region of Western Australia. A Qantas Empire Airways plane leaves for Singapore on the first scheduled international flight.
1928 First flight of the Australian Inland Mission Aerial Medical Service: Pilot Arthur Affleck takes off with Dr Kenyon St Vincent Welch from Cloncurry on May 17, in a De Havilland DH50 biplane named Victory, leased from Qantas.
1945 Sister Myra Blanch is one of the first paid nurses, known as “Flying Sisters”, to join the Flying Doctor Service, working until 1954.
1960 Until the 1960s, the service rarely owned aircraft, using contractors to provide aircraft, pilots and servicing. Henceforth, the RFDS begins buying aircraft and employing its own pilots and engineers. Nurses become a regular addition to air crews.
1942 The air service changes its name to the Flying Doctor Service.
1963 The assassination of John F. Kennedy.
1947-48 Anne Lewis becomes the first female pilot to fly for the Flying Doctor Service. She flies patients to medical care in Kalgoorlie in the late 1940s. Wylie Talbot Gibbs becomes a doctor with the service, and is later elected to the Australian House of Representatives as the Liberal member for Bowman in 1963.
1964 Prime Minister Robert Menzies reintroduces National Service to increase the army’s strength.
1948 Holden manufactures its first Australian-designed and built car.
1935 The first base of the Victorian section of the RFDS was opened at Wyndham, WA. A provisional Section Committee for Western Australia uses a De Havilland Fox Moth aircraft to provide early services.
1964 The historic first RFDS base in Cloncurry, Queensland, is relocated to Mount Isa. 1965 Australia commits troops to the Vietnam War.
The Red Cross and Red Crescent Movement is established in Australia as a national society.
1920s 1929 Thanks to Alfred Traeger’s invention of the pedal-powered wireless, people living in isolation in the Outback are able to call on the Flying Doctor for help in an emergency.
1930s
1950s
1960s
1950 The Flying Doctor Service collaborates with the Red Cross, TAA, the Department of Civil Aviation and the RAAF to explore new techniques for dropping medical supplies to Outback communities stranded by flood or other hazards. 1931 With the prompting of Rev John Flynn, Dr Allan Vickers, above left, joins the then Aerial Medical Service of the Presbyterian Australian Inland Mission and, from 1931-34, is medical superintendent at Cloncurry, North Queensland. 1936 An official Federal Council for the Flying Doctor is formed. The South Australia Section, including the Northern Territory, is formed. The New South Wales Section is formed. The WA Section is officially registered on June 14. The Section’s first base at Port Hedland becomes operational on October 10. 1937 Dr Jean White becomes the first female flying doctor in Australia, and the world, working throughout Queensland.
The Wall Street crash in the United States begins the Great Depression.
1940s
The Flying Doctor SA Section first operates out of Broken Hill, jointly with the NSW Section. The Eastern Goldfields Section is established but, in the Kalgoorlie area, aircraft were flown on medical missions as far back as the early 1930s.
1950 Australian troops are sent to the Korean War to assist South Korea. 1951 Flying Doctor Service founder John Flynn, left, dies, aged 70, on May 5. Sister Lucy Garlick develops the “where does it hurt?" body chart still used in RFDS medical chests today. 1938 Flying Doctor emergency medical flights are first operated in Tasmania.
The famous School of the Air begins, using the Flying Doctor radio network to link children and their teachers.
1939 The first Flying Doctor base owned and operated independently by the SA Section opens in Alice Springs. The Queensland Section is registered in its own right.
1954 The Queen and the Duke of Edinburgh visit the Flying Doctor Service Broken Hill base.
Australia enters World War II. 1943 Dr Vickers returns to Queensland to establish the Charleville Base, operating from a World War II aircraft hangar.
1955 Becomes the Royal Flying Doctor Service (RFDS) by royal warrant from the Queen. 1958 Beth Garrett, the first woman in Australia to receive her airline transport licence, joins the RFDS.
1966 Robert Menzies retires as Australia’s longest-serving Prime Minister and is succeeded by Harold Holt. 1967 In December, Holt disappears while swimming at Cheviot Beach, Victoria. 1969 The US mounts the first manned mission to the Moon.
www.flyingdoctor.org.au
1970 A permanent exhibition telling the history of John Flynn, the RFDS and the experience of the early Outback pioneers opens in Alice Springs.
2010 Mary MacKillop, below, canonised as Australia’s first Saint of the Catholic Church. 2011 A 9.0 magnitude earthquake in Japan triggers a tsunami and the meltdown of the Fukushima Daiichi Nuclear Power Plant.
1980 Baby Azaria Chamberlain, above, disappears from a campsite at Uluru (Ayers Rock), reportedly taken by a dingo.
2014 Malaysia Airlines Flight 370 disappears from radar en route to Beijing from Kuala Lumpur on March 8, with 239 people on board.
1984 Advance Australia Fair is proclaimed Australia’s official national anthem and Medicare is established.
1985 The Flying Doctors TV series, later featuring Peter O'Brien and Rebecca Gibney, left, first airs and gains an international following. 1971 The Springboks' rugby tour sparks protests throughout Australia. Queensland Premier Joh Bjelke-Petersen declares a state of emergency in Queensland in response to escalating protests.
1970s 1972 Gough Whitlam becomes Australia’s 21st prime minister. Conscription ends, as does Australia’s commitment to the Vietnam War.
1987 Stock markets crash worldwide. 1989 The Berlin Wall falls. 1990 Royal Australian Navy is deployed in preparation for the First Gulf War.
1980s
Gunman takes hostages at Sydney's Lindt Cafe in December. 2000 The 27th Summer Olympic Games are held in Sydney. Cathy Freeman, above, lights the flame. 2001 September 11 attacks: terrorists crash planes into the twin towers of the World Trade Center in New York City, and The Pentagon in Washington, DC. A fourth plane is downed in the countryside. 2001 The SA Section of the RFDS becomes known as Central Operations. 2002 The Bali bombings kill 202 people, including 88 Australians.
1990s
2000s
2010s
1994 The service works with the Reserve Bank to design the $20 note, which features the face of RFDS founder Reverend Flynn.
1973 The last US troops leave Vietnam. 1974 Cyclone Tracy devastates Darwin on Christmas Eve.
1990s
1977 Kerry Packer’s World Series Cricket launches. 1978 Northern Territory achieves self-government under Paul Everingham as Chief Minister.
1990 Tim Berners-Lee invents the World Wide Web.
1979 US space station Skylab rains debris on a sparsely populated area of WA.
The Victorian Football League becomes the Australian Football League.
1992 The High Court delivers the Mabo decision, which recognises the land rights of indigenous peoples.
2004 The Boxing Day tsunami kills more than 230,000 people across 14 countries after a 9.1-magnitude quake strikes off the northern tip of Sumatra in Indonesia.
2016 South Australia’s new RFDS base at Adelaide Airport opens.
1996 Gunman Martin Bryant kills 35 people using a semiautomatic rifle at Port Arthur in Tasmania, triggering gun reform across Australia.
2009 Black Saturday bushfires sweep across Victoria, resulting in 173 fatalities.
2018 The RFDS celebrates its 90th anniversary.
In October, the RFDS in WA launches its first longrange medical retrieval jet. The aircraft, a Hawker 800XP medium-sized jet, is funded by corporate sponsorship from mining company Rio Tinto and public fundraising.
The RFDS PC-24 aeromedical jet for SA/NT and WA operations arrives in December.
1998 Astronaut Andrew Thomas becomes the first Australian to walk in space. 1999 The Howard Government deploys Australian forces to East Timor to lead the INTERFET mission, following violence in the wake of the country's vote for independence.
8 | FLEET
By air and by road
RFDS FACTS
It started out as an experiment with one aircraft in Outback
AIRCRAFT
Queensland. Now, the largest aeromedical organisation in the world has expanded its fleet to include ground vehicles, to provide the finest emergency and primary health care in rural and remote Australia PILATUS PC–24 jet Max altitude – 45,000ft (13,716m) Max speed – 787km/h Range – 3610km
69 AIRCRAFT + 115 HEALTH CARE VEHICLES CENTRAL OPERATIONS 16 Pilatus PC-12 QUEENSLAND 10 Beechcraft Super King Air 2 Beechcraft Super King Air B200SE 3 Beechcraft Super King Air B200C 3 Beechcraft King Air B350 2 Cessna 208 SOUTH EASTERN SECTION (NSW) 7 Beechcraft King Air B200C 1 Beechcraft King Air B200GT 7 Beechcraft King Air B200 2 Beechcraft King Air B300C WESTERN OPERATIONS 15 Pilatus PC-12 1 Hawker 800XP
GROUND CRAFT
BEECHCRAFT KING AIR B350C Max altitude – 35,000ft (10,666m) Max speed – 313 knots (580km/h) Range – 3345km
HAWKER 800XP
Max altitude – 41,000ft (12,497m) Max speed – 447 knots (813.54km/h) Range – 4667km
PILATUS PC-12
Max altitude – 30,000ft (9144m) Max speed – 280 knots (518.56km/h) Range – 2889km
CENTRAL OPERATIONS 3 Emergency 4WD ambulances QUEENSLAND 1 Dental/oral health vehicle SOUTH EASTERN SECTION (NSW) 1 Emergency 4WD ambulance 6 Road transport vehicles 1 Dental/oral health vehicle VICTORIA 96 Road transport vehicles 1 Dental/oral health vehicle TASMANIA 2 Road transport vehicles 2 Dental/oral health vehicles 6 Primary health vehicles WESTERN AUSTRALIA 1 Dental/oral health vehicle
PERSONNEL BEECHCRAFT KING AIR B300C Max altitude – 35,000ft (10,666m) Max speed – 305 knots (564km/h) Range – 3000km
The first Flying Doctor aircraft, a De Havilland DH50A named Victory, took off from Cloncurry on May 17, 1928. On board were pilot Arthur Affleck and the very first flying doctor, Dr Kenyon St Vincent Welch. Victory touched down 85 miles later, at Julia Creek in Central Queensland, where more than 100 people were waiting to greet it. Victory was owned by Queensland and Northern Territory Aerial Services, which would later become Qantas. The company leased the aircraft to the Rev John Flynn at a cost of two shillings per mile flown during the first year.
KING AIR B200/B200SE/B200C Max altitude – 35,000ft (10,668m) Max speed – 278 knots (536km/h) Range – 2700km
PRIMARY HEALTH CARE
CESSNA C208
Max altitude – 25,000ft (7620m) Max speed – 186 knots (338km/h) Range – 1071km
MOBILE DENTAL CARE
QUEENSLAND STAFF 337 PILOTS 60 CENTRAL OPERATIONS STAFF 205 PILOTS 34 VICTORIA STAFF 500 SOUTH EASTERN SECTION (NSW) STAFF 247 PILOTS 48 TASMANIA STAFF 20 WESTERN OPERATIONS STAFF 280 PILOTS 48 24 AIR BASES 157 FLIGHT PATHS 2338 MEDICAL CHEST LOCATIONS
2016-2017: A BUSY YEAR 26,412,555 Kilometres flown 73,104 Landings 36,933 Patients transported by air 70,576 Patients transported by road 14,356 Clinics conducted 338,825 Patient contacts 88,541 Telehealth consultations 10,832 Dental consultations
MOBILE PATIENT TRANSPORT
Help from the heart An act of generosity has helped the RFDS to invest in more life-saving equipment
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hen challenged to come up with enough money to purchase 70 automated external defibrillators (AEDs) to help the RFDS save the lives of rural and remote Australians, TAL staff took it to heart – quite literally. Embracing the company’s “Insuring the heart of Australia” internal campaign, staff at one of Australia’s leading life insurance companies devised fundraising initiatives from raffles and bake sales to taking part in Tough Mudder and a virtual “climb” up Mount Everest Their efforts raised more than $112,000 in the process – which, when matched defibrillator for defibrillator by the TAL Community Foundation, amounted to 80 new AEDs. The defibrillators, which can administer an electric shock to regulate an elevated or irregular heart rate, will be distributed among some of the 2400 medical chests the RFDS administers across rural and remote Australia.
Also added will be another vital piece of medical equipment: a pulse oximeter that measures blood oxygenation. “This is exceedingly exciting,” says Dr John Woodall, Chief Medical Officer, RFDS Central Operations. “AEDs are something most people take for granted – you get them in airports, hotels, large shopping centres, tucked away in little corners. When ... the heart is going in a very fast or very irregular and fast heart rhythm, that rhythm can be stopped by a short pulse of electricity. “If they have a shockable rhythm, the sooner they receive that shock, the better their chance of living. You can imagine how valuable that could be if someone is several hours’ flight away from the hospital.” Woodall is grateful for the efforts of TAL and its employees in helping the RFDS to continue to reduce the disparity in health outcomes between those in rural and remote areas and their metropolitan counterparts.
“Thank you TAL is all I can say for that. It’s wonderful to have the very prompt recognition by a donor that (the AED) is a valuable innovation and to come behind us and help us deliver it. Because we can’t do a lot unless we get the support of the people out there,” he says. Kent Griffin, TAL Chief Financial Officer and TAL Community Foundation council member says his company is “delighted” to be working in partnership with the RFDS. “The partnership between TAL and the RFDS brings together two organisations that share a focus on finding innovative ways to make a real difference,” Griffin says. “We are delighted to have been able to contribute in a meaningful way to the RFDS, to help them deliver life-improving medical services and expertise to Australians when they need it most. “We look forward to building on the success of our ‘Insuring the heart of Australia’ campaign throughout our partnership with the RFDS.”
Proud major national partner of the Royal Flying Doctor Service As Australia’s leading life insurer*, TAL and the RFDS are working together to make a real difference for those we protect. Learn more about our partnership at tal.com.au/rfds
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*NMG Consulting (2017) inforce premiums for risk only life policies
McDouall Peak Station resident Petie Rankin with a medical chest, top, and RFDS operation coodinator Damien Myles on a Telehealth consultation with a medical chest holder.
10 | RETRIEVAL SERVICES
The king of multi-tasking At Retrieval Services Queensland, there’s no such thing as having a nice, quiet day at the office
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n first impression, it looks like an office just like any other. Pods of staff working at their desks on computers or talking on the phone, a TV screen on the wall, managers working in smaller rooms off the main floor. But take a second look and everything changes. Those staff are monitoring the retrieval of sick and injured patients throughout Queensland; that TV screen shows a videoconference between staff and an emergency doctor in Townsville; those smaller rooms host Queensland’s emergen-
cy Telehealth services, which support rural and remote doctors and nurses. This is Retrieval Services Queensland (RSQ) and, for the state’s regional population, it’s the vital link between life and death. RSQ is responsible for all aeromedical retrievals throughout rural and remote Queensland, co-ordinating 20,000 patient retrievals per year – that’s an average of 55 per day. Hospitals, ambulance, fire, police, search and maritime rescue – all emergency services calls for aeromedical support come in through this one centre and the RFDS flies
You have to make a lot of very important decisions in a very short space of time. There's a level of urgency – there are times we may have seven aircraft all wanting to get airborne at once ...
the majority of these patients from Outback locations to metropolitan hospitals – and often back again. But retrieving a patient by plane isn’t as easy as picking them up from point A and taking them to point B. Everything must be taken into consideration: not just the patient’s condition but also the aircraft type, airstrip condition, weather and hospital bed availability, as well as getting the right medical crew on board. And what then happens if a separate emergency occurs and the aircraft needs to be diverted – will there be
enough fuel on board, enough space for the patients, somewhere safe to land? It’s a daily challenge that would overwhelm many but, for the RFDS duty tasking officer (DTO) based at RSQ, it’s all part of the job. “You have to make a lot of very important decisions in a very short space of time,” says RFDS Queensland DTO Greg Bushnell, an ex-RAAF loadmaster who has been in the role for the past three years. “There’s a level of urgency – there are times we may have seven aircraft all wanting to get airborne at once and we have to do our due diligence on all the aspects plus some, every single time. “Our priority is for the safe conduct of the flight as applied by RFDS. We’re not going to risk the lives of five people for the life of one. We maintain that strict discipline of: Can we do the flight legally? Can we do the flight safely? That’s the best we can do. I guess we try not to get swept up in the emotion of it all.” That information comes from QHealth’s clinical nursing staff based at RSQ. The situation is then discussed with the on-site clinical co-ordinator or Townsville doctor, who will liaise with the DTO. “What happens in very quick succession would be: where’s it from, where’s it to, what is the weather, are there are any restrictions on the airfield, is the airfield suitable for the aircraft we’re looking at – is the runway long enough, are there are restrictions at night, do we need to organise people to do strip runs to clear any wildlife off – any particular notices to airmen which may hinder the safe conduct of our flight? So there’s a whole range of things that may happen before we will give approval for this to be released to the crew,” Bushnell explains. “We’ll look at our alternatives. If we can’t get a fixed wing in, is it possible to get a helicopter in? If not, is it possible then that we have to move the patient by road to a more suitable landing area? Or is it more time efficient to simply move the patient by road to the hospital?” When it comes to road transport, that’s where Queensland Ambulance Service (QAS), also based at the RSQ co-ordination centre, steps in, arranging ambulance services to move the patient from the hospital to the pick-up airfield and from the drop-off airfield to the receiving hospital. “It’s quite a big machine,” Bushnell says. “It requires a lot of co-ordination from a number of different disciplines but it does work. Everyone’s committed to the role and you really feel as though you are part of a team.” Top: Greg Bushnell with RFDS staff member Chris Heinemann at work at Retrieval Services Queensland.
Thank you Royal Flying Doctor Service Congratulations on 90 years of serving the community. You can donate to the RFDS at any Woolworths checkout. All donations over $2 are tax-deductible, and will help support their important work.
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www.flyingdoctor.org.au
Survival against all the odds A helicopter crash almost cost Queensland farmer Michael Tomlinson his life – but he wasn’t going to give up that easily
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n the seconds it took his helicopter to plummet almost 30m from the sky after experiencing engine trouble, Michael Tomlinson’s only thought was survival. The then 26-year-old was mustering cattle on his family property near Augathella, 750km from Brisbane in western Queensland, when the drama unfolded on January 14, 2013. Travelling at a rate of 25-30 knots and at a height of around 30m, the helicopter’s engine suddenly started to show signs of trouble. Rather than panic, Tomlinson’s training kicked in as he managed to bring the aircraft down in a hover, reducing the velocity before crashing into a small erosion gully. His problems, however, didn’t end there. A spilt in the fuel tank caused the engine to burst into flames – with Tomlinson still inside. “I was still clipped in but I wasn’t knocked out. I unclipped myself and then I got out,” he says. “I did a stop, drop and roll but that didn’t put out the flames. I was wearing a cotton shirt that had painted-on checks and the paint caught on fire on the checks. I got up and pulled off my shirt and then ran across to a turkey’s nest (like an earth tank) and jumped in to help put out the fire. “I was in a fair bit of pain but, because a lot of my skin was so badly burnt, the nerve endings were burnt as well and so it didn’t actually hurt. It was the parts that weren’t as badly burnt that were really painful.” Luckily for Tomlinson, his brother had witnessed the crash from the ground and, within 45 minutes, arrived on the scene. An ambulance was called to take Tomlinson to the local Augathella hospital, where a crew
I think the RFDS is integral to rural Australia and I also think people probably take them for granted to a degree because they're already there
from the RFDS stood by ready to fly their patient to the Royal Brisbane and Women’s Hospital. The hospital, however, was a twohour flight away and, with burns to almost 70 per cent of his body and his internal organs beginning to shut down, the RFDS aircraft remained grounded until Tomlinson could be stabilised. Working with the Augathella hospital staff, the RFDS team sedated and then intubated Tomlinson to protect his breathing, before administering pain relief medication and fluids, as well as antibiotics and tetanus vaccine to ward off infection. Finally, with their badly injured patient stabilised, the crew could take off. “They flew me straight to Brisbane where they were met by ambulance,” Tomlinson says. “The RFDS guys stayed with the ambulance right to the Royal Brisbane and Women’s Hospital. I was put straight into ICU. I was in an induced coma for 35 days and I think I was in ICU for another two or three days after they brought me out of the coma.” Tomlinson was in hospital for a further four months, during which time he underwent 16 major operations, before he was deemed healthy enough to leave. It took a further 12 months of therapies before he had recovered from his injuries. Now, more
than five years later and with a new life in Toowoomba, a new wife, Anna, and a new daughter, Elizabeth, he remains indebted to everyone at the RFDS who banded together to save his life. “I’ve met all of the RFDS guys a couple of times, which has been good,” he says. “In the plane there was the pilot, the nurse and the doctor, and then there’s all the staff involved in co-ordinating the rescue.” And his survival has brought home to Tomlinson the true value of the RFDS to outback Australians. “I think the RFDS is integral to rural Australia and I also think people probably take them for granted to a degree because they’re already there,” he says. “The reality is anyone can utilise that service so, even if you’re someone who’s on holidays in Outback Queensland or driving to a friend’s place, they’re the guys who are going to be picking you up. “So don’t just take them for granted and try to help them out wherever you can.”
Clockwise from top left: Michael Tomlinson in hospital after the accident, wearing a second skin; with wife Anna and daughter Elizabeth; and undergoing his painful road to recovery.
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12 | FACES OF THE RFDS
The faces behind the Flying Doctor Up in the air or down on the ground, RFDS staff from across the country share their passion for the job and for the people whose lives they improve every day
STUART PEAKE
Deputy general manager of operations, WA Oversees operations to ensure 24/7 emergency healthcare and retrievals reach people throughout the region
It’s seriously the best job of all time. I’ve been in the role for just over two years but I wish I’d found it 20 years ago. I’ve never been in a job where all you have to do is be nice to people and treat them with respect. I go to work with a smile and come home with one. As one of my colleagues described it, you’re on the road for 10 hours a day, sometimes a bit longer, with one of your mates, and the bonus is you get to pick up people and help them by taking them to and from hospital, trying to make them feel better. The youngest patient we’ve had was nine, and the oldest 101. It’s as much about putting people at their ease and if you can cheer them up, that’s good.
Joining the Royal Flying Doctor Service has been both a career and personal highlight for me. There’s literally no other role that I could extend my entire professional experience to directly benefit the safety and wellbeing of others. In November 2016, the RFDS received an international call from Jakarta. A three-year-old Australian boy had suffered significant burns and needed immediate aeromedical retrieval. It was a significant logistical challenge. We broke new ground, facilitating an international response across a number of services between Indonesia and Western Australia. The young boy’s recovery has been a testament to the leadership and capability of the RFDS beyond boundaries.
TROY WILD
Engineering manager, NSW
Ensures all RFDS facilities have sufficient personnel, resources and equipment to facilitate the maintenance of all aircraft across the region
Charleville senior base pilot Nick Tully at work in Western Queensland.
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PHIL STRAPP
Patient transport officer, VIC Responsible for the safe and timely transport of patients
There’s a lot of trust that gets ingrained into our engineers, and with that there’s a lot of responsibility as well. It’s an outstanding crew we have – it’s a big team spread widely across the state and there’s a lot of job satisfaction. They don’t feel like an employee number – they’re a part of a family. I have a lot of trust in my team and they support the organisation in a superb manner and step up as required. I enjoy the diversity of the role. It’s bringing together multiple problems with multiple aircraft and multiple team members and delivering a reliable and safe product. I guess bringing together a complex puzzle and delivering it in one big piece is the outcome I seek. That’s where I enjoy both giving back to and being a part of a good cause.
NICK TULLY
Senior base pilot, Charleville, QLD Flies aircraft and manages a team of five pilots, including rostering; maintains aircraft and ground support equipment Working for the RFDS is very rewarding. It’s very humbling, helping people you grew up with. You get to see them return back to the community and see them recover and return to a normal life. I grew up west of Charleville on a sheep and cattle station. My mother was pregnant with me when she learnt to fly and we always had a plane kicking around. I was the youngest of 10 kids and we were always coming off motorbikes and having all sorts of accidents, so the RFDS was a pretty constant presence growing up – nearly all of us has been flown out at one stage or another. I’d have two members of my family who wouldn’t be here if it wasn’t for the RFDS. I really enjoy doing the primary health care clinics. You get to go out and have a yarn and get involved.
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MAL HATCHER
Team leader, primary health care, QLD Manages the clinical team to ensure clients receive quality treatment and referrals in a responsive manner My husband was offered a job by Queensland Fire and Emergency Services in Longreach and we came over from the UK. Everyone back home knows The Flying Doctors TV series so the Skype conversations to the family, well they’re still telling everybody who I work for, saying, “Oh my god, it’s so amazing”. It’s far more difficult for people out here. There’s a lack of resources that we take for granted in the city. Coming from a city in the UK and seeing what there wasn’t on offer here was a bit of an eye-opener. Even simple things like when people are unwell, they have to travel so far for treatment. Then there’s the cost involved, the being away from work ... It’s just unbelievable. Until you live through it, you don’t understand.
MANDY SMALLACOMBE
Chronic disease co-ordinator, primary health care team, SA Supports clients in rural and remote SA with chronic disease
Our team has grown significantly; there used to be just a doctor and a midwife. Now we have four doctors, a chronic disease co-ordinator, a specialist mental health nurse, a general practice nurse, a community midwife and a McGrath Foundation breast care nurse. We have also changed the flight plan so we have more bodies going to more areas more frequently in the month. Everyone’s so pleased to see us – we’re very welcomed within the communities so it’s a really, really lovely job. The biggest reward I get is seeing people just with some constant support being actively engaged in their healthcare as opposed to just being a spectator. My motto is “proactive instead of reactive”. I’m really strong on getting people engaged and interested in their health care.
BILLIE CORCORAN
GP registrar, QLD Consults patients in remote health clinics, managing issues ranging from adolescent health to chronic disease to mental health I grew up south of Cairns on a cane farm and I always wanted to live and work in a rural or remote area. The thing about RFDS that I loved was that it was such a generalist thing. You had to know a lot about everything and to me that was what I wanted to do – to help anybody who walked through the door, no matter what they came in with. I wanted to be able to help people who probably couldn’t otherwise access help very easily. Regularly visiting rural and remote communities, you get to know the people and establish genuine trust. There’s something very satisfying about seeing people who possibly wouldn’t otherwise engage in medical services. Even if you’re only able to make a small difference, you take your one step forward as a win.
KAREN BARLOW
Senior flight nurse, Dubbo, NSW Flight nurse and oversees the dayto-day rostering and management of flight nurses at Dubbo base It’s a really interesting job; every day is different and you’re using different skills every day. In the morning you might get a call to go to Cobar – someone’s rolled a motorbike or rolled a car, so you’ll get a trauma call and bring them back to Dubbo or wherever you need to take them, and then you might get retasked out to Wolgan to airlift a lady who’s in premature labour. So you’ve got to be a jack of all trades and master of some. I love to go for a fly. If you’re doing a lot of flying you can get really tired and dehydrated so you really have to be mindful and manage your fatigue, but you get a good flight and you forget all that. Even if you’re flying at 6am and the sun’s coming up and you’re tired and you just want to go to bed, it’s a pretty beautiful office to be in.
ALICE GUBBINS
JAKE WALSH
Dentist, VIC Provides general dental care ranging from fillings, extractions and root canals to oral health education
I grew up in a rural area so I’ve always wanted to give back in those areas, providing care they might not receive otherwise. It’s really nice to be able to contribute, because a new smile and oral health knowledge combined really can empower patients and give them a different outward perspective. Everyone holds the RFDS in such high regard so I feel proud to work for an organisation with such a strong reputation and get that feedback on the road. We are constantly expanding our needs to meet those of rural communities and it’s great to be a part of that. The organisation’s philosophy of ensuring those in country areas have the same access to health services as those in the city really hits home for me.
Line pilot, WA Operates the aircraft and assists with patient management and crew co-ordination
It’s an exciting job. I get to fly for the RFDS and contribute to saving lives, and no day is ever like the next. You need to be able to adapt to constantly changing tasks. You might be diverted while in the air and, while you can try to plan ahead, things change most of the time. On my first day flying a Pilatus PC-12, we were diverted to Albany to assist with the search for two people after their boat capsized. We managed to locate them in time and they both recovered, which is great. I love being part of a team, assisting the aeromedical doctors and nurses. Some of the places we travel to are so remote, you wouldn’t even know they existed. The people there are very relieved to see the RFDS.
ANTHEA RICE
STEVE STONE
Fundraising manager, SA/NT Oversees the fundraising team to ensure annual KPI targets are achieved in a professional and ethical manner As a team we know we make a real difference in the community. Our brand is strong in both metropolitan and rural areas. I’m proud to wear the RFDS uniform. I get stopped on a regular basis by someone who wants to share their experience of using the service – it might be when I’m putting petrol in the car or over at the shops. I’m very aware that everyone we interact with is a potential donor. Whether I’m presenting to a community group or providing a VIP base tour for a major corporate organisation, it could be the first step to us receiving a donation, a regular monthly gift or an offer of sponsorship – all of which are vital to us raising money to keep the Flying Doctor flying. We’re lucky we have the RFDS brand behind us – it makes our job easier.
Rural health worker and physical health worker, TAS Improves integration and co-ordination of primary and preventative health care in rural communities I’ve worked in private practice, occupational health and education. Rural health is a little bit different. The clientele’s health literacy is probably not as good so we’re helping them in that way, and that’s a really big area because, in Tasmania, 63 per cent are health illiterate. When they come in, we give them some really good information, broaden their knowledge, give them the skills to navigate the system. Working in the Medicare system, you can only see an allied health care professional up to five times. Here, we can see them a bit more and have better outcomes because of that. We can spend more time and care on the patients, and I think that goes a long way. The program has only been running since April 2017 but we’ve had a really good uptake and results.
IN THE AIR & ON THE GROUND,
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14 | B350
Care in the air With the latest technology in the cockpit, the Beechcraft King Air B350 is a game changer in aeromedical retrieval
As with the entire RFDS aeromedical fleet, the B350’s cabin pressure is set at sea level, just as it is in hospital, helping even patients with the most severe internal injuries to remain stable during the flight.
The B350 can pick up from more than one location when transporting patients to hospital, making transfers more efficient. Pictured: RFDS pilot David Collins with the B350 at the RFDS' Brisbane Base.
VITAL PATIENT MONITOR EQUIPMENT
The Proline Fusion touchscreen cockpit features: • Three 36cm widescreen LCDs with advanced graphics displaying 3D models of the surrounding terrain and aircraft, configurable windows, and touchscreen or point and-click navigation. • Touch-interactive maps with eyes-forward flight planning, high-resolution topography, real-time on-board weather radar overlays, obstacles, and special-use airspace and search patterns for expanded situational awareness and reduced workload. • High-resolution synthetic vision and extended runway centrelines with mile markers to better orient the pilot from top of descent through final approach.
The Queensland fleet’s first-ever three-stretcher configuration allows for greater carrying flexibility, including the ability to carry: • One, two or three patients on stretchers; • One, two or three seated medical staff; • Neonatal intensive care cots; • Non-stretchered patients.
With its larger fuel payload, the B350 can fly non-stop from Mount Isa or Cairns to Brisbane, making it the perfect aircraft for inter-hospital transfers. A quieter engine makes for a more comfortable flight for everyone on board.
ISTAT ANALYSER $12,000
INFUSION PUMP $2,500 ZOLL MONITOR $45,000
HAMILTON T1 VENTILATOR $49,950
A problem shared The RFDS’ Drought Wellbeing Service team in Queensland is here to help during times of difficulty
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ith some parts of Queensland now in their seventh year of drought, there’s no question that residents in remote and rural areas are doing it tough. Farmers are being forced to spend thousands of extra dollars on bringing in supplies to feed cattle while facing up to the all-too-real possibility of losing their properties, many of which have been in their families for generations. For some, financial anxiety mixes with guilt as they often blame themselves – is there something else they could have done to save their heritage and their livelihoods? Launched in 2015, the RFDS’ Drought Wellbeing Service (DWS) is there to help Queenslanders through these tough years. The service provides counselling and support to people working or living in areas impacted by drought, building strong links with communities and with other service
providers where possible. While feeling sad or stressed is normal, DWS manager Gail Jamieson explains that too much stress can affect your health and the health of those around you. “It is well recognised that dealing with ongoing stress-related problems can lead to both physical and mental health conditions,” Jamieson says. “People in remote and rural areas often have limited access to mental health services, such as those provided by psychologists or mental health clinicians, and that’s where the RFDS Drought Wellbeing Service can help. “Our mental health clinicians are specifically trained and available to assist people with a range of mental health effects arising from dealing with difficult times. They offer a confidential environment to express concerns and problem solve. Strategies are
designed to help prevent and resolve a wide range of conditions such as depression, anxiety, sleep problems and post-traumatic stress reactions.” As one of Australia’s most trusted Outback service providers, the Royal Flying Doctor Service is the trusted face of primary health care in remote and rural Queensland.
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18 year partnership $12.5m customer & employee donations 130,000 customer donors Local Hero Awards So many life-saving and memorable moments
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“I’ve just come back from the southwest with farmers who are in their seventh year of drought” Jamieson says. “They know that if they have a physical or medical emergency then the Flying Doctor is going to help. Due to the connection with DWS clinicians, many now realise that the same trusted organisation can assist with mental health.”
16 | HEALTH SERVICES
Services taking care of both body and mind Every rural and remote Australian knows about doing it tough. Drought, flood, fire, isolation ... Outback life is a series of never-ending challenges that change with the seasons, challenges that demand not just physical but also mental strength to survive. And, just as it provides physical health services and treatment to patients, the RFDS is there for those needing help with mental health issues, using its position as a trusted face in communities to support people on their path back to wellbeing. “There’s a lot of support for the RFDS in the area,” says Mal Hatcher, team leader, primary health care, RFDS Queensland, above. “We’ve been here for more than 10 years now. They recognise the value of having us. You can see that when we’re travelling further afield and there are less resources – it’s good to know there’s someone who can travel to you and see you.” With the drought now in its seventh year, RFDS Queensland’s mental health team has witnessed an increase in the number of clients accessing its services. And, in addition to offering counselling and clinical support, the team engages with communities to educate and promote acceptance on the issues of mental health. “You do general first-aid training so you know how to spot someone having a heart attack and what to do; I do the same with mental health first aid training,” Hatcher says. "I think it’s really important we work at keeping communities strong.” In South Australia and Tasmania, the
RFDS’ mental health programs operate in a holistic style, integrating the physical with the mental aspects of a person’s wellbeing. As the sole mental health practitioner at the Port Augusta base, Carol-Ann Stanborough is part of the primary health care team, working closely with the GPs and nurses at the clinics to which they regularly fly. “As a mental health nurse, it has increased my direct access to getting physical health care for clients we see with complex mental illness,” she says. “On the day, I’m there with a GP and other nurses. I can walk around the room and get the person with mental illness a physical assessment or health care there and then. It’s a more direct, holistic way. In Tasmania, the Integrated Primary Care Consortium (IPCC) consists of a mental health worker, a physical health worker and a rural health worker, addressing mental illness, cardiovascular disease, chronic obstructive pulmonary disease and dementia. “It’s a client-centred, holistic care with a co-ordinated approach across rural, physical and mental health,” says mental health worker Julie Gracey. Recognising the isolation that comes as part of living in rural or remote areas, the team is trying to reach those who might not otherwise access health care services, whether for geographical, social or financial reasons. “The community outreach component is so that those who are in dire need of support ... we’re actually going to them,” Gracey says.
Policymakers for the future The RFDS’ Research & Policy Unit is the driving force behind a healthier Australia
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ith just three staff members monitoring national healthcare data for the whole of Australia, the RFDS’ Research & Policy Unit in Canberra is a hive of activity. The unit may be small in size but, since it was created in 2015, its impact has been significant, helping to drive and implement policy to improve the lives and health of people living in regional and remote Australia. The unit consolidates data from throughout the RFDS and provides a national voice, bringing the RFDS’ research and projects into the national and political agenda. “Our research and policy unit was started in 2015 because we know there are disparities in health outcomes between people in the bush and people in the cities” says Dr Lara Bishop, the unit’s director. “After 90 years, those disparities still exist. Despite all of the technological improvements, we’re still seeing huge disparities across pretty much almost all illnesses, accidents and injuries, and the RFDS wants to know why and offer some evidencebased solutions.” One of the unit’s early success stories was a paper released in September 2015, called Filling the Gap, which explored inequalities in access to dental services for, and the poorer dental health of, remote and rural Australians. That paper led to a change in government policy that revitalised the existing dental health delivery model. “We were able to suggest a number of different ways in which services could be delivered,” Bishop says. “Rather than just have a dentist there, what about using infrastructures that the Flying Doctor has and fly in some dentists? What about some vans that travel around? We took those ideas to government and we’ve been able to get funded a national dental program through the RFDS where we now deliver all the different pre-
We started our Research and Policy Unit in 2015 because there were disparities in health outcomes between people in the bush and people in the city ventive and actual services on the ground through fly-in, fly-out, drive-in, drive-out.” The subject of Bishop and her team’s most recent paper is cardiovascular disease (CVD) which, in 2016, was responsible for 27.7 per cent of all deaths in Australia. From July 2013 to December 2016, the RFDS transported 20,379 people from remote, very remote and inner and outer regional areas into cities to receive treatment for conditions linked to CVD, such as heart attacks and strokes. The figures are confronting and Bishop’s role is to source not just the statistics but the solution, too. “What we’ll be able to do as a follow-up to this paper is look at all the primary healthcare data over the last three years,” she says. “Our report shows our aeromedical retrievals for emergencies but, because we’re the main provider of primary healthcare services in much of rural and remote Australia, we really need to look at that data as well. The main thing that patients have said to us – and the evidence is telling us – is around access to services: poorer access, fewer services ... You just don’t have the doctors, the allied health professionals and the hospitals out there. Looking at our primary health care data will be the next thing on the agenda to see what’s going on on a day-to-day basis, rather than just in emergency situations.”
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Positive signs for video trial A new Telehealth system is currently being trialled by the RFDS across the country. This key tool helps the RFDS deliver primary health care services to those living in Outback Australia by linking users with RFDS doctors and specialists. The RFDS performed 88,541 Telehealth consultations in 2016-17, up from 62,712 in 2015-16. And, with one in six remote patients waiting at least two days to see a doctor for urgent medical care, and being 1.6 times more likely to die prematurely than those in metropolitan areas, the service has proven vital. Now it is being expanded to include video conferencing, with 14 communities from WA, SA/NT, QLD and NSW participating in a new trial to gauge the value of a “face-to-face” remote consultation. “The communities all receive primary healthcare services from the RFDS anywhere from weekly through to monthly visits. In between visits they will receive an additional Telehealth service from the same doctor – but instead this time it will be via videoconference,” explains Dr Lara Bishop, RFDS director of Research & Policy. “It allows that continuity of care, it allows the doctor to see someone on that ongoing basis and to help them manage the conditions they have.” The trial, held in collaboration with the University of Queensland and due to run until mid-2019, is being rolled out in a “steppedwedge” format which sees one new clinic come on board per month. It is still in its early stages but the signs are positive. “It seems to be really accepted and embraced by the community as an additional service,” Bishop says. “I’m hoping that continues.”
Dr Lara Bishop
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Cultural respect is key to better health
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s a central, and sometimes the sole, provider of health care services in many remote and rural areas of Australia, the RFDS has built a strong relationship with indigenous communities over the past 90 years. The organisation’s commitment to improving health outcomes and access to health services for Aboriginal and Torres Strait Islanders was reflected in its 2016-17 Reconciliation Action Plan (RAP), which focused on three key areas: strengthening the RFDS’s relationships with indigenous peoples, demonstrating cultural respect and advancing health and wellbeing within remote and rural communities. “We were very aware that indigenous people make up a large proportion of people to whom we provide services,” says Lauren Gale, director of Programs & Policy at the RFDS’ Federation Office in Canberra. With the 2016 Census showing indigenous people make up only about 3 per cent of Australia’s total population, the fact that almost 50 per cent of patients attended to by RFDS staff are indigenous has a significant
impact on the organisation in terms of policy and practice. “We are making sure we are working to make services as culturally appropriate and responsive, and ensure there is good access for indigenous people to those muchneeded services,” Gale says. “The 2016-17 RAP was the first time the RFDS as a federation has had a Reconciliation Action Plan. Having one was important in terms of demonstrating our ongoing commitment to the efforts of Reconciliation Australia to offer social and economic opportunities to indigenous Australians, and also as a demonstration of our commitment to the Close the Gap campaign to improve health outcomes for indigenous people. The RAP also provided us with the opportunity to sit down in a focused way and determine how we are going to take those steps to continue to improve the appropriateness and effectiveness of our services.” The key to success, Gale says, lies in “clinical cultural competency” – with the onus on the RFDS to offer a culturally
appropriate service that encourages indigenous people to actively participate in their own health outcomes. “We know that indigenous people access services at a lower rate to non-indigenous people,” she says. “There is a difference in terms of the way a Western biomedical model thinks about health and health care as opposed to an indigenous approach, which has a more foundational, holistic approach to not only physical but emotional health, the wellbeing of a person and their community. We’re very aware that areas of communication difficulties or lack of culturally appropriate services creates a barrier to accessing services, so we support the call for cultural safety being embedded into clinical government and clinical professional standards.” The second RFDS RAP, launched late last month, recognises the need to train, support and employ more indigenous people. “We know that a key part ... is about having indigenous people to provide that cultural appropriateness of services, as well as ensuring the cultural awareness and competency of our staff more broadly,” Gale says.
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18 | BABIES
BABIES FLOWN BY THE RFDS EACH YEAR (UNDER THE AGE OF THREE) Brisbane 200 Bundaberg 105 Cairns 56 Charleville 13 Mount Isa 62 Rockhampton 160 Townsville 177 TOTAL 773
Take care – baby on board Transporting the tiniest of patients can prove the biggest of challenges for RFDS staff
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ith 90 years in the field, the RFDS is expert in retrieving injured and critically ill patients from remote locations and transporting them to metropolitan hospitals for medical care. It’s as normal to these pilots, doctors and flight nurses as it is for office workers to start up their computers first thing or exercise instructors to break that first sweat. But there is one form of patient retrieval that can make it not just a typical day at the office – the transport of babies and children. And it’s not just the medical aspect that makes paediatric and neonatal retrieval something of a challenge – there are a number of logistics involved, too. Paul Holmes, Director of Children’s Health Retrieval Services Queensland (RSQ), works closely with the RFDS on transporting babies and children throughout the state. “The basic medical training is for adults so, by the time you’re dealing with children and babies, it’s already a specialist training (involved),” he says. “On top of that, a lot of these children have complex needs or subspecialty requirements so we have to deal with all that as well. We put staff with intensive care and critical care skills on the flight to go out and get them. “Sometimes it’s the RFDS teams themselves – they have doctors on board and we can help give them advice. At other times, if it’s a critically ill child, we send a paediatric
intensive care-trained doctor and nurse from the paediatric intensive care here at Brisbane’s Lady Cilento Children’s Hospital out on the aircraft with the RFDS flight nurse, and then we go and retrieve the child or baby and then bring them to intensive care, either here at Lady Cilento or sometimes the Gold Coast or Sunshine Coast.” Holmes and his team co-ordinate around 2000 paediatric or neonatal retrievals throughout Queensland every year, flying patients out through the RFDS and other medical retrieval service providers. “The other issue is the lack of places that deal with high levels of care in children,” Holmes says. “Lots of hospitals have adult intensive care facilities but there’s only a handful throughout Queensland who do children, and certainly neonates, and so there’s a lot more (co-ordination) to move the children to the facility.” In 2017, RFDS Queensland transported 773 children aged three years and under from bases in Brisbane, Bundaberg, Cairns, Charleville, Mount Isa, Rockhampton and Townsville. Babies like Mack, placed in intensive care with suspected heart issues just hours after arriving into this world. At just two days old, Mack was flown 1300km by the RFDS and Townsville Hospital Neonatal Retrieval Team – a journey that would have taken 15 hours by road – to Lady Cilento, where specialist paediatric surgeons performed
The basic medical training is for adults so, by the time you’re dealing with children and babies, it’s already a specialist training (involved)
immediate open-heart surgery to remove a blood clot and save his life. To ensure success stories such as Mack’s, medical staff at Lady Cilento regularly spend time working with retrieval teams such as the RFDS. “They all work in the paediatric intensive care unit as well but they rotate through retrievals and spend time with us doing retrievals to get familiar with the equipment and gain a different consideration,” Holmes says.
Top left: Flight nurse Haidee Kerr with Angela Bowen and her daughter Halle; above, Paul Holmes, Director of Children's Health Retrieval Services Queensland.
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New frontier of dentistry The RFDS Dental Service is bringing much-needed oral health care to rural areas
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mergency extractions ... it’s a term that has been synonymous with the RFDS for 90 years, with images of patients being airlifted out of remote areas and transported to hospital for emergency treatment. But did you know the RFDS also does another kind of emergency extraction – of the oral kind? It may come as a surprise that the Flying Doctor is one of the largest providers of oral and dental health services in the country, reaching those areas other health care providers can’t access. Last year alone, the RFDS’ fly-in, fly-out, mobile and outreach services provided 10,832 instances of dental care across Outback Australia, 1490 of these in Queensland. It was only five years ago that the RFDS decided to partner with QCoal, a Queensland based mining company, to bring muchneeded dental service to communities that
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struggled to access such services across central Queensland. From 2013 to mid 2017, this philanthropically funded service visited 21 rural communities across Queensland, travelling 54,000km and treating more that 8000 patients, delivering $4 million in dental services. Since April last year, this vital service has continued under a new Commonwealth-funded program, with both the RFDS and QCoal Foundation proud to have proven the success of the mobile dental unit concept, convincing the government to ensure its sustainability. Today, this five-person team operates from an 18-wheel semi-trailer that features two state-of-the-art dental surgeries, a sterilisation area, a reception desk, kitchenette and the latest panoramic X-ray equipment. “We stay in communities for generally about two weeks, although we can extend it if the demand is there,” says Annette Saleta, state
services co-ordinator, RFDS Queensland. “We go to communities that don’t already have dentists, either private or public. In the last 12 months, we’ve been building relationships with Hospital and Health Services within the state and partnering with them to find out where they can’t go, which areas need more support, and so we’re helping to fill the gaps that can’t otherwise be filled.” The historical lack of access means a large
number of people living in regional communities are dealing with a range of oral and dental problems. Most common, RFDS dentist Alex Stipis says, is periodontal (gum) disease and broken-down fillings requiring large fillings or extractions. “A lot of infections are going on as well that have been there quite long term,” she adds. “I think a lot of the time the patients have only been seen if they’re in a significant amount of pain – that’s really the only motivation to travel the distance to go and see a dentist.” As well as physical procedures, the dental team provides education on dental and oral health, spreading the message that prevention is better than cure. The result, says Saleta, is a shift in the treatments the team provides upon return to those communities. “When we first visit a community, there may be a lot of extractions and emergency work and pain relief,” she says. “The more we go back and visit, the more that’s transitioning to preventive treatments.” It’s an observation with which Stipis agrees. “We have some patients who are really motivated and keen to take that (education) on. Now that we’ve been going back a little bit more, it’s good to see them not just for pain or emergency problems but being able to do more education and preventive things as well.”
Dentist Alex Stipis has seen an improvement in oral health since the service was launched.
20 | DONORS
Ground crew corporate sponsors helping to keep the Flying Doctor flying
casions, which I enjoy very much. It’s a very personable crowd of people – they’re just lovely, lovely people. When they got their new aircraft I was invited out to look through it when it landed from America. I said, ‘What do you need?’ and I chose a defibrillator and now that’s going around in the aircraft. It’s very gratifying. I’m very happy indeed to pass on money that will keep on going.”
FRANCIS KLEIN
Nudgee College student and fundraiser
Meet the generous donors, volunteers, fundraisers and
Donor
“In the mid-50s, I ventured out to Central Australia – that was my introduction to the Outback. It was a complete change and I’ve never, ever lost the love of the Outback. I’ve been fortunate enough to get to lots of places there and meet lots of people. There’s this opportunity for me living in Ipswich that I can help those people, because the Flying Doctor is so essential in their lives. It’s a great thing to do; the people of the Outback are wonderful people, and we have to help them in any way we can.”
VAL MARLOW
RFDS Brisbane Auxiliary president
“I’m a country girl and it goes right back to my grandmother, who always saved sixpence of her meagre pension to go to
the Flying Doctor and the Inland Mission. It’s been bred into me and it’s something that has always been important to me. The country people couldn’t do without the Flying Doctor, and the people in the city don’t realise that they could be part of it as well. Mainly it’s my own time that I donate, doing craft work for stalls, cooking, organising activities for fundraisers and things like that. Sometimes time is more important because that brings in more money. It’s a wonderful service because the people you meet are so interesting.”
HEATHER CRAIG
Long-term donor
“I started about 2000 because I had an inheritance from my mother. I decided I’d give it to charities over a period of time, including the RFDS. They invite me to special oc-
BILLY BANKS
“I’m a third-generation member of a farming family from Blackall, Queensland, and, as a result of living in rural Australia, my family relies on services such as the RFDS to provide urgent medical care in times of need. I am just one of many Nudgee College Boarding students who are from remote Australia. To us, the RFDS provides the comfort of knowing that living in an isolated area is no barrier to our families being able to access lifesaving health care. As a school with a long tradition of educating ‘boys from the bush’, the College is dedicated to supporting organisations that provide relief to our families.”
CHRISTOPHER WALLIN QCoal Foundation chair and QCoal Group managing director “As founding partner of the RFDS Dental
Service, the QCoal Foundation is proud to have supported the RFDS to deliver on our shared focus of assisting rural and remote Queenslanders. By prioritising programs that provide innovative solutions to identified community needs, the QCoal Foundation contributes to resilient communities through initiatives in health, education and liveability. The QCoal Group has been a proud Principal Partner of the RFDS in Queensland since 2013. Collectively, the QCoal Foundation and the QCoal Group have provided more than $4 million in support to the RFDS to date.”
CHERYL HOPKINS
Ergon Energy Retail executive general manager
“Ergon Energy Retail launched a statewide scheme to encourage customers and employees to donate either $2 or $5 via their electricity bills. In March, we celebrated 18 years offering this scheme and we’ve raised more than $12.5 million to date. In 2016, we extended our existing partnership with the RFDS Queensland Section by becoming the primary supporter of the RFDS Local Hero Awards. The Awards recognise the unsung heroes among our community who work tirelessly and selflessly to support the work of the RFDS in their region. Partnering with the RFDS seemed
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a perfect fit for us – an iconic Queensland lifesaving service and our families, friends, customers and communities! Our people live and work in regional Queensland so it’s a relief to have this service available should we and our communities need to use it. We are proud to provide this support to keep the service operating.”
TONY JOSEPH Rocklea owner
“I’m taking part in the 2018 Outback Air Race (a GPS-based navigation time trial through the Outback) with pilot David Tait. We leave from Archerfield Airport in Brisbane on August 19 and fly across the country to Broome in WA over eight days. It’s a new experience for me and I’m looking very much forward to it. Since we were given this challenge we’ve got out there and, through a network of people we’re in business with here in Brisbane, we’ve reached out to them and asked if they’d donate and they’ve been very keen to support us. They asked us to raise about $2000 per competitor – at the present time we’ve raised about $3100. A lot of people say that because the RFDS is a not-for-profit organisation, it’s a very worthwhile cause.”
DAVID BOND
CIMIC group general manager health & safety “I started donating to the RFDS about five years ago when the company I worked for started a workplace-giving program through our payroll system, called Good to
Give. I chose the RFDS for several reasons. Given the nature of my work, which is often in remote areas of Australia, I have seen many times the tremendous service the RFDS provides but, more than that, I see the RFDS as the epitome of what it means to be Australian. They never grandstand or make a song and dance, but they are always there to lend a hand. This allows us to live, work and play in our vast country, with the comfort of knowing that help will be there if you need it.”
JOHN SLOMAN
RideWest director “RideWest is a charity bicycle ride from Brisbane to Longreach that’s taken place every two years since 2010. These events have now raised more than $1,000,000 for the Flying Doctor, with the 2018 ride having just been completed, raising more than $300,000. Thirty riders and 14 support crew took part in this year’s ride of 1237km across a week. The people involved in RideWest are Brisbane-based, with contacts and family history with western Queensland. We’ve seen and heard of the effects of long-term drought in that area. In western Queensland, where we finish, the RFDS is one of the primary providers of mental health care, with clinics on the ground. We see this as a really good way of helping the Flying Doctor provide a really good service that actually makes a difference and helps support those people in tough times.”
Keep the Flying Doctor flying As a not-for-profit organisation, the Flying Doctor relies heavily on the generosity of the public to keep its services running, whether up in the air or on the ground. As well as its aircraft, primary health care vehicles, mobile dental and eye clinics and patient transport vehicles, the RFDS needs a wide range of medical equipment – from basic first aid medicines to the latest lifesaving technologies – to continue its proud 90-year tradition of saving the lives of remote and rural Australians. Another important resource for the RFDS is staff, from pilots and flight nurses to aircraft engineers, dentists to mental health workers and patient transport officers to bush nurses. Offering the best in both emergency and primary health care comes at a cost. Every donation, whether large or small, can help support the Flying Doctor and its work in regional and Outback Australia.
champion the RFDS Donate: Either as a one-off payment or regular giving. Fundraise: Think of an easy, fun way for you, your workplace, community group or school to raise funds. Bequest: Leave a gift in your will and create a legacy to be remembered beyond your lifetime. Workplace Giving: Your donation will be deducted from your pre-tax earnings, reducing your taxable income every payday. Corporate: There are a number of options available, including partnership, sponsorship, volunteering, advice, pro bono services and more.
There are a number of ways you can
For further information, log on to flyingdoctor.org.au or call 07 3860 1100.
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22 | OPINION
Legacy for life Passion and resilience lie at the heart of service, writes Dr Abby Harwood, Chief Medical Officer, RFDS Queensland
I
t was in early 2000, the night before my first day in a new job. For most of my life I have been a remote area GP. I had everything ready to go; or so I thought until my phone rang. It was the RFDS community nurse. She wanted to remind me to bring a change of clothes. She told me the river between the airstrip and the community where the clinic was to be held was up. We would have to fly in, then boat across to the community. Fortunately, on this occasion
we were able to cross in a four-wheel drive, as the river had subsided by the time we arrived. However, I quickly learnt that this is commonplace to get to remote places, and is an almost everyday occurrence for a lot of RFDS medical officers and nurses. You only have to look at a population map of Australia to understand why most of us take access to health care for granted. The vast majority of people live in or in close proximity to the capital cities or large regional centres. If you can’t get into your usual GP, there’s usually another one nearby with the capacity to see you. And, for those times when you are seriously ill, there’s the local emergency department. The reality for the half a million Australians who live in remote or very remote parts of the country is in stark contrast to this. The closest nursing post might be an hour or two by road – if the road is open. The closest doctor may be even further. Some Australians travel up to five hours by road to access medical care, and that’s
when the road conditions are favourable. If the road conditions aren’t favourable, there may be access by air or they may be completely cut off. Any significant illness may mean leaving their home, and their job, for months at a time. One example is a patient having to travel a full day either side of chemotherapy treatment. For some, it’s often easier and cheaper to temporarily relocate to the city. But this comes at a cost to the community. Suddenly the community is without their mechanic, electrician, teacher or bus driver. The ripple effect of one piece of a delicate community balance temporarily, or sometimes permanently, falling over is nearly impossible to quantify. For those of us who work for the Royal Flying Doctor Service, the challenge is to be as creative and innovative as those we serve. We provide regular GP services to places “beyond the normal medical infrastructure”. We provide 24/7 phone support and advice from our clinicians. When the phone service is down, we utilise whatever method of contact is available. And yes, assessing a person who may be 2000km away and coming up with a strategy to manage their illness or injury with just a phone is a challenge. Fortunately, and what is not commonly known, is that the RFDS provides access to more than 1300 medical chests located throughout Queensland, containing life-saving emergency medications. These are used to treat a patient un-
Jimmy barnes LIVE IN THE RODEO ARENA
Sunday 12th Aug 2018
der the guidance of the RFDS doctor. And they are life-saving while the seriously ill or injured await aeromedical evacuation, the service for which we have been known since 1928. While our service has innovated and grown in 90 years, certain challenges remain constant. Mainly, how to meet the need for access to health care for people living in remote parts of the country, the vast distances associated with living in such a large and sparsely populated country, and the ability to recruit passionate doctors to live in and to serve rural, regional and remote parts of the country. Working for the RFDS is a dream for many, with images of adventure and heroism always at the fore. And, while a sense of adventure is something I would always encourage in anyone thinking about a career with the Flying Doctor, what we always look for in potential recruits outside of our long list of professional prerequisites is flexibility, professionalism, resilience and adaptability. The RFDS has been around for 90 years thanks in no small part to a legacy of talented and dedicated individuals with a real passion for remote health care. If we are to continue that legacy for another 90 years, we must continue to recruit medical professionals who are as adaptable, passionate and resilient as those people who live in the communities we serve. If this sounds like you, the RFDS would love to hear from you.
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