The fallout from Tropical Cyclone Imogen
Tropical Cyclone Imogen crossed the western Gulf, near Karumba, late on Sunday, January 3, 2021. The aftermath of the storm left the remote community completely isolated as flood waters cut off main roads. The only way in or out was by air.
Dr Michael Clements, a Townsville based GP who regularly runs outreach clinics around the Cape and gulf country, was preparing to fly into the community to help as they recovered from the storm. Knowing they would be under staffed and under resourced, he put the call out to final year JCU Medicine students to see if they could lend a hand.
Hannah Kahn and Harjyot Gill were among the three students who jumped at the chance to help the people of Karumba, this is their story.
A privilege to help: Hannah Kahn
Getting to go to Karumba was an absolute privilege. When I saw the email saying there was an opportunity to go, I only had to read a few key points before I was sold.
Flying in a four-seater aircraft? Helping a community recover from a natural disaster? Getting a taste of practising medicine in a low-resource environment? I thought, “this is it, this is what I want to do!” and I am so grateful for the opportunity.
Air assist
Flying into Karumba you could see the extensive flooding. As it was a lower category cyclone, only a few trees were down, but what I found most striking was the degree of inundation.
While the town itself was not flooded, the entire surrounding area was, which was very apparent upon flying in. Seeing the Norman River spilling over its banks, causing the road to be well and truly cut off, was quite impressive.
There are many health implications that can stem from a natural disaster such as this, including an increase in transmission in arthropod-borne illnesses, in addition to skin infections and multi-system infections, including melioidosis.
We did see a bit of structural damage to some of the housing within the community, particularly to the older properties. There was an enormous gum tree down in the yard of an elderly couple’s home, and of course their physical condition would prevent them from being able to do anything about it.
Given that most community members have lived in North Queensland for most of their lives, they are a resilient bunch. With that said, it was clear how much strain the nurse practitioner felt due to the increased demands on the healthcare system. Her exhaustion was palpable. Also, patients with pre-existing mental health concerns seemed especially affected by the damage to their properties, as cleaning up that sort of damage is trying even at the best of times.
Valuable lessons
While we were there we had a number of opportunities to assist Dr Clements and the nurse practitioner.
There was a patient I helped with who presented with a venous stasis ulcer. The nurse practitioner was uncomfortable managing this patient in the community, given the scope of practice and resources, and under normal circumstances would have sent them on an aeromedical retrieval to Mount Isa. However, given the patient was coping and wasn’t an urgent case, flying her out at that time wasn’t really justifiable. That case gave me first-hand experience of seeing how clinical decision making is affected by context, both in terms of physical and human resources.
Most of the cases we were able to help with were fairly common and not directly linked to the cyclone. However, the opportunity to relieve some pressure from the local nurse and keep things moving efficiently for Dr Clements was amazing.
We were there and back in a flash, but getting to go on this adventure and, more importantly, getting to play a meaningful role in contributing to meeting the community’s healthcare needs, was truly the opportunity of a lifetime. I may have received a few mozzie bites along the way, but I also gained confidence in my ability to help in a healthcare system under strain, as well as being taught many valuable lessons by our enthusiastic mentor, Dr Michael Clements. I would go again in a heartbeat!
Supporting the community: Harjyot Gill
When I got the call up to help the community of Karumba recover from Cyclone Imogen, I knew this was my opportunity to give back. From my past experiences in natural disasters, most notably Cyclone Yasi, I understood how uplifting it can be to have the help and support of others during an arduous time.
My heart ached for the community of Karumba as we flew above in Dr Clements' plane and saw the aftermath of the cyclone.
Our day started as soon as we arrived in Karumba around 9.30am. After a quick introduction with the nurse practitioner and registered nurse at the clinic, we were given our own consulting rooms and patients to see. During my day, I saw an elderly man with an infected insect bite, a mother with a wrist fracture for whom I applied a backslab, a young man struggling to cope and an elderly woman suffering from a severe chest infection. Every patient shared their story, some with tears. In these vulnerable moments, I was continually reminded of the privilege of being a doctor and offering help and solace to patients in a bewildering time.
This experience also highlighted the unique challenges of rural and remote medicine as Karumba did not have access to advanced diagnostic testing and on the whole patients preferred treatment in the community.
Making a difference
The next day we went out into the community for home visits.
This was a great opportunity to not only assist patients in the comfort of their own homes, but also to assess their safety and risks, as well as access to basic amenities and support from family members.
The overwhelming feeling of being wanted, expected and needed in Karumba was one of the sublime pleasures of being a health professional. This truly was an opportunity of a lifetime that has left me with invaluable lessons from Dr Clements, and indelible connections with patients.
Harjyot Gill
My heart goes out to the community of Karumba as many of their concerns echoed deeply within me. I would like to sincerely thank Dr Clements for this unique opportunity.