Meagan McKelvie

MBBS6 Student

College of Medicine and Dentistry

Publish Date

1 July 2021

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Meagan McKelvie: My eye-opening placement

Ferrying across the jewel-blue skin of the Torres Strait to its numerous islands, with the tip of mainland Australia glimmering in the far distance. I gazed down at turtles and dugongs from a helicopter as they breached the surface of the ocean below. The only way through the jungle to get to Pajinka (the Tip) was by 4WD. We spectated as an enormous crocodile stalked a sea turtle amongst the waves from the cliffs of Somerset.

These are all highlights from my 10-week placement on Thursday Island and Bamaga/Northern Peninsula Area (NPA).

Arriving in the thick of the wet season in January, it is at first a shock to the system. Up this far north, the humidity and the rain are constant. Originating from Melbourne, Victoria, it takes some time getting used to, as does the thought of how close the equator is. Nonetheless, the world up here is full of beauty and splendour. The rainforest of the northern Cape envelops the communities of the NPA in an endless sea of glistening green. The earth is a deep volcanic red, and metres-high termite mounds tower on the sides of the roads. Wild dogs and horses roam the township and slink in between the trees. In the Torres, the ocean is a breath-taking panorama that defines every view-point from the islands.

However, it is the Torres Strait Islander and Aboriginal Australians who live in this special place that has made living and working here an unforgettable experience. I was welcomed by the communities warmly and enthusiastically, meeting several elders and even learning a bit of language. Here, people are dedicated to their families, often with several generations still living in the same place. Everyone knows everyone, related in some way through family, friendship, work or leisure. In town, both on Thursday Island and in Bamaga, I would be stopped to have yarns with colleagues and patients I had met at the hospital.

Meagan in the cockpit
Meagan in the helicopter
Left: Meagan in a helicopter on her way to the region's outer islands. Right: The view out over the water across the Torres Strait.

The medicine is unique

The medicine is unique, owing to population characteristics and remoteness. This includes plenty of work in GP, emergency, hospital wards, and outreach clinics to the outer islands of the Torres Strait (via helicopter!) or the other communities in the region via road. Unfortunately, the burden of diseases like diabetes, obesity, heart disease and their preventable complications are key health issues for Torres Strait Islander Australians. In Bamaga, I came to know many patients well and recognise the underlying issues affecting their health. Distrust or dislike in taking medication, difficulties in quitting smoking or sugar, or previous dissatisfaction with health care were some of the challenging barriers that we encountered often.

Like the landscape, the medicine too changes with the seasons. During the wet months, infection is a predominant presentation. For weeks, the ward on Thursday Island was mostly skin infections. Diabetic wounds in adults, or skin sores and bug bites in children, were the most common denominator. Additionally, the usual antibiotic regimes down south are rendered useless here, as superbugs such as Methicillin-resistant Staphylococcus aureus (MRSA) rates are well beyond 30%. For children, this meant frequent painful injections with a long-acting antibiotic to prevent acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Holding these children down while they cried in pain was very difficult indeed, but something that I had to get used to. Despite our ongoing efforts, ARF and RHD here have the highest prevalence rates in the world, and during my time in Bamaga I saw several cases of ARF including the kidney complications that come along with it, and plenty of RHD.

There are also many environmental dangers present. Toward the end of my placement in Bamaga, a young patient passed away from a fatal box jellyfish sting while fishing nearby. It was the first jellyfish fatality in Australia in 15 years, with the last one also from Bamaga. I dared not step foot in the water for the entire time I was there because of this.

Despite its highlights, this placement was the most difficult I have been on thus far during my six years of medicine. This type of medicine is not for the faint-hearted. With the endless rain, roads up the Cape flood and become impassable, and flights into the region are often cancelled making the feeling of isolation and remoteness more apparent. For much of the placement, I experienced significant isolation and loneliness. I found that becoming connected with colleagues and the local community was vital to surviving in such remote places.

Meagan at the Top End
4WDriving on Thursday Island
Thursday Island Dirt Track
Left: Meagan at the most northern point of the Australian continent. Right: A 4WD drive is a must on many roads during the wet season.

To future students

To future students considering a placement here, I recommend it for the amazing medical experience and breathtaking landscapes. However, to best enjoy Cape York and avoid cabin fever, a visit in the dry season would be ideal, and a 4WD is a must. Without a good car or dry roads, there is little chance of getting around, and one risks going a little stir-crazy! On Thursday Island, switch out the 4WD for a boat!

In the future, I wish to pursue some locum work in remote medicine to fill health care gaps, and I have an interest in general practice and rural generalist roles. I would love to work in a well-connected regional location with outreach services available where I can strike a balance between filling service needs and my lifestyle, which is so important.

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