Getting out of the Office
Filled with a sense of adventure, and a love for challenges, Murmur meets two young doctors who share their experience of a recent Prevocational General Practice Placements Program (PGPPP) in the Northern Territory.
Dr Jessica Reagh
A Junior Medical Officer in Sydney and originally from Vancouver, Canada, Jessica Reagh landed in one of the most isolated of the major Arnhem Land communities, Numbulwar for her PGPPP.
“The exposure to unfamiliar and challenging medical conditions was one of the most beneficial outcomes of my placements,” says Jessica. “There were complex diseases that I had never seen before, like Rheumatic Heart Disease (RHD). In medical school I had only ever seen 3 patients with RHD and had never seen a patient in the early phase of rheumatic fever. While on placement, my Supervisor and I diagnosed one new rhematic fever patient, who was subsequently sent to Darwin.”
“In terms of awareness, most of the community in Numbulwar knew about other family members who had had a valve replacement. They’d see people leave the community, and come back with a large scar down their chest. Most also knew about getting monthly penicillin injections for RHD prophylaxis.”
“The clinic staff were on top of tracking down patients for their monthly penicillin injections; however it could be a challenge to find them. Patients varied in their management of RHD – some were very proactive, but others needed constant reminding and chasing.”
Dr Iyngaranathan Selvaratnam
Completing his internship at Alice Springs Hospital in 2009, Dr Iyngaranathan Selvaratnam followed his yearning for tropical waters and Indigenous peoples, to the North-East Arnhem Land township of Galiwinku.
“I don't think the realities of Rheumatic Heart Disease (RHD) really hit home to me until I worked on Elcho and started managing patients in the community with it. In the hospital it's difficult to appreciate the social realities of this disease.”
“I was fortunate enough to spend time with the Chronic Disease team on the Island when they did their monthly Bicillin run to administer RHD patients their prophylaxis at home. Hunting down patients for any recalls on the Island would involve trips to multiple houses, outstations or even the beach using second hand information, speculation and gossip to figure out where an individual might be. The Aboriginal Health Practitioners (AHPs) and other local clinic staff are essential in situations such as this to find patients.”
“Initiatives such as regular Scabies Days go a long way towards raising awareness and reducing the incidence of scabies and associated pyoderma in the community. During Scabies Day we would try to visit every house in the community and hand out Permethrin cream en mass, and residents would be encouraged to wash and air all their bedding in a very public display, with prizes being given to the most proactive households. “
“My philosophy of what medicine is really about was reinforced on Elcho. For me, it is about understanding your patient in all their facets, sharing in their hopes and dreams, and helping to make them a reality.”