Articles and Case Studies

My Rural Elective - Broken Hill Base Hospital

13 Jun 2014

As a young Melbournian, Broken Hill is a place I had only heard of from watching Mad Max and Priscilla Queen of the Desert. But when I searched The Electives Network and read the reviews for rural Australian hospitals, Broken Hill in NSW stood out for its connection with the Royal Flying Doctor’s Service (RFDS), which has a regional base there. So I contacted the University of Sydney Broken Hill Department of Rural Health and arranged my elective. I was allocated to the Paediatric department – it wasn’t my first choice, but it ended up being a fantastic placement regardless!
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Getting to the quaint country town

I started getting nervous in the few weeks leading up to my elective. I had never travelled alone for two weeks, let alone in remote Australia! I split the nine-hour drive over two days, which gave me the opportunity to spend a couple of nights in beautiful Mildura, situated on the Murray River at the border of VIC and NSW. The drive itself was an incredible experience – driving along single lane highways through red desert with nothing but shrubs and wildlife to break the view; passing through tiny towns wondering how they manage to stay afloat with so few inhabitants, so far away from the cities.

Upon arrival, I was first struck by the realisation that Broken Hill was much larger than I had expected. Not a small country town by any means, Broken Hill is a sprawling regional centre, with suburbs spread out around a central mine. The town centre is quaint, with beautiful old buildings occupying much of the main street. To my delight, Broken Hill had all of the comforts I was accustomed to, including both Coles and Woolworths, a branch of my gym and air conditioning! But that’s not to say that my placement there didn’t give me a true rural experience. It’s incredibly sobering to be aware of just how remote you are, and that you would have to drive almost six hours to reach the nearest city (Adelaide). I was surprised to find that many of those living within Broken Hill itself lived suburban lives. However, those visiting Broken Hill for work, shopping and health care came from far and wide, from remote townships with tiny populations and minimal services.

At the Broken Hill Base Hospital

The Broken Hill Base Hospital is moderately sized and similar to metropolitan hospitals. The University of Sydney provided a comprehensive orientation for me and the other students starting placement at the same time, which included a tour of the town, a visit to the RFDS and a tour of the hospital. The Paediatric department consisted of a ward of around six to eight beds, a single resident who rotated from one of the major Sydney hospitals and a 24/7 on-call locum paediatrician who rotated weekly. The resident arrived the same day as me, so together we started to work out how the hospital and town operated. It was lovely working closely with a new resident who was like a mentor medically, but equally lost geographically. Each morning the locum and resident did a ward round and then held an outpatient clinic. There were only three inpatients during my two-week stay (quiet compared to the busy general wards!) – but they were interesting patients, giving me the opportunity to learn about medical conditions as well as communication skills, particularly with Indigenous patients and families.

The outpatient clinics hosted a range of patients – many with behavioural and developmental concerns, others with medical complaints, many for follow-up. It was intriguing to see the way that the locums worked, trying to track patients over time as they rotated to Broken Hill once a month or less, and trying to piece together information gathered by different doctors in between. Many patients travelled a long way to visit the Paediatrician, and had much further to go if they needed other specialist input.

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A day out with the RFDS

For one day during my elective I was able to fly out with the RFDS. I was allocated to attend a fly-in clinic in Ivanhoe, a miniscule town with a health service run by a couple of nurses and visited by the RFDS. Ivanhoe is a long drive from Broken Hill, but just a 20-30 minute flight. The small plane carried only around six people and was full with staff going to different clinics. As the only medical student, I was unceremoniously told that in case of a medical emergency where a patient needed to be flown out to Broken Hill, I would be left behind to wait to be picked up by a RFDS car! Thankfully, there were no medical emergencies! Having had the exciting experience of sitting beside the pilot for the flight, I arrived in Ivanhoe and attended the most varied clinic of my life, where young and old patients with a multitude of different conditions came to see the fly-in doctor. The building was old but clearly much loved by the generous and friendly staff. It was a fantastic experience to see how remote medicine is practiced, and the compromises people have to make when they live so far away from the care they may require.

Getting to know the town

All in all, my elective in Broken Hill was an eye-opening and wonderful experience. It was January so the temperature was high, but I found it oddly enjoyable as it was a far dryer heat than in Melbourne where the summer is humid and uncomfortable. I was lucky to have a quiet ward which allowed me to take some time to explore the town, and to be staying with a group of wonderful healthcare students in a well-kept share house provided by the University of Sydney.

We had a great time visiting just a few of the 30 over museums and galleries, including the Pro Hart gallery (where we met his wife!), the Regional Art Gallery, the Living Desert Sculptures and the world’s largest acrylic painting on canvas at the Silver City Mint and Art Centre. We took a weekend trip to nearby Silverton, where we went on a tour of the Day Dream Mine to find out what life was like for miners 100 years ago, saw the Mad Max Museum, and took the Silverton Hotel Challenge! And best of all, we got to experience some of the local cuisine, including a few dinners out and many visits to the famous Bells Milk Bar and Museum, a genuine 1950s milk bar that still serves amazing milkshakes and desserts!

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In just two weeks I fell in love with Broken Hill and the desert, and enjoyed the challenge of practising rural and remote medicine. I would return in a heartbeat, and strongly encourage anyone seeking an Australian elective experience to consider Broken Hill Base Hospital.

Emma Browne
MD4, University of Melbourne

 

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