“I see a large part of my role is to help health work­ers be real­is­tic and to have sen­si­ble expec­ta­tions,” Kirsty says, reflect­ing on her role facil­i­tat­ing CRANAplus’ Remote Emer­gency Care, Advanced Life Sup­port and Pae­di­atric Emer­gency Care courses.

“When I first went remote I had no idea. I signed up with an agency and thought I could do every­thing that would come to me. ​‘You might find it a bit dif­fer­ent’ I was told. This was a major understatement!”

From Aus­tralia to Africa and back again
Kirsty’s ini­tial move to remote health was part of her plan to work with Médecins Sans Fron­tières (MSF). In 2004 she went with MSF to Dar­fur in Sudan.

“It was for three months – and felt like three years,” says Kirsty.

Much of the work was with mal­nour­ished chil­dren. Kirsty was involved in pro­grams includ­ing a feed­ing cen­tre where moth­ers brought in chil­dren to be weighed and treat­ed, and to receive a ration of food. In anoth­er pro­gram, moth­ers would walk for two to three days to come to a ​‘blan­ket feed­ing’ to receive oil and flour to help feed their children.

“When I returned to Aus­tralia, I thought Indige­nous Aus­tralia – unfor­tu­nate­ly – is in just as much need. It’s a dif­fer­ent need but still demand­ing and chal­leng­ing,” says Kirsty.

This saw her start work­ing in Wad­eye in the NT.

“I worked there for years and loved it. The peo­ple are love­ly and the friend­ships you make with peo­ple you work with are total­ly dif­fer­ent from work­ing in a city. I learned a lot about kids very quick­ly and loved work­ing with them.”

Kirsty has also worked in com­mu­ni­ties such as Ten­nant Creek, Light­ning Ridge and Jabiru.

She also vol­un­teers with Pangea Glob­al Health Edu­ca­tion in Malawi in South­ern Africa, and with the Aus­tralian Resus­ci­ta­tion Coun­cil teach­ing an Advanced Life Sup­port course.

With her train­ing in inten­sive care and mid-wifery, Kirsty was sought out to become a CRANAplus facil­i­ta­tor in 2013, after she had been a par­tic­i­pant her­self in a cou­ple of courses.

Ground­ed in real life

“With CRANAplus cours­es, I want to help peo­ple know what it is they are going out to,” Kirsty says.

“Peo­ple may have an idea that it is roman­tic, that they are going to change the world. That’s not real­is­tic. It can be a slog and, for most of the time, the work is main­ly pri­ma­ry care with issues such as dia­betes and health checks – and then there’s an emer­gency, a car acci­dent or a heart attack, spear­ings in fights or a par­tial evac­u­a­tion of islands in the path of cyclones.

“You’re pulled away from the day-to-day work and you don’t have time for the pre­ven­ta­tive side of health care. You have to be pre­pared for any­thing and everything.

“I like to see the par­tic­i­pants open their minds, under­stand that an iso­lat­ed clin­ic is not going to have all the equip­ment they are used to; realise they have to do more read­ing before they go remote, find­ing out more about dia­betes, for exam­ple, and oth­er ill­ness­es, such as rheumat­ic fever and rheumat­ic heart dis­ease – med­ical sit­u­a­tions that are com­mon in remote set­tings and that you will not see in cities.”

Pae­di­atrics is one of Kirsty’s strengths and one of the skills she is keen to impart through CRANAplus cours­es is the need to be alert for signs of illness.

“Health work­ers in remote sit­u­a­tions need to have the guide­lines, to make sure they don’t miss a sign or an impor­tant step in the pro­ce­dure,” she says.

“A child may be play­ing and look fine but I can see by look­ing at their chest, the child is breath­ing too fast and there could be a res­pi­ra­to­ry prob­lem. If you’re going to work in remote, you need to look for and recog­nise the signs.

“Often it’s obvi­ous to the moth­er that there’s an issue, but not the nurse. The moth­er knows some­thing is dif­fer­ent, but the signs may not present them­selves at the clinic.

“The moth­er brings the child in day after day – and it could be a few days before the signs are obvious.”

Kirsty points out that the oppor­tu­ni­ty dur­ing the CRANAplus cours­es for par­tic­i­pants to share their own expe­ri­ences in remote com­mu­ni­ties is a cru­cial part of prepar­ing health work­ers for the sit­u­a­tions they may face.

“That’s the beau­ty of these cours­es, every­one has their own expe­ri­ences, and we can learn from each oth­er,” she says.

“In a trau­ma ses­sion – a car acci­dent for exam­ple – par­tic­i­pants will tell you their sto­ry, what they had to deal with and how they han­dled it.

“And then there are the occa­sions when you’ll get a report from a par­tic­i­pant after they leave. They’ll per­haps tell you they came across some­one hav­ing a heart attack – and each one will say ​‘thank good­ness I’d done the course and was prepared’.”