Remote medicine:
What I’ve learned as a JMO during COVID-19

This little snapshot of my time in the Pilbara highlights how the isolation of Australia’s remote communities became simultaneously an advantage and vulnerability.
Walking off the plane and quickly removing layers, Port Hedland welcomed me with a thick wall of warmth. A week prior, I had packed 10 weeks’ worth of belongings, excited for a brief respite from the Perth winter.

Now, due to COVID-19 and a state-wide JMO term ‘freeze’, I was heading into five months of heat and the unknown.

While some may have been disappointed about our original job description being extended to twice the length, as an intern with aspirations set on rural generalism, I was surreptitiously grateful for the chance to spend a longer time at a country hospital, albeit during the peak of a global pandemic.

For me, a large appeal of a country term was the chance to integrate into the community, and learn about local Indigenous languages, country and culture.

Equally, I had hoped to fully immerse myself into the sporting, camping, and fishing scene of my new town. With social distancing restrictions in full force as I arrived in the Pilbara, weekends and after-work free-time was instead spent isolating inside under the aircon. Dinner at the local pub with new colleagues was no longer a bonding opportunity, and my only exploration of beautiful Kariyarra country was limited to my daily run along the ship-scattered coastline.

Nevertheless, well aware of the challenges that were currently being faced across the globe, I was exceedingly grateful to be isolated in such a safe and majestic part of the world.

“Western Australia’s country health system was faced with unique challenges”

The safety afforded by geographical isolation didn’t come without expense.

Western Australia’s country health system was faced with unique challenges in order to ensure the best care was provided to patients, while navigating the complexities of quarantine and isolation.

To decrease the risk of COVID-19 spreading to vulnerable desert populations, surrounding Indigenous communities were closed to all visitors.

This meant that Allied Health and other specialty services were no longer able to visit to provide valued care. Additionally, patients from such communities returning from Perth were forced to isolate prior to reuniting at home with their loved ones.

With social distancing restrictions, funerals and sorry time were put on hold, forcing large families to wait many months before they could say goodbye in a culturally appropriate setting.

Every decision to transfer a patient to Perth was coupled with a conscious risk assessment about how this management would affect their quality of life, and the health of those around them.

As a future general practitioner, these experiences have taught me the importance of advocating for and protecting rural patients; considering the fine balance between medical and social-emotional wellbeing when providing care.

Dr Jess Piggott is a FGP Ambassador in Western Australia and intern at Royal Perth Hospital. She comes from a rural background, and has her sights set on becoming a rural generalist somewhere at the top of Australia. She likes swimming in gorges, mangos and BBQs with friends, and hopes to combine the GP life with all of the above.

Images thanks to and Nick Dunn.