Spinifex Health Services is a community controlled clinic providing health and community services to a remote community in Western Australia. The clinic has two registered nurses, an aboriginal health practitioner, two trainee aboriginal health workers and an enrolled nurse. There is a visiting medical service, negotiated at one month in three, visiting allied health professionals and healthcare specialists.
Our clinic is located in Tjuntjuntjara, an aboriginal community established by the Spinifex people who emerged from the Desert in the 1950s and 60s after the Maralinga lands were cleared for nuclear testing. Some community residents were raised traditionally outside colonisation. They were offered shelter and transported to a mission called Cundelee. When this mission experienced water problems, the Government relocated these residents to a purpose built town 170 kms from Kalgoorlie (on traditional lands).
After many years of heavy violence and drinking the community started a five year trek back to their homelands. They settled in Tjuntjuntjara which is located 670 kms from Kalgoorlie. The community is around 200 strong with traditional ownership (native title) of 55,000 hectares recognised by the Supreme Court of Australia. The settlement is located on the Great Victorian Nature Reserve and is seeking excision so that land tenure can be assured and funding sought for new housing and infrastructure. The land is semi-arid but provides good hunting for the community who still supplement their diet with traditional foods.
This community still retains traditional authority from their elders but as they grow frailer their authority is weakening. The Community Board is strong, however, and has supported a nutrition policy in the store where no lollies or fast food is sold and full sugar drinks are limited. Children are also prohibited from entering the store in school hours.
The types of conditions we see are similar to many remote communities; chronic conditions, deteriorating kidney function, and ear conditions in children. There are also a range of infectious diseases such as cellulitis, cold and flu and diarrhoea. Emergency care for accidents is provided and medical evacuation occurs through RFDS.
Our challenges in getting locum support are finding appropriately trained and versatile health practitioners that can cover children, chronic disease and who can work alongside aboriginal health workers. We also find it difficult to retain locums that are familiar with the community and who the community know and trust. We are very isolated which can prove to be a challenge finding practitioners who are willing to come to such a remote location.
I have worked in Indigenous Health Policy and Programs for many so I was familiar with the NAHRLS program when it was first established. I found this program to be a very streamlined process. The recruitment advisers demonstrated that they are willing to listen to our needs and are flexible in responding to those needs. With the cost of locum support being an ongoing issue, the fact that we do not pay any commissions or fees is very helpful.
There is no doubt that, without NAHRLS, nurses would find it difficult take a break from the rigors of remote practice and receive the ongoing training they need to ensure currency in registration. The community also benefits from having well trained and high quality locum nurses during periods when regular nurses are out of the community. The quality and experience of the NAHRLS locums ensure we benefit both in healthcare service delivery and clinic operation efficiency.
The NAHRLS locum placed at Spinifex Health Services was excellent. They were supported by a handover when they first arrived and an orientation/induction on the first day. The locum has returned several times so I believe they have, and continue to, enjoy their time here.
I will continue to use NAHRLS and I cannot give too much praise to the staff who I have found to be capable, compassionate and professional.