Tennant Creek/Alice Springs Cardiology Clinic
We were in Tennant Creek for three days. Our first day was at Tennant Creek hospital, and the next two were at the Aboriginal Health Centre (Anyinginyi). We flew back out on the Wednesday night to Alice Springs, and then spent Thursday and Friday at the Central Australian Aboriginal Congress.
Each day our setup was quite similar – we would start up by 8am and have patients booked in until 5pm. However, on most days we would finish later than this. The cardiology clinic was set up in a given area of the hospital/health care centre. We’d have three rooms given to us, the first of which was used by Joanna to take a history and ECG and do a physical exam on the patient. The patients would then see Dr Walsh who would do an echocardiograph and then go to see Anne to complete Medicare details and forms. The team has been seeing most of the patients on an ongoing basis, given that Dr Walsh visits Tennant Creek and Alice Springs every few months.
It really was an excellent experience, both from an academic and a cultural point of view. Academically and clinically I had the opportunity to see various cardiac conditions and clinical presentations I would not so frequently see in urban hospitals. It was a good opportunity to take histories, improve my auscultation skills, learn the diagnostic value of the echocardiograph and understand the management of cardiac conditions.
Culturally, there was also a lot to learn. The medical program has provided a lot of information regarding the socioeconomic and health inequities faced by our Indigenous populations, and these were evident in Tennant Creek and Alice Springs. There was a clearly higher level of drug and alcohol abuse, lower health status, decreased treatment compliance, lower socioeconomic status, lower education levels, decreased access to healthcare and poorer living conditions amongst the Aboriginal communities.
There also seemed to be a distinct difference in the priority placed on health, with Aboriginal people giving greater importance to things such as family and community. However, that is not to say that they didn’t care about their health or societal problems. I had the chance to talk to many patients, and many of them were genuinely distressed by the alcohol, drug and crime situation within their communities.
It was evident that the solution to the health inequalities faced by these communities is not going to be a straightforward one. The Indigenous community has been completely displaced from their core set of values and way of life, and the repercussions of that are vast. There are many underlying socio-cultural issues – unemployment, alcohol, drugs, lack of education, lost cultural identity and family structure etc – which will need to be addressed simultaneously for changes in health status and attitudes to take effect.
Additionally, health services and education will need to be provided in a manner which is culturally tailored and appropriate. There is a clear lack of access to healthcare – the fly in cardiology clinic is the only way Tennant Creek and Alice Springs have access to cardiac health care; evidently this will also need to be rectified to gain an improvement in the health status of the Aboriginal population.
The trip provided a good insight into the socio-cultural and health dynamics of our Indigenous population, I by no means completely understand the complexity of all the issues or the solutions, however have really appreciated the opportunity to spend some time there and begin my understanding of the situation. For those thinking about going for the clinic, this experience really is a fantastic one and I would definitely recommend it.
For those that do decide to go – some things you might want to know/ prepare:
- Brush up on cardiology, it’ll help you make the most of the experience.
- Think about and have a read over the Aboriginal health talks we had in the first years of the course, it helps give an understanding of the culture you are going into.
- Go with an open mind – though you might see cultural differences which you don’t understand/agree with, that doesn’t give us the right to judge anyone.
- Have fun while you are there – the team goes out for dinner every night, so you’ll get a good taste of dining in the Northern Territory!
Arti Arora, Stage 3 Medical Student