Out of comfort and into the Outback...

By: Felicia Koh

Felicia is a Physiotherapsit working in South Australia. In the below stroy, Felicia speaks about her experience in rural and remote practice.

In January 2006, I arrived in 48 degree heat to begin the challenge of taking on a 6-month locum position as a Paediatric Physiotherapist in the Flinders & Far North Community Health Service (A service of Port Augusta Hospital & Regional Health Service) Port Augusta, South Australia. My position was within the Child Health Team & Women’s Health Team.

Port Augusta has a population of approximately 15,000, 25% of whom are Aboriginal. It is situated at the tip of Spencer Gulf, located at the foot of the spectacular Flinders Ranges, and is widely known as the 'Crossroads of Australia'.

The specific challenge of rural, remote, indigenous and paediatric health each attracted me to the position. My role was predominantly based at the Flinders Terrace Community Centre alongside a multi-disciplinary team consisting of a speech pathologist, occupational therapist, dietician and allied health assistants. Within this team setting, we were able to provide more holistic assessments focused on family-centred practice. I have learnt that a multi-disciplinary setting is invaluable in creating a platform for further learning, development and partnerships across the allied health field.

Part of my job involved regular monthly “outreach” trips aboard the Royal Flying Doctor Service (RFDS) planes, which provided a unique opportunity for our team to service isolated and remote areas. A typical outreach day to Roxby Downs involved an early 7am start, followed by a 45-minute ride aboard an 8 seater plane across barren, dusty red landscapes of open sunburnt land. Upon arrival, the team’s allied health assistant helps to organise our transportation and consulting rooms for time efficiency. It’s a full 2-day outreach trip with clients and health promotional work back-to-back due to the limited health access in remote areas.

Some of my primary health promotional work during outreach involved giving talks about age appropriate play to a group of young mothers, doing a radio talk on the typical development of children’s leg and feet postures and providing information and practical skills for improving the local “Kindergym” program that targets children 0-5 years. 

Managing and supporting children and families in remote areas can be a challenge as access to both consistent day-to-day support and equipment is not as easily accessible. Most specialist appointments and wheelchair or orthotic fittings need to be accessed in Adelaide – a good 6 hours away by road. There are some families who have limited financial resources. I found that being creative & flexible, such as incorporating cheaper home-made play activities was important in supporting these families.

Some of the challenges during my time in Port Augusta included being the sole paediatric therapist without direct day-to-day supervision. However, I have learnt that it is during moments of clinical challenges that confidence, initiative and perseverance are best developed. Some of the important initiatives that I undertook include establishing long-distance mentoring with well established paediatric physiotherapists back home in Melbourne; becoming a member of the APA’s Paediatric Special Interest Group and making contact with local paediatric physiotherapists from Novita Children’s Service and Adelaide’s Women’s and Children’s Hospitals. All my professional mentors were invaluable, as they were able to support me both clinically and personally during my locum period.

One of my on-going primary health care projects called 'Have a Ball' included working closely alongside the team’s dietician to develop a “toolkit” with the aim of improving nutrition and physical activity in children from birth to six years old in Port Augusta. The toolkit included the development of culturally appropriate and easy to read pamphlets on appropriate play and nutrition, home-made play toys such as mobiles, shakers and posting tubs. The project was launched with an initial 8 weeks trial at 'Families SA' and within the hospital’s Child Health Team itself with great feedback for further development. Through the process of working on this project, I have realised that physiotherapists need to play a greater role in primary health care and in being more active health ambassadors within our own local communities.

Aside from all my professional growing, I was able to experience many other facets of living in Port Augusta, such as watching a live rodeo, fishing and crabbing in the Gulf, walking and hiking trips through the Flinders Ranges and camel riding through the outback. The slower paced lifestyle also gave me the opportunities to step out of my comfort zones by taking on more extra-curricular activities such as learning to sail, attending Spanish and painting classes and singing in an a’capella choir. I also enjoyed being a part of the local Aboriginal church as it gave me the opportunity to embrace more of our indigenous culture. I fondly recall the sacred Dreamtime stories that were shared with me and the patience taken to help me understand more about the continued challenges and complexities that face our Aboriginal people, both on a social and health care level. Together, these experiences have added to my appreciation of country living, the Outback and being Australian.

The Outback is a place rich and unique in its culture, spirituality, scenery and peoples and I would strongly encourage anyone with a sense of adventure to take up the challenge to spend some time in this setting. I am a now a strong believer that inexperience should not be seen as a barrier, but rather as a hurdle to be overcome through motivation and dedication. Working as a paediatric physiotherapist in the Port Augusta enabled me to embrace both my career and my personal life to a very full & rich degree.