Lisa Killian is an RFDS Primary Health Care Nurse based in Broome. She has lived in the Kimberley and central Australia for the past 14 years, working in a variety of nursing roles.
Q. What is your current role and what does it involve?
A. We fly to remote health clinics in the Kimberley on Tuesdays and Wednesdays. Tuesday can be a number of different locations – we visit three small Aboriginal communities and four Gibb River Road locations, including cattle stations. We usually see the staff only, but sometimes tourists arrive with injuries that need treatment. Most appointments are for general health issues, prescription renewals or mental health concerns. The Gibb River Road locations are fun – we are fed home-cooked lunches and have sometimes been transported by a mustering chopper to the homestead because of high water. On those days I have to pinch myself that this is my job.
Every Wednesday we fly to the Yakanarra community in the Fitzroy Valley. If the RFDS didn’t visit, their closest doctor would be at least a 90 minute drive away in Fitzroy Crossing. This clinic is quite busy. Patients can present with anything from ear infections to skin lesions, or needing a blood test for chronic disease screening. We might be giving injections for diabetes or monthly treatment for rheumatic heart disease. We also bring patients their medication each week. Sometimes patients present with acute infections or injuries and can be quite unwell.
Q. Why is Primary Health Care so important?
A. Primary Health Care focuses on preventative health care, early detection and the early management of illness and disease. This promotes wellbeing and reduces the burden of disease on the health care system.
I am hoping one day we can build a Primary Health Care team that includes health promotion, Aboriginal health workers, dental and allied health.
Q. You are a midwife and child health nurse and often care for women throughout their pregnancy and beyond – how rewarding is that part of the job?
A. It is so rewarding and it means the Yakanarra women don’t have to leave their community to have their antenatal checks or constantly re-tell their story to a stranger at each appointment. By building these relationships, the women have healthy pregnancies and we are able to intervene early if complications arise. Knowing I am their constant person also helps them to disclose difficult topics if they need to.
I am also a lactation consultant. Many of the mothers who have had babies in my care have been able to breastfeed which is so beneficial and a preventative for many negative health outcomes. As primary health providers we should be focusing on the first 1,000 days of life - the period from conception to two years of age is such an important foundational period which shapes development and wellbeing.
At 36 weeks gestation the women in this community are sent off for “sitdown“ ahead of their birth and I give them a bag of essentials like nappies, sanitary items, singlets and wraps.
Once they have their baby at Broome or Derby hospital, the women always send me a photo because they know I am so excited for them. Later they know they can text me to ask when vaccinations are due or when their baby needs to be weighed.
Q. The patients at the Yakanarra clinic clearly have a lot of trust in you – how have you created that?
A. As the constant person attending, I can build familiarity. At Yakanarra community, a different doctor attends with me each week. Being culturally appropriate in our care is so important, as well as being non-judgemental.
I also ask community elders for advice. Sadly, last year a child from Yakanarra community passed away from a mosquitoborne virus. I was advised by a nearby Aboriginal organisation that fogging and spraying for mosquitos would interrupt cultural mourning practices, but I could see the fear in the community members about catching the disease. I met with the Yakanarra elders and asked if it would be okay to fog and spray to help prevent further transmission. The elders came to the decision that this was a priority and it would not impact their spiritual and cultural process. The Shire came with us the following week and the mosquitos were eliminated.
Q. What do you love about working in the regions?
A. I think I have the best nursing job in WA. Who else gets to fly to places where everyone is so happy to see you? I am not stuck in an airconditioned office or hospital ward (although when it’s 45 degrees celcius in Fitzroy Valley I’d love some airconditioning), I get to use all of my skills and I am still learning so much. Seeing the landscape from the air change month to month is awesome and the pindan soil reminds me of my childhood in Port Hedland.
