Apr 06,2009 00:00
Sharon Whitley Larsen
CAIRNS, Australia — Several years ago, when I was in the outback at Kakadu National Park, cautiously trekking up a rough, rocky hill, enduring searing heat in the middle of nowhere with Warren Djorlom, my barefoot Aborigine guide, I remember thinking, What if I fall and break an ankle? Or, even worse, am bitten by a poisonous snake? How could I get help?
Thankfully nothing happened.
I learned later that, God forbid, had I had an accident, there would have been emergency treatment available. Even there, in the middle of nowhere.
For the past 80 years, thanks to the charitable Royal Flying Doctor Service — the first, largest and most comprehensive aerial medical organization in the world — tourists and residents alike can be treated throughout isolated parts of this vast country for serious illnesses and accidents. That can include car accidents (the No. 1 response call), broken limbs, heart attacks, strokes, burns, sheep-shearing accidents, complicated childbirth — even crocodile attacks!
Recently when I was on a Royal Caribbean cruise from Sydney to Cooktown, I opted for a shore excursion to tour the Royal Flying Doctor Service Visitors Centre (one of several in the country) in Cairns. I was intrigued to see what it was all about.
I learned a lot — especially from watching an interesting, short video called "A Day in the Life of The Flying Doctor" — peering inside a 1977, medically equipped Beechcraft Queen Air aircraft on display — and perusing the artifacts, which included newspaper clippings, letters, photos, and equipment.
"You need to be very self-sufficient if you're going to live in a remote area," explained our guide, Lyne Hortin, as she showed our little group a metal medical chest with more than 90 essential pharmaceutical items and supplies, each numbered for clarity. These chests, introduced to outback stations in 1942, are a vital tool to be used only with instructions from an RFDS medical officer over the phone or radio.
More than 3,500 of them are strategically placed as the first response for emergency treatment, until medical personnel can arrive for victims throughout remote Australia — which can include mining camps, cattle stations, and Aboriginal communities.
Also included in these chests, and on display, was the famous diagnostic Body Chart, drawn by Sister Lucy Garlick in 1951. With the body numbered by sections, a doctor in contact by radio or phone could ask a patient to tell him by number exactly where the pain was. I also saw the Traeger Pedal Radio, which provided communication in the early days, making the RFDS possible when it was begun in 1928 by the Rev. John Flynn, a Presbyterian minister.
In 1911, at age 31, he had started his ministry by doing missionary work in remote, rural areas, even traveling via camel in the outback. He was saddened and helpless to see seriously ill or gravely injured people unable to get desperately needed medical care. Back then things were especially desolate and primitive.
In the early days, it would take a nursing sister or doctor all day to travel in the unbearably hot sun 100 miles to tend to a seriously ill child or accident victim. Today, that same distance would take only minutes by turboprop!
It wasn't until 1917, when a tragic case gained national attention, that the urgent need for a flying doctor service was realized. In the Kimberley, Western Australia, a 29-year-old stockman, Jimmy Darcy, fell from his horse, incurring serious injuries. A nightmare ordeal ensued to get him medical treatment. It took 12 agonizing hours to transport him just 45 miles to a telegraph station, where the postmaster, F.W. Tuckett, had taken a first-aid course. But all that could be done for Darcy — besides giving morphine for the pain—was summon, via telegraph service, Dr. John Holland from faraway Perth.
Over the next seven hours, Holland, with the help of the Perth telegraph office, was able to diagnose a ruptured bladder and relay instructions to postmaster Tuckett — 2,000 miles away — how to perform the emergency surgery. And that was done with no anesthetic, just morphine — and with a pen-knife and razor! Although deemed successful, complications later occurred, and Holland journeyed to the patient to provide further medical treatment. Traveling 10 exhausting days — via cattle boat, car, horse and foot — Holland arrived too late: Darcy had died the day before.
The story received outraged nationwide attention. Flynn, among those who crusaded for better, faster medical treatment, coincidentally had received a letter from Lt. Clifford Peel, a young medical student in World War I with an interest in aviation. Peel had proposed the idea of using airplanes in the remote areas to provide medical help. (By 1920, Qantas Airlines had started service — adding to the idea and definite possibility of successfully merging medicine, airplanes, and the primitive Australian rural lifestyle.)
After Darcy's appalling incident, it took Flynn another 11 years of collecting other horrifying medical stories, traveling, writing impassioned articles, giving speeches, and persevering until ultimately a flying doctor service was launched. In 1928, when he was 48, Flynn was appointed the first superintendent of the Australian Inland Mission of the Presbyterian General Assembly. (He later had an aircraft named for him, and is featured on the Australian $20 bill).
The first flying doctor, Kenyon St. Vincent Welch, took off with pilot Arthur Affleck on May 17, 1928, in a medically equipped aircraft, a Qantas DH 50A named "Victory," to perform two surgeries. During the first year, there were 50 emergency flights, with 1500 miles flown. At least four lives were saved, with 255
With the airplane service — later known as RFDS — beginning in these remote areas, transportation was not the problem, but communication was. How would people in the bush — with no telephones or radios — be able to summon emergency help?
In late 1928, Alf Traeger, a brilliant electrical engineer, invented the pedal radio, hooked up to a Morse code machine, that was inexpensive and easy to use. It also provided social communication for lonely, isolated, depressed residents in the rural areas.
"It was like an early form of e-mailing," noted our guide Hortin.
And today, of course, satellite phones and the Internet have revolutionized communication. Currently covering a distance of more than 4 million square miles, the RFDS, with a staff of 772, and with 27 bases all over massive Australia, continue to carry out Flynn's vision. Thousands of health clinics throughout the remote areas are staffed by visiting RFDS medical teams, who offer a variety of health care, including dental, vision, preventive medicine, and childhood immunizations.
They educate patients about nutrition, diabetes prevention; conduct cancer screening; offer cholesterol checks and counseling services. Some 40 percent of the patients are Aboriginal. During 2007-2008, more than 261,000 patients were tended to by the RFDS, including over 35,000 evacuated on a fleet of 50 planes (which include Beechcraft King Air and Pilatus PC-12 aircraft), with more than 14 million miles flown.
"I hate to think of what would have happened if the flying doctor hadn't been here," said Joanne Ratsch of Mount Gambier on an RFDS video, whose two children were prematurely born at just 26 weeks and are doing well today.
"They really are a godsend," added another grateful mother.
The RFDS, with a heroic medical staff, is supported by government, corporate, public and private sectors.
"There is no charge for Australian citizens for emergency evacuations," explained Kerrie Smith of the RFDS National Office in Sydney, "although we do attempt to recoup money from private health insurers. Medicare pays for medical appointments. In regard to overseas visitors, their travel insurance covers costs and we have a reciprocal arrangement with some countries."
Available year-round, every flight — whether to assist a heart attack victim at a remote camp or to attend to a car accident on a lonely dirt road — not only has the latest medical equipment, but the staff includes a doctor on the more serious calls, and nurse. Rotating on call 24 hours a day, seven days a week, they can suddenly be contacted while at home or grocery shopping but, once alerted, they hop to it. Generally they can reach an emergency within two hours.
It's not rare in the outback to have to shoo kangaroos from the airstrip to take off — or to land on a pitch-black night, with a road or airstrip lit by a line of car headlights or kerosene flares.
"We have the best office in the world, at a scenic 30,000 feet," noted one doctor on a video. "And we get to do our job as well."
IF YOU GO
Royal Flying Doctor Service: For further information, including locations of the 10 RFDS Visitors Centers in Australia: www.flyingdoctor.net/ or www.flyingdoctor.org.au (Click on "Cairns Visitors Centre")
Sharon Whitley Larsen is a freelance travel writer.Copyright 2009 Creators Syndicate Inc.