Island Nurses

by Howie, Leonie; Robertson, Adele;

  Often Adele found herself crying as she drove home in the dark at the end of a long, stressful day. It was like her first six months on the island all over again.

  By now, she and Shannon had shifted out of the nurse’s cottage and were living in their own very small house. The telephone was in the lounge so that it was easily accessible when Adele was on-call, and Shannon began complaining that, because she was always on the phone, he couldn’t make the calls he needed to for the mussel-farming venture. One day, frustrated, Adele phoned Telecom and asked for another line to be installed to the house. It quickly became apparent that the phone rang for him just as often as it rang for her.

  ‘Your phone’s ringing,’ she would say with a smile as yet another dinner or TV show was interrupted.

  The busy—at times, frantic—life we lead often makes us think about the lives of those who had preceded us on Aotea. Adele has been something of a collector of stories and anecdotes of the old-time nurses on the island: locals and visitors have given her snippets of information, and her own research has filled in some of the gaps. Looking at their lives makes us realise that hardship has always been part of the fabric of nursing on the island, although less so as time passes.

  One of the earliest reports of a nurse on Great Barrier Island was Elizabeth Medland (née Stringer), who married Thomas Medland, one of the original farmers on the island. She arrived as a young bride in the 1870s. She was a Salvationist whose vocation it was to provide help to any who required it. The first nurse to be officially appointed to the island as a midwife was Annie Medland, Elizabeth’s daughter, who left the island specifically to train so that she could return and serve the community. She was to be the second of four generations of nurses in her family. Annie was registered as a midwife in 1923. She returned home during the First World War and worked on a voluntary basis until 1929, when we believe she was appointed to the position by the Auckland Hospital Board.

  In 1927, Judy McLean moved to the island to farm with her husband. She had trained at Gisborne and Taihape Hospitals. Their farm was in Nagle Cove, an isolated bay in the northern part of the island with no road access. Just like Annie Medland, Judy worked on a voluntary basis, responding to neighbours and other islanders when called upon. In 1933, she was appointed district nurse by the Auckland Hospital Board, a position she held until 1944 when she and her husband sold the farm and moved off the island. In 1947, she was invested with an MBE for her services to Aotea. Her story is all the more remarkable for the fact that she was married; in that era, women did not usually work after marriage. Indeed, Adele once visited an elderly widower who told her that his wife had trained as a nurse before they came to live on the island.

  ‘Did she work as a nurse?’ Adele asked.

  ‘No, definitely not!’ the man replied, shocked. ‘She was married!’

  Some still remember Judy McLean. They remember her arriving on her horse, beautifully dressed in her riding gear, with polished boots and saddlebags. Her regular monthly trips lasted a week, as she would stay at various homesteads along the way—longer if she arrived at a home where the mother was ill, because she thought nothing of staying a few days to assist with the running of the house.

  Mrs McLean and the early nurses rode to Katherine Bay (one of the last places on the island to get a driveable road) every fortnight—a trip that now takes Adele 25 minutes, but used to take Judy two hours over a very steep and rough bridle track. Judy’s daughter said that she once asked her mother why she was so grumpy when she arrived home from these trips. The next time she went, Judy took her daughter with her on the extremely long and tiring day. They were both grumpy at the end of it.

  In 1937, during Judy’s tenure, there was an outbreak of typhoid fever among the Māori community at Katherine Bay. Mrs McLean stayed with them for a week, helping to nurse those affected and to educate people about typhoid and how to avoid contracting it; the community had thought that the sickness had come about because of a curse. The Department of Health flew in to investigate and to immunise 87 people in the four affected settlements. A newspaper article at the time made much of the heroic exploits of the Medical Officers of Health but made no mention of the resident nurse.

  In 1946, Edna Metcalfe—known to all and sundry as Ted—was the first nurse to be appointed public health nurse to Aotea who did not have a personal connection with the island. She had travelled and nursed extensively overseas before her stint on Great Barrier Island, and she did more travelling afterwards. She and five subsequent nurses were accommodated at Glenfern—also called FitzRoy House—at Port FitzRoy, across the bay from the wharf. Their daily commute involved rowing across the bay to the wharf, or riding up and around the head of the bay on horseback. During Ted’s time, the nurses were supplied with a 1939 Chevrolet, but the roads were such that not all areas were accessible by car. Katherine Bay was still only accessible on horseback. After Mrs McLean, the horses used belonged to the Coopers at Okiwi, of whom Garth Cooper, the Okiwi telephone exchange operator, was one. A vehicular road finally reached Katherine Bay in 1956.

  The fifth public health nurse on Aotea, Muriel, started in 1948. She was given a farewell by the community at Port FitzRoy the following year—only to return a short time later married to Laurie Curreen, who farmed at Awana. The locals thought this was both hilarious and mystifying: on an island where everyone more or less knows everyone else’s business, they had not seen that one coming at all. There had been speculation, but in another direction completely. Adele actually knew Muriel, and attended when, in her eighties, she passed away in the presence of her daughter (also a nurse) and son, at home. Driving through the Awana valley, she still finds herself looking for Muriel in her wide-brimmed hat with a basket, collecting wild mushrooms from the farm paddocks.

  Phyllis Wharfe, the ninth nurse, held the position on the island from 1953 until 1958. Although Miss Wharfe had a car, the roads were unsealed and there were still twenty gates to open on her journey the length of the island. She made regular, three-month visits aboard a naval vessel, HMNZFA Endeavour, to the lighthouse families on the Cuvier and Mokohinau islands. Miss Wharfe was held in very high regard by the people of Great Barrier Island, and the feeling was mutual: she told a newspaper that ‘the people on the island are extremely hospitable and cooperative, and in cases of serious sickness or accidents will do everything possible to assist the nurse. Their launches, rowing boats and horses are at the nurse’s disposal at any time the need arises.’

  Phyllis Wharfe took a keen interest in the dream of young Grace Benson (née Medland), who was inspired by her family’s involvement in nursing on the island and also by her admiration for Mrs McLean and Miss Wharfe. In 1954, Miss Wharfe took Grace along when she walked to Whangaparapara from Claris (there was a slip on the road) to visit a family living near the whaling station. When Grace left the island in 1956 to train as a nurse, Phyllis kept in touch with her, and in 1959 sent her a white handkerchief to mark her graduation.

  The nurse’s cottage was built between the wharf and the shop at Port FitzRoy in 1956 by Harry and his brother Chris Ngawaka, and it is still in operation today. In 1989, when an upgrade of the septic tank system was contemplated, Adele received a phone call from her superiors in Auckland asking her whether it was possible that the Auckland Hospital Board did not own the land where the house was situated. The best information they had been able to find seemed to suggest that it had belonged to the Forest Service, and was therefore now owned by the Department of Conservation.

  Adele laughed. ‘It’s totally possible,’ she said. ‘They were simpler times. Government departments talked to each other in those days, and they actually cooperated. I can imagine the Department of Health talking to the Forest Service and saying, “We need to build a clinic for the Great Barrier Island nurses”, and both agreeing on a suitable site. It would have just been “government land”.’

  That struck her as typical of Great Barrier Island. So, too, did the fact that, when the nurse’s
cottage was upgraded after the Community Trust took over ownership in 1994, it was Harry’s son Opo and Harry and Chris’s nephew Aaron who performed the work.

  There was a high turnover of nurses once Phyllis Wharfe left. Some are remembered kindly; others less so. There are many stories. Adele was told of a close predecessor of hers, a colourful nurse who also had her pilot’s licence. None of the locals were game to fly with her because she also rode a motorbike.

  ‘If she flies like she rides,’ they would say, ‘no way am I getting in an aeroplane with her!’

  In 1991, Nancy retired. This was a wrench: she was such a support for both of us in our early days, and even now we regard her as a mentor. But she was replaced as part-time public health nurse based in Tryphena, at the southern end of the island, by Peter, who transferred from the public sector to become Aotea Health’s first bona-fide employee in 1994. He joked that he thought being in management was a bigger risk than being an employee, so he chose to become an employee. He has been a stalwart of our health team ever since. His official title is rural nurse specialist, and his role encompasses community mental health and emergency specialities along with the usual range of regular health-centre clinical work that we all perform.

  When he is not nursing, Peter farms a 115-acre property at Taylors Bay on the southern side of the entrance to Tryphena Harbour—the scene, incidentally, of one of the Barrier’s more notorious claims to fame due to a murder that happened there in 1886. A settler known as ‘Tusky’ Taylor farmed there and was killed by a man who arrived with the avowed intention of abducting his daughter, Elizabeth. Elizabeth evaded him, and the murderer and an accomplice were eventually caught in Sydney, then tried and executed in Auckland.

  When Peter first arrived, the wild cattle that frequently emerged from the bush and crossed his land kept his family in meat. Nowadays he has orchards and his own livestock that he farms over his predominantly bush-clad land. Peter is a gifted storyteller and enjoys regaling us with snippets from his life. From his pig-story repertoire, the most memorable ones describe his relationship with ‘Feral Cheryl’.

  Peter first met Feral Cheryl when he and his partner, Wendy, were driving home from the health centre in Claris one Christmas Eve. As they were driving up Medland Road, he rounded a corner and spied a small wild piglet foraging at the roadside. He braked hard and pulled off the road.

  ‘I’m going to catch that pig,’ he told Wendy.

  He jumped out of the car and, as the piglet ran off, he gave chase, staying on the seaward side of the road. To his right the road fell away into dense scrub, and that is where the piglet wanted to be. The road on its left-hand side cut into the hillside, and so the piglet was forced to run along the bank with Peter pelting along beside it.

  He saw the moment at which the piglet decided it was not going to outrun him. Instead, it tried scrambling up the steep bank, but quickly realised this was futile. So instead, it rounded on Peter, growling and snapping. Peter grabbed the piglet and carried it, squealing and wriggling, back to his car. Wendy was none too keen on it—and less keen when she found it was covered in lice—but Peter soon won both Wendy and Feral Cheryl (as he named her) over to the idea of having (and being) a pet pig. Over the next three years, he kept us entertained with stories of Feral Cheryl’s exploits. We even have a photograph on the team noticeboard from the early days that showed him fast asleep in a favourite chair, with a tiny piglet on his lap, also fast asleep, with its wee snout in the air.

  Later in life, of course, Feral Cheryl grew to be a gigantic sow with a capacity for eating everything and anything.

  The next addition to Aotea Health’s payroll was Peter’s partner, Wendy, our part-time receptionist at the community health centre in the middle of the island. Wendy was a retired psychiatric nurse with an excellent grasp of office management, an understanding of medical confidentiality and amazing people skills. She fitted the role perfectly. Over time, our administrative and support staff has increased, but Leonie remembers just how luxurious it seemed to finally have someone else to act as the first point of contact with our patients, even if it was only for a few hours a week.

  Of course, by 1997, the real need was for an additional general practitioner. Ivan had by now been working as the island’s sole GP for nearly sixteen years, on-call 24 hours and seven days a week. We often talked about how good it would be to recruit another doctor—especially if that doctor were a woman, so that we could offer a choice to the islanders. But we had no accommodation to offer, and the finances would only allow for a very small part-time position.

  Ivan and Leonie have a deep Christian faith and proposed that they would pray for a doctor to be sent to the island. After waiting some time, Adele suggested that we might have to be a bit more proactive and advertise. The Howies had planned a holiday, so it was decided to defer the discussion until their return. It is fair to say, though, that Adele wasn’t holding her breath.

  Then one day, shortly after they had left and Adele was looking after the reception while the receptionist was off at lunch, a woman walked in.

  ‘Hello,’ Adele said. ‘Can I help you?’

  ‘Hi,’ the woman answered in an English accent. ‘I’m a doctor—a general practitioner—and I’ve just moved to the island. I was wondering if you would have any work for me. I can only work one or two days a week, but, well, I thought I would ask . . .You know, on the off-chance.’

  Adele realised she was staring, open-mouthed.

  She couldn’t wait for Leonie and Ivan to get back to give them this amazing piece of news. Sarah subsequently worked with us, part-time, for five years.

  For the islanders, one of the changes we have been able to make since the health reforms and the creation of Aotea Health is being able to place a rural lens over all our contracts and any policies that come our way. Using the islanders’ experience, we have become skilled at identifying and hopefully rectifying potential pitfalls. Through this lobbying, our team now includes two full-time general practitioner positions. Previously, there was little chance we could have attracted doctors to the island, because it would take a special sort of person to accept the crushing on-call load that the sole-charge GP shouldered: so far as we could tell, Ivan was one of a kind. Similarly, while we knew we had become adept at wearing many hats as nurses on Aotea, we were quite chuffed to see how many scopes of nursing practice our contracts covered: a ‘rural nurse’ on Aotea is a practice nurse, a district nurse, a public health nurse, a palliative care nurse, a child health nurse and a school nurse. Creating Aotea Health has enabled us to share the load with other nursing members, who work on a part-time basis but still carry an on-call load. And of course, all good health teams rely heavily on administration staff and Aotea Health is no different: we have been lucky in our loyal team members. Not that we have been able to put our feet up! The two of us remain full-time rural nurse specialists and rural midwives, in addition to our management load.

  We all belong, all of us part of the community in which we work. For some, personal career changes and shifting family needs have necessitated moves back to the mainland. These nurses and doctors remain in touch, still interested in the island and its people. There is something about Aotea and what you are part of when you work here—involved in the islanders’ lives from cradle to grave—that leaves its mark.

  The Great Barrier Island Community Health Trust has stood beside us all the way, providing the nuts and bolts to keep our service running with well-maintained buildings and vehicles for us to lease. Expensive medical equipment materialises from tireless fundraising and ensures that we no longer feel we are attending emergencies with a Band-Aid.

  We have also come a long way since Adele was first responder to the car off the road at Kōtuku Peninsula. Emergency care services on the island have evolved, too. The Ministry of Health and ACC commenced a scheme known as PRIME (Primary Response In Medical Emergencies) to facilitate improved pre-hospital emergency care in rural New Zealand. Successive island
doctors and nurses have received specialised emergency training. And whereas the New Zealand Police—most of the time, the sole-charge Great Barrier Island policeman—used to provide the ambulance service, for the last five years St John have joined the island’s emergency team, operating as a First Response Unit and providing ambulance support. An experienced St John manager came to live on Aotea and offered to set up a service to complement the health team. He himself has retrained to paramedic level and is extremely competent, and, following his lead, some of the locals have volunteered and become skilled practitioners too, moving up through the ranks. It is encouraging to see the long hours of training they invest in helping their fellow community members. This collaborative emergency team approach can also involve the police, the Great Barrier Voluntary Fire Force, the Coastguard and the Civil Defence team. All have been staunch in their ongoing support, dealing with emergencies together in the time-honoured Barrier way—part and parcel of island life.

  All the same, and with all the latest and best procedures, personnel and protocols in place, the Barrier sometimes has a way of making events dance to the beat of its own, unique drum.

  It is the Christmas holidays, and Jill’s two older sons are over on the island, as they usually are at this time of the year. Jill tells Leonie that they love making the most of everything the Barrier and their bay has to offer. This year the eldest has brought his pregnant wife.

  ‘Oh?’ Leonie’s ears prick up. ‘How pregnant?’

  It turns out she is only a little over 26 weeks along, but Leonie does not relax. She knows from experience that, the moment you take such things for granted, they have a habit of setting you straight. She often hears people—locals and visitors alike—sigh, ‘Oh, everything will be fine. It is only the early days of the pregnancy and there are midwives on the island.’ Their blind faith in our services has a habit of backfiring when an emergency arises and it is the middle of a foul night when aircraft are grounded.