by Paula Heelan
The young married couple moved into Medway, a 20,500-hectare cattle station near Bogantungan, west of Emerald and just below the ridge of the Great Dividing Range. ‘When we married we were part of a big Donaldson family partnership and Robert’s father ran all the family properties. I continued to work five days a fortnight at Alpha.’ Just over a year after they married, Rob and Gayle had their first child, Laura in 1994. Gayle was 27. ‘I took maternity leave and when Laura was nine months old I fell pregnant with twin boys. That was a surprise. By this time you couldn’t have your first baby in Alpha, so Laura was born in Emerald and with early twinges I was sent to Rockhampton at 32 weeks to wait for the twins. Sam and Hastings arrived naturally and without complication and weighed over seven pounds [3.1 kilograms]. This was the practical component of midwifery. I returned home with three children under two. I’m sure I’m a more compassionate midwife having had my own children. I remember things I said to expectant mothers when I was 22 and think gosh, it’s a wonder they didn’t deck me. I’d say, Now come on, it’s just that burning feeling, just push through it. Yes, it’s a lot more than a burning feeling.’
Gayle returned to work at a small clinic in the little town of Jericho when Laura was four years old and the twins were three. ‘I took the children in with me and lived in town during the week. The kids stayed with a family day-care mum during the day and she would even stay on call for me overnight. She’d come at any hour if I was called out. She’d get the kids and I’d go off in the ambulance. It was mad really. Having a babysitter was the only way I could do it and I was determined to work. She was a wonderful girl.’
The clinic at Jericho was almost always busy. The nurse Gayle filled in for said Gayle had the ambulance constantly on the go whenever she came in. ‘One Friday a doctor on duty at the clinic rang me and asked if I could come quickly. I could hear panic in his voice and as I made my way over to the clinic, I was wondering what on earth could be wrong.’ Gayle rushed into the consulting room to find the doctor and his patient (a pregnant woman) sitting on the examination bed with their legs up and looking petrified. They pointed at the fridge. ‘On close examination I found a huge brown snake. It was spring and I guess it must have been hibernating around the warm fridge motor over the winter. The days were warming up and it had clearly decided it was time to emerge.’ It was an unusual situation and caused a lot of excitement. Gayle is used to seeing snakes and they don’t frighten her, but that doesn’t mean she likes to get too close. She got all the patients in the waiting room out into the street and called the local garage man who came over to capture and release the frightened snake.
On another occasion in Jericho Gayle was able to assist a young junior doctor who had just arrived. She was checking a young baby that was fully breastfed. The mum was a first-time mother and had lots of questions. She told the doctor that the baby hadn’t opened its bowels for six days and before that, had gone eight days without a poo. ‘Young doctors were sent to rural areas fresh out of uni and a lot was expected of them,’ Gayle says. ‘Our young doctor was very concerned about the baby and ready to send it on to a bigger centre for further assessment. As a midwife I was able to help out by advising that it was quite normal for a fully breastfed baby to go up to 10 days without doing a poo. The guidelines we go by for fully breastfed babies are that they can poo up to ten times a day or once every ten days. Health care in rural areas really is a team effort. Times have changed a bit now and there is a lot more support for doctors practising in rural areas.’
Laura remembers the trips to Jericho well. ‘Mum would pile us all in the car and off we’d go – we didn’t care, we just wanted to be with her and with each other. We grew up spending a lot of time travelling in four-wheel drives over dirt roads to clinics and hospitals,’ Laura says. ‘I remember on my sixth birthday we called into the Alpha Bakery on the way to Jericho to pick up my birthday cake. We hung around the clinic all day eating cake and doing our school work. We liked going there because the people next door had a really cool treehouse and let us play in it. Mum didn’t have much sympathy for any of us when we got sick. Once I cut my arm open and because we lived too far from a hospital, Mum stitched me up with a Steri-Strip – you know that bandage they use to pull the skin together to close small wounds. I still have the scar.’
Families living in isolated areas form extraordinarily close relationships. And it’s clear the Donaldson family has done just this. Laura said she knew that no matter what sort of day her mother had had, she would still put others first and never let her personal life affect her work. ‘She’s a very compassionate person and gives hours of her time – including voluntary work for bush kids away at camps. At home our phone was often ringing for Mum – and still does. I’d recognise the names of women ringing a lot during their pregnancies or when they had little kids – they’d ring Mum for every little thing to ask her advice. They’d say, Do you think I should take him or her to hospital? And Mum would say, No, it’s just a cold. But if there was something serious going on, she’d be there for them.’
At Jericho, Gayle saw everything from maternity and babies to horse, farming and road accidents. ‘I loved the antenatal and postnatal work. I didn’t like being away from home, but the day care worked for me. Accessing day care in rural areas is often impossible, so I was lucky.’
After a few years in Jericho Gayle was asked to work in the Alpha Hospital again and she signed on for two days a fortnight. Due to the long-distance travel her days are usually consecutive. But it’s unusual for her to only do two days because due to short staffing at the hospital, she is often called on to work extra shifts.
‘I fell pregnant with my fourth child and Bella was born in 2002. When the kids were small I did my child health training externally through the New South Wales College of Nursing. It was mostly theory, reading and assignments and without internet access it was hard. Gaining qualifications and upskilling can be difficult when you live in the bush.’ Gayle is often asked to join a video conference with work via Longreach. ‘I could do it from home, but a three-hour session would be impossible with our extremely limited internet-download capacity. So I have to drive to town whenever something like that is needed.’ In between droughts, fires and floods, it took Gayle two years to graduate in child and adolescent health.
Before leaving home for boarding school, Gayle’s children learned through distance education from their preschool years through to Year 7. It began with Laura in 1999. Gayle juggled work with weekend and night shifts in Alpha, leaving the kids with Rob. ‘I wasn’t a dedicated home tutor,’ Gayle says. ‘Over the years we’ve had nannies, backpackers and governesses to help teach – I’d have to step in if we didn’t have one. Homeschooling four children made life very busy and to cope, we had to be extremely organised. I kept working because I loved it – and I think it kept me sane. Every year we looked forward to a Volunteers for Isolated Students’ Education (VISE) teacher, who would take over the schoolroom for six weeks. We had some amazing teachers pass through our schoolroom.’
Staff at the Alpha Hospital have always been very supportive and child friendly, which was wonderful for Gayle, who sometimes didn’t have the child care she needed. ‘There were times when Robert was away and I’d have to take the kids into the hospital and they’d sleep in there with me. If they were short-staffed when Bella was a baby I would take her in, put her to sleep in a cot, work and then take her home in the morning. One night she was asleep and I had to do an ambulance transfer to Emerald. When she woke up in the morning, she didn’t even know I had gone.’
Gayle’s son Hastings was accident prone, and one day while he was in the outpatients’ waiting room he split his head open. ‘No one knows what happened. There was blood everywhere and we were grateful we were in the hospital and able to glue him straight up.’
One night when Gayle’s shift was almost over and she was preparing for the handover, the front doorbell rang. She assumed it was the night staff arriving. ‘I kept wr
iting and a few seconds later I heard my name being called by a lovely young mother I knew well. Gayle, I need you. Now! I rushed out to find her holding her flat, pale, unresponsive baby. She said, I accidentally gave him rice. He’s allergic to it and this is what happens. I didn’t know the food I gave him had rice in it. She was so distressed.
‘While I was making an assessment the night staff arrived – it was Jody. The baby’s airway was clear and there were no breathing problems, but the poor little fellow was vomiting profusely. He had nothing left in his tummy – he was vomiting coffee grounds [a term for old blood] and there were small flecks of new blood. This meant he had some kind of gastric irritation.
‘Without a resident doctor we dialled Telehealth [a video-conferencing medical service for rural and regional areas] for assistance. A team of doctors from a neonatal ward talked to us and looked at the baby. It was a great help and very reassuring for us. They organised the baby’s hospital transfer. About four hours later a doctor reviewed the baby and the allergy subsided. The mum has since seen a specialist and found the baby has an adverse food reaction involving the immune system, called food protein-induced enterocolitis syndrome [FPIES]. I had never heard of it. I had been seeing the baby since he was born and knew he was having some problems and not steadily gaining weight. It was a relief to know the cause and to be able to turn his condition around.’
Being an outback nurse means having to improvise in unusual circumstances. Being a highly trusted one also means sometimes extending your skills to treat creatures other than humans. One day one of the nurses brought her small dog that had delivered six puppies. ‘A few days post-delivery the dog started having seizures. A common treatment at the time for seizures was Valium, so I gave the dog some, and lots of it. It didn’t stop having seizures, so I rang Rob’s brother, who is a vet in New South Wales. I told him the symptoms and he said the dog had milk fever and the treatment was calcium, not Valium. When I told him how much Valium I had given the dog, he was surprised the poor thing was still alive.’ Gayle had an intravenous line into the dog, so they gave her the prescribed calcium and she stopped having seizures. Mother and puppies all survived.
On a more serious occasion, after a full day of seeing expectant mothers and babies at a midwifery child health clinic day at the Alpha Hospital, Gayle was called out. ‘It was school and university holidays so Laura was in with me doing some “assistant in nursing” work and Bella had come in to play cards with the elderly patients. Laura and Bella drove home about 4 pm and I was finishing up when suddenly Jody burst into the room and asked for our DON [director of nursing], Lea. We have an ambulance call-out to a local property. They’re doing CPR on a nineteen-year-old. We all snapped into emergency mode. Lea and her partner, Michael, grabbed gear and knowing the seriousness Lea asked if I could come along, too.’ With lights flashing and the siren blaring, they reached the cattle station within 30 minutes. On route Lea and Gayle worked through an advanced life-support plan of action. ‘We all knew the people who lived on the property and I prayed the whole way, knowing that was wrong, that it would be a stranger. We got there and tried to revive the patient. Our attempts were unsuccessful and the beautiful young man, who we all did know, didn’t make it. It was devastating. It had been a freak motorbike accident – he hadn’t been doing anything wrong. I had visited this boy and his mother in hospital when he was born. He played footy with my boys. I’d given him his school vaccines. He was a special young man and loved by everyone who knew him. The grief was heartbreaking, and his widespread community fell into mourning. The accident was hard-hitting and changed my view of life. Our boys do the same kind of station work as this boy had done. I hug my kids whenever I can and tell them I love them every day.’
With their beef cattle operation well developed now, Rob is kept extremely busy running Droughtmaster and Charolais cross cattle and Gayle helps out when she’s needed. Nurses tend to get roped into a lot of volunteering for bush events, so the long, dusty road trips are still common for Gayle. Each year she volunteers as duty nurse for the week-long Isolated Children’s Parents’ Association (ICPA) sports camp held for geographically isolated students. Laura says every year at the ICPA camp Gayle is up most nights with sick kids. ‘Then she patches them up during the day from sport injuries. It’s a long week for Mum, but she enjoys catching up with all the other distance education mums.’
Gayle also attended a kids’ camp in Brisbane, which came about at the request of her son Hastings, who attends boarding school in the city. Most of the children at the camp had profound disabilities and Hastings offered to care for a young boy over the week. His school’s older students spent the time helping the children participate in sport and activities and the volunteer nurses were on hand. Not only is it a wonderful week for the children, the caregivers are given a week’s respite. Gayle flew down and loved every minute of her week helping out. ‘Times like this remind me of the fragility of life and the magic of human connection.’
CHAPTER
10
Olivia Bigham
When Olivia Bigham arrived in Benin, West Africa, a Mercy Ships’ staffer was there to meet her. She had changed into her Mercy Ships T-shirt on board the plane from Paris so that she was identifiable when she walked into the airport. Olivia had arrived to work as a volunteer nurse on the floating hospital, the Africa Mercy. Inside the airport she met two other young people wearing the same T-shirts, and like Olivia they were excited. The three were escorted directly from the airport and driven through the town to the ship, which was docked at the massive Cotonou Port that sits on the west coast of Africa. Great lines of shipping containers on trucks paved the way. It was late at night and unsafe for them to be out. Olivia later learned that one half of the town was opulent and the other was a poor shantytown inhabited by extremely underprivileged people.
But on arrival Olivia had little idea about the port city and walked behind the others along a massive gangway to be met by the ship’s purser and Gurkha security guards. Her luggage had been left behind in Paris due to a flight delay, and despite looking forward to this new adventure, she was tired but filled with nervous excitement. ‘Our passports were taken and we were issued with a photo ID card and told to keep it on us at all times. I knew safety was a priority and we needed to take measures to avoid kidnapping or injury.’ Gradually overwhelmed with nervous anticipation, she wondered if she’d made the right decision. ‘I thought, This is more intense than I expected.’
Shown to her cabin, she met her bunkmate, Claire, who had arrived earlier that day and had claimed the bottom bunk. Like a naval ship, it had a six-bunk cabin and the crew was English-speaking people from around 30 countries, with the bulk from America and England. They made up the 450 or so people who lived on the ship. ‘With Claire it was instant friendship and my spirits lifted the minute we met. It took my bag a couple of days to arrive from Paris and Claire shared her toiletries and clothes with me. Following an induction, we began work a few days later.’ Astounded by so many different terms, medications and unfamiliar equipment, Olivia was grateful to meet and become friends with Carlissa, an American girl who helped her decipher all things new.
It was 2009 and Olivia was 31 when she left Tasmania to work as a volunteer nurse with Mercy Ships. It was quite a culture shock compared to her small island home in the southern hemisphere. Mercy Ships bring first-class medical care to the world’s poorest nations. The medical services are free for people suffering illness or injury, usually as a result of abject poverty. Because she had trauma-nursing experience, Olivia was assigned a ward nurse to work with adults, paediatrics and in the intensive care unit (ICU). ‘I worked in orthopedics, surgery and we saw a lot of cleft palates in babies and young children. The surgeries performed depended on which doctors and surgeons were on board, but included eye surgery, plastic constructive surgery and facial surgery for tumours and deformities – most of which are rarely seen in the West. The lack of medical services and prohibitive cost of med
ical care resulted in very large tumours requiring major surgery.’
A large number of women suffer from a condition called veso-vaginal fistula (VVF), which is usually correctible by surgery. ‘If a woman experiences a prolonged labour without medical assistance, the babies often die from obstruction,’ she explains. ‘The pressure of the head causes skin breaks between the vagina, the urethra and the rectum and forms a hole. This leads to the mother losing control of their urine, menstrual blood and faeces. And when this happens they’re regarded as dirty and ostracised from their communities.’
Before the ship docks at the port, an assessment day is organised and patients are given a yellow card and a surgery date. Hundreds of women come in with vaginal fistulas and are looked after post-op, usually for up to 21 days. Then they can go home, and in most cases, they’re accepted back into their communities. ‘The day they leave the ship is amazing,’ Olivia says. ‘They are “dry” – no more “leaking” – and they celebrate like there’s no tomorrow. A special ceremony is held and they’re given a new dress and hat and they literally sing and dance their way off the ship. It’s just beautiful to see and I loved joining in with the singing and dancing along with them if I was invited. Women who were so physically afflicted – experiencing so much joy after their operation. While I was there more than a hundred surgeries were performed.’
The Africa Mercy is a floating blood bank and Olivia had to donate blood on two occasions. ‘I’m type B negative,’ she says. ‘In Australia only about two percent of the population has this blood type. But in Benin it was one of the most common. Captain Tim and I were kept on the ship if there was a big surgery planned for a patient with our blood type. Once our blood was directly transferred into a critically ill man with a huge umbilical hernia – he survived.’
With any sign of civil unrest the self-contained hospital and crew can quickly evacuate. ‘Because it’s a floating hospital, it can dock at any port,’ Olivia says. ‘Volunteer staff pay their way to work on board, which lowers the overheads – it’s a charitable organisation. It flies under a Maltese flag rather than the United States – which was important to my dad when I applied,’ she says. ‘The threat of pirates and terror plots had him worried and that safety measure placated him a little.’