by Paula Heelan
Her decision to work in Africa came as a surprise to her parents, Jeanette and Peter, but they knew she was determined to go. ‘Olivia is a born leader and from a young age she had direction,’ Jeanette says. ‘She was always very focused and took things seriously. She wanted to do her best at everything she tried and at times we worried she was pushing herself too much. We’d try to rein her in a little. But she’s strong and very determined. In primary school she sang and danced competitively and was good at drama and we thought she’d go down that path. But eventually it became clear that nursing was her calling.’
Olivia grew up attending the Baptist church in Launceston and that’s where she heard about the Mercy Ships and the need for volunteer medical crew. Having already worked in the Philippines and Kenya as a nurse, she googled Mercy Ships to find out more and applied for a three-month stint.
While Olivia experienced a couple of daunting moments, working on the ship was truly rewarding. It’s also where she met South African midwife Kate. ‘Kate is the reason I decided to become a midwife,’ Olivia says. ‘She transferred her passion and enthusiasm for midwifery to me. She said she could see me as a midwife and that I needed to go and do it.’ Olivia and Andi, who was the other Australian nurse on board, both studied midwifery after falling under the influence of Kate.
‘I developed resilience and gained more confidence working in Benin. It was an inspiring experience and one I’ll always be grateful for.’ Olivia returned to Tasmania and spent the next twelve months studying for her midwifery at the Royal Hobart Hospital.
She jokes about the first time she helped birth a newborn. She was very young and staying at her grandparents’ sheep-and-cattle farm at Cluan Tiers, near the small town of Westbury in northern Tasmania. She was watching a sheep birthing twin lambs. ‘The first lamb came out and then one hoof emerged, but not the other. My papa said, Put your hand in, Olivia and get that other hoof out. I did what he asked and pulled the other twin out. That’s what you do on a farm,’ she says, laughing.
Olivia began her nursing training with the University of Tasmania and the Royal Hobart Hospital in 1996. She worked as a student midwife at Hobart Private Hospital and studied midwifery externally through Charles Sturt University at Wagga Wagga. It was in Hobart that she saw a baby birthed for the first time. ‘I remember thinking, Oh, so that’s how it happens? I wasn’t totally fascinated with it. But I did feel honoured to be a part of that.’
After her training, Olivia took a job at Launceston General Hospital and clocked up experience across several wards. ‘The only reason I got that job was because the woman who interviewed me knew my family and was my Sunday-school teacher when I was a kid. She knew I’d be a good worker.’
In her graduation year Olivia became addicted to emergency care. ‘I really enjoyed that and ended up moving to Melbourne to do my trauma training,’ she says. ‘I had a fabulous clinical lecturer, Lisa, who helped me through. I wouldn’t have done it without her. She was one of those positive people who make you think you can do anything. We’re still friends.’ Olivia applied for an emergency position at Dandenong Hospital and at 22 it was a massive change for her. ‘I liked the diversity. They say emergency nurses know a little bit about a lot of stuff. Every hour and day was different.’ Within a few years Olivia was promoted to acting nurse-in-charge, which requires a good dose of skill and responsibility. You also need to be an effective communicator, extremely organised and able to roll with the punches. She stayed in Melbourne for eight years and spent most of her time in resuscitation, trauma and triage.
It was the emergency experience that helped prepare Olivia for overseas volunteer work. In 2003, at 27, she took a three-month placement with World Youth International (WYI) in Western Kenya outside the tiny town of Ugunja and close to the Uganda border. Based around the city of Kisumu, along the edge of Lake Victoria, and providing vital medical care to underprivileged communities, her work was also a unique opportunity to gain valuable experience.
When she drove into the little village, the fact that she was the only medical worker in her group began to hit home. Technically, volunteers can’t go into Kenya as a nurse. The WYI group’s official task was to build a school and community hall and Olivia entered as a volunteer worker. But as a trained nurse she knew she would not be able to help treating anyone that came through the door. In a country ravaged by HIV/AIDS and malaria and where people don’t have access to the most basic treatment, Olivia knew she would face new challenges. When she arrived she drew on her strengths as a capable emergency care worker and nurse-in-charge.
Mindful of local customs, she had to be aware of the local medicine men. ‘We were careful not to step on their toes,’ she says. ‘From day one I saw myriad cases from slashings, stabbings and victims of violent attacks to helping out with babies, cuts and injuries and common illnesses. I discovered a mix of mud and cow dung makes really good plaster to set broken bones. I even washed out animal intestines, a main ingredient for a special broth to help people get well.’
Not long after her arrival, a man came to the church and asked Olivia to accompany him. His wife was heavily pregnant and bleeding. Olivia followed him back to his home, not sure what she’d be confronted with and hoping she could help. ‘But by the time we reached her, it was too late,’ she says. ‘The pregnant mother died in front me. She had suffered from placenta previa, where the placenta covers the cervix. She needed a caesarian – you can’t birth the placenta before the baby.’ When Olivia walked out of the little hut she found the woman’s other three children happily playing. ‘It was heartbreaking,’ she says. ‘They didn’t know their mother had died. I can still see the faces of the mother and father and each of the children. The mother’s family came in and took over and it was very obvious when it was time for me to leave. This was the sad and extremely difficult side of my work there. The deaths of children in third world countries are extremely hard to handle and sad when you know most could be avoided with immediate access to health care, hospitals and doctors.’
In 2005 Olivia volunteered to work in the Philippines with the Christian organisation International Needs Australia, which is based out of Melbourne. She worked in Manila and to the south at Legazpi. And again, as the only medical person, she found it challenging professionally and personally. ‘You arrive with a stethoscope and perhaps some Panadol in your bag and that’s about it,’ she says. ‘Once I was in Kenya and the Philippines I was able to purchase medications. I’d ask a local to take my list and buy them for me because I’d be charged a fortune. But each time I work in developing countries, my skills are honed – both visual and listening and back to basic nursing skills. I always come back a better nurse from the experience.’
There are many sponsored children in Manila and Olivia spent time with them, helping to set up their schooling. ‘International Needs had established quite a few community projects, like breakfast programs for schools, and our job was to help develop more. I ran a few medical clinics and just used what little resources I had. Medical care is crazy expensive. I saw acute cases of nasty infections and sores. The people understood we were limited in what we could do and were grateful for anything we could help with.’
After returning from Manila, Olivia moved back to Tasmania in 2008 and worked in the emergency department as an in-charge nurse. She completed her midwifery training in 2010 and applied for a CareFlight job in 2011. ‘It was time to do something different, so I applied for the job not really expecting to get it,’ she says. ‘The call came a week later asking if I could start right away. I thought, Oh no, now I have to move to Darwin!’ And she did. Soon after she packed her bags and drove from one end of Australia to the other.
It was an immense change for Olivia. ‘You can’t compare being in a hospital to being in an aircraft,’ she says. ‘The working space, the back-up or the resources just aren’t there. It’s just you and the pilot. When you’re working independently under guidelines, the pressure is on and you need to know wha
t you’re doing. We treated anything from heart attacks to car accidents, people dying of renal failure, women birthing, sick kids and victims of domestic violence.’
For Olivia, domestic violence cases were the most confronting. ‘We were called out a lot for that. Once we had to fly into a community for a man who had been assaulted by a family member. When we arrived there were more than 200 people, mostly men, waiting at the front of the clinic. We had to get in there. The doctor who had flown in with me was absolutely terrified. I said, They’re not here for us, they’re here for the patient and they’re looking for the man who assaulted him – we’re not going to have a problem.’ And they didn’t. Olivia boldly strode through the crowd. ‘I saw a woman I knew and stopped to say hello, then kept walking,’ she says. ‘We stabilised the man and flew him to Darwin for surgery.’
When Olivia arrived in Darwin one of the first things she had to do was take an Aboriginal cultural awareness course. ‘I soon realised I had to be mindful of many things. I engaged with Indigenous elders whenever I was invited to – that could have been at a clinic or when they came as a patient. It wasn’t culturally okay for me to just seek them out. I didn’t want to offend anybody. They’d tell me where you didn’t go and what you didn’t do and I had to make sure my knees were always covered. If I had a pregnant woman close to birthing on a plane, I wouldn’t divert to pick anyone else up. We couldn’t have a male on board at the same time. Birthing babies was strictly women’s business. I wanted to learn as much as I could and that meant spending a lot of time talking with the local Indigenous people in each community and I was guided by their advice.’
Assisting women in labour could be extremely testing. ‘It was common for very young girls to be pregnant,’ she says. ‘Trying to explain what’s going on could be very difficult. It wasn’t always a happy situation. Sometimes it was a matter of having someone to hold a hand. A lot of the time there was no one to do that. Many of the pregnant women who needed to fly were frightened of the plane. I’d sit right next to them and stay by their side. The young women always had a support person fly with them – an aunty, sister or grandmother. Whether you’re an expectant mum having a baby in Launceston or a remote community, you need somebody with you.’
Olivia’s first week in Darwin gave her a taste of what lay ahead as a flight midwife. ‘I flew to one of the Tiwi Islands north of Darwin to assist a mother who had gone into labour. I realised we probably wouldn’t get her back to Darwin on time, so we prepared for her to birth the baby in the clinic. Better there than in the aircraft. With minimal fuss and great joy, the young mother birthed a baby boy on the floor of the clinic. Her aunty told me it was the first baby born on country for the last five years and everyone was ecstatic.’
That day happened to be the Tiwi football grand final and the town was overflowing with people. Before Olivia left the clinic for the airport with the mother and baby to transfer them back to Darwin, the family asked Olivia if she could drive the mother past the football ground on the way. ‘We drove slowly past the footy ground and from the back of the troopy I had to hold the baby up at the window for everyone to see. As we drove past people clapped and cheered and kids ran along behind us. I said to the pilot, Oh my gosh, I can’t believe this. He laughed and said, Welcome to Tiwi, Olivia.’ Everybody knew the baby had been born on country and it caused huge excitement. ‘It was clearly a special event and I felt really honoured to have been a part of that,’ Olivia says.
Not long after Olivia was tasked to fly into an Aboriginal community south of Darwin near a croc-infested river. A woman had lost one of her fingers to a crocodile while hunting for Arafura file snakes in the mangroves. ‘She also suffered a mangled right hand and leg wounds. It’s thought she probably grabbed the croc by mistake as attacks by freshwater crocodiles are rare. But in the real crocodile-infested parts, people are crazy. They fish standing in water up to their knees in areas inhabited by six-metre crocs. I was called out to a few croc attacks while I was there, but sadly the victims didn’t survive – they rarely do. It reminded us how very real it was.’
The daily tasks with CareFlight were diverse. ‘One day I flew to Bullo River Station, which my grandparents had told me about. We flew out a stockman who had been crushed between two Brahman bulls. He was okay and lucky it wasn’t worse.’ When CareFlight planes fly into cattle stations, they often land on four paddocks. The fences are moved for the planes so the pilot can land in the middle, then taxi along with the wings going over the height of fences, which are made especially to accommodate the planes. The plane then shuttles snuggly between the gates all the way up to the shed. ‘The pilots thought that was the coolest thing ever – and we didn’t have to walk far,’ Olivia says.
On the day she flew to Bullo Station, Olivia was working with one of her favourite pilots. ‘On our way in we had such a great aerial view of the station and impossibly beautiful landscape.’ Bullo Station spans more than half a million acres and is close to the Western Australian border, about 78 kilometres north-west of Timber Creek and 115 kilometres north-east of Kununurra. The Victoria River flows through the property from the Bullo Gorge for over 80 kilometres. ‘From the air we crossed rugged ochre mountain ranges, meandering rivers and waterholes blanketed with pink and white lilies. We saw flocks of galahs, solitary eagles, kangaroos and feral pigs. I knew this was something special. Sadly, my grandparents had died before I moved to Darwin – I was sad I couldn’t tell them about my flight into Bullo River Station.’
Knowing the CareFlight King Air aircraft had two engines and the pilots were extremely skilled, Olivia didn’t have any fear of flying. She trusted the pilots implicitly. ‘I am in awe of them,’ she says. ‘They pitch in and help without asking. They know where things are and unpack for you. At the Bullo job, I realised I’d left a little machine on the plane and turned to walk back to get it. But the pilot knew I’d need it and had already gone back for it. They’re also very protective of the flight nurses – we don’t go anywhere alone, they constantly watch out for us.’
Olivia was regularly tasked to work at Nhulunbuy on the Gove Peninsula in the Northern Territory. ‘I’d be sent out there with a pilot to work at the non-doctored base for a week.’ While there was a lot of seriousness to the work in Darwin, there was also a lighter side. ‘One of my favourite days was Territory Day. It’s like Australia Day, but the Territory’s own. You can set off as many firecrackers as you want, wherever you want, from 6 pm until midnight. It’s like flying over a war zone. The noise, colour and excitement are all encompassing. And of course, there are injuries every year – a finger lost, a leg burnt. Darwin is four hours from everywhere except Perth. On holidays, I’d fly to a capital city somewhere to meet friends or family who’d also fly in.
‘I worked with some fantastic pilots and medical crew and appreciated the chance to do it. I love to help people and to be given the chance to do a job like that was wonderful. Every day was an amazing day and I was very proud to wear the CareFlight uniform.’
In January 2014, after three years in Darwin, Olivia took the long drive back to Tasmania in her Subaru Outback with her personalised number plate SUBARU. ‘Everyone has personalised plates in Darwin, so I thought I might as well join the majority. I drove via Uluru and Kings Canyon – places I’d always wanted to see up close,’ she says.
Back in Tasmania, Olivia returned to midwifery at the Hobart Private Hospital and also worked in emergency at the Royal Hobart Hospital. At times she uses her midwifery skills in emergency or her emergency skills in midwifery. Recently she birthed her 100th baby, who turned out to be the brother of a little girl that she had helped bring into the world. ‘I had nursed his sister four years before. It was special because I knew the family well and it was nice for them to have a midwife they knew. I’m part of a scheme called Know Your Midwife (KYM), where women alternate visits between the obstetrician and the KYM midwife. The idea is that one of us will be on hand to birth the baby.’
Each of thos
e one hundred births and more was unique and for Olivia each new birth continues to be fresh and exciting. Recently she had been eagerly waiting all night for a text to ping. It came in at 9 am. The expectant mother under her care had been admitted the day before following an induction. Olivia had met with the couple several times to talk about their birth expectations.
The expectant father had texted Olivia to let her know the labour had begun. She had been involved with the family since she was a student of midwifery and was about to help birth the couple’s fourth child. She had helped birth two of their other three children and was thrilled to be here for this one. The couple’s first child, a girl, was birthed by a caesarian section (or C-section) before Olivia had become a midwife; the second was a successful vaginal birth after a C-section (VBAC) when Olivia was a student and the third child was another VBAC with Olivia. With the risk of the C-section scar tearing, careful consideration had been given to the best birthing plan for this baby.
When Olivia stepped into the warm, quiet room just before the mother’s contractions had started, she was glad to find there was some time to talk more about what the mother wanted for this baby’s birth. ‘She smiled at me and said, I’m happy to go with the flow. My faith in you is a hundred per cent. The dad vigorously nodded in agreement.’
Totally focused and calm, the woman’s trust in her experienced midwife was clear. As Olivia watched the woman stand and lean into her husband to work through the contractions, she was moved by their instinctive teamwork and love. ‘The dad tenderly held her through it and kept hugging her. They knew I was there,’ Olivia says. ‘But as one of my mid teachers told me once, midwives need to learn to knit, crochet and sit on their hands. I can do all three.’