by Pitt, Turia
The committee expressed surprise at the way the FESA call centre, Comcen, handled Dr Brandee Waite’s initial call from checkpoint two. Dr Waite advised there were people with burns and they needed help with evacuation; at the end of the call she was asked to hang up and call 000 again and request an ambulance service. The committee was of the view that Dr Waite should have been kept on the line while FESA/Comcen organised contact with other relevant emergency services.42
The committee found serious failures in sat-phone communications on 2 September;43 sixty-three emergency phone calls were logged between RtP officials on their satellite phones and various agencies (e.g. FESA, St John’s Ambulance, 000) between 2 pm and 8 pm; many of them were recorded as failed calls when the line dropped out before an operator could be reached or during the initial seconds of the call.44
The committee made fifteen recommendations.45 Most were ways various authorities could improve handling of future events, e.g. determining minimum safety standards and improving communications.
Among its recommendations were:
• That Tourism WA revises its sponsorship agreements to ensure that risk management plans are submitted for approval with all relevant agencies and local and State authorities no later than two months prior to a sponsored event, and that milestone payments are linked strictly to this deadline;
• In regard to its due diligence processes for sponsorship agreements, Tourism WA requires event organisers to complete disclosure questionnaires; if an organiser is found at any time not to have complied, or to have withheld material information, penalties should extend to nullifying the contract;
• That Eventscorp ensures that organisers of events it sponsors are directed to all the appropriate authorities and stakeholders;
• All relevant insurance policies and schedules are lodged with Tourism WA by the time a sponsorship agreement is signed and organisers adhere to a clause allowing any claims against them be enforceable in Western Australia or the sponsorship will be withdrawn;
• FESA, WA Police and St John’s Ambulance establish a uniform system for handling multiple agency emergency responses that do not involve callers having to make multiple calls to 000;
• That the Western Australian Attorney General gives urgent consideration to an ex-gratia payment to Turia Pitt and Kate Sanderson.
While denying responsibility, the Western Australian Government did make an Act of Grace payment of $450,000 each to Turia and Kate in November 2012. The payment was in recognition of the financial stress of their surgical procedures and medical needs. Deputy Premier, Dr Kim Hames, also mentioned the ‘unlikelihood of justice through the court system’.46 The figure settled on was similar to an amount awarded to a woman recently injured in a helicopter crash.
But by the time of the inquiry’s outcome, Turia’s medical and associated outgoings had already moved into the millions of dollars; and how can you compensate for a young life tragically altered forever? Greg Walsh continued to pursue justice for Turia from RtP. Finally, in February 2013, Greg received a letter from RtP’s lawyers. While RtP remained ‘deeply concerned at the serious injuries’ Turia sustained, that concern did not lead in any way to legal responsibility for those injuries and it denied liability. Subsequent mediation failed.
On 21 February 2013, Greg filed Turia’s statement of claim in the New South Wales Supreme Court. The claim lists a catalogue of omissions by RtP which led to her catastrophic injuries; this included its failure to get advice from the emergency fire authority.
EPILOGUE
FUNDRAISING
Australians nationwide have taken Turia’s story to their hearts since it hit the headlines in September 2011. In particular, the close-knit community of Milton–Ulladulla, where Turia grew up, rallied quickly to raise funds to defray her family’s considerable expenses.
The first fundraiser was held within weeks of the fire: a local surfing identity, Kurt Nyholm, owner of Milton Akwa Surf, organised a surfing competition at Mollymook Beach. This event raised $20,000.
Later, it became apparent that Turia would live and that her ongoing financial needs would be immense. While the majority of her medical expenses would be covered by Medicare and her health fund, there were other huge ongoing medical and associated costs, such as cosmetic procedures, pressure garments, physiotherapy, occupational therapy, occupational aids, counselling support and day-to-day living expenses during her years of recovery. Turia’s debilitating injuries also meant she would be unable to work for some years.
Her two best friends, Kristen Briggs and Nicola Tucker, decided to set up a formal way for people donate. When they were casting about for a charity that might issue the authority to fundraise on Turia’s behalf, they came across the Fire Foundation, Australia’s only national charity organisation dedicated to supporting fire and burns victims. The foundation was happy to help and, with Turia’s consent, set up a trust account in her name to which she had access.
After that, they contacted Go Fundraise, an online fundraising service provider, and asked if it could liaise directly with the Fire Foundation to set up an online donation page for Turia. They agreed and waived their service fee for two years. The online donation page went live in early March 2012 with a target of $100,000. Hundreds of people donated amounts from $25 to more than $3000 and the target was almost reached within a year. Most donors were individuals who wrote moving and encouraging messages with their donations but social clubs, organisations and small businesses also made donations. Many of her former colleagues at the Argyle Mine raised money individually with the Argyle Shave, which required them to shave their heads for money.
The Kununurra community also got into fundraising. Two hundred and twenty locals in this small town turned up for a trivia night which raised $18,000. Included in this amount was the money raised by auctioning naming rights for a crocodile at the Wyndham Crocodile Park. Turia’s two friends and former flatmates, Mary Kavanagh and Elle McNamara, were part of a group that chipped in for the winning bid to name the 3-metre croc ‘Turia’.
They said they made the purchase in honour of their friend’s good sense of humour and to ensure a bit of it remained in the Kimberley. And indeed, when Mary told Turia about her namesake during her visit to Turia in hospital, Turia loved the idea and had a good laugh. Because crocodiles can live for decades, Turia thought it hilarious that tourists would be asking for many years to come why the croc was called Turia.
Six volunteers from the St John’s Ambulance in Kununurra participated in an annual mountain-bike event called the Gibb River Challenge. Seventy teams entered the event, which is held over five days and covers 740 kilometres of the Gibb River Road, an old stock route. Teams use the event to raise funds for their nominated charity; the St John’s team raised $33,000, which was divided between Turia and Kate. Another event which raised funds for both Turia and Kate was a fun run in Melbourne in September 2012 organised by one of the competitors in the Kimberley Ultramarathon, Samantha Gash. This event raised $30,000 and brought in another $20,000 in online donations.
But the biggest fundraiser of all was one the whole community of Ulladulla got behind – the masquerade ball in the local civic centre hall on 5 May 2012. It was a sell-out, with more than 500 people paying $60 a ticket to attend; many others who couldn’t attend bought ‘virtual tickets’ online for $40 each. The total raised on the night was more than $60,000. The Macquarie Foundation matched one-third of the night’s proceeds, kicking in an additional $20,000.
The ball was the brainchild of Kristen and Nicola and they chose a masked event in deference to Turia having to wear a compression mask; they wanted her to feel comfortable, even though they knew she would only be able to attend for a short time. It was a major event for the two young women to organise but they were fortunate to win the support of everyone they approached. Once they worked out what needed to be supplied, such as catering, alcohol, decorations, lighting, sound, entertainment, raffle prizes and auction items, they contacte
d everyone they knew who could help or point them in the direction of someone who could.
A friend who was a chef organised the catering; another friend’s father owned a bottle shop and he organised the alcohol; decorations were done by local girlfriends; businesses in the surrounding district donated items to raffle or for the live auctions. The highlight of the auctions was a diamond donated by Rio Tinto, owners of the Argyle Diamond Mine, where Turia had been working.
A photo booth was set up where people could pay $5 to have their photos taken – one to keep and one to go into a memory book for Turia. People who bought virtual tickets were asked to send a photo of themselves; these were printed and pasted on balloons which became part of the decorations; the balloons were photographed and sent to each virtual guest so they could see what a great night their virtual self had enjoyed.
Turia used this money to fund her trip to the specialist burns clinic, the Ster Centre in France, in March 2013.
In the weeks following the fire, Turia’s family was overwhelmed by the generosity of so many people. Michael Pitt was moved to write a letter to the Milton Ulladulla Times:
Thank you from the Pitt Family of Ulladulla. Thank you to the wonderful people of this great town. The well wishes, kind thoughts, offers of help as well as donations from so many of you have touched our hearts as a family. You all need to know that this has been an inspiration to Turia as she faces the greatest challenge of her life. She is conscious, aware, positive, and progressing well with her recovery.
To all those who have been involved in saving Turia’s life, we can never thank you enough.
The fellow runners who found, and attended to Turia and Kate at the scene of the accident, and who ran for help; the courageous and skilled helicopter pilot who airlifted the girls out; the paramedic and St John’s Ambulance volunteers who attended the girls; the Royal Flying Doctor Service who flew the girls to Darwin General Hospital, and Careflight, who flew them on to Sydney and Melbourne. The staff of both Darwin General Hospital and the skilled surgeons, nurses and staff of Concord General Repatriation Hospital.
And thank you to those who helped, but are not on this list. Thank you to everyone for your continued fundraising activities and support for this special lady.
Great people.
Great town . . .
How good is Australia.
www.firefoundation.org.au/
http://supportturiapitt.gofundraise.com.au/page/turia
Michael Pitt
ABOUT SKIN DONATION
Most people are aware that hundreds of lives are saved every year by donated organs. People tick the boxes for organs they know can be transplanted, such as kidneys, heart, lungs, corneas – but few people realise that donated skin can also save lives, so it remains in short supply in Australia. On average, skin from three donors is needed for one recipient, and currently Australia can neither meet the immediate demand for skin nor stockpile it for use in the event of major disasters, such as bush fires and terrorist bombings like the Bali bombings in 2002.
With an average total surface of about 1.8 m2 and a total weight of about 11 kilograms, skin is our largest organ. Apart from giving us our appearance and shape, it has other important functions, such as regulating our body temperature and protecting us from the environmental impact of chemicals, the sun’s UV radiation and bacteria. Skin also provides us with one of our most important senses – that of touch. This is made possible by cells and nerve endings in the skin which send impulses to our central nervous system.
Most recipients of donor skin are burn victims and the skin grafts are used as a sort of temporary bandage. The donated skin helps to decrease pain, acts as a barrier to infection, prevents fluid and protein loss, and helps regulate body temperature. As in Turia’s case, donated skin can be used as a temporary treatment to cover severe burns and infected areas while the patient’s own skin heals. It promotes healing of underlying tissue and provides excellent wound cover till the patient’s own donor skin sites become ready for re-harvesting. The skin eventually sloughs off or is removed after a few weeks.
While skin and tissue donation is far less common or well known than organ donation, many more would-be donors meet the criteria to provide skin. Whereas organ donation requires the very specific circumstance of clinical brain death, combined with continued respiratory and circulatory support, there are few medical conditions that rule out tissue donation. Exceptions would be transmissible diseases such as hepatitis and HIV.
Transplanting donated skin also differs from organ transplantation as the skin grafts are used to provide temporary protection and are not expected to survive in the recipient permanently. This means that neither ABO blood group nor HLA matching is required for allograft skin transplantation. So literally anyone can be a donor for anyone else.
The decision to donate skin is made in the same manner as other organ donations and does not affect the medical care given to the donor before death. Donating skin does not cause body disfigurement; the skin harvested is a very thin layer, a bit like the skin that peels off after sunburn and is taken from the abdomen, back and legs; it can be donated up to twenty-four hours after death.
Skin is not the only tissue that can be donated after death and anyone can be considered for suitability as a tissue donor. Other tissues that can be donated include:
• Eyes can help restore sight to people with cornea problems, which may result from eye disease or injury or birth defects; the white part of the eye (the sclera) can be used in operations to rebuild the eye.
• Heart valves can be transplanted to help save the lives of children born with heart defects and adults with damaged heart valves.
• Bone has an important use in artificial joint replacements or replacing bone that has been removed due to illness or injury. It helps reduce pain and improves mobility.
• Tendons, the elastic-like cords that attach bones and muscles to each other, can help rebuild damaged joints.
The concept of skin donation after death is not new and there have been enormous developments in the field of tissue transplants over the last fifty years. The discovery of the protective properties of glycerol and its ability to maintain the cell structure unaltered led to the establishment of tissue banks throughout the world. Their aim was to collect, treat and distribute tissues. Skin can also be preserved by freezing, which, unlike storage in glycerol, maintains cell viability.
The first proper skin bank was established by the United States Navy in 1949. Subsequently many others, mostly multi-tissue banks, were established across the country. Today the American Association of Transplant Banks has around fifty accredited skin-tissue banks. The first tissue bank in the UK was established in Yorkshire in 1960. The Netherlands established a skin bank in 1976 and further evolution of techniques to preserve skin led to the opening of the Euro Skin Bank in 1992. This bank distributes homologous skin to more than thirty burns centres throughout Europe. The Euro Skin Bank is regulated by European directives, national legislation and internal protocols; it collects, qualifies, processes, cryo-preserves and distributes bone and skin taken from brain-dead donors. The tissue bank is also involved in education, scientific research, training and the development of a donation culture in the community.
Italy currently has five tissue banks that store skin and Canada has four. With improvements of the health sector in many developing countries in the last thirty years, more and more patients have been treated using sterilised tissues imported from developed countries; but the cost of this is high, significantly increasing the cost of treatment for burns and other conditions, such as leprosy, intractable skin wounds and pressure-sore ulcers. With the support of many developed countries, skin banks have been gradually set up in developing regions; there are now sixty-six tissue banks in the Asia-Pacific. The first tissue bank in Latin America was set up in Argentina in 1993 and there are currently thirty-seven tissue banks in seven countries of the region. There are seven countries in Africa with tissue
banks.
Australia’s small population means it is not considered cost efficient to have a separate skin bank in every state. The Donor Tissue Bank of Victoria (DTBV) is the country’s main source of donated skin. It is run by the Victorian Institute of Forensic Medicine attached to Monash University and specialises in the collection of human tissues such as heart valves, skin, bone and corneas. Established in 1989, the DTBV was the first, and remains the only, multi-tissue bank in Australasia. It is also Australia’s only tissue bank which screens donors, processes, stores, tests and distributes multiple types of tissue from the one facility. It is a public-sector, not-for-profit organisation and its main function is providing Australian surgeons with safe and effective tissue grafts for transplantation in many areas of orthopaedic, cardiothoracic, reconstructive surgery and burn care.
The only other skin bank in Australia is the Queensland Skin Bank, which opened in 2008 and is based at the Royal Brisbane and Women’s Hospital Burns Unit. It is divided into two services: the Queensland Skin Culture Centre, which takes small samples of undamaged skin from the patient and grows the top layer (epidermis) from the patient’s own skin cells and returns it to the patient to permanently cover their burn wounds; the other service is the skin bank, which stores allograft skin (donor skin) from deceased tissue donors.
In her effort to promote awareness of skin donation, Turia and has become an unofficial ambassador for Donate Life, the Australian Government’s Organ and Tissue Authority. The authority, an independent statutory body, was established in 2009 as part of a government reform package to bring world’s best practice to organ and tissue donation for transplantation. The government believed its reform program would provide an unprecedented opportunity to transform and save more Australian lives.