Aortas

Before we came to NT, Joy and I decided to avoid the word aorta.  You know how it goes - Aorta get rid of the dogs, and so on.  But it really hasn't been a problem.  We have no idea really what aorta do.  Interestingly, those we talk to don't dwell on solutions.  It seems that policy makers are keen on assimilation.  The white fellas who have been here for a while grimace and get on with their jobs.

It is frustrating though.  One serious plan was a business taking tourists into the bush, or fishing with indigenous people.  But regulations stepped in.  The guides had to do tests on map reading and understanding GPS directions.  Developing an industry with honey from native bees seems to be facing a hurdle of OH&S rules about food handling and business administration.  The local people involved are incredibly skilled, and far better than white fellas, in the practical aspects of these proposals. The bureaucratic barriers reinforce the depth of the gulf that exists between indigenous culture and the dominating white one.

We continue to be very impressed by the care that we see from the RANs - the Remote Area Nurses.  They are the ones who provide the health care.  They know their local clients well, and go the second mile in doing what they can.  My concept of government introduced "intervention" was uninformed health professionals rocking in to small communities, not really respecting boundaries, to achieve better health outcomes.  That's not what happens here.  Better outcomes are aimed at by appropriate communication and motivation, and provision of high class care.

This afternoon we met the careflight bringing "Mary" back from Darwin.  She is an elderly lady with end stage renal failure.  She lives at the small aged care house that Joy has been visiting.  Last week, the staff there rang to say that she was semiconscious and pretty bad.  I  wandered around to find 3 of the RANs preparing to bring her back to the clinic.  It was pretty clear that she was dying.  Back at the clinic, we did some tests that confirmed that her kidneys were not working.  (For those interested, Na 115, urea >50, creatinine 672).  What to do?  She had, with her family, indicated that she did not want any resuscitation.  But the clinic is not a hospital with inpatient facilities, and the aged care house does not have nursing staff overnight.  She couldn't go back to her family easily.

The system here is that the RANs discuss problems with the District Medical Officer, a doctor in Darwin who recommends appropriate action.  Jim rang him.  He was very clear that she should be transferred to Darwin.  That was tough, as the thought of her dying away from her country was not good.  However, she went, and with some Darwin magic, improved.

Her wave as she was stretchered out of the plane was wonderful.  We got her into the car we have to use, and took her home.  I wheeled her around her fellow residents, who held out their hands and in the best way they could, welcomed her back.  It was an emotional moment.  She's back for good now.

Well, there's some health stuff.  It isn't what I was going to write.  That will have to wait.