Another Physio Outreach Mission To Palm Island
I’ve never really been one to be nervous about anything, so the weird sensation I felt as I was driving to the airport to fly from Canberra to Townsville on 2nd November 2014 caught me by surprise. I was heading north to Palm Island, 65km north-west of Townsville, to spend a week volunteering as part of a Health Outreach Mission with the SOS foundation, helping to bring physiotherapy to those who maybe wouldn’t be able to readily access healthcare services. I was really unsure what I would be experiencing, so I decided I was going with an open-mind, no pre-conceived ideas, and this was reinforced on Sunday night by Lynda, our wonderful HOM coordinator, who presented to us the tale of the single story: how what is presented to us in a story (i.e. the media, or Google, or however we might garner information) can often not depict the true story or representation of what the story is about. The history of Palm Island and its people are often depicted in an unfortunate light, and I felt that to be able to contribute to this HOM in a significant manner, we had to understand the community and people and form a relationship from what we experienced, not from what we have seen/heard previously.
I met the rest of the team in Townsville, Lynda – our SOS coordinator, Enid – a retired physiotherapist from Brisbane, Barbara – an experienced physiotherapist from Sydney, Nick – Barbara’s husband and retired neurosurgeon, Kate – physiotherapist from Melbourne (and fellow Kiwi!), and Natalie – an administrator from Melbourne. A great bunch of people with various experiences and skill-sets, and good team.
Day 1: Monday 3rd November
A 5.30am alarm signaled the start of the day in Townsville, followed by a hearty breakfast and off to the ferry terminal for the 7.30am crossing to Great Palm Island. A calm sea made for a smooth ferry ride, and our team chatted away like good team members should – no uneasy chat about the weather! We met some members of the local representative league team – the Barracudas, who I would be working with during the week, and also discussed our role on the island for the week with other community members returning from Townsville. The approach to Palm made for some excellent photo opportunities – such a stunning North Queensland tropical island, with lush bush land and white sand beaches.
We collected our luggage and supplies and headed straight for the clinic. It was there that we met Lauren, the current full-time physiotherapist on Palm Island with the SOS foundation, and Patricia, the admin assistant. First up was assembling the rest of the multi-gym cable weights machine – not an easy task for some one who realised a mechanical trade would not be for him at an early age. But how many neurosurgeons and physios does it take to finish putting together a piece of gym equipment (large piece) – just one of each, and we made a pretty good fist of it to boot (although I never would have made a very good assistant to a neurosurgeon). The clinic was looking really good, a nice compact little gym area and reception area, and professional looking treatment room, with a stockroom on its way to completion.
There were some clinic appointments taking place, and the clinic had the feel of a well functioning physiotherapy practice, and down the hallway was the Sandy Boyd aged care hostel, where we met residents who we would be working with during the week.
During the day I met a local who was working with men on diversion programmes, and those with mental health conditions. There was a gym setup in a shed, with a woodwork area outside – I could tell he was proud of the work taking place, and offered to help out in any way during the week. I popped into the shed later that night to see some of the gym work taking place, and had a good chat to the guys there – was great to see some making use of the equipment on offer.
Walking around the islands main precinct, everyone in passing smiled and said hello – such a welcoming community.
Later that afternoon I headed down the road and beach to footy training, where I met members of the Barracudas, and the Warriors – another Palm Island team. Some ankle assessments and strappings took place, along with some fitness work involving pushing a Ute up and down the field. The guys were all looking forward to the upcoming tournament in Cairns on the weekend – a big finish to the season.
Dinner and debrief followed, and then a well earned sleep ready for the 2nd day.
Day 2: Tuesday 4th November
Day two kicked off at 7am, with team breakfast, and then Enid and I walked 25mins down the road (and beach) to Ferdy’s Haven Drug and Alcohol Rehabilitation Centre. We had a dog join us for the trip (a common occurrence on Palm), and wandered quietly past a few of the local roaming horses. At Ferdy’s we met Fernando, the manager and registered nurse, who described to us the programme running at the centre. Physical exercise and movement was playing a major role in the rehab programme, and we watched and joined in the exercise session that took place. Friendly hints and tips were passed on, and we devised a plan as to how we could contribute during the week.
I joined the exercise class at the aged care facility later that morning, and thought that the residents thoroughly enjoyed the fresh faces and activities that took place, outdoors and in the fresh air.
Lunch was spent down at the Pub on Palm, where a luncheon was put on with the running of the Melbourne Cup. There was no luck for me in the sweep, however I was pretty pleased with the seafood plate delivered out after the race.
Lunch (long lunch!) was followed by a trip to the Joyce Palmer hospital, where I gave a presentation to the local doctors and nurses about low back pain, and following a biopsychosocial approach in the management of this.
More clinic appointments followed, and then it was off for the 25 min walk down to the footy field, where more strappings took place, and a lot of assessments of various aches and pains as I built up more of a relationship with the teams. One gentleman injured his knee in 2007, explained that he had ‘torn some ligament’, didn’t want surgery and had continued to play each year with strapping as required. A quick test revealed that he was ACL deficient, and he further explained that at the time of injury the doctor had told him that he would never play again without surgery, but he was determined to prove him wrong! He said the knee would ‘collapse’ under him now and again while playing, but when it did, he would just hit the deck quickly, and get back up and carry on!
I returned back up the road/beach, and caught the end of Kate’s pilates class, where she had a good turnout of ladies, and then it was time for a quick dinner, debrief and bed.
Day 3: Wednesday 5th November
The day again kicked off at 7am, breakfast and the walk down to Ferdy’s (no dogs joining us this time). Enid took the group through an exercise programme, involving mobility and balance tasks. We walked back, and found some excellent photo opportunities with the tide in and blue sky prevailing. Bookings were made for clinic appointments, and I prepared an in-service for the GPs at the Children, Youth and Family Centre. We sat down with the GPs over their lunch break and had a good discussion around pain management, interesting for all. Following this it was back to clinic for some appointments, and then to the library, where a local gave us an insight into the history of Palm Island and its people. There were some interesting discussion points, and it is sad to see how the indigenous people here have really lost their identity through the process of how their past generations ended up on the island. Following this it was back down to the footy fields for training, where strapping for various ailments was in hot demand, and I discussed the role I would be able to play with the two teams on the weekend up in Cairns.
The walk back towards the hospital I was able to catch the last of a beautiful sunset over the water, it really is a beautiful part of the world.
I called into the Mens Shed at 7pm, where there were some guys working out, others completing some woodwork, and a good spread put on for those there. Such a great initiative being put in place.
We were invited to a BBQ dinner put on by the hospital doctors which was great, and Nick put on a great presentation about King Island in the Bass Strait, where he and Barb have spent some time in the past, with Barb locuming at the sole practitioner physio clinic there on numerous occasions. The hospital staff are a top bunch, with various histories and experiences before working on Palm, but all committed to providing a quality health service on the island.
Post dinner everyone looked very tired, so time was called at 9.30pm, with the offer of a 6.30am run out forward by Kate…
Day 4: Thursday 6th November
6.30am run offer was taken up, and we headed south towards the airstrip. It was very warm already, and a few gentle hills had us huffing and puffing. There were some nice views out into the ocean, and I enjoyed walking out along the beach near the airstrip. Until on our way back that we saw a sign that had been pushed over that warned not to go near the waters edge due to crocodiles! Later on one of the local police officers reassured me that no crocs would have been in that area…
Following this was breakfast, and the now traditional walk down to Ferdy’s for the morning exercise routine. We mixed it up and added some different exercises – it would be interesting to see how everyone’s legs are feeling the next morning!
At 10am it was across to the Sandy Palmer aged care facility to partake in the exercise class. Not too many willing participants today, however we got through some degree of class type exercise.
Following this I went down to Joyce Palmer hospital with Nick and listened in on his presentation to the medical staff about the history of neurosurgery and science behind it, and also a short presentation on mild head injury, and post-concussion syndrome. It was interesting discussing with the medics post-concussion screening, and the role of neuro-psychiatry in the rehab of these people.
After lunch I went across to the CFC and treated a couple of the staff there: some interesting MSK presentations were found within the medical staff there (no surprises really!!) After this it was the walk down to the footy field for training (the last before the trip to Cairns), which was quieter with one team already headed off the island. A couple of strappings, and then I had a run-around with the boys playing tag league. I quickly realised that there was no way I would be returning to playing rugby myself anytime soon…
Dinner was had at the Pub on Palm, and then we had a de-brief session, where discussion was had about the impact that we had had over a week, and where the SOS service should be headed in the future.
Last morning on the island tomorrow, before the trip up to Cairns!
Day 5: Fri 7th November
Our last day on Palm came around quickly, breakfast and then the last trip down to Ferdys Haven for the exercise group. A good session took place, hopefully what we have helped put in place will remain into the future, and that exercise can become an important rehab tool for all those involved at Ferdys.
It was then back to the motel to pack up my gear, across to the clinic to give an acupuncture/dry needling treatment, some time waiting around for a no-show after this (a somewhat frequent occurrence!) and then off to say good-byes to some of the locals I had met, and get some last photos. It was great to see a traditional indigenous dance performance put on by the local primary school – unfortunately it was the only time I came across representation of indigenous culture by the people during my time on the island – a sad fact that represents how possibly a lot of indigenous tradition has been lost to the community here.
I was picked up and taken out to the airport – I left a couple of hours before the rest of the team at midday, saying some quick good-byes, as I was getting a ride up to Cairns.
The flight over from the island to Townsville was fantastic, a small single engine aircraft with seats for 9 passengers! Some great views flying over, and took a lot of photos. As a child I was an aspiring pilot, so I found it spectacular being able to look out the front of the plane and also see the pilot at work.
I arrived at the small airport 20mins later, and gave a phone call to let my ride know I was there…Alas my ride had cancelled! I was now organised to get a seat on the bus with some team members at 6pm from the ferry terminal. The joys of the laid back nature of the Palm Island people, an issue that can be seen with the number of non-attended appointments within the healthcare system, and a factor in trying to get an efficient physiotherapy clinic up and running on the island.
So I waited at the airport for a couple of hours to meet up with the team again!
The remaining footy players came in on the ferry at 6pm, and it was off in the rental van up to Cairns. Story telling passed the time, though when the boys were talking amongst themselves, I had no idea what they were saying most of the time – it was a descriptive form of English anyway. Eventually arrived at the motel in Cairns at 11.30pm after a couple of stops, and it was pretty much straight to bed for me.
Day 6: Saturday 8th November
The tournament kicked off at 9am for the Bwgcolman Warriors, who came away with a first-up win. The Palm Island Barracudas followed at 10am, with a first-up loss. There was a lot of strapping and rub-downs taking place, I wasn’t sure if my supplies were going to last out the weekend.
The trend for the teams continued for each of their remaining two matches, the Warriors deservedly taking out all three of their games, with the Barracudas unfortunately losing their two – although each game was tight, and they didn’t seem to have luck on their side.
Fortunately there were no major injuries until the last 30secs of the last game – an awkward tackle and twist may have resulted in an ACL rupture for one unlucky fella – it was hospital clearance and Scott knee brace for him for the rest of the weekend, I hope he goes for an MRI when he gets back to Townsville/Palm Island, and the appropriate management is there for him.
The boys played extremely well considering the heat and humidity in Cairns this time of year – I was struggling without having to run round for 3 games in one day! The pool back at the motel was well utilized, and then it was quick dinner and retire to rooms as everyone was very much worn out.
Day 7: Sunday 9th November
The last day for me started with strapping prior to the Warriors 9am game – quarterfinal time. It was an intense match, with the Warriors holding the lead until 5 mins to go when they were overtaken. With 30secs to play a chip-kick was put through and regathered, with the offload resulting in a try underneath the posts! The kick sealed the win with the final hooter sounding – great game of finals footy!
The Barracudas were next up at 11am, playing in a repecharge semi-final. The first half saw there best footy played all weekend, and they ended up winning easily to book themselves a place in the final.
By this time the strapping supplies were running low, but the boys were holding together ok.
The Warriors semifinal kicked off at 1pm, unfortunately they were behind early, but produced a barn-storming finish, with 2 tries in the final 3 mins, and had a go at another on the final play – but was not too be with the Warriors going down by 4. Again such a great spectacle of rugby league!
Following this, I did some final strappings, and then it was goodbyes, and off to the airport for my flight back to Canberra. I didn’t get to see the Barracudas in their final!!
Summary
Cairns is quite a long way from Canberra, so I had some time to reflect on my experiences of the past week. Palm Island as a community has its challenges: being a relatively remote island, 65km off the mainland – getting supplies/services to the island can be time-consuming and expensive. I feel that the indigenous people on the island struggle to relate to any type of heritage – with the way people were brought to the island in the past, there is representation of 70+ indigenous tribes, along with the original Manbarra people. Its remoteness and small geographical area means services are limited, jobs are limited with only a small percentage of the population being employed, and the average age on the island is 26-27 years. However the local people I encountered were all very friendly and welcoming, always offering a smile and wave: such a great experience for a newcomer walking around the community. It is plain to see that a major health issue on the island is obesity and its associated co-morbidities, along with what I perceived as a major lack of health literacy of the people on the island (definitely compared to throughout New Zealand and Canberra, areas where I have experience): peoples lack of trust of health professionals is also tied up in this.
The SOS foundation is doing a great job of getting physiotherapy service to the people of Palm Island – prior to this physiotherapy was restricted to one physiotherapist coming to the island once a fortnight through the hospital system. I feel that the greatest contribution we can make as volunteers to this great cause is through education: not only to the local people on the island, but being able to pass on our specialised health knowledge and skills as physiotherapists to those health professionals working on the island in a fulltime capacity. I look forward to seeing the SOS health clinic on the island progress forward, and I hope that from our time on the island we were able to make a significant positive change to the health of those on Palm. I definitely enjoyed my time on Palm, and would like to thank the SOS foundation, and my workplace Sport & Spinal Physiotherapy, for giving me the opportunity and time so I could contribute to this rewarding cause. Through this experience I was able to develop both professionally and personally: volunteering is always such a fulfilling experience, and I encourage everyone at some stage or another to take up an opportunity such as this, as there is as much to gain as there is to give.
