Michael Djukic

Student placement, Doctor of Physiotherapy, Melbourne University

"From neurological intervention we switched hats to cardiorespiratory physiotherapy."

I was on a student placement program with SOS Health visiting NE Arnhem Land with my supervising physio and the Laynha Health medical team.

It was a very humid morning when our healthcare team arrived in the indigenous homeland of Gurrumuru. This was a remote Yolngu Homeland that was only accessible by small aircraft due to the water-logged roads from the wet-season. The first patient to arrive at our makeshift clinic was a teenage girl with cerebral palsy. Her sister brought her in a wheelchair and was holding a broken wrist brace for us to do something about. Improvising with supplies and objects on hand including foam sheeting, electrical tape and a ruler, a temporary wrist splint was created till a replacement brace could arrive.

When fitting her splint, we noticed a distinctive rattling in her chest and a laboured breathing pattern that sounded more typical of an elderly chronic smoker rather than a teenage girl. Her sister described her chest irritation as something that could never be coughed out, but dismissed it as something we shouldn’t worry about because the patient has tolerated it for years. With a glance at my supervisor, we both knew this was a problem we could do something about. From neurological intervention, we switched hats to cardiorespiratory physiotherapy and began teaching some mucus clearing breathing techniques with immediate success. Tissue after tissue of viscous secretions was coughed up over a ten minute treatment cycle, leaving her lungs rattle-free and her breathing pattern normal.

The effectiveness of our treatment grabbed the sister’s interest straight away. We decided to extend our treatment session to educate both the girl and her sister to continue this chest maintenance technique at home. This was the first time I was able to make an immediate and significant difference to the health of a patient on this Health Outreach. The geographical isolation of Gurrumuru made me appreciate the limitations of accessing necessary health services by Yolngu people, but also made me appreciate their resilience to endure discomfort and pain without the need to seek help.