Kate Experiences ‘the wet’ in NE Arnhem Land

My experiences are probably atypical as I arrived in the wet season which made accessing Yolngu clients in their Homelands impossible for most of the week due to flooded rivers blocking the roads. However, this did give me a chance to get to know the dedicated, hard-working medical team at the Laynhapuy Health Medical Centre, at Yirrkala, under the guidance of Manager Jeff Cook.

I ran a Back Care and Manual Handling workshop for the staff, ergonomically assessed their workstations and we problem solved loading equipment into the back of the 4WD Outreach Vehicles.

Margie Cotter, the Laynhapuy Education Officer ran me through a workshop on the Communicare computer system used to document clients medical histories. This allows physiotherapists to find out about their client, document assessment, findings and treatment strategies, how to alert other team members to findings and treatment recommendations, organise future recalls for a physio check-up and for Case Conferences if clients require referrals.

My Cultural Awareness education began at the SOS Health initial briefing session which I attended online via Zoom Meetings. I also had in depth 1:1 discussions with SOS Health Volunteers Manager Shanta Parker in the lead up to my trip, with her sending me a great resource by a Dr Stephen Bryce all about the Yolngu language. At the Medical Centre, an excellent session was run by Balpalwanga Maymuru and Jeff Cook for new staff.

The important information I learned was, when working with Yolngu clients, to be polite and non-dominant. Also there is no such thing as queuing to see me. With the complex interrelationships of family, community, clans and the world as a whole, the people who arrive for help and advice instinctively know who is entitled to see me first, not who has arrived first, or who is in the most pain.
With this in mind I was delighted to see that an 11month old little girl was my first client in Dhalinybuy! She had been born with Talipes of one foot/ankle, but with diligent physio and parent exercising intervention, there was no sign of deformity or any limitation of ankle movement in either ankle and she was standing and walking normally and will not require surgery.

I saw more than one client with low back pain with weak abdominals and hyperlordotic lumbar spines and one with neck pain and a protracted head position. Using the approach ‘let’s find out what makes your pain worse and what makes it better’, abdominal exercise in crook lying and in standing against a wall or a tree proved a pain free way for these clients to understand how they can stand and move more comfortably and at the same time improve their posture. On a seat or a log the Mackenzie flexion exercise can be used to reverse the hyperlordotic spine and relieve discomfort from prolonged standing.

Teaching one elderly lady how to get up from her mattress on the floor by rolling onto one side to get on her hands and knees, then half keel to push up to standing, using a chair beside where she sleeps, helped her avoid back pain when getting out of bed. A folding walking stick I had brought with me, adjusted to the correct height, used correctly in her right hand, eliminated her left Trendelenberg limp as well as her left leg pain. I gave her the stick.

When a client keeps saying manymak (good) frequently, I hope I am on the right track to empowering them with strategies to relieve their own pain.

I drew simple diagrams with clear instructions for each client to remember the exercises and realise pre drawn exercise sheets will save time when assisting clients at the Homelands clinics in the future.

We had to suddenly pack up and leave to avoid getting stranded due to the heavy rain. As it was, many tracks had already turned into river beds, but we made it back to Yirrkala safely.

I am looking forward to returning for two weeks in July this year, in the Dry Season, when I will have more opportunity to run clinics and work with more Yolngu communities. I do not regret the opportunity this Wet Season week has given me to get to know the medical team, learn how the Communicare system works, feel more confident about being culturally aware, as well as learn more about the Yolngu language and know my way round the area, thanks to being given use of a car to use after work.

Thanks SOS Health for this experience, I’ve learned lots, and I hope helped a few people!

Kate Tuohy-Main