Delta exposes the inadequacies of NSW health services and pandemic response planning for remote Aboriginal communities.

The coronavirus hotspot of Wilcannia is 1000 km by road from Sydney, located on the Barrier Highway to Broken Hill.

When the Berejiklian government refused to immediately lock down Sydney hotspots in June, then dithered on travel restrictions to the regions, Wilcannia nurses began to fear the worst.

“In the first weeks of the so-called lockdown, people were leaving Sydney and coming out here in convoys,” said RN Suzy Pluker, president of the NSWNMA’s Far West Rural and Remote Branch, who works at Wilcannia Multi-Purpose Service (MPS).

By early August, the virus was spreading among the Aboriginal community in Dubbo, a day’s drive east of Wilcannia.

“That’s when we knew Wilcannia would be in for it,” Suzy said.

“Indigenous communities are highly mobile and family obligation is everything.

“For instance, if one of your family members dies, you’re obliged to go to the funeral, and you will travel big distances for it.

“Pandemic response planning could have recognised that if the virus gets into any rural town with an indigenous population, it will spread to other communities.

“However, effective risk assessments appear not to have been done.

“On paper, there may have been plans to stop the spread, but they had no practical effect.

“It’s not enough to say to people ‘don’t travel’; you have to put up checkpoints along the highway and other routes.”

South Australia’s tougher approach more successful

Suzy points to the tougher, more successful approach taken over the border in South Australia, where authorities blocked the highway from Broken Hill and side roads.

“The police effectively blocked dirt roads that cross people’s properties, by giving owners padlocks for their gates and putting up cameras. You can’t sneak into SA.”

Wilcannia MPS includes a two-bed ED and an eight-bed residential aged care unit.

Before the virus hit the town, the MPS usually had only four senior RNs plus junior nurses to provide 24/7 coverage and crew the local ambulance. There was no resident doctor.

For a time, only two senior RNs were available – and they had to work 12-hour shifts.

Perpetual understaffing made it difficult for nurses to travel to the nearest supermarket in Broken Hill, 200 km away, or to take booked leave.

Suzy’s home is over the border in South Australia, but she hasn’t been able to take time off to get back there since November 2020.

Advice on pandemic preparation sent by the Ministry of Health to Wilcannia MPS included a surge process that gave nurses permission to work 12-hour shifts.

“We laughed at that because we’ve been having to do 12-hour shifts for ages,” Suzy said. “We were begging for staff.”

She says the staffing situation at Wilcannia typified Sydney’s neglect of remote health sites.

Warnings not heeded

As early as April 2020, The Lamp reported a warning from Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO), that indigenous communities need “resources, equipment and guidelines out on the ground – yesterday” to prepare for COVID-19.

When The Lamp spoke to Suzy 17 months later in early September 2021, one in six of Wilcannia’s 650 people had already been infected. National and international media were focused on Wilcannia’s plight and authorities were frantically rushing resources to the town.

“Broken Hill sent a team to do hospital in the home and they are checking on people every day. Swab teams and vaccination teams are going house to house,” Suzy said. “We’ve even got a doctor on deck.”

“The teams are skilled and motivated and they’re really putting in. Community members I’ve spoken to are pleased that they’re getting hospital in the home and other support.

“Telstra has put up a mobile tower and suddenly we can get decent internet and phone calls don’t drop out. It’s amazing what international headlines can do for you.”

Suzy hopes all the attention will lead to long-term staffing improvements.

“For instance, we have been pushing like hell to get a nurse practitioner. We haven’t got a permanent health service manager and we haven’t got the NUM position filled.”