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July 2, 2022
  • THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
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rural nsw

Delta unmasks rural neglect

October 5, 2021 by Madeline Lucre Leave a Comment

The Berejiklian government plays the blame game as Sydney’s Delta outbreak spreads to regional areas with under-resourced healthcare facilities.

According to the NSW government, the Delta variant emerged on 16 June, when an air-crew driver working under lax NSW Public Health Orders that did not require him to wear a mask or be vaccinated, was diagnosed.

By then, the driver had visited a dozen sites in Sydney’s eastern suburbs. Gladys Berejiklian waited until 25 June before imposing a light lockdown on parts of the city’s east. The virus seeded into Western Sydney.

Loose regulations allowed movement between Sydney and the rest of NSW: for work, to look at real estate, to get COVID-19-tested, or to visit a second residence, for example. Delta subsequently spread across the state.

Rural communities with limited and under-resourced healthcare facilities have been grappling with the consequences.

Healthcare services for people outside of Sydney were dire even before COVID-19. This was made clear in a December 2020 sub-mission from the NSWNMA to a state parliamentary inquiry into health care in rural, regional and remote NSW.

The NSWNMA submission said: “It is not acceptable that residents in the rest of NSW are provided with an inadequately resourced, substandard system of healthcare while metropolitan Sydney residents enjoy far superior access and outcomes.”

It made 24 specific recommendations for improvements, including boosting nursing numbers at sites with no doctor to ensure a minimum of three per shift – two of whom would be RNs. It also recommended better staffing of emergency departments and recruiting more nurse practitioners.

Remote indigenous communities with higher rates of chronic illnesses such as diabetes or kidney disease and shamefully low vaccination rates – a shared federal and NSW responsibility – are particularly vulnerable to COVID-19.

“Indigenous Australians were one of our greatest concerns at the start of this pandemic,” Prime Minister Scott Morrison said in December.

Morrison’s actions failed to match his rhetoric.

Despite Aboriginal people over 12 being prioritised as 1B in the rollout, only 6.3 per cent of the Aboriginal population in Western NSW was fully vaccinated by 26 August, compared to 26 per cent of the non-Indigenous population in the region, ABC News reported.

Aboriginal communities dangerously exposed

Human Rights Watch accused both the federal and NSW governments of leaving Aboriginal people “dangerously exposed to COVID-19 with limited access to vaccines”.

The Maari Ma Aboriginal health service in the Far West warned both the NSW and federal governments in March 2020 that they needed to urgently prepare for an outbreak.

However, the Berejiklian government refused to take any responsibility.

Health Minister Brad Hazzard agreed the vaccination rollout to Aboriginal communities had been “challenging”, but said it was a federal government responsibility.

As The Guardian’s Anne Davies wrote: “The NSW Government’s response (to the worsening Delta crisis) has been a blame game … When it comes to the state’s role there is a stubborn reluctance to admit there may be a better way.”

On Aboriginal health, the NSWNMA submission says Aboriginal people in regional, rural and remote parts of NSW should have access to Aboriginal Community Controlled Health Services.

Epidemiologist Dr Peter Malouf, from the Aboriginal Health and Medical Research Council of NSW, told a parliamentary inquiry into the pandemic that the state government was “very lacking in engagement, particularly listening to the voices of Aboriginal people”.  

The remote settlement of Enngonia in north-west NSW has no hospital, no resident nurse, and no shop. Its mostly Aboriginal residents must travel 97 kilometres to Bourke for health care and groceries.

By the third week of September, COVID-19 had infected 25 – or about one third – of the township’s indigenous population, said Tannia Edwards, CEO of the Murrawarri Local Aboriginal Land Council in Enngonia.

The virus had also claimed the life of a beloved elder.

Ms Edwards told The Lamp that vaccinations were not provided at Enngonia until shortly before the township’s first infection, which followed positive cases in Bourke and Dubbo.

She said vaccination should have started once the virus reached Dubbo, almost 500 kilometres away, because Enngonia residents often travelled there on public transport.

She said government health messaging on COVID-19 had been poor.

“It’s not people’s fault they weren’t getting vaccinated. We needed better messaging, because not everyone can understand what’s happening on TV.”

She said it was hard to self-isolate when as many as 12 people could be living in a four-bedroom home.

“It’s not possible to tell small children they’ve got to stay in a room for 14 days. It’s not possible, and it’s cruel.”

She said rural fire service volunteers were doing a great job, delivering food parcels to the community.

Health service manager for the Bourke Aboriginal Health Service, Claire Williams, told The Guardian the public health response to Delta was “chaotic” and said it wasn’t clear who was in charge.

The Aboriginal Health Service is running a vaccination clinic in Enngonia and delivering medicines.

Western NSW Local Health District said it was doing “routine COVID-19 testing” in Enngonia and had begun “a household-by-household assessment of the community’s health and social needs”.

It said COVID-19 vaccination of indigenous Australians was a federal responsibility.

Nurses volunteer for West’s pandemic battle 

October 5, 2021 by Madeline Lucre Leave a Comment

Wearing PPE is uncomfortable at the best of times. The level of discomfort goes up a notch when you’re outdoors in hot weather and flies are crawling under your face shield.

Bush flies were among the challenges faced by Sydney nurse Lyn Whitlam when she joined the fight against COVID-19 in the outback town of Broken Hill.

Lyn, the branch Secretary and delegate at Ramsay Health Care’s North Shore Private Hospital, flew to the state’s Far West in response to an urgent call for volunteers.

“I wanted to do my bit to assist a very remote area of NSW that was struggling to deal with the pandemic,” she said.

Lyn was one of five nurses in the first Ramsay team to go to Broken Hill. She did an online COVID-19 vaccination course before starting her 10-day stint in late August.

She was seconded to the public health system and divided her time between an indoor vaccination centre and a drive-through testing clinic on Broken Hill Memorial Oval.

“At the testing clinic, I had my Ramsay uniform on with a thin blue apron, N95 respirator, face shield and gloves,” she said.

“It was hot, despite it being winter, and I expected someone to swallow a fly every time I asked them to open their mouth wide to obtain the throat swab.”

Not enough PPE

The out-of-town nurses helped move Broken Hill Hospital’s small immunisation clinic into the town’s civic centre, which enabled an expansion of the vaccination program.

The Sydney outbreak had been spreading for two months, yet Broken Hill could not supply enough PPE for the vaccination team, which typically comprised two nurses drawing up the vaccine, four vaccinating, two in the observation area, and a team leader.

“We had to ask Ramsay to send extra PPE, including N95 masks and face shields,” Lyn said.

“There were not enough computers and only one printer, and the internet was very poor.”

At the drive-through testing clinic, data collection was slow and error-prone due to a lack of computers and QR codes.

“The admin staff had to write down all the information – names, addresses, birth dates, Medicare numbers, etc. – then transfer it onto pathology forms, then hand the forms to me or another RN to do the tests. We would get the visitor to check the details and about 10 per cent of forms had incorrect information.

“All tests had to be sent back to Sydney for pathology and at one stage, we were told it was taking five days to get results back.”

During the weekend Lyn spent at the testing clinic it received only 148 visitors including locals, truck drivers and other motorists passing through town.

Serious communication issues

She says this partly reflects in-adequate COVID-19-related planning and publicity for the outback.

“There is a serious communication issue out west and people don’t have easy access to information,” Lyn said.

“A lot of locals are in a lower socio-economic group. They don’t have smart phones – they use flip phones or land lines – and don’t have computers. They can’t make appointments online and they can’t access their vaccination records.

“The local newspaper is now only available online and the town is in lockdown, so meeting places like pubs and clubs are closed.

“The word about testing and vaccination hasn’t been getting out. Very few of the local nurses had received their first dose of vaccine when we were there.”

Lyn has told Ramsay she’s happy to volunteer again at a vaccination or testing centre, including in Broken Hill.

“Hopefully they will move the testing centre indoors for summer, but I’d be taking a fly net just in case.”

Bring a cheque, Hazzard told

October 5, 2021 by Madeline Lucre Leave a Comment

Broken Hill Mayor Darriea Turley urged Health Minister Brad Hazzard to commit to more support for health services in the Far West when he made a flying visit to the region in September.

Cr Turley said local COVID-19 contact tracers were struggling to keep up.

Addressing Hazzard via ABC Radio, she said: “Please bring some relief for these staff. And please make sure you review essential travel, and you review regional travel.

“To come from a hotspot, two hotspots, and travel around – lovely of the minister, but please bring a cheque.”

Cr Turley later told a parliamentary inquiry that the spread of the virus in overcrowded housing in the Far West should have been planned for, given how well known the problem was.

She said decades of underfunding for health and housing services in Aboriginal communities had laid the groundwork for the crisis.

“The deep cuts to funding, the disrespect these communities are being shown, the lack of planning, has made them vulnerable,” she said.

Central Darling Shire administrator Bob Stewart told The Australian that the Wilcannia outbreak had “led to emergency management scrambling to find solutions to a long-term legacy issue”.

“It represents a massive failure of government over many years to address the basic human right of shelter, despite the warning signs contained in various reports and submissions,” Stewart said.

Bush the poor cousin in Pfizer rollout

October 5, 2021 by Madeline Lucre Leave a Comment

As COVID-19 spread from Sydney to regional NSW in late July, Gladys Berejiklian ordered 40,000 Pfizer doses to be redistributed from the regions to Sydney.

Berejiklian wanted the vaccine for Sydney Year 12 students so they could return to classes for the HSC.

With Pfizer in short supply due to the Morrison government’s bungled procurement process, Berejiklian’s decision did not go down well in the bush.

“There are frontline healthcare workers who [still] haven’t been vaccinated [in regional areas],” Rural Doctors Association of Australia’s CEO Peta Rutherford told ABC News.

Opposition came from the premier’s own side of politics.

Member for Calare and federal minister Andrew Gee called for the Central West to be exempted from the reallocation of Pfizer doses.

“Having just come out of lockdown, it’s not the right time to be diverting the Pfizer doses to the city. We’re only out of lockdown for two days and we’ve got COVID-19 traces in the sewer at Molong,” warned the National Party MP.

Roy Butler of the Shooters, Fishers and Farmers Party, whose state electorate of Barwon stretches from Walgett, Narrabri and Coonabarabran in the east to Broken Hill in the west, also expressed concern.

“There’s a stack of people in Walgett who were booked in to get the vaccination, only for them to have their appointments unexpectedly cancelled,” Butler said.

Less than a fortnight after Berejiklian’s announcement, health officials were rushing to send 1200 doses of Pfizer back to Walgett after the virus hit the town and large swathes of north-western NSW went into lockdown.

Griffith rallies for ratios

June 18, 2021 by Rayan Calimlim Leave a Comment

Nurses and midwives held a lunchtime rally outside Griffith Base Hospital to highlight their frustration at the NSW government’s failure to address staffing shortages.

NSW Nurses and Midwives’ Association (NSWNMA) Griffith Base Hospital branch members will join the growing chorus of communities calling for nurse-to-patient ratios to be implemented urgently.

NSWNMA Councillor and Griffith branch secretary, Kristy Wilson, said mandated shift-by-shift ratios were desperately needed to boost staffing, including one nurse to three patients (1:3) in emergency and 1:4 in medical and surgical wards.

“In recent weeks, over a thousand nurses and midwives have walked off the job, closed beds or rallied at more than 30 public health sites across the state,” said Ms Wilson.

“We need mandated shift-by-shift ratios to guarantee safe staffing here in Griffith, instead of the growing workloads and overtime we’re constantly battling.

“The government can’t continue simply relying on the goodwill of nurses and midwives working under these pressures, it’s not safe for patients or the staff.

“It is shameful how nurses and midwives are being treated across NSW. Victoria and Queensland have mandated nurse-to-patient ratios. It’s time for the NSW government to step up.”

Murray MP, Helen Dalton, attended the lunchtime rally in support of local nurses and midwives seeking nurse-to-patient ratios, as well as dozens of community members.

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