04 February 2019

Noa Shalev's Jabiru experience


As I hopped off the Greyhound bus on Friday afternoon in Jabiru I was excited and nervous to begin my first placement as a John Flynn Medical Student.

After my first weekend in Jabiru I felt like I had lived there for months. I was invited out on a hiking trip to Motor Car Falls, to have dinner at a neighbour’s house, to go off-track four-wheel driving (the car was almost tipped over onto my passenger’s window!) and fishing. These were my favourite things about being in Jabiru: the welcoming community feel and the incredible, beautiful surrounds of Kakadu National Park.

Despite constantly being told that I should come back in the dry season, the wet season is when the bush turns a lush green, the waterfalls are gushing, and the sounds of the wildlife really come alive (Kakadu is home to around a quarter of Australia’s bird species who all seem to form a chorus at dawn every morning so I never needed my alarm).

Jabiru is the major township in Kakadu National Park, located around 250km south-east from Darwin (about a three-hour bus ride), close to West Arnhem Land. Jabiru town was built in the early 1980s to service the nearby uranium mine, so many of the people living in Jabiru work at the mine.  The mine, however, is now set to close in the next few years, making the future of Jabiru township and its residents quite uncertain.

When Monday morning came it was time to meet the rest of the staff and prepare for my first day at the clinic. Jabiru Health Centre looks like something between an ED and a GP clinic. There are consultation rooms where patients can see the GP or nurse practitioners who manage chronic disease, and there is also a four-bed treatment room where patients can see remote area nurses (RANs) for more acute conditions. The clinic also has several Aboriginal healthcare workers, a psychologist, a public health team, a midwife, drivers to pick up and drop off patients, as well as visiting staff. Some of the staff who visited while I was on my placement included a mental health nurse, a physiotherapist and an ultrasound technician. Specialists such as cardiologists come to Jabiru for around two to three days every six months.

I quickly became used to the transient nature of the clinic staff – some RANs would come to Jabiru for only a few weeks, and the clinic did not have a permanent doctor during my placement (however a couple of locums did come in).

It was really exciting to learn from so many different people and it made for a very clinically diverse placement. The clinic services the town of Jabiru as well as several outstations, which are mostly Aboriginal communities. Some of the outstations I was fortunate enough to visit included Patonga, Arrajawin (Whistle Duck), Mudginberri and Manaburdurma (Jabiru town camp). Driving out to these communities was a wonderful opportunity to both see more of the beauty of Kakadu and learn about the places in which many of the clinic’s patients live. Most of the drivers grew up in the area and taught me so much about the history and culture of the communities we were visiting and also about the plants and animals we saw along the drive. We spoke about different bush medicines and they also told me Dreamtime stories relating to the local wildlife.

I spent most of my time at the clinic with the RANs in the treatment room. The presentations ranged from chest pain and trouble breathing, to injuries from fishing hooks and spears, to a range of tropical skin sores. I did several ECGs, looked inside kids’ ears, took vital signs, listened to breathing and blew bubbles to distract kids from their injections, but most of the time I observed. The nurses were great and always took the time to explain to me what they were doing and why. They taught me a lot about remote and Aboriginal health care and the different approaches that are sometimes taken due to different health risks – for example, an Indigenous child who came into the clinic with a sore throat was given antibiotics due to the high risk of Rheumatic Heart Disease following strep throat, whereas a non-Indigenous child would have been advised to simply rest at home.

There were also quite a few evacuations, where someone would have to get flown by CareFlight to Darwin to go to the hospital. The process of arranging for the evacuation could take hours and sometimes all day, which was often quite distressing for the person waiting to get flown out as well as their families’. These situations made me aware of how much I take for granted living so close to a major hospital and how easy it is for me to go to the hospital to visit my friend or family member. I really can’t imagine how scary it must be to get into a small plane, leave your home and community and put your life into the hands of strangers.

My two weeks in Jabiru flew by and every day at the clinic brought patients with conditions that I had never heard of. In the afternoons after the clinic closed I would sometimes go with some of the staff to the Crocodile hotel for a drink, once we drove out to see the rock art and sunset at Ubirr, I went twice to Cahill’s crossing to try and spot some crocs (no luck) and I also went to the aqua fitness class at the pool a couple of times, which was run by my neighbour.

On my final morning in Jabiru before boarding the bus back to Darwin, I woke up at 4am, got picked up by a couple of the nurses, and drove to the airstrip for a scenic flight. It was an incredible opportunity to see some of the waterfalls and wetlands that are almost impossible to access by road during the wet season.

I’m really grateful to the people at Jabiru, especially the staff at the health centre, for making my first placement in Jabiru such a memorable clinical, cultural and social experience. It’s definitely an experience I would not have been able to have without the John Flynn Placement Program and all the organisation and support from NTGPE. I can’t wait to come back to the NT for placement number two!


Noa Shalev