First, let me say this: If you ever get a chance to travel to the Kimberley … do it!
Having just spent 3 weeks in Kununurra in the East Kimberley, I can certainly attest to the stunning physical attributes of the region. Rugged rock formations overlook the town providing great walking trails as well as vantage points to view the invariably gorgeous sunsets. The weather at this time of year is heavenly – blue skies and temps in the low 30s most days. The broader region boasts cliffs, gorges, rock pools and natural springs, the enormous lake Argyle and the Purnululu (Bungle Bungle) National Park. The town itself is right up the north-east of Western Australia, near the Northern Territory border. The population is somewhere around 4000-ish, but goes up considerably in the dry season as the tourists flock to the area. Apart from tourism, the main local industries are agriculture from the Ord River irrigation region, healthcare and support for resource projects including the famous Argyle Diamond Mine and its coveted pink diamonds. There is also a thriving local art scene, and the area boasts many talented local Aboriginal artists.
This was my second visit to Kununurra. The first was as a 6th year medical student in 2006 and I had such a great time then that I have always wanted to come back. In fact, I had a secret suspicious that maybe Kununurra was “the one”, the town I was destined to settle in once I became a country doctor. Naturally, I jumped at the chance to take up a locum position and get a taste of what it’s like to live and work there.
The job was a locum obstetrics DMO position at the Kununurra District Hospital. In the north of WA, DMOs are “district medical officers” who are employed by hospitals to provide a variety of services including emergency, GP, adult and paediatric inpatient admission, obstetrics and anaesthetics. This was a great learning experience for me as I was able to expand my emergency and inpatient skills as well as experiencing the challenge of working in a remote area with unique geographical and resource management issues. I saw lots of interesting clinical scenarios such as febrile neonate, severe secondary infection from headlice infestation, a couple of tendon injuries of the hand, a deep facial laceration, a large hyphaema, pancreatitis, unstable diabetics with sepsis and of course the all too common physical and psychological consequences of alcohol abuse. Some of the logistical challenges involved deciding how and when to transfer patients who needed higher level care eg deciding whether the patients with severe burns goes to Royal Perth or Royal Darwin Hospital – largely influenced by the current trajectory of the RFDS plane – and negotiating with the tertiary hospital as to whether a child with a cranial nerve palsy really needs RFDS transfer to Perth for imaging or whether a much cheaper and often quicker commercial flight would be sufficient. Luckily, all of the permanent doctors and my fellow locums were brilliant and very supportive so I never felt like I was on my own and out of my depth. Also, there are pretty clear on call arrangements with specialists of every flavour, based either in Broome or Perth, which adds another layer of support.
I must admit I was a bit disappointed to not have more obstetrics action while I was there. I was on call for obstetrics roughly every 3rd or 4th day and was responsible for 3 deliveries during my time there, all of which were uncomplicated SVDs which didn’t require any assistance from me whatsoever. That’s great news for the patients, but not so good for me for keeping up my procedural skills, particularly caesarean sections.
In terms of the lifestyle, I think I must be getting used to this locuming thing, as I really didn’t experience the same loneliness and isolation as I did in my first couple of weeks in Albany; maybe because I was working with a large team at the hospital, maybe because I was working so much I didn’t have time to get bored or maybe because I was already familiar with the town. Having said that, by the time the 3rd week rolled around I was ready to go home and wasn’t sad to be leaving like I was with Albany, probably because I didn’t have time to really establish any close friendships in such a short time.
As always, the big question for me is: Is this somewhere where I would come back to in the long term? And the answer is a bit mixed on this one. There are many appealing qualities to Kununurra including a well functioning, wonderfully friendly and inclusive hospital, pretty good access to specialist and allied health services and interesting and varied clinical work. The locals also rave about the laid-back Kimberley lifestyle, particularly for those who enjoy camping, fishing, hiking and other outdoorsy activities. And who could go past the abundance of beautiful fresh fruit and veggies? I have had the most delicious rockmelons and pawpaw I have ever eaten, and later in the year the mangoes will be hanging off the trees just waiting to be picked and scoffed in their dozens.
On the other hand, I really don’t know if I could cope with the hot climate all year round. Even in June, one of the coolest months of the year, going for a jog at 6:30am was still bordering on uncomfortably warm. It would be downright unpleasant in November. Also, I think I’d prefer to be somewhere where there is a bit more obstetrics activity as it really is a part of the job that I love. And finally I’m not sure if the DMO type of job is right for me either. Even though I did four GP sessions while I was there, I can see that the GP service really takes a back seat to the emergency and I really missed establishing that regular follow-up and continuity of care that you get from regular community general practice. Certainly if I was to go back, I would perhaps look at working half time in private GP and half time at the hospital.
So, Kununurra, as much as I love you, I think Albany is still ahead by a nose at the top of the list of future work destinations. Although if I could work out some way to work up north in winter and down south in summer that really would be the best of both worlds.
My next job is a similar role as an obstetrics DMO in Derby, in the West Kimberley. I’m really looking forward to getting to see the other side of the Kimberley region, and also to getting another taste of the hot climate / DMO lifestyle to see if it would be a realistic career path for me. Another adventure awaits!