A year after I started work in Aurukun a book was published (2009) Called “The Seven Seasons in Aurukun”. It was written by a woman who’d been a young teacher for two years in Aurukun in 2004/5. It was the book I’d wanted to write, her experiences, her impressions. She didn’t try and explain the “Indigenous Situation”, wasn’t overly political, the book was highly personal. Just want I needed to read at that time, to see how another woman had survived in Aurukun. I’d been writing my own account in a journal with the thought that it would one day make an interesting read. She was a teacher, I was a nurse, both had very different jobs and relationships, but when I heard about her book I assumed I didn’t have anymore to add.
Sitting around the white plastic table in the kitchen of the clinic one morning, the nurses discussed this book. A male nurse loudly stated his opinion that the book was “self-indulgent crap”. I cringed inwardly wondering how he’d judge anything I wrote in the future. It’s taken me a few years to realize someone is always going to say that about anyones memoir, and worse. It doesn’t matter, we all have a story within our one life and only we can express it.
I’m now on the third draft of my remote area nurse memoir and I hope I’m prepared for any opinion, comments and judgements when it’s published. Each story passed on adds to the wealth of human experience.
Aurukun
Journal keeping
I’ve written in a journal for years, not daily, but often. During the years I’ve worked as a remote area nurse I’ve jotted down thoughts, events, names and places. It helped with all the changes that were happening, to feel real and solid, the events able to be processed and not to disappear into nothingness.
Writer, Joan Didion, stated that notebook-keepers “are a different breed altogether, lonely and resistant rearrangers of things, anxious malcontents, children afflicted apparently at birth with some presentiment of loss.”
I wrote because I didn’t want to ever lose the experiences, because I never wanted to forget the names, because one day I knew I would want to read my own stories.
Magpie Goose Stew
Magpie Geese are large noisy birds that frequent the swamps of the Top end of Australia, especially during the wet season, when they nest and lay their eggs. They are a valuable source of food for Aboriginal people in those areas. The sky becomes filled with honking black and white flocks of birds and you know you’re soon going to come across cold camp fires when you’re out walking, with scattered feathers and bones around them. For me, they herald Christmas.
This recipe was given to me by an Aurukun health worker:
Magpie Good Stew
You need two geese, soy sauce, vinegar, One onion, Two potatoes, two garlic cloves, Two knobs ginger.
Cut out the bones, cut up the meat into cubes and soak in soy sauce and vinegar for two hours. In a camp oven throw in diced onion and potato, garlic, ginger and a cup full of water. Toss in marinated geese pieces, cook on the fire until meat and potatoes are cooked through. While the stew is simmering, place the geese bones on a grill on the fire until crispy and crunchy, they make a good snack. Serve with boiled rice.
A Breadfruit Tree
There was a breadfruit tree In Aurukun. Fasi and I found it one day when we walked along the back track to the store. He pointed it out with excitement. He always saw food on land and sea. The tree was in the middle of a block of land covered in long grass, enclosed by a broken wire fence. The fruit, round and green, the size of small basketballs were ripe. No-one seemed to own the land or showed interest in the tree. We found a way in through the wire, Fasi fashioned a long forked stick and jabbed at where the fruit joined a branch until they fell and caught them before they hit the ground.
He showed me how to scrape the skin off, cut them in quarters, boil them till almost soft and finish off the cooking process by oven baking. The kitchen filled with a warm baked smell, we ate it with a curry, dipping it into the spicy juices.
The tree isn’t native to Australia it was found originally in New Guinea and the islands of the Pacific, the Aurukun one would have been planted by visiting islanders.
We heard later that the overgrown block used to be a market garden which grew a variety of vegetables, possibly overseen by an islander. Garden cultivation is not a traditional part of the lives of Indigenous Australians but where an islander lives there is usually fruit or vegetables growing nearby. There was something comforting about the sight of that breadfruit tree, maybe it was the memory of the baking smell or simply the knowledge that in that remote place food could be found somewhere else other than the local store.
Food logistics
The barge is a welcome weekly sight in Aurukun, as it is in many remote communities along the Australian coastline. In the wet season it’s the way food and goods are delivered. It takes a few days to arrive from Cairns so it’s amazing that fruit and vegetables are still edible by the time they’re put in the store fridges.I quickly found out, once the rains arrived, that frozen vegetables provided the most variety.
If the barge is delayed, which happens from time to time, many people in the town eat rice, damper and tinned foods and hope each day that the barge will be sighted at the landing, so they can stock back up on food.
Since working in Aurukun I’ve never taken Woolworths for granted again!
Sleep Deprivation
When I applied to work in a remote clinic I assumed that being on call after hours would be like doing night shift. It wasn’t. With night duty you know what hours you are rostered to work, with remote area after hour call outs, nothing is certain. You quickly learn that you could be woken up several times a night, rarely for real emergencies.Nurses are often told to educate the community on what an emergency is, but at 3am arguing with someone who’s woken you with a toothache,simply guarantees that you lose more sleep than if you just get out of bed and go and see them.
The US National Sleep Foundation recommends that adults need between seven and nine hours sleep a night. Continued lack of uninterrupted sleep results in sleep deprivation with potentially fatal effects.Remote area nurses usually have fatigue leave (if they don’t work in a single nurse post) which is supposed to make up for lost sleep. While we all value it, it is rarely a substitute for sleep. If staffing is short or clinic demands many, a nurse repeatedly on call can be functioning at a much reduced level of competence. When important decisions have to be made for patients health one has to wonder if the added responsibility put upon them to “educate” the community about what an emergency is, is a wise thing?
Among the many results of lack of sleep are an increased risk of accidents and injury, impaired attention, alertness, concentration, reasoning, memory and problem solving. It can lead to health problems such as heart disease, stroke, diabetes and depression. Judgement can be impaired, especially in regard to being able to assess what lack of sleep is doing to oneself. Also hurting their ability to make sound judgments because of a reduced ability to assess situations accurately and act on them wisely.
Before deciding to work in remote areas nurses do well to assess how well they function without sleep.
Wet Season Christmas
Getting caught in the rain, Mel and Fasi managed to turn it into an adventure while I was nursing what I thought was a broken wrist…but it was a memorable Christmas for us all and the first North Queensland one!
Reverse Culture Shock
I worked in Aurukun at the top of Cape York, Queensland on a five week contract before deciding to apply for a permanent job in the clinic. After I was interviewed and got the job I was flown home to South-East Queensland for 10 days to pack my things to be shipped back for the three-bedroom house I was to move into.
En-route I stayed overnight in Cairns. There were too many people at the airport, the shops and the motel foyer. There seemed to be more cars on the roads than when I was there five weeks previously. The colours were brighter, there was too much choice in the shops and everyone seemed to be talking loudly. I felt strange just walking around Cairns Central looking at the shops. I felt out of place, like I didn’t belong.
When I arrived home and met up with family and friends their questions sounded trivial to me, or their lack of questions widened a gap I felt was opening up between me and everything I’d considered normal before I left home.
I didn’t know it then but I was feeling the effects of reverse culture shock.
When a person returns home after being in another country or social environment it takes a whole other set of adjustments to when they first encountered the new setting. People assume because their friend or family member who’s been away, looks and sounds like the person they knew, that they still belong to all they left behind. But often things have changed in their absence and they have experienced life outside their previous norms in the time since they left home. They can, in fact, be quite disorientated on return.
Being aware of reverse culture shock, being prepared to experience boredom, isolation, disorientation and annoyance on arrival home will help a person to readjust. It’s a good idea to keep in contact with new friends made from the host culture and to talk to people with whom you can relate. It’s also often helpful to use creativity to incorporate the new cultural experiences into one’s regular life by writing articles or creating a photo exhibition, or simply by bringing art or cultural items into one’s home as a reminder of the time away.
Asking yourself what you’ve learnt and how you’ve changed help you to be more aware and to adjust and for the time away to have a positive effect.
I have to admit though that while these ideas are helpful, coping with reverse culture shock takes a much longer time than you’d think and if a person moves between cultures fairly regularly it doesn’t seem to get any easier. In fact one often feels like an in-between person not quite belonging anywhere.
Samoa in Aurukun
My first weekend in Aurukun I wondered how I was going to fill in the time where there were no café, cinemas or friends. But I was invited to go fishing with another nurse and the two Samoan guards. I caught my first fish, a Trevally, and began a habit of walking down with the boys most weekends and spending time with a rod among the mangroves. Fasi and Tupe were fun to be around. They laughed, joked and told stories of Samoa. The time with them went too quickly.
I soon looked forward to having a chat with Fasi, on the clinic verandah on my way back home after seeing patients after hours. His English was better than Tupe’s and he told me stories about working on the family plantation in his village of Tuan’ai on the island of Upolu, before and after school. Of the long walk there and the need to please his often angry father. Being taught to dive by him, to spear fish and octopus to feed the family. He taught me a few Samoan words and laughed at my pronunciation. He talked about breadfruit, taro and coconut cream and other Samoan foods.
A month or so after I arrived Fasi and I walked down to the landing most afternoons after work if we weren’t on duty. The landing was where we fished and where the locals put their boats into the Archer river and headed off closer to the Gulf waters. On a slow wander along a red dirt track one afternoon we found a tall breadfruit tree, covered with green fruit the size and shape of small basketballs. Fasi was excited to see what he called in Samoan, an ulu tree. He knocked down four with a long forked stick and we carried them back to his flat. I had my first lesson in Samoan food preparation. The tiny kitchen soon filled with the warm scent of baking ulu. The next thing to do was to find coconuts to scrape the flesh and make cream to dip the ulu in, take fish out of the freezer and an island style feast would be ready in no time.
Security
Before I flew into Aurukun the Director of Nursing at the Health Clinic told me she employed two Tongan security guards to keep the nurses safe in the clinic on after hours emergency call outs.
When I arrived in 2008 I was taught how to lock the ambulance securely in a shipping container. Prior to that idea ambulances had been stolen and wrecked by local youths hungry for adventure.
I soon became accustomed to carrying several keys for various secured doors and the padlocks of closed heavy metal gates.
The word security means the state of being free from danger or threat, it comes from an old Latin word, securitas, which means “free from care”.
Aurukun over the past 20-30 years has had a history of violence, riots in the streets and fighting between families and clans. The reasons are too many and complicated for this post. But it’s resulted in the need for high security measures for all who work there.
It’s an odd thought that to be safe and free from care actually requires a large amount of resources, planning and attention. It’s just another paradox I’ve encountered as a remote area nurse.
Where Curiosity led 