Grief

Today is a sad day in the Torres, Cairns and beyond. Soon the funeral will begin for eight children killed by their mother last month in Cairns. There are no adequate words for such an unimaginable event. There is no easy way to make meaning of what happened. Sometimes the work of making meaning has to be suspended and grief must be expressed in all it’s many forms. Today is such a day, to grieve for the children, for their fathers, their families and their mother. To remember and stand by all the people in the helping professions that have been involved with this happening over the past weeks and into the future. May we be generous and kind in our grief to all these people. Our minds and lives can be much more fragile than we realize in our busyness, none of us are really super heroes, we don’t know how we would react given the “right” amount of pressure and we don’t really know what’s going on in the minds and thoughts of those around us, even those closest to us. This is part of what it is to be human, to not know. Let us grieve today and be sad in our own way for what happened in Cairns and may it lead us to be kinder and gentler on ourselves and the people around us.

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.

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.

Arriving

100_0035Arriving somewhere new, for a holiday or work or to meet someone is often accompanied by varying emotions and have layers of meanings. I’ve often people watched at airports and wondered what was going on in different people’s lives at the time. Airports and train stations are places of transition, arrivals and departures are portals into another life and with any journey the traveller never really knows how their lives are going to be affected by their destination.

When my partner arrived in Aurukun, a few months before me and before I even knew that he existed he wrote in his diary after landing “This is a strange place.” A short sentence but filled with many meanings that he was yet to discover, as would I too, months later.

On the 1st September 2008 and a few hours after landing in Aurukun this is partly what I wrote in my diary:

“I flew into Aurukun today, the first day of Spring. From the sky the area around is criss-crossed by dirt roads and rivers. Dense bushland, small fires spiralling up smoke, odd patches of semi-cleared ground…and still more flying time left. How far away is this place I’ve come to work in at the top of Cape York. I have no idea what to expect. I don’t know what my curiosity has landed me in this time. A place I’ve never heard of and couldn’t even find on the map. I don’t know what a paediatric nurse is doing in a place like this. I climbed down the stairs of the plane and walked into thick heat, dust and dark-skinned faces tinted dusty red by the gritty wind. There were people everywhere, standing about, shouting, waiting, kids on bikes, skinny, mangy dogs and police checking bags for alcohol…while I waited my turn to have my bags searched curiosity dissipated the shock of strangeness.”

We both described Aurukun as strange immediately on arrival. I felt afraid, Fasi was intrigued, we told each other months later. It was a place like no other we’d ever seen, nothing in my experience as an Australian prepared me for it and certainly nothing in Fasi’s experience as a Samoan had even come close. Neither of us had a clue how our lives would change after the long journey there.

Perhaps there’s more than one reason people feel apprehension at the beginning of a journey, for themselves or those close to them. And maybe it’s not always the hope for a physically safe trip…it’s because travelling and arriving has the potential to change our lives. There’s no guarantee that the person who arrived will be the same when they’re ready to depart.

The photo here is of the airport shelter at Aurukun place of so many arrivals and departures and in the wet season, the only way of entry.