One doctor’s adventures in Aboriginal medicine
Wavelength sends doctors all over Australia, but perhaps the most unique experience we offer is the chance to practice indigenous health in some of our most remote communities.
Some become quite enamoured with this kind of work, such as Hobart-based Dr Amin Sadruddin, who’s undertaken a number of locums for us in Aboriginal communities across the top-end.
I wanted to understand the appeal, so I called him to talk about his experiences. Firstly, I asked him how he got started.
“Years ago I took a five-week locum in Far North Queensland to save money for an overseas trip, but I ended up working in indigenous health for two years,” he tells me. “I never made it overseas.”
An ongoing fascination
Dr Sadruddin did eventually return to urban practice, but recently has once again answered the call of the outback. So what is the fascination, I wonder?
“Outback work really is the antithesis of general practice in cities,” he says. “My days are always interesting, challenging and satisfying. Working in indigenous health is a great use of my medical education and I often have to go back to first principles.”
He explains that cases often present late and a history can be hard to glean. Physical examination becomes a critical part of the diagnostic process again.
Aside from the clinical challenge, he feels privileged to work in places that he would never otherwise visit. Plus - he gets paid.
The gratitude from the people he works with is palpable. “In the city I feel surplus to requirements, but in these communities my services are in high demand,” he observes.
“I am often the difference between a medical service staying open or being shut down. It’s a humbling experience.”
“My days are always interesting, challenging and satisfying. Working in indigenous health is a great use of my medical education and I often have to go back to first principles.” Dr Sadruddin
Like most Australians, Dr Sadruddin’s prior experience of Aboriginal Australia was limited to cultural stereotypes and encounters on city streets with people on the fringe of both societies - the so-called long grassers.
His new understanding could not be more different. “The people I meet are so nice, and I’m always amazed by how much diversity there is between communities. The desert people are completely different from the coastal tribes, and the Torres Strait Islanders completely different again.”
His experiences have also given him a unique perspective on the state of indigenous health in Australia. I ask him if he notices any trends.
Oh, the places you’ll go!
“I see glimmers of hope that Closing the Gap is working and more often than not, communities empowered to run their own health service appear to have better outcomes than government-driven initiatives,” he observes.
“Not only are these communities motivated to serve themselves, but they also provide care in a more culturally appropriate way, which really helps to break down barriers.”
“Communities empowered to run their own health service appear to have better outcomes than government-driven initiatives.” Dr Sadruddin
Amusing cultural differences
Dr Sadruddin is all too familiar with such cultural differences but in the early days his naivety lead to some bizarre and amusing misunderstandings.
One, he recalls, was straight up frightening. While visiting a palliative patient he found the house filled with about 50 relatives with as many dogs. The patient passed away that night and everyone disappeared back into the desert on sorry business for several days.
“The next thing I knew, there was a chanting crowd approaching the surgery armed with burning branches.” Confronted with this novel sight he immediately deduced that he was being blamed for the death and was about to be subjected to payback - another well documented Aboriginal tradition.
Clinic staff quickly re-assured him that this was a smoke-cleansing ritual and that the surgery was next on the list.
Such experiences (once established as non-threatening) have been at the heart of Dr Sadruddin’s fascination with the indigenous health experience. And this is what keeps him coming back for more.
“I am often the difference between a medical service staying open or being shut down. It’s a humbling experience.” Dr Sadruddin