GHC Blog: Rohani Oorloff

Rohani Oorloff, MBBS II

July 4th, 2010:

Professor Rob Moodie, Chair of the National Preventative Health Taskforce highlighted the importance of prevention, at all stages, to really achieving positive ground in the realm of global medicine. He linked the area of Society (with culture, resources, environment, media) to influencing Socioeconomics (including education, employment, family, attitudes) which in turn determines health behavior (tobacco, exercise, birthing) which combined with biomedical factors of blood pressure, cholesterol, weight create a person’s health status.

Broad Society → Socioeconomics → Health Behavior → Biomedical Factors → Health Status

My Human tutorial today focused on Refugee Health and Dr Christine Boyce, as a GP in Hobart, expressed the need for the refugees to become whole again. So much in their lives was trauma, shattered dreams and hopes, splintered families, lost culture. In assisting with the physical wellbeing, the psychological, social, cultural and often spiritual connectedness must also be considered.

Listening to our final presentation by Nick Bearlin-Allardice, I laughed in recognition as he spoke of the amusing-in-hindsight challenges of backpacking through India. I frowned in recognition as he spoke of the environmental waste ground which the Ganges has become. I shuddered in recognition as he spoke about the brothel towns, the street kids of no family, no history, no name. He shared his passion with incredible conviction, urging everyone to grasp hold of one of the images he was showing us, to always keep in mind the human face behind all this big talk of global health, to forever work towards making life better for each of the individuals, without getting caught up in the ‘intellectual’ thinking and losing the driving emotions underneath it all. He summed up the key message of GHC 2010 – Big Picture, Small Steps. As many of the speakers have said all along, find your passion and do something with it. There are no expectations for you to do everything. But imagine what you could do if you try. It’s widely accepted that young people are the drivers of social change. As Nick said, we are naturally rebellious. We also hold an incredible power to make people listen, and to direct the future which we want to be a part of. With so many fascinating ideas and areas out there, it’s always been hard for me to stick with one thing. GHC has given me more information, more ideas and I’m beginning to find the areas I know I’ll be passionately working in for years to come. I look forward to being involved, to being part of the change as it happens. Many thanks go to all the speakers and all the other students with whom I discussed and learnt and shared with over the four days; it’s been an incredible adventure.

July 3rd, 2010:

Saturday unveiled the mystery of Challenge Day. Split into teams of around 8 we jumped to the call of a placement in a refugee camp. First up was triaging of patients and first aid management and my concept of modern warfare was tipped on its head by finding out that bullet wounds are the most common injury in conflict. We then were tasked with planning and constructing a refugee camp including budgeting for bribing the guards at border crossings to bring in our construction material. Meeting challenges of cholera outbreaks and medicine shortage we handled that medical clinic with great teamwork and smooth combination of medical knowledge, although we did move far too slowly – something which will no doubt change with practice. The challenge day highlighted the challenges of refugee life and was summed up as a balance of preserving their identity while being driven by a desire to grow and lead a better life. It was exciting to see the team come together, having never met before, each contributing their unique skills to achieving this collective goal. I look forward to being part of the reality.

July 2nd, 2010:

Today a couple of us rose early for a wander in search of a delightful breakfast treat, and enjoying delectable eggs and brioche we dawdled a bit too long over the final sips of coffee. Realising the time we dashed off down the hill, through the laneways, for this was certainly not a morning to be late. Opening was the much admired Senator Bob Brown. Having heard him speak many times, and on the occasion sing, in the casual chilled zone of the Woodford Folk Festival I was slightly disappointed to be faced with this suit and tie politician. A powerful ‘Vote Greens’ message was definitely a not-so-subtle undercurrent, and you could certainly sense the gearing up for an upcoming election. Despite this pollie approach, it was still dear Bob underneath and he spoke of the changes to society that are beginning to contribute to our tolerance of environmental destruction. Raising ideas that the modern day self-focused, competitive, self-gain mentality has directed a move away from the collective support approach. With such a heavy focus internally, it’s becoming impossible for people to focus and relate to the needs of the greater biosphere. I admire his statement that “This planet should be better for us having been here…..it nurtures us, we should nurture it.”

Following up in equal incredible form was Tim Costello. Strongly involved in wide social justice areas, he’s currently Chief Executive of World Vision Australia and promoted the recent campaign of ‘Child Health Now’. Linking in with the fourth UNMDG of reducing child mortality it is global advocacy focusing on healthy mothers and children, nutrition, disease prevention and healthcare access. He challenged the idea of growing national sovereignty with the poignant examples of the classic butterfly fluttering its wings in the Amazon, to cause a cyclone in Australia, and linking with the more recent ideas of swine flu in Mexico closing schools in Melbourne, a war in Iraq creating bombings in Bali and refugees to Australia. It is definitely a global, group effort, requiring the might of human power falling into alignment to really make that difference.

This year’s GHC saw the introduction of tutorial streams, in Captain Planet theme, of Human, Earth, Wind, Water and Fire. Heading off to my Human streams we heard the brilliant Dr Jill Benson speak of her work in Tullawon Health Service at Yalata in remote South Australia. It was a fascinating insight into the complexities and daily challenges of providing effective health care to an area so remote and so entrenched in a culture intensely foreign from one’s own. I was very jealous of Flinders Uni for having such a terrific mentor to guide their work in indigenous health. My second tutorial was with Kevin Perriman of the NTGPE giving us the basics to interpreting and understanding kinship amongst aboriginal clans. There was a brilliant moment of ‘ah ha!’ as we pieced together the interlocking relationships, generations and customs. Using flowcharts and diagrams we gradually pulled it together and then realized that this information is retained in people’s heads, to be passed in memories from parents to children! The system of naming connects with such diverse cultural importance and we gained some insight into the disastrous outcomes of the Stolen Generation, when people lost their skin names.

July 1st, 2010:

The feeling as we all gathered in the lecture hall for the first time was of such heightened excitability and eagerness. Everyone was ready to learn, to discuss, to challenge and change. Converging on Hobart from all parts of Australia’s medical schools we stood together as a group, acutely aware of the power and potential in the room. I heard the number 500 for attendees and it seemed about right, as we overflowed the chairs and perched in walkways to hear the opening greetings and listen in awe as the diverse spectrum of speakers stood and engaged us and inspired us over the next four days.

We were blasted full speed into the global health mode of thinking with the opening plenary from Dr Helen Caldicott. A paediatrician by training, she is certainly one of the most articulate and passionate women I have ever had the fortune to hear espousing remedies for the current progressing destruction of planet earth. Devoting her time now to educating every man, woman and dog about the dangers of the nuclear industry to health and the environment, Helen speaks with incredible urge and power to captivate the attention of all in the room. Claiming “our planet needs an ICU” her fluency with facts, numbers and science portrays an interesting picture. Growing up in a family with decidedly anti-nuclear sentiments, my ingrained opposition to its use as an energy source has been challenged recently with friends and high standing, personal idols in the scientific and governmental fields declaring support. It was refreshing to hear logical and science based ideas for the dangers and in particular, the inefficiencies of nuclear. Admittedly though we all took it with a grain of salt. Helen challenged our thinking, challenged us to consider again, why we were on the side we were. But she also made us laugh, usually at the farfetched and extravagant comments that had her labeling ‘wicked’ men and planning to mix contraceptives into the water supply to limit over population. Definitely a highlight of the program and encompassing just why we travel thousands of kilometers to sit in a room with other med students – it’s the chance to broaden our horizons, examine our beliefs and act for our future.

The first day was wrapped up with a forum on Globalised Medicine – Does One Size Fit All? The question of “why treat?” does not often play at the forefront of medical students minds. It’s taken as a guarantee – if someone is sick, help them get better. However when the resources are limited and the help needs to be culturally appropriate, the ethics behind this become layered. When I was in Year 12 geography class, myself and 3 mates devised a plan to save Myanmar and pull it, and its people, into the 21st century. We planned harbours, hydroelectrical dams, schools, medical clinics, micro loans and cultural trading. We thought we’d covered it all – medical, political, environmental, community. Our principal casually wondered past one lunch time and sticky beaked into our brainstorming, and after briefly listening, calmly commented that we’d missed the point entirely. We were planning to enforce our ideas of civilization and society, thinking they were the best options. Maybe Myanmar didn’t want saving. Maybe they didn’t want our chemotherapy drugs, our cardiac surgery, our money making schemes, our industry, our English classes. This lesson stayed with me and a lot of the forum resonated with similar ideas. It can be pretty much assumed that every human being wants to be healthy, live a long and happy life. But the specifications on how to be happy and healthy differ drastically between countries, cultures, generations. Ngaire Brown, CEO of the Australian Indigenous Doctor’s Association emphasized cultural competence, clearly pointing out the strong need to deliver a health model designed to suit the people it aims to service.

June 30th, 2010:

The Tasmanian adventure begins, for me with a late night brissy flight on the cheap chips airline Tiger. Of course the epic journey is complicated by a 6hr midnight layover in Melbourne, dozing on metal chairs (seriously, the budget doesn’t cover some cushion?). Finally we rock into Hobart in the glare of the rising sun, which does nothing to the frost crunching under foot, nor offering any ray of warmth for my poor shivering body as it stumbles across the tarmac.

At the backpackers, so named the ‘Pickled Frog’, (not the Leaping Lizard, as I reported to the airport shuttle driver – whoops!) I defrosted in front of the log fire and added several more layers before venturing to the Outside again. I spent my first day strolling the ciy streets, ending with a brilliant cinema viewing of the German film ‘Soul Kitchen’ – a hilarious drama of owning a restaurant while managing a criminal brother, a psychotic chef, a girlfriend in China and a slipped lumbar disc. Much recommended. The little Star Theatre, playing host to such arthouse, foreign films sets up a joyful cinema with 16 glorious armchairs to sink into and delicious food to accompany.

Tuesday I got adventurous and explored Mt Wellington on foot. I criss crossed back and forth along the Eastern face passing from waterfalls and fern rainforest to the exposed upper slopes of rugged alpine shrubbery. Teetering on the rocky slopes below the ‘Organ Pipes’, massive vertical rock columns, I was in awe of the landscape and view. Then the steep ascent to the pinnacle, across ice crusted rock and onto the top, fighting to remain upright against the cyclonic wind that permanently harasses the tourists brave/stupid enough to emerge from their cars. Seeking calm within the wind shelter, listening to the wind howl and scream, the view was spectacular. A beautiful sun touched all of Hobart and the Derwent river sparkled in show. It’s a glorious city combining water and rock.

Today was a touch warmer, until the sun got gobbled in cloud. So a perfect chance to explore the older part of Hobart. I found a spectacular sunny spot in Princess Park above Salamanca Place to finish writing my postcards home and then enjoyed a delectable lunch at Jackson and McRoss on Hampton Road – a spot to excite anyone’s appetite!
Catching up with the crew tonight to begin the GHC adventure!