Kalgoorlie is a town of 30,000 people, six hours inland by road from Perth. The town was founded during the gold rush and has the wide streets and early 19th century Australian architecture typical of outback towns. Green grass is a rare sighting in Kalgoorlie instead red earth covers what isn’t concrete and ubiquitous gum trees line most streets. Walking around the streets you feel as though your shoes and trousers are going to take on the rusty hue.

The town still thrives on gold although transformed from its more modest beginnings the mining industry now uses hypertrophied trucks and diggers to create the ‘super pit,’ an open cast mine 3km by 1km wide and 300m deep. The land around Kalgoorlie is flat for probably 1000km, any hill seen in the distance is likely created from tailings of one of the multitude of mines.

For the last six months I have been living in Queenstown spending my spare time climbing and running up the multitude of peaks surrounding Lake Wakitipu. Coming to this arid land has been a contrast in scenery and in the hospital I am used to working in. My base hospital, Lakes Hospital in Queenstown, is a small affair with 12 inpatient beds and a busy emergency department. Kalgoorlie Hospital is a sprawling interwoven maze of departments covering a full city block (all be it the hospital is only one story high).

This week I have been with the paediatric team. The first day at the hospital was spent walking down endless corridors trying to find my way back from referrals in the emergency department to the paediatric ward. Eventually I found my bearings and made sense of the counterintuitive diagonal hallways.

The paediatric team was welcoming and spent a lot of time teaching about the different patient presentations and pathology. This week has been bronchiolitis week, baby after baby presenting with coughing, wheezing and fever. One of the more memorable was a six week old baby who was born at 31 weeks, when we saw her in ED she was having apneas and dropping her heart rate into the low 60’s.

The consultant recognising the life threatening condition immediately, set up CPAP and gave caffeine. It was my first experience seeing a neonatal resuscitation. I was impressed how quickly the team moved to set up the equipment, insert lines and provide care for this fragile baby. After a few days the baby recovered and was able to go home with a tired but relieved mum.

Later in the week the Australian Flying Doctors brought a boy from “the lands”, an area 500 km north east of Kalgoorlie sparsely populated by indigenous Australians. The ten year old boy they retrieved was known to have rheumatic heart disease and was thought to be having a recurrence. The boy was known to be non-compliant with his monthly prophylactic penicillin injections, had a sore throat and arthritic knee pain.

It was fascinating and heart breaking for me to meet this child and his mother who lived so remotely and with minimal health care. They both spoke english as their second language and were shy when talking to doctors. It was decided that he needed further input from cardiology in Perth, as new heart murmurs were emerging daily showing that the disease was progressing.

It is likely that this child will have long term health complications and go on to need surgery and heart valve replacement. I asked him why he didn’t like taking his penicillin and he said that he was afraid of needles. His mother understood that he needed  the medication and was a devoted loving mother to him on the ward, but was still unable to ensure that he received his medication each month.

At first I felt frustrated at my patients mother for not ensuring the health of her son, however there are so many complicated factors at play in the Australian indigenous population that I only glimpsed in my first week.  It is very hard for me to imagine what their living situation looks like, but the local doctors and nurses explained that they were unlikely to have a refrigerator or a television, that there might be a shop nearby that was unlikely to have any fresh produce, and they would move around a lot making education difficult.

I hope one day I am able to travel to these remote settlements so that I can see first hand how these people live and appreciate how difficult accessing health care can be.

And now it’s a rainy Sunday and I’m spending the afternoon catching up on school work after a morning spent exploring the mines and markets of Kalgoorlie. Yesterday we drove to the famous Lake Ballard, an enormous salt lake with an impressive art installation along its shores. Next week I’ll be on the general medicine team. I’m looking forward to learning about adult health in Western Australia, although I’ll miss the cute babies.

Read Clare’s final blog