‘It all happened very fast’: GP’s role in Katherine emergency

A few months into a new job in the Northern Territory, Dr Karin Jodlowski-Tan realised a major emergency was in the making.
 
Earlier this month, monsoonal rains were taking hold in Katherine, where she started a clinical governance role at the town’s central Wurli-Wurlinjang Health Service last September.
 
While the NT Government had not yet issued any major evacuation warning, she and her colleagues decided the time had come to act at an emergency meeting on 6 March, with the Katherine River rising rapidly.
 
‘We had no direction from Government, but the AMS [Aboriginal Medical Services] decided we were going to activate our major flood plans based on our knowledge,’ Dr Jodlowski-Tan told newsGP.
 
‘And at the time, unbeknownst to most of us, the satellite for the Katherine region was actually out of action for four days.
 
‘We actually had no idea what was happening locally, it was all via the satellites in Darwin.’
 
That local insight proved crucial as the biggest floods in 28 years started to envelop the township and its surroundings.
 
Dr Jodlowski-Tan, also RACGP’s National Clinical Head of Rural Pathways, has done disaster management training before. Even so, the speed of developments surprised her as she helped lead a major flood response for the first time.
 
‘From the Thursday night to the Friday morning, the river rose from nine metres to 15 metres, so that was very unexpected,’ she said.
 
‘It all happened very fast.

‘People were moved into shelters, the aged care facilities were evacuated, three schools were set up in Katherine as shelters.
 
‘And because they were classified as shelters, they weren’t getting as much government resourcing as evacuation centres. That was something I wasn’t aware of until late in the piece.’
 
The hospital was also soon evacuated, with patients flown to Darwin, and a temporary AUSMAT field hospital set up in its stead, while two of the town’s three Aboriginal Community Controlled Health Organisations (ACCHOs) had to shut their doors.
 
With the Wurli-Wurlinjang Health Service remaining out of the flood waters, it became central to the response, widening its care to the whole community – and with workers from all the ACCHOs joining forces in a major effort to coordinate primary care.
 
This included setting up a mobile clinic in one of the school shelters where more than 300 people had taken refuge.
 
‘It was really great collaboration between all the ACCHOs to service the shelters over that week, supporting their communities that were flooded out,’ said Dr Jodlowski-Tan, who feels the flood response highlighted the pivotal role of her profession.  
 
‘Primary care, particularly the AMS, all came to the fore in that situation.
 
‘It highlights how much primary care and general practice is needed in disaster management, in crisis.
 
‘That’s the care that most patients need – we saw 500 plus patients over the course of five days.’


The primary care response team in Katherine, including Dr Jodlowski-Tan (crouching, bottom left). 
 
Among the obstacles were finding medications for patients with chronic disease, many of whom had evacuated from their communities without their regular medicines – and the additional complication of a now-flooded pharmacy.
 
Public health was also a priority, and she liaised with government agencies about quarantining respiratory virus cases, and working to prevent gastroenteritis.
 
The healthcare was the easy part, she found.
 
‘When things like that happen as a doctor you almost go into automatic mode, you just do what needs to be done,’ Dr Jodlowski-Tan said.
 
She says the non-clinical issues were trickiest, including inter-agency communication, housing issues, patient transport, as well as the ‘ongoing challenge’ of sourcing medications.
 
She also praised the work from NT Government workers who she says ‘were doing their best on the ground despite the systems challenges’.
 
Their work may not be over yet. There has been further flooding, and more rain is expected in Katherine this weekend. While forecasters have said it is unlikely to reach the same levels, Dr Jodlowski-Tan is conscious the wet season can linger on into April.
 
‘Everyone is a bit frazzled by the uncertainty, that’s what wears people out even more,’ she said.
 
Now outside of Katherine, where she spends half of every month, she is due to return after Easter and hopes the flood recovery will be gathering pace.
 
‘Social support is really hard and things are worse afterwards, the cleaning, the mould, the long-term stuff – that’s going to wear people out,’ she said.
 
‘We’re anticipating and have seen a lot of mental health challenges.’
 
As for the baptism presented by the first wet season in her new role, she has no regrets.
 
‘I was very grateful I was there on the ground when the first flood hit, so I was there for the team,’ she said.
 
‘On a personal note, it’s actually harder not to be there because you’re trying to help from afar.’
 
Log in below to join the conversation.
 

disaster response emergency planning rural general practice