‘The world’s your oyster when you’re a rural GP’

Dr Ishani Kaluthotage has crossed jungles on the West Papuan border, braved crocodile infested waters in a dinghy, and explored remote islands in East Arnhem Land.
 
She has volunteered in Papua New Guinea, Sri Lanka, Nepal, India, and Tanzania, and worked in Far North Queensland, East Arnhem Lands, and the Far North and West regions of South Australia.
 
On an average day, you will find her up in the clouds, treating patients in an area spanning 840,000 square kilometres as a rural generalist with the Royal Flying Doctor Service.
 
And last year, she was joint winner of the RACGP’s Rural Registrar of the Year Award for her ‘passionate advocacy for reducing the health inequalities faced by isolated communities’.
 
It is an impressive resume.
 
‘I wanted to work with vulnerable populations, those less fortunate and those with limited access to healthcare,’ Dr Kaluthotage told newsGP.
 
‘[My parents] left a world of political unrest and poverty for better opportunities for us.
 
‘I’ve been blessed with endless opportunities throughout my life, and I’ve always wanted to make sure those less fortunate have the right to good health – a basic human right.’
 
Dr Kaluthotage is now a staunch advocate for doctors exploring careers outside major cities, and the more she travels, the more she sees a need to create change.
 
‘Despite spending so much time overseas, it always saddens me to see that we have similar third-world conditions in our own backyard,’ she said.
 
‘Health literacy and access to resources is a big issue – access to good continuity of care, limited specialist outreach services and patient populations with complex comorbidities.
 
‘It’s not easy for us to tell someone to be healthy when access to healthy foods such as fruit and vegetables out in remote communities is so limited, and even if they do have access to it, it’s very, very expensive.’
 
Dr Kaluthotage’s advocacy comes at a time when Australia is battling a rural healthcare crisis.
 
Even though strategies are already in place to entice GPs back, including cutting red tape for international medical graduates and new RACGP-supported placements, dozens of towns have still been left without a doctor, while many more have just one left to service an entire population.
 
It is these regional communities suffering most from maldistribution, with patients in remote areas more than twice as likely to die from potentially avoidable causes.
 
Dr Kaluthotage said there is a lot to be done when it comes to helping Australia’s most isolated communities, but progress is being made.
 
‘Increasing education, increasing health literacy and awareness about good health from a young age is really important because as you get older, it’s really hard to change bad habits,’ she said.
 
‘Since the COVID pandemic we’ve realised how vital telehealth is. It’s a great tool and we should be using a lot more of it because for remote communities, it’s not always feasible to fly or travel far to get basic healthcare.’
 
And having worked in those communities, Dr Kaluthotage has gained invaluable insight into the issues they are facing, both within the healthcare space and outside of it.
 
‘You get a lot of autonomy and it’s very different to a city tertiary hospital where you are surrounded by a lot of health workers. When you’re out rural it might just be you and two nurses,’ she said.
 
‘You get a better understanding of where patients are coming from, distances needed to travel to get health care and the resource challenges that smaller hospitals might be having.’
 
Overall, Dr Kaluthotage summed up her time spent out bush as ‘pretty special’ and is now encouraging all GPs to think about a stint working remotely.
 
‘The world’s your oyster when you’re a rural GP,’ she said.
 
‘I’ve learned so many things about culture, languages, and local food, you get given artwork and jewellery that people have made, and you’re always very welcomed into these communities.
 
‘Even if it’s not for a lifetime or a long-term plan, I highly encourage everyone to spend some time working in a rural area as it is an experience you will always remember.’
 
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