essay: Kalkarindji

Fri 4.9.09

Hi, greetings from Kalkarindji – a very small very hot (washing dries in minutes)  little place with a nice brand new clinic, a shop, a school, a police station and not a lot else – and yes a nice big house which I share with several big fat geckoes.  Major problems establishing a home internet connection so I am not sure when this will go off, but here’s hoping.
Easy flights to Alice and Darwin early last Saturday, nice big hotel on the Esplanade overlooking the sea, and spent the afternoon walking around Darwin – small quiet place all relatively new after cyclone Tracey.  Curious welcome:  I’d walked a hundred metres from the hotel along a broad footpath when thump a strange whitefella (?schizophrenic, certainly not drunk) road a pushbike straight into me from behind. I turned to remonstrate and he sort of smiled and said “hit me”.  I walked off keeping a wary eye on him as he veered all over the path.
Up at 0530 next day for a taxi to the airport to catch a Greyhound to Katherine, but my itinerary wrong so a rapid taxi back to the bus depot near my hotel (!) just as the bus was arriving late.  Greyhounds rather luxurious like small jets, and the 4hr trip reminded me of Oz’s vast emptiness – mile after mile of flat mulga scrub, countless thousands of termite mounds up to 3m tall and 4-5 metres around the base.   WW2 historical sites all the way down.
Arrived somewhat unexpected but managed to track down Dr Andrew Bell and had lunch with his nice GP wife Kate and family.  Andrew runs the Katherine West Health Board (my employer) responsible for a vast area of NT.  It has pioneered a successful model of local black community (rather than govt) controlled health care which Andrew is busy spreading to the rest of NT.  He’s a big bald cheerful bearded chap, a pilot and bird lover with an academic’s mind for detail.  They have a lovely property on the edge of Katherine, a menagerie of tame parrots, many chickens and Dalmatians (which bare their teeth when they smile,  in a terrifying rictus).
Then set up in a motel opposite the Board, and spent the next few days being oriented largely by Dr Louise Harwood, very nice young ex Kiwi GP and committed to Katherine as Andrew’s 2-i-c. Interesting sessions with David Lines, Kalkarindji man and Aboriginal Community Development Officer who quietly gave me all the umpteen reasons why true communication might be difficult – including the nice phrase “gratuitous concurrence” – smiling and nodding but not really understanding.  Also a session with a gay regional STD coordinator, who gave me twelve dozen Snake condoms in flavours of vanilla, strawberry and chocolate – designed by local black youth and highly prized.  Where have I been?? STD especially syphilis is very prevalent and already I’ve seen a number of (young) patients with that dreadful disease.
Spent Tuesday morning getting to know Communicare the difficult klunky computer program used throughout NT health – designed more for epidemiol research than for clinical doctors, and then onto the mail plane – four seater single engined Cessna for the 1.5 hr flight to Kalkarindji, stopping once at the famous old station Victoria River Downs.  Katherine airstrip is also Tyndal airbase home to about 50 FA18’s (??) – fighter bombers which form a significant part of our northern defences – one took off just beside us and it felt like Armageddon.  They were exercising that day so our little moth had to fly low through a long narrow corridor.  The afternoon heat rising from the land made it very bumpy and after taking off from VRD I started to get airsick – nice retired black teacher next to me directed his cool air stream onto me but to no avail – his name was Maurie and I’ve met him since and he is starting a black political party up here.  By the time I got here I was not my usual robust self – definitely a whiter shade of pale.  Picked up by our very friendly helpful nurse manager young Simon Stafford, but not feeling too social so went and slept a few hours – but did manage to cook tormato macaroni pie that night!
So have now done 3 days work, struggling with Communicare, but now feeling much better about it.  Four white staff incl me and about 4-5 black, everyone v friendly and helpful – a bit of a wonder in that they must so often show the ropes to new locums.  Alcohol and diabetes and kidney disease are huge out here , as is STD and trachoma, so its very different of course from Melbourne – no appointments, everyone just arrives and waits or gets brought in by one of the clinic’s 4wds. A snake in the clinic today then nobody could find it – I’m told it doesn’t happen very often.  Some v big stations around about eg Wave Hill, with numbers of young white people working there.  I am going to try to find the fellow who gave me a lift from Katherine to Cosham St all those years ago.
Alcohol v restricted.  You can get a permit for your house, and there’s a rather nice shady club for beer, open after work 5-8pm.  Gambling – cards – very big here – esp after pension day – hard to get folk to come to the clinic in the afternoons. I’m told large sums of money change hands and then winners shout everyone in a big spend-up.
Have been walking half a k down to the Victoria River in the cool of the mornings – carrying a length of hose re roaming packs of dogs, though they don’t look fierce.  Now in the dry it’s a series of stagnant ponds in a gorge, but becomes massive in the wet – there are floodlines through the town!  Saw brumbies this morning and there’s horse poo everywhere – they graze in the town at night.
V nice welcoming bbq’d barramundi last night at Simon and Lea’s place a few houses along.  A bit of exploring coming up this weekend, and Simon/Lea/Tiger coming for tuna bake on Sat nt.  That’s it for now.   Love, Rod

Friday 11/9:  It’s the weekly letter from Kalkarindji, not quite up there with ‘Letter from America’ by the late great Alistair Cooke.  Less to report now as I settle into the quiet routine of work and life in ‘Kalk’ – the clinic is relatively quiet, some days very quiet – not such a bad thing for my first foray into such a different community and health system.  Now that I am better at the basics of Communicare, my work is a lot more efficient, but this is really a public health care clinic I am contracted to, and there are a lot more rules than in private health.
Simon called out to a fatality early in the week – a young white couple from one of the stations hit a roo in the early hours, ran off the road and rolled several times, not wearing seatbelts, the car completely crushed, so was the young man but the girl unhurt – unbelievably lucky for her.  I spent the weekend catching up on orientation readings esp some fascinating acculturation stuff eg different styles of black/white communication.  We value eye to eye contact, and generally relate 1:1.  Blacks tend to broadcast ie it’s communal, not directed at anyone in particular and power is with the listener not the speaker.  This has lots of odd consequences eg courtroom behaviour that upsets magistrates, and frustrates blacks who don’t understand our behaviour.  Traditional aborigines value silence not lots of loud direct talk, often contemplate a question for days before replying – strange to deal with unless you are aware of these substantial differences.
Finally worked out my home emails – have to do them late on the back verandah in the heat and flies – that’s when the Telstra Next G wireless signal is strong enough – also with laptop plugged in, as the battery isn’t much good – all my own rather slow painful deduction.  Cynthia, one of our Remote Area Nurses a Brit with 20 years of isolated postings in Oz, took me on a Cook’s tour last weekend, round the town and over to our sister community Daguragu 8k distant, including a swim in beautiful Wattie Creek, famous in the history of land rights.  It’s the only local waterway that flows in the dry – the great Victoria River just near home is a series of muddy ponds.  Wattie Creek was wonderful – a walk across broad flat red rocks to this lovely deep 30m wide creek, lined by lovely big trees of all types; swam for about 200m with Rosie the red kelpie /heeler swimming joyfully ahead.  No saltwater crocs this far in, I was assured. Saw lots of wild donkeys, which are apparently somewhat sacred to the local folk.   The donkeys have a big, obvious brown cross on their backs ‘where Jesus sat’!!
Quite enjoying consulting with a vastly different group of patients, though at times it’s confronting eg thin little child of 14 wanting her Implanon removed to get pregnant and she has already had one TOP. Mandatory reporting of sex with a minor is for 13 and under in NT, or 14-15 if the fellow is more than 2 years older.  This makes for difficult consults and some subterfuge re true ages. We went to The Club last night to have farewell drinks for the other RAN who leaves today – quite a pleasant outdoor setting where you can drink beer from 5-8pm except Sundays.  Interesting to be one of 7-8 whites among maybe 300 blacks.  Its clearly the social centre of the town, and kids aren’t allowed so they get left at home.  You get breathalyzed on the way IN, and there’s a late rush for the bar much like our own “6 oclock swill” in the days before 10 oclock closing. I’d love to have been able to take a photo of the old girls swaying to the loud rock.  Alcohol is very restricted in these communities, but people find a way, of course.
Horse poo on my back lawn this AM so the herd obviously tracked around the side of the house in the night – so I am shutting the gates as trying to keep some lettuce seedlings alive.  Apparently a little while ago a stallion killed in the paddock out front when one of the other horses kicked it in a fight.  So Simon rang council to report a dead horse; after a while a couple of blokes arrived in a ute, tied a rope to the back legs and dragged  it all the way to the tip.  So I’m not going to die in Kalkarindji.
Last night after reading some of Eve’s rather quirky present “Wildwood – a Journey through Trees” by Roger Deakin, I found a large beautiful green tree frog in the bathroom and made him a pond for a while; it’s so dry here. I felt a little less frog friendly when told today that he probably came out of the toilet.
This weekend I’ve got a big old Land Cruiser so will probably find my way back to Wattie Creek. Pumpkin and polish sausage pasta on the menu tonight.  Cheers and love, moi

Fri 18/9: It’s the 3rd and, you may be relieved to hear, penultimate letter from Kalkarindji – after next week Rochi arrives and stays here for a few days before we fly back to Katherine then off on our Kakadu adventures.  Not much happening here now, and last weekend was very quiet indeed –  getting some good books read, and lots of time for that more dangerous activity thinking.  Have had a few more swims in lovely Wattie Creek, and another afterwork drink at the Club – very much the centre of social life in Kalk.

Left to my own devices I tend to return to that perennial question ‘What to do with the rest of my life?’  You’d think I’d have worked it out by now.  For me the thinking leads to whether or not to develop a consuming specialized interest (eg painting or writing, or male modelling – the possibilities are endless), or accept the fact that I’ll always be a generalist, a butterfly, and live with it.  It’s getting late in the day for the former, though not impossible, but whenever I ‘specialize’ I get easily bored, or someone threatens to sue me.  Maybe better to just relax and accept what I am.  Sorry for that bit of self-indulgence, but there’s only me to talk to about it.

We’ve had a med student Lara here for a week and that has meant doing a bit of teaching, which varies work a bit.  Also managed to get some cheap headphones to turn the laptop into a DVD player so that I could watch a pair of DVD’s an old friend enthusiastically sent me.  They are a sort of introduction to quantum mechanics, relativity, and the existence of other realities, in a sort of ‘seriously entertaining’ highly repetitive earnest American presentation which is really for people who have done no science.  2 hours into the first disc with no end in sight I gave up, or maybe fell asleep, so I’ll have to think of a polite way of telling my friend that it’s crap.

Good 4 Corners program the other night on the NT Govt’s controversial decision to further dismantle bilingual education – there are only 8 NT primary schools left which still teach in a local Aboriginal language as well as English (at different times of the day!).  The program was happily partisan, not even-handed, and made the NT Govt look like rednecks.  Much of the discussion and footage was of Lajmanu, 100k south of here.  It’s the centre of the Walpiri language group, the largest in NT, and the people are apparently quite different from the quieter more peaceful Gurindji people around here.  (But all these people move around a lot, and we see many Walpiri’s, and often talk  to our sister clinic in ‘Laj’; last week the whole of Kalk seemed to empty when everyone headed off to a funeral in Laj, and we couldn’t find any patients to come to the clinic here).

The program added to my strong feelings of how badly, despite some wonderful programs and individuals, we have failed these people – nothing new in that thought, but being here really drives it home.  The sequence of their decline is pretty obvious:  historically they are crushed by a dominant and completely alien culture (ours), especially by the loss of their land, and by some pretty determined early attempts to eradicate an ‘inferior’ culture.  They become desperately poor, uneducated, depressed fringe dwellers (re Western culture) – absorbing its worst elements eg rubbish food and alcoholism, violence and vd, beset by epidemic levels of 19th  century diseases, diabetes, kidney failure and other western diseases that occur when people adapted over aeons to scarcity eat a tradestore diet.  For my money the answer to these grim realities is of course to improve health, literacy and other key areas, but with local people in control – ie self determination.  It clearly doesn’t work if we just try to give them what works for us.  This more recent approach seems to be working for my employer, the Katherine West Health Board.  But on the whole we seem to have failed to help aboriginal people adapt well to the dominant culture (which has changed at great speed even for those of us born to it) without losing their own.  It’s a sad picture, but with some bright hopeful areas.

Late today I had a very frail 45y/o woman on home peritoneal dialysis, presenting with pneumonia.  I organized treatment at home, but Simon the nurse/manager here was very anxious about the consequences should she die over the weekend, and suggested I speak with specialists in Darwin. I was  less aware of how readily a plane can be sent to evacuate a sick person, but in the end she started to feel better after initial treatment and didn’t want to go. I was also less aware of the potential for retaliation in the event of a death.  Health care and medicine and medical transport is free for these people (indeed all people in remote areas), and that is one of the better things that we have done.

That’s it for now.  As I said, too much time to think.  Love, moi

Fri 25/9:   Well, I’ve been here 4 weeks now, Rochi arrives in a few days, at 5 weeks we leave, and there’s not much more to say.  I’m not sure that I would want to stay much longer living alone in such a small isolated spot.  If I come again I’ll come with a few more planned activities.
Last weekend I had another shot at watching “What the Bleep.!  Down the Rabbit Hole” – all 6 hours of it, and it was quite rewarding to do it when fresh.  I believe a shortened version exists, and its about quantum mechanics, wave/particle theory, the Planck Scale ten to the minus thirty four metre as the basic building block of matter, and really leads to the idea that we are all connected by a common sea of consciousness, the interconnectedness of all things, and the interesting scientific evidence for these ideas – that was something I read quite a lot about years ago in texts on mysticism, and found quite compelling – so it’s interesting to see it from the scientific angle. A few other ideas to give you the flavour: the existence of multiple alternate realities or worlds, the potential for travelling forward or back in time, mass meditation changing world events; the observer as linked to and changing and in fact generating reality; reality as pure consciousness or thought – we create reality; science and spirituality in fact the same: a unified universe; the structure of our brain and how old negative behaviours can be replaced, growing new neural circuitry over weeks by holding on firmly to new thoughts or visions of how our new life will be.  Heady, heavy stuff and fortunately I was rescued by Simon and Tiger and driven out to a beautiful clifftop desert sunset view from Mt Possum and beers with some nurses and teachers camping out there for the weekend.

More disconnected thoughts – last weekend our nurses on call drove 170k to a car accident – it’s a big area we cover! Chatted to my neighbour Pam the local school principal about that program on bilingual education.  As usual there’s more to it than presented on TV – one big problem is retaining aboriginal teachers who get caught between 2 cultures and burn out; also poor school attendance and patchy support from the locals: “We cant teach them their languages – it’s up to them to maintain their culture.” Similar situation in health care  – some of the locals employed just aren’t up to it or are too conflicted, so worthwhile programs fail, and there are few who want the jobs.

Went trawling for barramundi in Simon’s tinnie on the Victoria River where it becomes a mighty waterway about 15k from here – very enjoyable if fruitless (fishless) endeavour, but a very rough road in w shredded one of the boat trailer tyres – took us a while to get out.  Lots of wallabies on the banks, bustards (protected but very good eating I’m told), and Simon’s home brew.

It’s a real menagerie here at home – the geckoes are quite bold, and I now know there’s a huge resident green tree frog under the lip of the toilet.  He doesn’t do much, but occasionally gives off an enormous deep croak which the toilet bowl amplifies.  I was cleaning my teeth the other night when there was this huge sound behind me, an d I nearly wet myself – that’s when I made his acquaintance.  Working in the clinic can be similarly unnerving – the cleaner Gladys is a large woman who is stone deaf (v high rate of hearing problems here re childhood chronic ear infection) – anyway Gladys emits frequent piercing shrieks like a cockatoo – takes a bit of getting used to.

Had a phone chat with Dr Janet Mather last night – I thought of Barrie while reading that book Wildwood by Roger Deakin that you gave me Eve.  Barrie has dementia now and Janet looks after him – very sad – he’s not that old.

A tricky issue at work today Friday.  A badly neglected child to be temporarily removed from its family on advice from this clinic.  You can imagine how sensitive this issue is in this community – politically, socially and in every way you could imagine; nightmare heavy drinking family, abusive male, several kids, wife in late pregnancy.  A couple of DCS women, one black and one white, arrive to take the child away by plane to Katherine Hospital; they arrive unannounced so the family won’t go bush; they refuse a police escort, and manage to get the child out.  Death threats to all of us involved but later the parents have cooled off.

That’s it folks, signing off from Kalkarindji – we’ll be back in town about 18 October.  Love, moi


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