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Taking ultrasound to Australia’s remote communities

January 10, 2017
Travel to the northernmost point of Australia’s mainland, and then another 39km across the Torres Strait and you’ll reach Thursday Island, one of the country’s most remote communities. A year ago, Emma and Lindsay Pickstone moved here with their two young children and began working at the local hospital, she as a doctor and he as a mechanical engineer, pursuing their shared ambition to help improve the lot of Australia’s disadvantaged populations.
“I’m living within a small population of people that I really feel passionately for,” says Emma, 32, who’s doing a mixture of family and emergency medicine, as well as “retrieval medicine … working on helicopters and boats to bring people from the other islands who are in urgent need of care to Thursday Island.”

Emma is the winner of the inaugural Rural and Remote Ultrasound Scholarship, awarded by Ultrasound Training Solutions (UTS) and GE Healthcare. Applications from across Australia were assessed independently by expert rural and remote-medicine doctors Minh le Cong and Casey Parker. The judging criteria, says Dr Michael Duncan, business manager at UTS, were “community health benefits, local health benefits, and commitment of the individual. Emma Pickstone really stood out on her community focus and individual commitment focus, as well as her clinical experience.”

The scholarship is valued at more than $15,000, including travel costs to cover attending an Ultrasound Training Solutions course in Melbourne, the course fees, 10 mentorship sessions with UTS educators and the provision of a state-of-the-art GE Vscan dual probe ultrasound machine for a year.

Pickstone’s medical career began with a Bachelor of Health in nursing, and an honours year studying the nursing system in Timor Leste, which inspired her to continue her studies. “In medical school, I joined the Rural Generalist program … and just built my passion over time for that. I really enjoy emergency medicine; that was where I thought I might go. But I actually enjoyed the community medicine even more, and so for me the idea of coming to Thursday Island was that I would live within a community, hopefully get to know the people, and appreciate a very different version of Australia than what you get anywhere else.”

The majority of the Torres Strait Islands population is Indigenous, and if passion counts for anything, Pickstone will be one of the people who truly helps to close the gap for them, at least in terms of healthcare. She talks about the fortnightly clinic she holds on Yorke Island, known locally as Masig, where the small community numbers about 250 people. “They have two dedicated remote nurses out there and a small health clinic, and they have nothing,” she laments. “No radiology, no ultrasound, no imaging means at all. Any blood that we take have to be brought back to Thursday Island [for analysis]. That’s the reality of living on these small islands.”

14 doctors support Australia's most remote communities around Thursday Island.

There are 14 doctors, mostly Australian, working on Thursday Island but, as Pickstone says, “we look after Bamaga, the outer islands, Thursday Island, primary health, the hospital... So we’re quite stretched.”

The GE Vscan will enable her to take ultrasound technology to those outlying clinics. “Becoming adept at using a hand-held ultrasound will increase the services I can provide,” says Pickstone. “The emergency department uses ultrasound all the time. The basis of my application for the scholarship was the wide use that I’m going to get out of the machine, and the training.”

The idea for the scholarship had been “brewing in the back of my head for the past couple of years,” says UTS’s Michael Duncan. The Melbourne-based company, which turns 10 this year, conducts training across Australia and beyond. “There’s a real need in rural and remote Australia for this kind of training ... and we have provided free and discounted educational services to people from PNG; we’ve sponsored some of our staff to go to Mongolia; we sponsored training here for a midwife from Burma. The scholarship establishes a formal process for us to be able to do it in a sustainable way, with a local focus, and made it much more transparent. GE saw it was a great fit, particularly with the Vscan, but also because they’re also looking to focus on rural and remote Australia as one of the key areas of need. The Vscan garners a lot of attention because of its practical application and its portability.”

The Vscan's portability is making rural and remote healthcare more available.

Ultrasound Training Solutions courses attract a huge range of medical professionals, including midwives, nurses, physios, intensive-care physicians, obstetricians and gynaecologists. “There’s a great deal of focus on the technology, but at the end of the day we make the analogy that ultrasound is a practical sport, and you really need to invest in your own skills development,” says Duncan. “Our education focuses on three core areas: utilisation of the machine, hand-eye coordination, and pattern recognition.” Emma Pickstone will be taking up her scholarship to do the UTS Emergency Ultrasound for Rural & Remote Medicine course in March.

In the meantime, a new school year is starting soon for her children, and life on Thursday Island goes on with a mixture of long, hard hours, study (she’s completing her masters of tropical medicine and public health) and blissful breaks.

“We absolutely love living here,” says Pickstone, listing just a few of the islands nearby that they can quickly reach via speedboat to go swimming and snorkelling. “Our kids go to Tagai State School and they love learning the local culture, they’re picking up a bit of Torres Strait Creole, and they learn all the singing in the local language, and they love that. There’s beautiful beaches; the islands around us are absolutely glorious. It’s a great place to holiday; it’s a great place to live. It’s a very close community, and the community here are all about their family, and that’s a wonderful environment to live in.”