Dr Melanie Matthews

Dr Melanie Matthews is the New Fellow representative for the RACGP Rural Council. She currently lives and works on Kunibídji land in west Arnhem Land. She shared her story during the webinar ‘Become a rural GP: Aboriginal health and remote opportunities’ in April 2021.

Hear from Dr Michael Clements and Dr Melanie Matthews below.

This rural life – Celebrating GPs working in Aboriginal and Torres Strait Islander health

Dr Michael Clements, Chair, RACGP Rural and Dr Melanie Matthews, New Fellows representative, RACGP Rural

Michael Clements
I'm Dr Michael Clements, Chair of RACGP Rural Council. Very, very lucky and privileged to be here in Maningrida in Arnhem Land in the Northern Territory, with Dr Melanie Matthews, who's one of our Rural Council members.

I was very excited to be able to get the opportunity to fly in and spend a night here and learn about the Aboriginal Medical Service here Mala'la, and the really tight-knit group of GPs and healthcare workers that are really making massive strides in community healthcare here.

So I'm going to ask Melanie some questions about why she's here and what drew her and what might inspire you to come out and work in Maningrida.

Melanie, can you tell us a bit about what brought you here?

Melanie Matthews
I got into Aboriginal health when I did my John Flynn placements back in medical school, and then was very lucky when the PGPPP [Prevocational General Practice Placements Program] program was still running to come up to Maningrida and do a three-month stint here from Melbourne because that's where I was living at the time. And I just absolutely loved it. And so that actually got me into GP training. I decided that I was going to be a GP, but I wanted to work in Aboriginal health. And so I did all my training up in East Arnhem Land. And then once I Fellowed, I came back to Maningrida. And I've been here a couple of years now, and I absolutely love it.

Michael Clements
So we hear time and time again, PGPPP program has been very successful at converting interested medical students, well, interested junior doctors into GP medicine. I think that's another great success story.

And how many doctors do you have here that you work with?

Melanie Matthews
So we currently have equivalent of four about four and a half FTE [full-time equivalent], but we've got five doctors and a registrar. We all have like sort of different work structures, I guess. We've got one full time GP who lives in community. We have another full-time GP who does four days in Maningrida and one day in Darwin. Then myself and another GP who do three weeks on, one week off. And then another one who flies in to spend three days every week, who lives in Darwin and flies in. So very flexible sort of work arrangements, which is really great.

Michael Clements 

So tell me what is leaving in Maningrida and working what does that mean to you? What do you do in your off time?

Melanie Matthews

In my off time? So I'm not a camper and a fisher, fisherwoman but that is a really big draw card for a lot of people here. We’ve got a boat that's going out right now.

So people love getting out and going fishing. So yeah, lots of camping and fishing opportunities and really beautiful outstations and locals that are very willing to take you out, hunting, crabbing and that sort of thing.

We’ve got a really good group of people that I work with, so we do have social events. Just last weekend, we all came down to the beach and watched the sunset together, which was really lovely. So, you know, we are in a remote community. We do have a cafe, which is great that we that you can go down to on the weekend. There are things to do and if you're an outdoorsy person, then it's incredible. Some of the best scenery in the country.

Michael Clements

I have to say that the is sometimes the perception that you're going to be your remote doctor, you have to be the superhero. There's a perception that you have to be able to do the caesarean in the middle of the night by yourself, by candlelight.

So tell me what do you need out here in terms of general practice?

Melanie Matthews

 Absolutely do not do any caesareans by candlelight.

I'm no superhero. Okay, I'm definitely not. I just love the work that I do.

For anyone who was thinking about it, but was a little bit apprehensive. I mean, really, all I think you need to do is an ALS [advanced life support] or a REST [Rural Emergency Skills Training] course to help you with some of the emergency stuff, but a lot of it you're going to learn on the job. I mean, yeah, there's some extra things that I do. Like I've had the opportunity to learn to do ultrasounds and take x-rays, but that's something that Malala has provided for me. And I just think the breadth of medicine. Yes, it's very broad. But it's really interesting. And you don't need to be able to do everything. We've got really experienced RANs[remote area nurses], I'm always running things past the other GPs here, we have the DMO [district medical officer] service, which are very experienced remote GPs in Darwin. And then we have Careflight, who has it's like similar to RFDS [Royal Flying Doctor Service] in the rest of the country who are ICU [intensive care unit] and emergency physicians. If you've got someone really sick, we call them we call, we call for help. And they come as fast as they can. And they talk us through what we need to do in the meantime.

So I'm not a superhero, but I really enjoy the breadth of the medicines that I get that I've experienced here. And I think it's an absolute privilege to be able to do that.

What triggered this career path for you?

During medical school, I was fortunate enough to get into the John Flynn Placement Program and I chose to come to the Northern Territory and did placements in Nhulunbuy in east Arnhem Land, Groote Eylandt. This sparked a love of remote Aboriginal and Torres Strait Islander health. I did my GP training in the NT through the AGPT [Australian General Practice Training] pathway at NTGPE [Northern Territory General Practice Education] RACGP. After that, I did my Fellowship in Advanced Remote General Practice in Aboriginal and Torres Strait Islander health. I did a community project on medical termination of pregnancy and set up a service In Nhulunbuy, which had never been available before. It’s something that I am proud of.

What do you enjoy most about rural medicine and working in Aboriginal and Torres Strait Islander health?

One of the things that I love about working remote is the team environment. It is not doctor-centric, it is about working in a team of very experienced remote area nurses, allied health professionals, Aboriginal health workers, and community workers. They are some of the most important people that we work with. They know the community and they help us bring people in, interpret, help us with cultural issues and are integral to providing the best healthcare we can.

What are the benefits and challenges of living and working in your location?

Maningrida is the largest remote Aboriginal community in the Northern Territory, with a population of approximately 3500. Maningrida does not have a hospital, so we manage everything that walks in the door. It is a six-hour drive from Darwin. Three hours of that is on unsealed roads, and in the wet season we are completely cut off. We cannot drive anywhere for about six months of the year, so we have to fly. Luckily, we have two flights a day with Air North.

Describe the diversity of services provided

The scope of what I see is incredible. I see all the common things; for example, diabetes is highly prevalent, COPD [chronic obstructive pulmonary disease] and heart disease; however, there are things that are more specific to remote areas, such as rheumatic heart disease. I often will make the joke that … in medical school you are sort of taught horses before zebras, but sometimes up here it feels like zebras before horses, because the stuff that we see is just incredible. The job is can be very challenging at times. I have had to deal with some traumatic things, but at the same time, I have skills that I would not have if I was working in a city. It is a great, varied job and I really love the people that I work with.

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