Dr Sarah Beck’s work on Thursday Island has helped improve access to health services for women in the Torres Strait.
Situated in one of the northern-most points of Australia, Thursday Island, traditionally known as Waiben, is the administrative centre of the Torres Strait Islands, which are located 39 km north of Queensland’s Cape York Peninsula.
This level of remoteness is what drove Dr Sarah Beck, recipient of the RACGP’s 2014 General Practice Registrar of the Year Award, to work in the area.
‘I have always loved the idea of working in exciting and exotic locations and you can’t get any more exciting or exotic than Thursday Island,’ she told Good Practice. ‘The work here is absolutely fascinating and I’ve had the opportunity to manage really complex medical and emergency cases, as well as gain skills in offi ce gynaecology and colposcopy.’
Starting out
Beck was born and raised in New Zealand and completed a Bachelor of Science at the University of Otago, majoring in psychology. However, she was always determined to study medicine.
‘I was always interested in doing medicine, but I didn’t get marks that were high enough to apply at the end of high school, so I decided to do a science degree fi rst,’ she said. ‘I got the marks at the end of my degree to apply for medicine and went straight into the second year of a six-year medical degree.’
Beck’s interest in all areas of medicine, from obstetrics to surgery, quickly led her down the path of general practice.
‘There was never one particular specialty that I loved over another,’ she explained. ‘I liked the idea of being a true generalist and being able to provide not just whole-person care, but whole-family and generational care. I have been able to design my own career and, along the way, I have developed my own special interests in Indigenous women’s health, colposcopy and PCOS [polycystic ovarian syndrome], and that has been fantastic.’
Remote health
Beck was provided with her fi rst experience of rural medicine when she moved to Gisborne, a small town on the east coast of the North Island of New Zealand, after completing her medical degree.
‘There were about 10–12 interns there, but no registrar. So that was a really great learning opportunity for me and really affi rmed my desire to continue working in small towns and rural areas,’ she said.
Beck joined the Thursday Island community in 2012 following a 12-month term as a GP registrar at Wuchopperen Health Service in Cairns. She did an elective general practice term in sexual health at the Melbourne Sexual Health Centre, as well as six months as a GP registrar in Malanda on the Atherton Tablelands in Queensland. She also worked as an emergency career medical offi cer in NSW after moving to Australia from New Zealand.
ew Zealand. The logistics of working as a GP in a location as remote as Thursday Island mean Beck comes across a range of experiences outside of the consulting room.
‘Every day is different, with new challenges. One day I might be doing a colposcopy clinic on Thursday Island, the next day I am jumping in a helicopter to travel half an hour to another island to do an outreach GP clinic,’ she said. ‘Later that week, I might be on a chartered fl ight with the RFDS [Royal Flying Doctor Service] to go and do a women’s GP clinic on a small island near PNG [Papua New Guinea].’
Thursday Island measures approximately 3.5 square kilometres, roughly 0.7% the size of Cairns, and is closer to Papua New Guinea than to Cairns. For most clinical emergencies, the closest airstrip is on Horn Island, a 10-minute ferry ride from Thursday Island, followed by a 1.5-hour plane ride to Cairns.
‘One of the main challenges that we face here is the remote location,’ Beck said. ‘You have to manage very complex medical and emergency cases and it may be some time before you can get any tertiary-level clinical assistance.
‘You may be waiting six hours or sometimes even 24 hours for the [RFDS] to retrieve a patient who is critically ill, due to the weather or if the plane is being used elsewhere.’
Beck is also involved with the RFDS’ Rural Women’s GP Service, travelling to other remote communities that do not have a female GP.
‘I started working for the RFDS Rural Women’s GP Service in 2013 when they had a position available for a GP servicing Saibai, Boigu and Horn islands [in the Torres Strait],’ she said. ‘I was already working on Thursday Island, doing a lot of women’s health and knew a lot of these women, so saw this as a useful extension of my current work.’
Women’s health
Initially a hub of the pearling industry in the late 1800s, Thursday Island played an important role as the military headquarters for the Torres Strait and hosted Australian and US forces during World War II. Today, the island has a population of around 2600, which is mostly made up of Aboriginal or Torres Strait Islander peoples.
Beck is one of three female GPs on Thursday Island who, together with nine other doctors, provide medical services for approximately 12,000 people in the Torres Strait and Northern Peninsula area.
‘There is an especially strong need for female GPs in Indigenous communities,’ she explained. ‘Indigenous women generally prefer to see a female doctor about women’s business. There is a concern that if Indigenous women do not have access to female doctors then they may delay presenting to health services.’
Understanding the importance of obstetrics and gynaecology skills in rural and remote communities, Beck obtained her Diploma of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (DRANZCOG) Advanced in 2009.
‘It is extremely important in remote areas such as the Torres Strait to have highly skilled doctors in anaesthetics or obstetrics available,’ she said. ‘It means that a woman with a low-risk pregnancy can have the choice to stay on Thursday Island to have a baby.
‘Otherwise, the woman would have to leave her family, leave her support network to travel south to a place where she might not know anyone.’
Beck also recognised the need for a comprehensive, evidence-based service for women with PCOS across the Torres Strait and started a clinic with a colleague in 2012.
‘One in fi ve Indigenous women have PCOS, a hormonal disorder with long-term health implications such as metabolic syndrome, type 2 diabetes, cardiovascular disease, infertility and depression,’ she said. ‘This is the fi rst evidence-based PCOS clinic in Australia in an Indigenous setting and it is really exciting. You can see that you are helping to improve the health outcomes of Indigenous people and really making an impact and a change to their lives.’
First published in Good Practice November 2014:18-19