Thanks to Rustica, I was lucky enough to spend two weeks on Palm Island doing my 5th year selective at the Joyce Palmer Health Service. The small size of the health service meant that I was able to spend time in GP, ED and on the general ward of the 15-bed hospital.
Palm Island (also called Bwgcolman) is a 90-minute ferry ride from Townsville in Queensland. It has about 3000 residents and 95% of the population is Indigenous. It is a tropical paradise with a dark history. It was settled in the 1920s and used as a penal settlement for Aboriginal people. Due to many riots and murders, it was controversially named the most violent place outside a warzone by the Guinness Book of Records in 1999. Palm Island became a household topic in 2004 when an Indigenous man died in custody.
It is a “semi-dry” community, so the single pub only sells mid-strength beers and only a six-pack at a time. You can buy a glass of wine if you buy a meal, but there are no bottles of wine sold on the island. However, the “sly-grog” trade is rampant on the island – people ship alcohol over in small boats. I heard that a cask of wine can cost up to $50 on the island. Other drugs are a problem too, as well as a very high rate of unemployment.
Apparently the rates of alcohol-related domestic violence and presentations to ED have decreased since the introduction of the semi-dry laws. However, in my two weeks on Palm I did see a significant number of alcohol-related injuries, including gastritis, fractures from falls and lacerations from assaults.
I was on Palm Island on ANZAC day so I went to the service which showed a different side of the community to the emergency department. The multicultural ceremony demonstrated the island’s continuing diversity.
I also spent a weekend on Magnetic Island where I went kayaking, snorkelling and bushwalking.
This was my third placement in an Aboriginal community thanks to Rustica and once again I witnessed how intergenerational trauma and social disadvantage are direct determinants of health. This is a highly political issue that is often neglected, but as future Australian medical professionals we are obliged to act.