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Growing as a rural generalist obstetrician
Rural generalist obstetrician Dr Riley Savage is the medical lead for the Weipa Birthing Project, which will allow women in western Cape York Aboriginal and Torres Strait Islander communities to give birth closer to home.
The Weipa Birthing Unit is set to open soon, with capital works due to be completed this month. The unit’s central feature is the Palm Cockatoo Midwifery Group Practice.
The 2009 James Cook University graduate, who has an advanced skill in obstetrics and gynaecology, supervises JCU GP registrars and medical students at Weipa Integrated Health Service. Dr Savage talks about what inspired her to become a rural generalist, what she loves about her work, and why bringing birthing services to Weipa is so important.
Star-struck on Thursday Island
Growing up in Dampier, Western Australia, I think I always subconsciously knew that I would end up rural again. After thinking for a long time that I wanted to be an obstetrician, I didn’t really know what a rural career would look like for me until my fifth-year JCU medical school placement on Thursday Island. I was star-struck by the rural generalists there, who were masters of so many disciplines, from critical care in the Emergency Department to primary care in beautiful island communities.
On top of that, each had advanced skills in areas such as surgery, anaesthetics or obstetrics. I could see how they loved and valued their community, and beautifully, how the community loved and valued them in return. That was my light-bulb moment, and from then on, I focused on achieving my goal of becoming a rural generalist with advanced skills in obstetrics and gynaecology.
I love the variety that rural generalism has to offer. While it’s hard to pick just one part of my job that I love the most, I’m a bit of an adrenaline junkie and get a lot of satisfaction from a well-run resuscitation or critical care case.
Culturally safe birthing
Over the last two years I’ve been the medical lead for the Weipa Birthing Project, and we are set to open the service this year.
I’m so incredibly proud of the service we have produced – a women-centred Midwifery Group Practice model of care, focusing on collaboration, community engagement, and cultural safety.
I learned early on in medical school that, almost universally, healthy women mean healthy communities. I largely thank my friend and mentor, the late JCU lecturer Maggie Grant-Wronski, for this wisdom. I am passionate about the rights of women, and in particular, marginalised women.
I also find looking after women very satisfying. From discussing and managing pregnancy options, to antenatal and intrapartum care, breastfeeding support, to menopause and incontinence, and everything in between, there is so much scope to improve the lives of women and girls as a rural generalist with advanced skills in obstetrics and gynaecology.
This is why bringing birthing services to Weipa is such important work. We are using an evidence-based model of care to deliver maternity services to families who would otherwise have to leave their home town for six weeks or more in order to have their babies, at great financial and psychological cost.
Weipa to Palm and the way back
I first came to Weipa in 2011, as a PGY2 on the Rural Reliever program. During my first flight in, I looked out of the window and was immediately struck by the rich red earth, the clear blue ocean, and the fluorescent green of the wet-season scrub. It was so like Dampier that it felt like I was coming home.
The similarities didn’t stop with the aesthetics, though. In no time at all I had a solid friendship group (people I’m still close friends with today), and more invitations to go camping, fishing and quad bike riding than I could possibly take up. I came and went a few times after that, but I knew I’d eventually end up back here.
My first rural generalist/Provisional Senior Medical Officer role was on Palm Island, a spectacular island off the coast of North Queensland, with a vibrant and resilient community of First Nations People from many different places across Australia, and a complex history. The people of Palm Island generously taught me about intergenerational trauma and cultural competency, and I gratefully carry those lessons with me still.
From there I came back to beautiful Weipa. This was a time of adventure, with countless days (when I wasn’t working) chasing waterfalls, riding quad bikes, fishing and camping. I also met my husband then! After a little over a year, we moved to Cairns, where I did my DRANZCOG Advanced (Diploma of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) and received my Australian College of Rural and Remote Medicine Fellowship. Then I spent quite a few extremely enjoyable years in Mareeba before we returned to Weipa with our two children.
We’ve been back in Weipa for two years, and I love the fact that our kids are growing up with the advantages of rural life that I had. We now spend every weekend we’re not working either camping or on the boat and have been swimming in more pristine creeks and waterfalls than I can count. We are totally spoilt by nature here.
Exceptional JCU medical students
Working in Weipa is an incredible privilege. We have a team of exceptional clinicians, who are committed to providing high quality, evidence-based, multidisciplinary and patient-centred health care to Weipa and the surrounding communities.
We usually have at least four JCU students at Weipa Hospital at any given time, so I speak from experience when I say that JCU medical students are, more often than not, exceptional. They often have maturity and situational awareness beyond their years, and the sixth years are usually at the level of a fully functioning intern or beyond.
We consider the medical students an integral part of the team and guide them to extend themselves in clinical settings. I love teaching them about rural and remote medicine, and I hope to inspire some of them to choose the rural generalist pathway.
We also have several JCU GP registrars, who are inspirational in their commitment to rural medicine. Most of them have advanced skills in obstetrics, anaesthetics or internal medicine, and continuously amaze me with their level of skill. It’s incredibly rewarding being part of their supervising team, and I’m sure they teach me as much as I teach them.
Equity in global health
I was the founding president of SANTE (Supporting All Nations Towards Equality), JCU’s global health group, although I was really only a small part of a dedicated team who got things going. We were a small group of students interested in global health, and after participating in a few global health conferences (AMSA and IFMSA), we decided we needed a dedicated group of our own.
It seems like a long time ago now, but we started a number of annual fundraisers that I believe are still going today, like Red Party. I was very lucky that this led to me accompanying Professor Tarun Sen Gupta and Maggie Grant-Wronski to Colombia for The Network: Towards Unity For Health Conference in 2008. This was an incredible opportunity to learn from representatives from all over the world about the complexities of health care across the globe.