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The Guardian - AU
The Guardian - AU
National
Mandy McKeesick

A wing and a prayer: flying doctors and the struggle to access healthcare in remote Australia

Kelly Foran at her property in Glen Innes.
Kelly Foran at her property in Glen Innes. Foran’s family know the value of the Royal Flying Doctor Service to rural Australians. Photograph: Simon Scott/The Guardian

Belle Kidd was eight months and ten days old when she died in Brisbane’s Mater Hospital.

Born with primary pulmonary hypertension, Belle was not destined for old age but neither was she destined for a life solely within the confines of white hospital walls.

“I wanted to take her home so she could pat the dogs and touch a horse,” mother Helen Kidd says. “We took her on the four-wheeler and for a swim in the Cooper.”

Home for Kidd is a cattle station at Windorah in far western Queensland. The only option for air travel is a mail plane that flies to Brisbane twice a week. The Kidd family were often on board, assisted by the Patient Travel Subsidy Scheme - a government initiative to provide financial aid to access medical services not available locally. But when the mail plane did not align with Belle’s appointments it meant a 14-hour 1200km road trip to the hospital.

In Belle’s last days the Royal Flying Doctor Service (RFDS) transported her back to the Mater. “It was an amazing thing,” says Kidd.

“I heard the sound of that big plane coming in and when the Mater retrieval nurse stepped out with Belle’s file I felt a rush of calm because you feel so helpless on your own when you can’t help the ones you love,” she says.

Helen Kidd at her property in Windorah, walking and leading a horse.
Helen Kidd at her property in Windorah. Photograph: Mandy McKeesick

When it was time for the final journey home Angel Flight took Belle’s tiny coffin and her distraught parents, flying low over the station in farewell before landing.

Years later, Kidd’s second child, Charlie, required major head surgery in the same hospital where Belle died. Her husband, Dude, also needed the RFDS after a motorbike accident.

The RFDS treated 387,042 patients in 2021-2022 and transported 45,347 people via plane and 72,775 via road to hospitals.

Just over half of its annual revenue of $491m comes from federal (22.47%) and state (30.12%) governments, according to its 2021-22 annual report, but the remainder comes from commercial funding, donations and bequests. Donations dropped 24% in 2020-2021 and recovered slightly last year, but not to pre-pandemic levels.

The service relies heavily on donations to purchase and fit out aircraft.

“With such a large continent and small relative population in Australia, the tyranny of distance is always going to be a challenge when it comes to health care access,” says Lana Mitchell from RFDS.

Angel Flight, run by volunteer pilots, receives no government funding and relies on donations from private and community sources.

Angel Flight CEO Marjorie Pagani says living in the bush should not prevent access to medical care.

“For 20 years Angel Flight has provided bush people with free air and ground transport to attend medical treatment in the city,” she says.

‘I couldn’t do anything for him’

Kelly Foran’s medical nightmare began on Boxing Day in 2002 when, pregnant with her first child, she was transported via road ambulance from Gilgandra, in central western New South Wales to Dubbo Hospital with a severe headache.

Foran spent three days in Dubbo Hospital and was about to be discharged when a visiting locum from Royal Prince Alfred Hospital (RPA) noticed she couldn’t walk straight and arranged an emergency CT scan.

“Within an hour they had diagnosed me with a brain tumour and I was put into intensive care there and then, before being flown to RPA [Royal Prince Alfred, Sydney],” Foran says.

An RFDS emergency airstrip sign on a road.
Helen Kidd says the sound of the RFDS plane coming in to land brought calm in her daughter Belle’s last days. Photograph: travellinglight/Getty Images/iStockphoto

“I was given steroids to shrink the brain tumour and then, via caesarean section, I gave birth to Jake. He was born with a hole in his lung, hyper insulin anaemia and jaundice. In the next four months I developed diabetes, had 16 hours of surgery on my head, suffered a stroke on my right-hand side, spent three weeks in intensive care, a week in neurosurgery, developed meningitis, and was diagnosed with muscular dystrophy. I had pain in every joint, struggled to walk, talk and eat but finally I was allowed home to my son – and I couldn’t do anything for him.”

Jake was diagnosed with eye cancer a year later. The family had moved to Goondiwindi in Queensland, and began the medical round-about again with a new hospital in a new state.

After five years Jake made a full recovery, as did Foran. It wasn’t their last medical emergency: Foran’s husband, David, had a farm accident three years later which required RFDS transport.

Kelly Foran with her dog Chomp, at her property in Glen Innes.
Kelly Foran with her dog Chomp, at her property in Glen Innes. Photograph: Simon Scott/The Guardian

The experience motivated her to help other families. In 2011 she set up a foundation called Friendly Faces Helping Hands (FFHH) to ease country people through their own medical crises. The foundation takes care of the logistics of being sick – how to get to hospital, where to park, where family members can stay, how to access resources, how to find financial assistance.

FFHH maintains a hotline and it is often Foran answering the calls.

Kelly Foran sitting at a desk.
In 2011 Kelly Foran set up Friendly Faces Helping Hands to ease country people through medical crises. Photograph: Simon Scott/The Guardian

“I know exactly how people feel in these situations,” she says. “Your mind is so scrambled you can’t think about anything. You can’t even think about what you have in your coffee. So I think for them. .I try to make their journey easier.”

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