Western New South Wales residents fear something "catastrophic" will happen as increasingly frequent power and phone outages cut them off from telehealth and emergency services.
Rain, wind, storms and machinery have all impacted the Essential Energy power lines connecting Tottenham, Tullamore and Trundle, leaving the towns without electricity 10 times in the past year.
Telecommunications outages followed when Telstra's backup battery ran out.
Lifelong Tullamore resident Gary Brown said the outages were becoming more frequent, and longer, with one event lasting up to 20 hours.
Mr Brown said the events left the community without the ability to contact the local hospital or other emergency providers.
"We can't dial triple-0. We can't dial anything. We've got nothing," he said.
"It's an accident waiting to happen."
Essential Energy said the outages had occurred more often in surrounding rural areas.
"It used to take a few hours to go out and now it's almost immediately when the power goes out, the phones and internet go out," Mr Brown said.
Outages sparking worry
Tottenham Rural Fire Service captain Rick Bennett said crews could not receive texts or calls for help during the outages and feared they might simply miss jobs.
"You wouldn't be aware of the fire [if one started] and it could lead to a pretty severe one," Mr Bennett said.
The NSW Nurses and Midwives' Association said the reality of working at the town's multipurpose clinics, west of Dubbo, could mean being on ward for hours with little communication with the outside world.
Acting assistant general secretary Michael Whaites said there was one instance where hospital staff were without telecommunications for an entire eight-hour shift.
"If you don't have good lines of communication, how do you raise issues in an emergency?" he asked.
"How do you make sure you can contact the local ambulance service or get help from further up in the Local Health District?"
The hospitals have generators, but telehealth services are used at all three facilities when a locum specialist or GP is not available.
During the telecommunications outages, mobile services and landlines did not work.
In a statement, the Western NSW Local Health District said "in rare instances", the ability to contact the facilities had been impacted for short periods.
Second-rate rural services
Mr Whaites said the prolonged outages would not happen in a city.
He said it was not the fault of the health service but a failure of the state government to invest in vital infrastructure, and a consequence of privatising utilities.
The Local Health District said there had been no significant impact on patient care and it was looking into mobile alternatives as additional back-ups.
In a statement, Essential Energy said it was undertaking projects to improve network resilience but, like all electricity providers, was "unable to guarantee power availability 100 per cent of the time".
Telstra's regional general manager Michael Marom said battery backup power kept services online for a period "but cannot keep them running for an extended time".
He said the battery at Tottenham had recently been upgraded.