I’ve recently come back from a two week rural GP run up in Whangarei, and it’s definitely been the highlight of my medical student career so far. From experiencing the local poverty that exists here in New Zealand, to seeing talented, empathetic doctors helping these communities, it had everything that I could have hoped for in a two week run.
The problems stemming from poverty were literally made as close to home as possible during my two week stay. An example was a Friday night where my emotions were racing – my flatmate returned home drunk and angry at his partner, screaming and shouting which quickly escalated to thuds of aggression. While I feared that there was abuse going on upstairs, I cowardly locked the door of my room and texted the landlord instead – fearing even that he might hear me call the police if I were to call myself. 45 minutes later when the noises and banging had continued until the police arrived, I had to closely examine myself – was this cowardly response of mine the right thing to do? I thankfully found out afterwards that the noises had actually been the breaking of a flat screen TV, two doors, and some furniture, much less serious at least than domestic abuse! It really did make me think though, I never realised how differently we might act when really put in these circumstances, and I hope to be far more courageous if a situation like that ever happens again.
How is this related to poverty though? It might seem more like aggression and a lack of compassion on the surface. And while that’s true, I do believe that deeper down, poverty is a root cause underlying these superficial behaviours. This man who might now be labelled as a “convict” was actually a nice, generous human being. I don’t mean that in a cheesy, diplomatic way either – while I spent my first few nights freezing in a sleeping bag without blankets, he immediately lent me some as soon as he found out, without me asking at all. He was however suffering not from the type of poverty we see on TV with African children dying of starvation, but a more subtle type of poverty where he had not been raised in an environment comparable to the one you or I grew up in. Having visited the schools where many children have no food to eat, the households where having two parents was a rare privilege rather than the norm, and the frequency of theft in the neighbourhood which instilled a culture of violence and fear; I realised that I would have been just the same (if not worse) had I grown in the same environment.
Even digging deeper into the alcohol and drug problems that are so prevalent in poorer areas of New Zealand, which many of us may not be happy to help through tax-payer funded welfare, attributing these problems to the lazy and uneducated who have failed to take up personal responsibility. In all honesty, I have no doubts of how easy it would’ve been for me to slip into these same habits had I grown up there – I had been already close to slipping in both of these issues right here in the socially privileged North Shore, let alone this much more stressful environment! The saddest things about this though is how the stats show that poverty is worsening within New Zealand, partially because of how poverty breeds more poverty unless efforts are made to break the cycle.
Having said all this, Whangarei is far from having no hope – I was also lucky to witness some of the greatest national heroes taking on these issues every day in their community. Te Whareroa O Tikipunga, a GP Clinic established by Dr. Aniva Lawrence, was a clinic created with family centred care and health literacy being the core of what they do. Now almost every health organisation claims to also encompass these big buzz words, yet this was the first time I truly witnessed it. When a man with Rheumatic fever came into the clinic, he wasn’t just diagnosed and judged for his habits. The doctor instead went the extra mile and walked him through all the support services available to him and made it her personal responsibility to help him find work suitable for his condition – linking him to WINZ and several other support services who could help him find the right work. This was just one of many consults that had sent heart-warming feelings running right through me.
Another doctor had set up an incredible initiative of free GP visits within the community, with no appointments necessary. While I initially thought that many might abuse such generous community services, I was surprised to find out that this couldn’t be further from the truth. Despite the clinic starting at 9am, an orderly queue of patients had already formed by 8.30am. These patients weren’t presenting with minor things like a runny nose or a cold either – many had come with not just one, but two or three different serious medical problems, each of which was more than worthy of a GP consult. It was refreshing to see such a co-operative system work so well, and the effect this was having in the community was definitely noticeable.
These GPs have transformed my perception of the GP profession as a whole – it’s easy to think that GP can be a rather unchallenging, and repetitive profession, although I have realised how far this is from the truth when seeing every patient not only presents with the challenge of finding the right diagnosis, but even more importantly is an opportunity for improving their health literacy and motivations to live a healthy lifestyle. This educational role of a doctor is usually either dismissed despite the original latin meaning of doctor being “teacher”, or assumed to be limited to giving basic advice to patients such as “You really should stop smoking”. The intricacies of motivating patients to improve their health independently are however much more complex than that, and for the first time I witnessed this done in such a professional yet experienced way.
I could write pages and pages about the different experiences I had witnessed and the heart-breaking situations I had seen patients in all ages I had gone through, but I am limited both by time and by patient confidentiality in sharing these stories. What I learned though was not only the extent that local poverty exists within our own country, but also how many incredible leaders are already working quietly in these communities to making a difference. I hope that one day I will be able to have a fraction of the impact in my community as these great heroes.