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>>>Faces of Rural Generalism | Dr Lachlan McIver

Faces of Rural Generalism | Dr Lachlan McIver

Rural Generalist and Co-Founder| Rocketship

Dr Lachlan McIver has always been interested in international health and community development. After completing his training as a Rural Generalist in the early years of the QRGP, Lachlan furthered his studies to become a tropical medicine and public health specialist. With his FACRRM in hand, he commenced a new role with the World Health Organization (WHO) South Pacific office, during which he spent two years roaming around the ‘Blue Continent’ (Pacific region) completing a PhD on the health impacts of natural disasters and climate change. It quickly became apparent that there was a huge need and opportunity to improve rural healthcare in the Pacific region, which led to the creation of Rocketship.

“Every Pacific island country I have worked in is unique and beautiful but struggles with similar issues. The majority of the population live in rural areas and the health needs of rural communities are greater, but the health workforce in rural areas is too small, lacks resources and is poorly supported.”

Lachlan’s research and project work identified that, in addition to the wide range of health challenges experienced by Pacific island people, most medical professionals in the Pacific have no access to postgraduate training in family, community or rural hospital medicine; a fundamental gap in the region’s health professional development systems. With this at the forefront of Lachlan’s mind, he recognised there was an opportunity to learn from the lessons of the Rural Generalist movement. “When I started talking to some senior colleagues in the Pacific about the Rural Generalist concept and how our profession has developed to meet similar needs in Australia, they thought it was a great idea.”

Among the earliest and most enthusiastic supporters of this initiative was the late Dr Steve Homasi, former Director of Health in the small Pacific island nation of Tuvalu.  “As a true Rural Generalist himself, a well-respected leader and Tuvalu’s only surgeon, who still did his share of shifts in ED and outpatients, Steve recognised the value of the model immediately.  He told me ‘the Pacific definitely needs more jack-of-all-trades doctors’.  And that’s really the moment when Rocketship was born.”

After Lachlan completed his WHO assignment, he returned to Australia, eager to develop rural workforce solutions tailored to the healthcare needs of the Pacific islands. Lachlan consulted and collaborated widely within the Rural Generalist community in Australia which ultimately led to the establishment of Rocketship – Remote Opportunities for Clinical Knowledge, Education and Training and Support for Health in the Pacific.

Rocketship is an Australia-based non-profit health and development organisation with a vision of healthy Pacific communities supported by strong and sustainable primary healthcare systems. Rocketship works in partnership with the Ministries of Health in each country to design and deliver programs to enable rural doctors and nurses to train to the top of their scope and provide quality, sustainable primary care to improve health in island communities.  

“Ultimately, our aim is to make ourselves redundant, by helping build a rural health workforce in the Pacific that is sufficiently large and well-trained that external support is no longer needed.  In the meantime, we’ll continue to grow and strengthen our organisation to meet the demand for the essential services we provide in improving health care and outcomes across the Pacific,” Lachlan says.

Lachlan’s Rural Generalist training set him up with useful knowledge and skills for his work in international health.  “Thinking quickly, being flexible and working with limited resources all come with the territory, plus we’re well-renowned for having a sense of adventure and a tolerance for risk.”

These skills and attributes are priceless in Lachlan’s work in developing countries, which has also included several years as Medical Advisor for Infectious Diseases and Epidemic Response for Médecins Sans Frontières (Doctors Without Borders), doing short-term field missions in Africa and the Middle East while he was based at their headquarters in Geneva, Switzerland.  “Whether that means seeing patients under a coconut palm, doing surgery with one anaesthetic drug and no electricity, responding to a humanitarian emergency or setting up new systems of care and health professional education – the Rural Generalist philosophy and approach is the best one to have, no doubt about it.”

Lachlan lives by his belief that as a Rural Generalist, he must be willing and ready to provide accurate information and guidance to both patients and political leaders, so they can make the right decisions to improve health. “I’ve spent much of the last decade working on the two issues considered by WHO to be the greatest challenges to global health this century – climate change and antimicrobial resistance.  Those two phenomena combined are already causing hundreds of thousands of avoidable deaths around the world every year, and that’s going to get a hell of a lot worse if some major changes aren’t made very soon to the way we manage two of our most precious resources – energy and medicines.”

In an environment where some problems seem all but impossible, Lachlan is keen to tackle ‘wicked problems’ using his RG skillset and find solutions to improve healthcare in the Pacific and other developing countries around the world. Rocketship is inspiring excellence within the health workforce, improving clinical knowledge and building capacity.

You can find out more about Rocketship’s work at

May 22nd 2020| Faces of RG, |