Rural Generalist | Cairns and Yarrabah (Yidinji and Gunggandji Countries)

Dr Sarah Fairhall is a Rural Generalist in Northern Queensland working in Cairns and Yarrabah across both primary care and secondary care settings. Sarah has dual advanced skills in anaesthetics and paediatrics, and a graduate certificate in allergic disease. Sarah has been working at the Gurriny Yealamucka Community Health Service since 2019, where she enjoys providing medical services to the Yidinji and Gunggandji peoples.

Sarah’s journey into rural medicine started during medical school at James Cook University (JCU). “JCU had a strong rural and remote focus and my journey to becoming a Rural Generalist was cemented when I was awarded a Queensland Health Rural Scholarship. I completed my junior doctor years in and around Cairns, before relocating to Hervey Bay for a year of anaesthetics Advanced Skills Training. I completed my Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) in Central West Queensland, then returned to Cairns for family reasons where I was fortunate to complete a second advanced skill in paediatrics. I now split my clinical time between Yarrabah and Cairns Hospital, where I put my RG roots to very good use”.

The Yarrabah area is described as a ‘paradise by the sea’. “Yarrabah has a population of over 3000 people with around half being under the age of 16. The children of Yarrabah are cheeky and cheerful and can often be found playing in the streets, riding horses bareback along the beach or joining in on activities hosted in the community. The community has always been friendly and welcoming to me, willing and eager to share their stories and culture, and the elders continue to provide strong cultural leadership to the community”.

Healthcare delivery in Yarrabah is a team effort across the public and private sector. “Queensland Health staff provide a 24-hour emergency care service, basic imaging, a mental health service and a satellite dialysis unit. Gurriny provides primary and preventative general practice health care, delivers social and emotional wellbeing services, tailored community-based programs, a public health and advocacy unit, guides women and families during the ‘first 1000 days’ after birth with dedicated support teams and programs, provides a pathology collection service, ITC service and courtesy transportation service, and supports a vast array of visiting allied health and non-GP specialist outreach clinics”.

“There is no ‘public vs private’ divide in Yarrabah, we all work together to seek the best care for our community. Practically, this looks like frequent communication between Queensland Health and Gurriny staff, shared electronic medical records, shared education opportunities and shared knowledge and expertise for the best outcomes for our patients – often, all under the same roof”.

The Gurriny Yealamucka Community Health Service is an Aboriginal Community Controlled Health Organisation (ACCHO), sometimes called an Aboriginal Medical Service (AMS). It is a term used to describe health services that are specifically designed and tailored to provide culturally appropriate health care to First Nation’s people in Australia.

“As the name suggests, organisations like Gurriny are managed by a board of directors who are elected by local community members (community controlled). The board’s role is to ensure the service is kept accountable to the community they serve. There is a strong emphasis on cultural safety and the delivery of tailored services which acutely reflect the health needs of their specific community. ACCHO’s adopt a more holistic approach to health than mainstream general practice allows. This involves delivering a model of care within the one organisation, that encompasses and provides services for physical, social, emotional, and cultural wellbeing. ACCHO’s, like Gurriny, work to remove healthcare barriers as much as possible so services are often provided at no or very low cost, carefully and deliberately located, equitable and easily accessible. At Gurriny we actively engage with and empower our community”.

Sarah is proud to be part of the Gurriny team who work closely together to serve their community.

“One of the great things about working at Gurriny is that you often don’t just belong to one team. I am lucky enough to call both the GP and child health teams “mine”, but I also dip my toe into maternal health, sexual health, and public health from time to time. Our GP team’s greatest strength is, undoubtedly, our team-based approach… to everything! We are a team, we have each other’s backs, we share our strengths and vulnerabilities willingly and constantly learn from one another. I am extremely humbled to work with such a group. The child health team’s greatest strength is their ability to play, to genuinely love and enjoy their work and have fun while doing it! It’s very contagious”.

It is within these teams that Sarah has learnt the most about the local culture. “Gurriny has a robust formal cultural training program which has allowed me to better understand the complex history of First Nations people but also the specific history of Yarrabah itself. I have however learnt the most from the staff I work with each day, and of course, the patients themselves. I strive to establish trust and respect within the community and with individual patients and sometimes prioritise long term rapport building over short-term biological goals that I learnt during training. I listen and try to understand my patient’s stories, perspectives, priorities and wishes and collaborate with them to achieve their desired outcomes”.

“My greatest satisfaction at work comes not from helping a patient achieve a normal HbA1c or getting their blood pressure within target (although that’s great), it comes from connection and by establishing trust. From having a mum open up to me about her struggles with the transition to parenthood, or building enough rapport with a teen that on our third, fourth or tenth consult they feel able to share their story with me, to hearing patients call me ‘their doc’ and bringing their family in to see me as well. This is why I do what I do”.

The journey to becoming the Rural Generalist Sarah is today, hasn’t been a solo one. “I am fortunate enough to have many people that I can go to for support and advice, and not always just on a professional level. I am surrounded by incredible clinicians and humans who are willing to share their expertise, experience, and enthusiasm. I hope one day to be one of those people for others”.

As NAIDOC week approaches, Sarah is looking forward to being actively involved with Gurriny in various community events and celebrating it with those around her. “This year I hope to spend time celebrating with community, mingling with the kids, hearing stories, and standing in solidarity with the people and voices of Yarrabah”.

To learn more about this year’s NAIDOC theme, follow this link to their website.