The about page of Australia’s Royal Flying Doctor Service doesn’t do full justice to such an incredible organisation. “The Royal Flying Doctor Service is one of the largest and most comprehensive aero-medical organisations in the world, providing extensive primary health care and 24-hour emergency service to people that live, work, and travel across the 7.69 million square kilometres of Australia.”
To understand the impact of this statement, we should look at the landscape in which the service operates.
Australia is one of the most sparsely populated places on Earth. Its land area is nearly three million square miles; India’s is about 1.3 million square miles. Australia’s population is about 25 million people; India’s is about 1,350 million. In other words, Australia’s population density is about 1/150th that of India’s.
Even these facts don’t explain it all. Australia’s five largest population centres — Sydney, Melbourne, Brisbane, Perth, and Adelaide — account for 16 million people, about 65 per cent of the total population. In relation to the size of the country, the land area of these cities is insignificant. So, discounting the cities which have excellent medical facilities, about nine million people live in the vast Australian landmass of nearly three million square miles — a density of three people per square mile.
But nearly 70 per cent of this landmass — the famous Australian outback — is practically unliveable for humans. Australia is the driest inhabited continent with nearly 35 per cent of its land area covered by deserts and another 35 per cent covered by semi-arid bush. Life is harsh in the outback and there is little vegetation and very little water other than a few oases and watering holes.
Mining a big industry
Yet, thousands of people, mostly Aborigines (the native peoples of Australia) and Australians of all backgrounds live in the outback and have done so for centuries. The 2006 census put the outback population at about 700,000.
The outback is rich in iron, aluminium, manganese, uranium, gold, nickel, copper, lead, and zinc - so mining is a big industry. The region is home to some of Australia’s most dramatic landscapes - buttes, hills, wadis , and flat brush. Although extremely dangerous animals — snakes, crocodiles, scorpions, and centipedes - are everywhere in the outback, adventure travel and tourism form a huge sector. The outback, therefore, has its share of small business owners in the hotel, restaurant, and travel industries.
Most outback towns and villages are very small in size, with just a few residents. Cook, a railway junction located in the state of South Australia on the Trans-Australian Railway has a permanent population of just four people. Roads and highways are rare - so residents employ pick-up trucks and SUVs to drive off-road.
So, what happens when someone in these outback communities falls sick or requires medical care?
Medical emergencies
This is where the RFDS steps in to save lives. Employing a fleet of 77 single-engine and twin-engine propeller planes, the RFDS sends doctors and nurses to these communities when they are made aware of a medical emergency. The response time for distant areas can be as long as 4-5 hours - from when a call is received at an RFDS facility to when the plane actually arrives at its destination. RFDS planes routinely travel upwards of 1,500 kilometre, about a three-hour trip one-way, to just reach a patient, refuelling in mid-air from spare cans on board.
The planes — which serve as mobile hospitals — are remarkably well-equipped. Doctors, who are certified pilots, can perform surgery in the cramped quarters of the plane. If patients require longer-term care or the facilities of a brick-and-mortar hospital, they are flown back in hospital beds (typically two beds to a plane) and handed over to a traditional hospital in one of Australia’s big cities. Ventilators and full life-support systems are available on these planes.
The RFDS has a wide footprint in Australia and has centres at 23 bases spread across the nation. Operating across vast distances, harsh landscapes, and in far from ideal conditions, the organisation is forced to innovate. As remote regions get internet access - many only have satellite phone service and no mobile phone coverage — the RFDS employs tele-health as a quick and convenient way to serve patients that don’t have emergency conditions, and dispatches help only when an in-person visit from a doctor is essential.
Remarkable growth
Established over 90 years ago by a missionary, the Reverend John Flynn, the RFDS continues to operate as a non-profit organisation. While it receives funding from the federal government of Australia and the six state governments, a large portion of its operations continues to be underwritten by donations, workplace giving, and gifts in wills from people who pass on - many from international donors.
The RFDS attended to more than 370,000 patients last year - remarkable growth for an organisation that started off by having doctors see just a handful of patients in local communities visiting on horseback.
The next time you fly over Australia’s sparse country, you may spot an RFDS plane well below you, attending to a patient emergency. It is a fascinating organisation that most people in the world have never heard of, but its service is vital to thousands of rural communities in a vast country. A service that often means the difference between life and death.