Home' Australian Pharmacist : Australian Pharmacist December 2015 Contents Australian Pharmacist December 2015 I ©Pharmaceutical Society of Australia Ltd.
Praveen Mahendrarajah is a 4th year pharmacy
student at Charles Darwin University and Tobias
Speare is a Pharmacy Academic at the Centre for
Remote Health, a joint centre of Flinders University
and Charles Darwin University.
services: A student
BY PRAVEEN MAHENDRARAJAH WITH TOBIAS SPEARE
Central Australia is a region of immense beauty that spans a vast and
sparsely populated landscape across several states and and the Northern
Territory. It is known globally for its spectacular iconic landscape and the
diversity of rich and vibrant Indigenous cultures.
However, behind the picturesque
backdrop is the sad fact that the people
of remote Australia have shorter lives
and higher rates of disease and injury
than Australians living in urban centres.1
As the distance from Austral ian cities
increases, mortality rates climb, access
to essential health services declines
and rates of preventable hospitalisation
for chronic diseases markedly rises.1,2
Delivering quality healthcare in remote
Australia is a complex and challenging
endeavour due to the geographic
isolation of many communities.
Pharmacists play an integral role in
providing appropriate health services
and access to medicines for all
Australians. In remote locations where
there are no pharmacies, how is this gap
in health service provision addressed?
This is a question that I had asked
myself as a final year pharmacy student
at Charles Darwin University before
undertaking student placement in Alice
Springs. I was soon to get first-hand
exposure to the delivery of healthcare in
remote Indigenous communities.
I commenced a three week placement
at a busy pharmacy in Alice Springs that
supplies medications and pharmacy
services to Indigenous communities under
the Remote Aboriginal Health Service
Access Scheme (often known as Section
100) across central Australia. When you
walk through the door it looks like your
regular community pharmacy. However,
upstairs is dedicated to the mechanisms
and machinery necessary to supply a huge
number of dose administration aids.
It is a hive of activity with packing
machines humming busily, pharmacy
technicians attending to the machines
and pharmacists reviewing medication
lists and checking dose administration
aids. I was fortunate to accompany
Peter Hatswell, one of the outreach
pharmacists who provides QUM and
medication management services,
on a visit to two remote Aboriginal
communities. Our transport was
Peter's two seater Cessna aeroplane.
With Peter at the helm, we flew towards
the Queensland border and the small
Aboriginal communities of Lake Nash
Lake Nash, also known as Alpurrurulam,
is an Aboriginal community of
approximately 450 people situated
17 kilometres from the NT-Queensland
border on the edge of the arid
On arrival I was overcome with the
sheer expanse of red earth littered
with termite mounds and native flora
accompanied by silence.
The community has a local store, a school,
an aged care facility and a busy health
clinic. The health clinic has examination
rooms and a large drug room containing
everything from frequently used statins
to patient-specific medications. During
our brief visit we were able to review
the medication regimes of a number of
patients -- identifying the inappropriate
use of enalapril in a breastfeeding
woman -- and provided education
for health clinic staff and community
members. We also conducted a review
of stock management and provided
solutions to some issues, including stock
My placement experience in central
Australia was greatly enhanced by the
exposure to remote pharmacy services.
The pharmacy placement in Alice
Springs and the bush trips gave me
first-hand experience of the challenges
faced by people living in remote areas
and the lengths to which health services,
including pharmacies, are going to
minimise the barriers to healthcare.
This placement has challenged my
beliefs and spurred me to enhance
my clinical knowledge, improve
communication skills and work
collaboratively within the healthcare
team. I would encourage all pharmacy
students to undertake a placement in a
rural and remote area.
1. Council of Australian Governments Reform Council.
Disability 2011-12: Comparing performance
across Australia. 2013. Accessed online at www.
2. Australian Institute of Health and Welfare. Rural, regional
and remote health: a study on mortality (2nd edition). 2007.
Rural health series no. 8. Cat. no. PHE 95. Canberra: AIHW.
3. Moore B. NAIDOC Week 2014: Life at Alpurrurulam. 2014.
ABC North West Queensland. Accessed online at www.abc.
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