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Published: February 6th 2010
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weka
silly flightless birds we arrived in westport late sunday evening.... toni (the practice manager) met us in the new world supermarket parking lot, and lead us to our digs in carter's beach. we will be working in westport for a total of two weeks, and living in a flat in carter's beach, which is about an 8 minute drive away from the hospital.
we were both quite impressed with the flat, which is the nicest accommodation we've ever had during any of our locum placements. and, we are just a 2 minute walk to the beach!
westport itself is quite a cute town. population about 5000 with a total catchment of about 7000. it is located in the "Buller" region which spans the northern part of the west coast, and inland along the buller gorge. the buller river is well-known for having great rapids. the primary industry in westport is coal mining. the only and largest coal mine in NZ (stockton) is about a 30 minute drive to the north. pretty dirty energy, but we've been given a different perspective, since a large part of the population in this town is completely dependent on it for employment. the west coast of the
south island, particularly the buller region, is one of the most poverty stricken in the country. farming is likely the second largest industry here...
the clinic and hospital are near the "downtown" area. there are about 4 full time doctors here and a good complement of nurses. apparently, they would ideally fill 8 full time GP positions. while we were there, two of the full timers were on vacation. the remaining semi-permanent docs are all ex-pats...from the states, australia and the UK. there were four locums in total working while we were there (including ourselves). matt (from maine, originally) and weiling (our friend from canada.)
the impressive thing about NZ is that it has almost completely, as a country, made the transition to electronic medical records (even in the smallest and most remote regions.) i guess it's easier with a population of only 4 million. and, to make things even better, about 90% are on the same system (which should make things easier once we get used to the 'medtech' system.) we received about 1 hour of training with the EMR, so it has been a bit challenging so far, but i think we are getting a bit
quicker...
the clinic runs from 8:45am until 4:45 pm... we usually get out around 5:30-6pm (catching up on paperwork at the end of the day). patients are booked every 15 minutes, and there is usually one GP dedicated to same-day bookings. there are several nurses that see patients during the day and will squeeze patients into a GP's clinic if there is something requiring more attention. there is one pharmacy in town. the hospital has a small 2-bed emergency department. interestingly, most of the acute type issues seem to get sent to the clinic for assessment (ie. acute chest pain, query fractures, etc...) we've found this a bit difficult at times, since 15 minutes is not adequate to work up someone with concerning symptoms. also, there is no laboratory in town. there is a phlebotomist that draws blood, but it all gets couriered down to greymouth (1.5 hours away) for processing. we do have basic x-rays available, but there is no ultrasound or other imaging (patient's have to travel to greymouth to have more advanced imaging done.) basically, patients that are extremely ill are stabilized and sent by air or ambulance to greymouth or to christchurch (the largest centre
on the south island.)
in new zealand, low-risk obstetrics is predominantly done by midwives. there are a handful of midwives in westport and they have their own maternity clinic where they follow patients. they also do most of the immediate post-partum care for women and their newborns.
we're each on call about once per week. there is a pretty good triage system here, so we only get called in for Level 1's and 2's (emergent and urgent); lower acuity issues are advised to follow-up in clinic the following day. we are also on call for "PRIME", which is an acronym for Primary Response in Medical Emergencies. in these small communities, the ambulance services are run by volunteers that often only have very basic first aid training (ie. can't put in iv's or administer any type of medication). so, when we are on call, we are given a car equipped with medications and emergency medical equipment (eg. for intubation/lines, etc....) if there is an emergency on the road or in someone's home, and the patient is unstable and the paramedics can't manage it, then they will call us to go to the scene.
anyways, that's enough about work.
we have been enjoying our time in westport so far... we've been able to explore the local area. tauranga bay is just about 15 minutes away and is a great surf spot. there is a fabulous restaurant called the Bay House that oversees this bay (http://www.thebayhouse.co.nz/) . we had an astounding meal there (after locking ourselves out of our house and) before heading off for the Inland Pack Track on the weekend.
most days we have been going for runs in the carter's beach area. i don't like to be too far away from the car when on call, so we've been running a loop in our neighborhood. on days when we're not on call, we've driven out to some scenic walks and jogged along. the cape foulwind walkway is just about a 5 minute drive away and goes along the cliffy coastline between cape foulwind and tauranga bay. it was very hilly and also went by several sheep farms. seal island is located near tauranga bay, and is inhabited by a protected seal colony. we stopped to check them out during our run. pups are born december to february, so we were able to see lots of babies
flopping around. we also went for a run along the charming creek walkway, which is about 30 minutes north of westport. this is near stockton (the coal mine). this trail follows the old charming creek railway (the tracks are still there). there is an old mine in this area as well as a couple old mills. we ran along the tracks (which follows the creek), past a large waterfall and through tunnels to these abandoned sites.
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