It Takes Heart
It Takes Heart is an unmissable podcast where healthcare workers share their honest and unique experiences from Australia’s frontline.
Discover real-life stories of passion and purpose, insight and inspiration from people on the inside and tales that are equal parts heart-warming, heart-wrenching and hilarious. It Takes Heart is co-hosted by cmr | Cornerstone Medical Recruitment CEO Samantha Miklos and Head of Talent and Employer Branding Kate Coomber.
It Takes Heart
Nurse, Advocate, Storyteller: Annabelle Brayley’s Impact in Remote Australia
Annabelle Brayley says "Yes" when opportunities come her way. When a publisher at Penguin read an article she wrote in Outback Magazine, she began curating Bush Nurses for them which eventually led to becoming their published author.
Annabelle's journey is nothing short of extraordinary. Growing up in a small community on the Western Darling Downs, she spent her early days as a registered nurse before transitioning to pivotal roles such as facilitating the establishment of a federal dementia program in Queensland, contributing richly to the RM Williams Outback magazine, and now her advocacy work with Remote Australians Matter.
Annabelle reflects on her early aspirations of becoming a hairdresser, influenced by her father's insistence to pursue nursing, to the unique learning environments of urban versus rural hospitals, the narrative paints a vivid picture of life and growth in rural settings.
In this episode, the topic of healthcare professionals’ transitioning into rural health and community service is explored. We hear about individuals who pivot from conventional roles to impactful positions, leveraging life skills like project management and community involvement.
The conversation takes a critical look at healthcare disparities in remote Australia, emphasising the logistical challenges and the importance of community involvement in healthcare decisions.
This episode of It Takes Heart has CEO of cmr Sam Miklos hosting alongside Head of Talent and Employer Branding, Kate Coomber.
We Care; Music by Waveney Yasso
More about Annabelle's Charity of Choice to Sponsor a Rural Generalist Doctor to attend the RMA conference:
Rural Medicine Australia (RMA)
Rural Medicine Australia (RMA) is the peak national event for rural and remote doctors of Australia. Hosted by the Australian College of Rural and Remote Medicine (ACRRM) and the Rural Doctors Association of Australia (RDAA), RMA attracts a diverse and collaborative community of junior doctors, students, educators, academics, and medical practitioners who are passionate about generalist medicine in rural and remote communities.
Visit https://rma.acrrm.org.au/ for more information.
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Follow @ittakesheartpodcast on Instagram, @cmr | Cornerstone Medical Recruitment on Linked In, @cornerstonemedrec on TikTok and @CornerstoneMedicalRecruitment on Facebook.
We care for the land and sea. We care for the energy. We care for our community. We care. Welcome to it Takes Heart. I'm Sam Miklos and I'm Kate Coomba. We hope you enjoy these incredible stories of healthcare professionals making a difference in communities across Australia and beyond. Through our conversations, we look to celebrate the spirit of community and care. We acknowledge the traditional custodians of the land who have long practised and shared ancient methods of healing, providing care and support for their communities with wisdom passed down through generations.
Kate Coomber:Join us as we explore what it truly means to take heart.
Sam Miklos:Today we are thrilled to have Annabelle Braley with us. She is the true embodiment of seizing every opportunity. Though she initially trained as a registered nurse, annabelle's journey has taken her from a remote sheep station to managing a federal dementia program, purchasing a news agency and working on a number of board roles. She's even become a published author, with six books now to her name, and is a regular contributor to the RM Williams Outback magazine. Annabelle's passion for rural and remote healthcare shines through her recent work with Remote Australians Matter, where she champions equitable healthcare access for all remote Australians. Having recently retired from her role with the Australian College of Rural and Remote Medicine, annabelle now dedicates her efforts to this vital cause. Join us today as we explore Annabelle's remarkable journey. Welcome to it Takes Heart, annabelle.
Annabelle Brayley:Thanks Sam, thanks Kate. It's lovely to be here. Thank you.
Sam Miklos:So I have to first start. It really resonated with me that you love to seize every opportunity, and for me that's always been my motto. I'm just a yes, yes, details, details, We'll work it out later. Tell us about one of the craziest times you've said yes to something where it's really worked out for you.
Annabelle Brayley:I would actually say that I can't really remember a significant time when it hasn't, because I think that you can always make something of everything.
Sam Miklos:I love that.
Annabelle Brayley:Even if it's only embracing the experience. So it may not have worked out the way I thought it should or hoped it might, but it's, you know, everything's a learning opportunity Totally. And I think you should say you know, have a go at everything that interests you and say yes to any opportunity, because you just don't know where it might lead. And for me, certainly the significant thing was and it was prefaced by other yeses that kind of led me into that situation but writing the story. I was asked to write a cover story for Outback Magazine about remote health and, just to go back, I actually got into being a published writer because in 2006, we were living in Morven, we'd moved up there, We'd sold up in 2001, moved up to this tiny community for five minutes and we're still there because it's such a fabulous community, community for five minutes. And we're still there because it's such a fabulous community. And I had done various other things.
Annabelle Brayley:Anyway, in 2006, I happened to write to the editor of the Outback, rm Williams Outback magazine and asked were they sending somebody up to write a story about the Victoria Downs Marina Stud in our district, which was celebrating their centenary? Anyway, the short part of that story was that they weren't and asked me, could I write? And ultimately I wrote that article and it was the first paid for article that I had had published. And I say paid for because the really exciting bit about it. I was actually cleaning out a drawer the other day and I photocopied the che check when it came from that first story. It was so exciting. Yeah, and it's exciting to see your words in print.
Sam Miklos:Yeah, I can imagine.
Annabelle Brayley:So I hadn't expected to have that opportunity, but you know I did, and some years later, the magazine asked me would I write a cover story about remote health? And I very nearly. It was towards the end of a year, I guess, 2011, that it was going to come out. I had other things on and I thought I don't really know that I have time to do this, and the honest thing was that I actually didn't know what a cover story was, but I said yes anyway in the end. I love that and I wrote this story, and I'm pretty sure it wasn't a very good one, because they've never asked me to write another cover story. However, as a result of that, I came home. It came out in January 2000. I can't remember which year it was 2011 or 2012. And it must have been 2011. And there was a message on my phone that said this person's name and I'm an editor from Penguin Books Australia and I'd like you to give us a call back and I actually thought you know somebody.
Kate Coomber:I know, but it was a Melbourne phone number.
Annabelle Brayley:So I rang the number and sure enough it was an editor from Penguin Books and a publisher there had read that article in Outback Magazine and asked me would I be interested in collating the stories that ultimately became Bush Nurses? And that was actually a philanthropic project of theirs. They do that every now and again, or they did back in those days, and the royalties from that went to Frontier Services, which I had worked for at one stage, and you know, like Frontier Services really in many ways John Flynn, and you know the origins of all the healthcare services that we have in Australia, and so I had that opportunity and because of that, when I read some of the stories that came in, I actually said to the publisher, andrea, like we've got some gobsnacking stories here. They are really really amazing stories, fantastic nurses, and as a result of that they gave me a contract to write Nurses of the Outback and the books that followed. And that wouldn't have happened had I said no to that cover story.
Kate Coomber:None of that would have happened. I think that's incredible. It's really inspiring, isn't it? Of where you just have to take a chance and thank you for saying yes here today and coming to see us I have to say this is not my comfort zone to be honest.
Annabelle Brayley:I don't like public speaking and I don't I like being on the other side of the storytelling, of asking the questions I wanted to ask that, because what do you think makes a great storyteller?
Sam Miklos:you know you've written so many books now, and now you see yourself as a. I want to ask that, because what do you think makes a great storyteller? You know you've written so many books now and now you see yourself as a storyteller.
Annabelle Brayley:What makes a great storyteller. It took me a long time to get my head around the idea that I might actually be a good storyteller because I guess in part because I fell into it you know one of the things about anything we do and certainly the saying yes thing, is, sometimes it's better if you actually have to apply to do things and go through the process of you know whether it's a job or, in this case, you know, having an opportunity to tell stories, whatever. But go through the process of winning the role because it gives it a legitimacy that you don't normally or I didn't necessarily feel when things have happened, just because I said yes, but then I realised that you know the fact that you're asked in the first place probably counts for something. Yes, but then I realised that you know the fact that you're asked in the first place probably counts for something. Yes, absolutely.
Annabelle Brayley:And so I think that my talent as a storyteller is that I'm very clear in my own head that they're not about me and I'm actually just a conduit for other people to tell their stories. So I'm a tool and I'm actually just a conduit for other people to tell their story. So I'm a tool, I can take their stories and turn them into something that somebody else wants to read. I'm really really pedantic about accuracy and can be about detail, et cetera. I'll check and double-check things and if somebody tells me something that I decide is more about their memory or mis-memory than it is about fact, then I'll find a way to circumvent it or not include it. That kind of stuff, yeah. But I think that in my case, what makes me a good storyteller is that I actually am very clear. I am telling somebody else's story and I don't have anything to do with it whatsoever. I don't have any opinion about it. I try not to have preconceived notions about it. I'm just the tool for them to share their story.
Kate Coomber:Yeah, I love it, so can we maybe go back and this is where you are now. But how did healthcare come about?
Sam Miklos:Take us way back. When is it always desire? Because didn't you want to be a hairdresser?
Annabelle Brayley:Yeah, did I really? I did want to be a hairdresser. I grew up in a small community of miles, which is on the Western Darling Downs. My parents were both professionals. My father was the dentist in town. My mother was a teacher. Well, she wasn't actually a teacher when I this is a thing.
Annabelle Brayley:You'll probably need to remind me of the question you asked, because I'm just going to digress here for a second. Go for it. My mother was actually an only child. She was born in North Queensland, had no experience of you know bush life, or Well, she did, but not living it herself permanently as an adult with children etc. She actually lectured chemistry and physics at Queensland University and she actually lectured a lot of, she tutored a lot of the doctors and dentists who would now be in their I guess, 90s I suppose, who went off to the Second World War and came back and resumed university, so that kind of age group in the early 40s she was tutoring and she married. My father came to Miles and to this little bush town with like the straight out of academia, so he was from there.
Kate Coomber:Yeah, yeah, yeah.
Annabelle Brayley:And like she must have just been the ultimate fish out of pond, yeah, I went to Miles just recently?
Kate Coomber:Yeah, you did, and it's probably. Is it bigger than it would have been then?
Annabelle Brayley:Oh, certainly, yeah, yeah, yeah, yeah, but in some ways it hasn't changed. You know, like my grandmother's house is still in the main street. Yeah, and, and excuse me, there are things about it that are the same and it's essentially, you know, a small community, but, yeah, it's grown in many ways.
Sam Miklos:So your career.
Annabelle Brayley:Yeah, mum actually was able to transfer. I can't remember the details of how this happened, but because of her qualifications at uni she was able to translate that into a teaching qualification. So she actually went back to the local high school and taught when three of my brothers and I were. Three of us were at boarding school at the same time. One of them was at university, which is a big undertaking. So she went back to teaching, which was such a fortunate thing for some of the kids in that community because she actually changed the lives of people in that community, because she was such a wonderful teacher and she opened them up to opportunities. It didn't occur to her to say you know, you can just be a farmer.
Annabelle Brayley:She was like well, you can go to university and be a chemistry lecturer. And I know at least one doctor from that community and various other professionals who've kids from that community who became a doctor, who would say they did it because of the influence of my mother. Yeah so, but when we grew up four brothers I just wanted to be a hairdresser. I do have an artistic streak and for me, I don't know why I wanted to be a hairdresser, but that's what I wanted to be. And I keep saying to people you know, I did train as a nurse because my father said you've got to be a nurse or a teacher, but I really should have been a hairdresser. And I don't mean that with any disparagement to hairdressers, because I actually think that hairdressers are the world's are just penultimate counsellors.
Kate Coomber:Yeah, oh, absolutely, you know people go to their hairdresser, particularly women you know, offload all your joys and your sadness and whatever, and it's really critical. You know, you walk out unhappy and and you come out looking fabulous.
Annabelle Brayley:Yeah, you know, it's just gold. And so I really should have been a hairdresser. Because the other side of that, of course, is that what I realised later as a storyteller is that I really just wanted to hear the stories. I didn't want to. I can remember getting into trouble when I was nursing at PA for sitting on a patient's bed because I was sitting there talking about you know, they're telling you their story. But I didn't realise then that that was a thing I could or might have done.
Annabelle Brayley:So I did start my nursing training at PA. I finished it at the Charleville Base Hospital. Oh, because this was the other thing. When Dad said you've got to be a nurse or a teacher because he knew that I wanted to go and live in the bush or further west I said, oh good, well, I'll go and train at Charleville or Gundawindi, which at the time had regional training programs. And he said, no, if you're going to be a real nurse, you know, if you're going to train properly, you've got to go to the city, and I at the time I was, you know.
Annabelle Brayley:I stomped off to PA and and um stomped back out again about 18 months later, did something else for a while and went back and finished my training in Charleville.
Annabelle Brayley:But I saw, experienced and learned more in 18 months at Charleville than I did in 18 months at Princess Alexandra. And I would say part of the reason for that is because I at PA was moved by chance to mostly you know specific wards, like you know children's orthopaedics, renal whatever as opposed to just a general nursing ward. And I know in a way there would be nurses who would say but that's what you're doing, general nursing. But for me it was just all the wrong place at the wrong time. Whereas in Charleville, whatever happened you get involved in and I would say that to any staff now I mean, we can come back to this later but certainly the opportunities for practising your craft you know the thing that you've been trained for so well for so many years the opportunities to actually embrace that and deliver that are far greater in a rural or remote area than they are in a city hospital.
Kate Coomber:Getting the exposure, aren't you? Oh, totally yeah, and do you think?
Sam Miklos:that that could have. You know, could a graduate have that same experience? Do you think it would be? You know a graduate would feel as comfortable and supported going out first year to a rural, remote community and working there, or do you think there's a benefit to them having some time in the city?
Annabelle Brayley:Well, I personally think that they should be training in the bush. I think everybody should be training there. I think, you know, we didn't do anybody any good service when they closed down the hospital training programs and personally I just think that was universities grabbing money. Quite frankly, we'll train them and we'll have the money. I could be completely wrong, but that's what it feels like, because we took away so much of the workforce as well, not just in rural communities, but in the city. You know, it just didn't make any sense.
Sam Miklos:It would have helped too, I imagine, with that if they were training in those regional and rural communities. If that's someone from the city, they might not have never had that experience, but they might be willing to go back and work Absolutely, you know they're exposed to that.
Annabelle Brayley:Well, the other side of that was when I was training at Charleville. They obviously weren't training doctors, training nurses, and so they were training assistant nurses and nurse aides at the Charleville Hospital. The nurses including me who were doing registered nursing training went to the Toowoomba General for a block to do our lectures, but then we'd go back and we would nurse at Toowoomba General at the same time. So we got that dual experience. But then we went back to the hospitals and we had, you know, all the sisters were, you know, teaching nurses et cetera, even if that was just the practical skills on the floor. But it was a learning environment. So med students coming into there or allied health students, anybody coming into that environment, was coming in and working in an education, teaching environment, and that's very different to coming into the kind of environments we have now, where we are returning a bit to that learning kind of environment and there's certainly support networks, but not the kind of teaching environment we had back in those days.
Annabelle Brayley:I don't believe. And I would say now to anyone who's half interested in training, certainly in Queensland, look at the Southern Queensland Rural Health Hub sorry, the Rural Hub which is a collaboration between and I'm hoping I'm getting this correct UniSQ, uq, darling Downs Health and Southwest Health and Hospital Service and they have hubs at Charleville, has been there for a while, st George, and I think they've just opened one in Chinchilla. But in Charleville we actually they are training nurses again for the first time and I believe they're also progressing towards medicine, so that you know we have nurses, not necessarily just country girls, but because anybody can apply to join the program, because anybody can apply to join the program. But they are training in rural and remote and I can't just say, I can't over say how important that is. It will make a difference, yeah.
Sam Miklos:In what way? How do you see that making a difference?
Annabelle Brayley:Because they're learning where they're working.
Kate Coomber:You know, there are so many things that are different.
Annabelle Brayley:Many years ago I actually coordinated a program for the Isolated Children's Parents Association, which was it's a federal organisation but also has state context. And so I coordinated that for Queensland in the late 90s, bringing student teachers from QUT into rural and remote schools for pracs context. And so I coordinated that for Queensland in the late 90s, bringing students, student teachers, from QUT, into rural and remote schools for pracs. I set up their pracs where they went, et cetera, talked to their parents, came down here, talked to the students before they came, told them a bit about where they were going to go, what they would find.
Annabelle Brayley:Parents would ring me and ask me everything from how will I get there? How long will it take? One even rang me and asked me how to drive up the Toowoomba Range. All of that like just because people don't know, they have no experience of it. And so in that same way, I think, because it's a very well-supported and I use the word nurtured advisedly because I don't think that they're overly, you know, helicoptered or anything, I just think they're well supported Teaching environment to someone like Charleville that they're actually learning their craft on the ground and having that same exposure to whatever's going on you know, if something they would know what's happening in the community or over in the hospital at any one time.
Annabelle Brayley:There's, you know, just a no-brainer.
Kate Coomber:So did you work as a nurse? Well, I did for a little while. Yeah, what was the? Where did it go from there?
Annabelle Brayley:Well, I finished my training. I worked straight after I graduated. I actually went and worked as a receptionist at Grascos in Charleville, which is a shearing contractor, yeah right and moonlighted at a pub at the same time on Friday nights, because my heart really wasn't in it. I should never have been a nurse, not in terms of looking after people and actually making a difference to their medical outcomes. I really should have been a hairdresser to their medical outcomes. I really should have been a hairdresser. But the advantage for me was that when it came to writing about nurses, I had a. You know, it's like a badge, you know I trained as a nurse.
Annabelle Brayley:I get the black humour, I get the. I get them. You can relate and totally and I think, and I'm grateful for that reason that I did them. You can relate and totally and I think, and I'm grateful for that reason that I did, that I'm not a lot of help in a medical crisis. There are some things I can do and not. But you know I'm not, it's just not my thing, you know.
Sam Miklos:But I'll tell you stories. I totally appreciate that, because I trained as an occupational therapist and I worked clinically for five minutes, I would say, in Toowoomba base and it just wasn't. It wasn't there. But healthcare was something I was just so passionate about and I think it's I understand now when I talk to allied health professionals, I understand what they're doing and their challenges, but it just wasn't the place that I wanted to be. You went on then and you were on the board of ARCRM, the Australian College of Rural and Remote Medicine.
Annabelle Brayley:Well, well before that, I got interested in I mean, look, I've always been interested in remote health. I'm alive and I live out there, so you know we should all be interested in health and our health outcomes. It's your health, it is our health. That health and our health outcomes, it's your health, it is our health. That's exactly right, or it's your health? Yeah, when we sold our property and dissolved this partnership well before that actually, our kids had gone to boarding school and my husband said to me one day you need to get a job because we were quite remote. And he said you need to get a job because otherwise you're going to end up brain dead. And I clearly needed something to occupy my time.
Annabelle Brayley:Yeah, and other than you know, going out and helping. And now that I look back I think, okay, so maybe he was getting me out of the way. I hadn't actually thought about that before. Anyway, so I applied for a job that I absolutely was not qualified for. And just to correct your introduction slightly, yeah, I wasn't the coordinator of a national dementia respite program. However, I did apply to be the manager of a dementia respite program, which was Auspice Roo Blue Care here in Queensland, in remote Queensland, for which I absolutely was not qualified. But I applied anyway and this comes back to that.
Annabelle Brayley:You know, have a go like apply for anything that interests you. Because for me, part of that was just about I'd never applied for a job ever in my whole life, and when I did that I must have been 45 or something, you know. So I never applied for a job in my life and so I didn't. Actually, I learned a lot from that process. I didn't expect to get the job I mean, I probably hoped to on some level but the process of actually applying and asking people to help me write my application, which I did a friend of mine who was a teacher at Cunnamulla at the time, helen Miller helped me. You know finesse my application and I actually and I used things because I didn't have a CV so I used things like my experience living on a remote cheap station. You know every now and again you've got contractors coming in. You know you've got to organise sharing. Through the year I had home-tuned my kids, bought up a family, managed a house, all of that sort of stuff.
Annabelle Brayley:You're a project manager Exactly exactly multitasking project manager and I had also had quite a lot of experience in various levels with local community things and with isolated children's parents. I used that coordinating that teacher thing as one of my skills on the application and I actually scored an interview and was offered a job. And I remember I came into Toowoomba, I caught the train down to Toowoomba for the interview and I went to it in my best Sunday dress because I had no idea.
Annabelle Brayley:I was so overdressed for it I had absolutely no idea what I was doing. But they offered me a job as a project manager with this new service because they actually had, they got the funding for it but they hadn't actually set it up. So I did that for six months and then I switched to a role coordinating the placement of respite workers into the homes of people who were looking after someone with dementia in a remote area, and so I would go, do the assessments in the homes, work out who needed to be there, try and match personalities, which again, coming back to storytelling was, which I wasn't doing then. But that know, kind of hairdresser, listen to people's stories, things thing was helpful because it enabled me hopefully to place the best person into any situation, the most appropriate person, and so I did that for a few years.
Annabelle Brayley:I've done, I've done a lot of actually worked at a lot of jobs at times, but I stayed working for Blue Care in that role for three years. It was a pilot program. The government chose to can it, which was just tragic, because it actually was. You know, it was a costly but cost-effective way of keeping people with dementia at home for as long as possible, and some of them are quite young people living on farms and properties where you know going away. It's not just about you know popping down the street to the nursing home.
Annabelle Brayley:This is a whole different ballgame when you live in a remote area and you have to go somewhere else for whatever it just has implications not just for the person involved and the immediate family, but for whole communities, and so we need to rethink the way we close that distance and that we can come back to that later as well. Anyway, I did that for three years and then I continued to work for Blue Care for a couple of years until I started falling asleep driving, because I was doing a lot of driving around Queensland. And I fell asleep one day driving home. Fortunately, nobody else was on the road and I didn't do any damage.
Annabelle Brayley:But it gave me a fright, and it wasn't just, you know, like that blink. I actually fell asleep and ran off the road. Well, ran, you know. Anyway, it was fine, nothing happened. But I realised that I had to get out and be doing something else. So I bought the local news agency in our little community. So I bought the local news agency in our little community and just quickly I bought that, and a few weeks before I took it over, I had this conversation with Outback about writing the stories, and so I had this opportunity to write a story, and I'd just taken over a news agency and I didn't know where either was going.
Kate Coomber:Anyway, you're in the right spot to market your own magazine, yeah.
Annabelle Brayley:Maybe if I hadn't been negotiating to buy the magazine who knows I mean to buy the shop, who knows I mightn't have thought about. Actually, you need to write, somebody needs to be writing the story. You know, timing is everything.
Sam Miklos:Totally.
Kate Coomber:You can sense that you are so passionate about the community that you live in and that you're a part of even the newsagent. You know that understanding of people. I can just imagine. It's almost that hairdresser dream of being able to talk to everybody in the community as they come in.
Annabelle Brayley:I think in a very general sense just sorry, I am not. I am a bit passionate about my community in some ways, but I'm more passionate about community having a say in their communities, about people having the opportunity to be involved in the decisions that are made about their communities. I know that some people don't want to be, but none of us are ever asked and I think you know I will die pushing for community to be asked and the first question I will always ask any organisation is where's your community representation?
Kate Coomber:So if we can get to your current sort of passion and role, but touching on the Akram role as well, the. Rural Remote Medical College. How did that come about? And I think what's really interesting in this conversation is that you can work within healthcare. You can work within this area even if you don't want to be clinical Absolutely.
Sam Miklos:As you were saying.
Kate Coomber:You know, and it's just wonderful to hear all the different opportunities that you've had.
Annabelle Brayley:In terms of Akram. So I got a contract to write Bush Doctors. Before that happened, I actually pushed it back. It was supposed to come out in 2016 and I asked the publisher if we could push it back because I wanted to write the stories about Vietnam, the Australian women who nursed in Vietnam, all the Australians who nursed in Vietnam, because some of them were medics, and so I actually pushed that back and it took me two years to get my head out of Vietnam because I essentially debriefed some of the people I interviewed and when I did, it was because I actually got I joined Twitter so I stalk doctors, yeah, yeah, because there are a lot of doctors on Twitter.
Annabelle Brayley:On.
Sam Miklos:Twitter they are.
Annabelle Brayley:So I actually, literally, was stalking doctors on Twitter and I found a doctor called Kate Closer, who and I can't remember which happened first whether I read something on Twitter that she had been appointed no, she'd been awarded Registrar of the Year, I think. Or she was going to the Antarctic, I'm not sure which caught my attention first, but that kind of caught my attention and all of a sudden I was into doctors and as a result of that, I discovered the Australian College of Rural and Remote Medicine, which I'd never heard of and I think probably most Australians hadn't then, and I got in contact with them and Ewan McPhee, who was not I can't quite remember how I I think he might have been president of Rural Doctors Association at the time, I'm not sure, but anyway, I asked him to write the foreword for the book. He told me about Akram. You know, various people were telling me about Akram, so I got in touch with them because I could find more doctors and I learned what they do, which is actually train doctors specifically for rural and remote practice, and it was like, oh my gosh. You know, here I get it. I've found a lot of my people, and so I became aware of them.
Annabelle Brayley:Anyway, in 2017 or 18, about the time the book came out but they decided to advertise for a community director on their board. They didn't tell me about it. I read it in the Australian or something. Yeah, right, Anyway. But when I saw it I thought, oh my God, I know what that is.
Sam Miklos:Yes.
Kate Coomber:And this is all that opportunity thing.
Annabelle Brayley:I know what that is. I'm going to apply for that completely unqualified. I have no skills in the boardroom.
Sam Miklos:I know nothing about anything but everything about it, but I live in the right place. I was just going to say, yeah, you've got the lived experience.
Annabelle Brayley:So I actually successfully applied and the college were fantastic. They offered me the opportunity to do the course at the Australian Institute of Company Directors, which I did and managed to qualify through that and graduate. And so that began my association with Akram and what we were able to do was establish their community reference group, which is a really important part of the organisation, I think. What does that entail? So when they first asked me to be a board member, I don't believe anybody can represent anyone collectively on their own. So I set up this group and I told them I was doing it. I set up this group across Australia of people I knew, so that if they asked me a question as a board member or there was something that I needed to be aware of, that I had people across Australia I could go to and say, oh, an opinion about this, that or whatever else. And so when it came to them thinking you know they wanted a community reference group, that was sort of a natural transition to start.
Annabelle Brayley:Yeah, yeah, so some of those people came onto that first, which was a pretty kind of casual group in the beginning but was actually formalised, and I chaired that group until I actually resigned from the board. I resigned from the board, I think, or didn't re-sit, can't remember which happened, but anyway in 2022, but stayed on as the chair of the community reference group until 2023. And I had a succession plan in place. So someone moved in Gus White, who's now the chair of the group. You know that was a well thought out process on behalf of the College and me, and that group continues to advise the college in terms of community input and opinion about anything to do with the college and raw and remote medicine.
Sam Miklos:Tell us about Remote Australians. Matter then.
Annabelle Brayley:So, as a result of talking with all of those people, one of the things that became very obvious to me is that remote gets lost in the real context. You know, people are starting to and I say people usually when I say people I mean decision makers, politicians, et cetera, who are making decisions about other people, whether they, you know, are qualified to or not, and I believe that remote is just too hard. Can I just ask?
Sam Miklos:you there? What's the difference, you believe, between remote and rural Australia? Everything. Can you describe that Because so many people wouldn't be aware of that?
Annabelle Brayley:Okay, so socially, economically, culturally, demographically, geographically it is different because everything is more extreme. And socially it's more extreme because distance are further, and socially it's more extreme because distance are further, so it's harder to be social, as in face-to-face socialisation, everything is, you know, harder to access. I can remember years ago when I was interviewing actually I was in the Northern Territory in an Aboriginal community, interviewing a nurse for the book, and the manager of the clinic happened to be there at the time and they something like, and I can't remember what, the machine was, but it was something basic like the ECG or you know whatever, and it had broken down and I said, oh, winston, you weren't arriving.
Annabelle Brayley:And they said, well, we ordered it eight months ago and we still haven't heard when it's coming Like. So that's kind of an example of some of the resourcing problems. And it's not that they can't get it there, it's that it's like when we need something in a remote area, just get it there. You know the logistics and palming off about getting stuff done is just awful. You know, just make it happen.
Annabelle Brayley:Because one of the things that I firmly believe and that at RAM we believe, is that you can take any number of services that you design and you know develop in a metropolitan or even rural area. You take them to a remote area and they're almost destined to fail because they won't have the support networks. You know the votes, the money, the people, the anything around it that ensures continuity. If you design something in a remote area and make it work, it will work anywhere, because you just add people and money and you know whatever. And so for those reasons, I think that remote has to be considered separately and I believe there's no equitable access to primary health care in remote Australia, and I believe that we can do something about it. Every Australian has a right to universal health care.
Kate Coomber:They do yeah, and I think, getting the right people out there as well, because if they don't have the resources, I think some of the doctors that we've spoken to in this podcast they actually really enjoyed the work in the community and immersing in the community, but sometimes, if they don't have access to the pathology, they need the imaging that they need. They want to make sure they're making the best decisions with the best outcomes. I think there's a bit of a sorry, I'm interrupting. No, not at all. I think it's just making sure that they've got the resources, like the machinery that works, so that they can help people.
Annabelle Brayley:And it needs to be the basic machinery that works, though it doesn't need to be. You know, I think we rely a lot on technology in medicine these days, and I don't think that's doing anyone any favours either. I can remember one of the nurses, chris Belshaw, who used to be an RFDS nurse, saying you need to eyeball your patient. You know, you need to be able to look at the patient. Don't look at the machine, look at the patient. And I've had doctors say the same thing. Really good remote doctors and nurses who will say look at the patient. Like you know, don't be worrying about the gizmos, yeah, yeah, but you do need the basic ones.
Sam Miklos:You do need the basic ones to actually facilitate, you know, good basic care I think what's the work then I'm just going to say that what's the what's the work then that rams is trying to do to close these gaps well, ram's not fixing anything Right.
Annabelle Brayley:So Remote Australians Matter is a group of there were five, there's currently four, and we're a very defined demographic and we're very aware of that, so we don't claim to represent anybody whatsoever. What we're trying to do is set up a conduit that enables remote Australians to get involved in the decisions that are made about their primary health care. Access to primary health care we need place-based, innovative, sustainable primary health care access on community, whatever that is and community is different things to different people and there's absolutely, without doubt, the Royal Flying Doctor Service does amazing service across the country, and they do deliver great primary health care, but they're not, they don't go to everybody or they're not accessible to everybody for whatever reason, and all those clinic runs aren't, and so we need to make sure that every remote Australian can access the primary health care they need, particularly children under five. You know so the kids start school. Education and health are inexplicably linked. In my opinion, kids should be starting school knowing that they can hear, knowing that they can see properly, knowing that their walking's straight, knowing that their spines are straight, knowing that their eyesight is all of those things, and that's not happening Now. It may not be happening in the city, I don't know. But people who live in metro areas or even rural areas can more easily get to somewhere where they can access those things.
Annabelle Brayley:For people who live in remote Australia that is just not always possible and telehealth doesn't cut it.
Annabelle Brayley:Rfds is the original telehealth providers in my opinion, they've been doing telehealth since the day they've got the radios going. Providers in my opinion, they've been doing telehealth since that day they've got the radios going. But that's a completely different um scenario for um, you know, the modern day version of telehealth to be um promoted as an option, as an alternative to good primary health care access is just not viable because you have to. It's that eyeballing the patient thing. Um, you know, mostly rfds will be mostly um from primary health care. They will be doing um telehealth over the phone or whatever with people that they see on a clinic run, you know, or that they have a history of, etc. So, um, we need we we really need to focus on remote australia and make things work there for a whole lot of reasons that include national security and biosecurity and border security, et cetera, and fix that and then we can translate that elsewhere and more people resources, then more clinics more people Depends on what you mean by people.
Annabelle Brayley:Yes, definitely to all levels of medical staff. I don't think doctors on their own can fix this. I think that we need to take a collaborative view of delivering healthcare to remote Australia, that we need to be. It could be, for instance, most communities not everyone, but most communities will have a nurse or someone who trained as a nurse, or someone who, like, is almost a nurse or whatever, like there'll be a nurse-like figure in just about every community, and they're often the linchpins of the community. So they're obviously really important. But I think, from a collaborative view, that we need to be thinking about okay, so who's in any community that has any health experience? And that, for me, includes vets, who are really some of the most, you know, the smartest, most highly trained medical deliverers in the country. They just happen to be delivering to people, to animals, who?
Kate Coomber:can't talk back to them.
Annabelle Brayley:So you know, but I think that if we took a view that we could set up place-based sustainable, set up place-based sustainable, you know, kind of collaborative primary healthcare options that may, in a very tiny community, revolve around a person who has some medical knowledge, who can be the you know, on the drafting gate, you know you come to them and you say, okay, look, I've got this problem and they will be okay. So we've built this team. Now the team's going to look like different things in different places. It could be a building on the street or it could be, you know, a phone call to a team. It could be.
Annabelle Brayley:This is where it comes into. Communities need to work out what suits them, but somebody who can facilitate that access to whatever it is they need. Now, the context I'm talking about there sounds a bit more emergent than primary health care, but if we have that level established, then surely that can be established on the foundations of a primary health care access that works for everybody. One of the other things we achieve with all of this course is that if people have access to primary health care early and they get into the habit of accessing it, then not only are they learning the things that they need to know about their own health management but they're also learning the language.
Annabelle Brayley:That gives them the health literacy they need to be in control of their health outcomes, and health literacy, as you would know, is a huge thing, absolutely huge. But we definitely need to bring more medical staff into remote Australia.
Kate Coomber:And so I guess, if there are people who live in rural remote areas listening and you talk a lot about the community involvement and they really need to drive this, what can they do?
Annabelle Brayley:Well, for starters, they can get to know who their local medical staff are, you know, just socially, just find out who's around and make them welcome into the community. I think also that they can be responsible for their own health. I think we should all be responsible for our health outcomes Sorry, not for our health outcomes, for our health outcomes, sorry, not for our health outcomes, for our health management. And I mean that I don't mean you have to know how to fix stuff, I mean you have to know that it's your responsibility and you need to go to the doctor or the nurse or whoever it is you need to go to and find out what's wrong and find out how to fix it. Because everyone knows the statistics, particularly in remote Australia, are much higher for things around. You know smoking, drinking, obesity, whatever, apparently and certainly life expectation is shorter. But a lot of that is because you know that access is not available. So people don't think about taking responsibility. I mean, some people do. I know a lot of people who take responsibility for their health management, and some of them in very remote areas. But in general it's an environment we need to work on and encourage people to be better involved in.
Annabelle Brayley:So there's that, but there's also, I think, communities need to, regardless of where they are, communities need to, regardless of where they are, need to not think about their medical professionals as an entitlement or something that they have a right to.
Annabelle Brayley:We all have a right to expect equitable access to primary health care, but I do not have the right to walk up to you, dr Kate, in the grocery store and ask you about my ingrown toenail, because you know that's like you're a person. All these medical professionals are still people and they need to have a life. And one of the reasons I think that and look, I didn't always think this way, I've had a lot of years to think it through and different environments to many people to think it through in that the first time I heard a medical professional say to me, you know we need life balance, I'm like really. But of course we do. You know we all want to live our lives the way we want to live them, and so should medical practitioners. So community again need to be responsible for respecting the demarcation lines around the lives of their medical professionals and embrace them socially. But if you want to embrace them professionally, make an appointment when their surgery is open on Monday morning.
Kate Coomber:Respect the boundaries a little bit.
Sam Miklos:What about, then? Any advice you would give then to a medical professional going into a rural or a remote community. What's the flip side? What would you tell them? How? What's the flip side that? What would you?
Annabelle Brayley:tell them how to make the most of that opportunity. I would say for anybody going into a community, but particularly medical professionals go with an open mind, be confident in your own capacity. Don't be undermined by you know, fear about being out there on your own, because most people now there are, you know people, colleges like the Australian College of Rural and Remote Medicine, certainly RACGP, rural, et cetera I'm sure all of the colleges and training facilities are excluding the universities, and I have a reason for saying that actually have a. You know they feel strongly around supporting their staff. And obviously recruitment agencies such as yours and I've come to know a bit about you, your group just recently clearly support your staff well when you go out. So from a professional perspective, they go with that knowledge. So don't be afraid to step out there because you know that you can always ring. You know you can always ring back to wherever.
Annabelle Brayley:But in terms of actually settling into the community, I would say yes to every opportunity to socialise, join the gym, if there is one, find out what the organisations and social things are in town. Even if the only thing in town is the CWA, then that's one of the best places to start. Go to the CWA and say to them I'm the new doctor, nurse, physio, whatever in town, and I don't know anybody and I don't know what to do. They'll set you social life, you, doctor, nurse, you know, physio, whatever in town, and I don't know anybody and I don't know what to do. They'll start your social life, or, you know, just make an effort to enjoy it for what it is, you know. Don't go out there thinking, oh my God, I've got to go to the bush for four weeks or whatever it is, or you're going to have to go change the world, yeah.
Annabelle Brayley:And also, don't go thinking you're going to change the world. That too, sam. Yeah, I think for anybody coming in, if you move into a new community, come with an open mind. Don't try and change anything, just be quiet and learn what's going on in the community or at work, whatever. Get to know the politics before you start trying to change things. And when you do join, whatever it is you're trying to change, and do it from the inside, gently and I think that that really speaks to anywhere that any group that you go into, if you start a new job, if you move to a new town.
Kate Coomber:I think that's not isolated just to if you go into those communities, but absolutely not I never don't need to go in and fix these communities yeah there's that mentality.
Sam Miklos:Is there um one story that, really like for all the books that you've written and certainly we've both read a number of them is there one that really has stayed with you?
Annabelle Brayley:um, I think from a professional medical perspective. Oh look, there are a number, but I've never, ever forgotten one of the nurses who was sent to Badoori and I actually think her story was in Bush Nurses. In fact, I know it was in Bush Nurses and I don't think it was in Nurses of the Outback, although I wrote about her in Nurses of the Outback. Anna Burley, she was a nurse on her own. She was actually worked in the finance world in New York and I think maybe London, but certainly New York, until she decided that she wanted to do something more significant, that, you know, making lots of money was really not doing anything for the planet or her own self-esteem.
Annabelle Brayley:Anyway. So she did a nursing training. She ended up as an RN at a clinic in the Channel Country, in Badoori, and had a call out one day to a really bad accident where four kids had been had rolled a car and they were 80 kilometres out on the Diamantina Road, development Road. Now, this is a long way from anywhere, long way from RFDS, long way from everywhere. And they got a message. A truckie found them, called in Vara Station into Miduri. Anna and the local policeman went out. Somebody went out to the accident and she was out in the middle of nowhere with these four kids, one of them with, you know, raccoon eyes, is that what you call it? You're the one of you you know more about nursing than me Like seriously injured and so far from anywhere, and I mean handled it beautifully. The outcomes were awful but as good as they could have been in the circumstances for the kids involved. But she managed. That.
Annabelle Brayley:It's just always stayed with me that well-trained staff, not necessarily confident in the moment, but well-trained staff who know what they're doing, who are trained for you know, like all of the possible circumstances, can manage anything in any circumstance. If they just take a deep breath and rely on that training. There will always be the circumstance they weren't trained for, but they'll use all that other experience to work out how to get through, because in the end you know who else is going to like. You have to step up and I remember Claire Schmidt, who's the flying doctor on the front cover of Bush Doctors, saying that to me. She was a young English doctor, she had an army background, came to Australia almost on a oh yeah, I'll apply, you know, on night duty one night in Working out later In UK.
Sam Miklos:I'll apply and work out later.
Annabelle Brayley:Ended up at the RFDS in Charleville saying on a flight, her first flight out to you know somewhere, on her own, saying there is no one else, I have to step up. And that's what you do. You step up. And you know, like there will always be situations where we're all going to think shoulda, woulda, coulda, you know whatever. But you all do the very best you can in the circumstance and I have the absolute utmost respect for every member of the medical staff who come into Rural and Remote Australia, particularly into remote, because you know, you really all you just make such a difference.
Kate Coomber:It's a huge impact. With every episode, we are donating $500 to a charity of our guest choice. Where is that money going today?
Annabelle Brayley:Well, thank you for this opportunity. It's not quite the usual charity, but I would really like this $500 to go to sponsor a future rural generalist to go to the RMA 24 conference in Darwin in October. So that will be via Akram, because I really believe that we need to encourage all our young professionals to go out and have what experience they can to meet the people they can, and I know from past experience that going to RMA is a really great opportunity for young future rural generalists, whether they're a medical student or already a qualified doctor, for future rural generalists to get to know the people they know and hear the stories they need to hear to encourage them on their pathway. Wonderful.
Sam Miklos:I love that. That's a fabulous choice. I love when any of our guests have chosen something like that. That's just that little bit different and that little bit more specific too. So that's fabulous. Thank you for that. Thank you for your time today. Honestly, you've just we could just have sat here. We had so many questions for you that we had to keep culling them because we could have sat and talked to you for a long time. But we really appreciate you, particularly being here in Brisbane and coming all the way in, and you're clearly so passionate about rural and remote health and we're so fortunate to have had some time with you today. So thank you, annabelle.
Annabelle Brayley:Oh, thanks Sam and thanks Kate. I really appreciate the opportunity. Thank you.
Sam Miklos:Thanks for listening. Don't forget to share, rate and review. This allows us to reach more people and share more incredible stories. Click the follow or subscribe button to ensure you never miss an episode. Thank you.
