(Originally published at EisenhowersLastSmoke.com on 7/27/2013)
Perth is commonly known as the most isolated city in the world, being 1,300 miles away from the nearest ‘large’ city (Adelaide) (though I am not sure it’s 100% true). It is the capital of Western Australia, or W.A., which covers a vast territory – it covers one third of Australia, but has just 11% of the country’s population. The state has 2.4 million residents, and of those, Perth has almost 2 million of them. I learned that five Spains fit in the Kimberly, the farthest northern region of WA.
The city itself is often referred to as “a country town.” It’s set on the Swan River and has some beautiful vistas.
But I understand that the best parts of Perth are actually in the suburbs, and there wasn’t much of a city center to speak of.
What the city lacked in café culture, it more than made up for in the vibrancy of the people I met. People were bold thinkers; they thought big. The chief nursing officer for W.A. Health explained, “We’re a bit like cowgirls. We’re so far from anything else that we aren’t stuck in the mainstream.” And they look ahead. W.A. Health is working on a reform plan that will take them to 2030. The chief nurse was contemplating what the workforce will look like in 2030. And she had some far out ideas, like what if primary care as we know it today becomes secondary care in the future, because consumers, enabled by technology, are able to care for themselves for the most basic primary services? Or what if when you turn 65, you got a certain amount of health care funding to spend however you want? So if you take good care of yourself and invest in prevention, you could have a surplus? I mean, these are not the kind of ideas I thought I might find in the world’s most remote city.
Perhaps the remoteness breeds community. I had the chance to meet the former CEO of the Royal Flying Doctor Service (http://www.flyingdoctor.org.au), who explained that the organization's founder, a Reverend, encountered lonely people as he roamed the vast land. And then he realized that people in those remote areas needed doctors. And today, if you have a heart attack in the far reaches of W.A. (or anywhere in Australia), you will get medical care.
The geography might be remote, but the mentality of the people I met was simply not. My delightful host, the Executive Director for System, Policy, and Planning of the Western Australia (WA) Health department, had only recently arrived from the U.K. That they hired her, with a perspective from across the world, reflects the efforts they take to mitigate physical isolation. Almost everyone I spoke with, if not literally everyone, referenced practices from other parts of the world. They’d lived elsewhere or visited, many on a quest specifically to find out what others do. And they all could cite research studies or emerging trends from Canada, the U.S., and/or Europe.
And they were more than willing to engage with me. A call with Julie, my in-country coordinator, revealed that she doesn’t usually fill up fellows’ programs as much as she had mine. “You just want to meet everyone,” she said. “And everyone wants to meet you.” As my Perth host, David Flanagan said, “I reckon we don’t get a lot of visitors here!”
It's too bad more people don't make it here. There's a lot to learn from the cowgirls and flying doctors.