The majority of flights the Royal Flying Doctor Service embark on begin with one thing - a call for help. Ensuring those calls are heard, and the challenges met, has been the sole purpose of the organisation since it was founded in 1928.
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But in 2020 as the health industry continues to respond and adapt to the challenges of COVID-19, the year that marks RFDS Tasmania's 60th birthday suddenly looks very different.
In the nine months leading up the pandemic, the organisation's primary health care teams had covered enough kilometres to circle Tasmania 124 times. But almost overnight, physical and mental health outreach services were halted and moved online.
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When 180 Australians landed in Darwin after being evacuated from the coronavirus-stricken Diamond Princess cruise ship in February, the RFDS helped get people cleared from quarantine back to their home states.
But as the transition from response to recovery continues to play out, the organisation is now bracing for what's expected to be a new wave of long-term challenges for the regions it serves. The people living in some of Tasmania's most rural and remote communities who are already disproportionately affected by poorer health outcomes.
For RFDS Tasmania chief executive John Kirwan, one of the major concerns is what's predicted to be a new wave of mental ill-health as communities start to come to terms with what has been lost.
Referencing research from the United Kingdom, Mr Kirwan said while we will eventually find a vaccine for COVID-19, we will probably never find a cure for the mental health issues that come from it.
"The biggest challenge we know from previous emergencies and natural disasters, is that some of the issues will be long-term and deeply embedded," he said.
"That issue of anxiety, people losing their jobs and in particular the bread winner of the family suddenly being out of work. Isolation, social isolation - those issues are not new to us. It describes a lot of our rural areas. But how we access them and how we provide early intervention to stop things escalating will be the challenge now."
Almost a century ago an Australian engineer named Alfred Traeger invented a pedal-powered radio that revolutionised communication in some of Australia's most remote locations.
Over time it was installed at homesteads, hospitals, missions and the bases of the Aerial Medical Service - something which later became the RFDS. It became one of the world's first examples of telehealth.
In Tasmania, it's a system that remains deeply ingrained in how the RFDS operates its key resources. Alongside aeromedical services in partnership with Ambulance Tasmania, they include primary health care, dental care and education.
In the past few months some programs, such as education, transitioned to entirely digital models. Others, like its dental outreach program, were able to continue as essential emergency services. However, for the majority of primary health outreach programs it marked a significant shift.
"Normally we would be out on the road providing mobile services in a face to face capacity, but we have had to re-think all of that," Mr Kirwan said.
"They are outreach services based on where people live, so it has been challenging to adapt. But telehealth is embedded in our DNA, so we figured if we couldn't make it work then no one could.
"Interestingly, we are now seeing more patients and clients because they are logging online. Because people are sitting at home, in some of our physical exercise classes they are getting 100 per cent attendance where they would rarely do that.
"In fact we will now probably do more in the second six months of the financial year than we did in the first, because we are not travelling."
The RFDS and its programs are supported by Commonwealth funding, but it's also heavily reliant on charitable donations. Like many, the cancellation of fundraising events has seen them hard hit in 2020.
"We would normally fundraise up to $500,000 a year. So fundraising has taken a hit for us," Mr Kirwan said.
"This is our 60th anniversary year, so we were looking to have a whole range of events and some innovative programs which we have now had to put on hold and put into next year. Hopefully we will be able to recapture some ground there."
To date, more than 27,000 Tasmanians are estimated to have lost their jobs since the pandemic began, with more expected. It's something that's predicted will further exacerbate community pressures - particularly those in rural and remote areas. While the RFDS will continue to provide emergency support, moving forward Mr Kirwan said it and the health industry more broadly would continue to do what it does best - triage.
"Throughout this we have reacted well. Yes there have been a few issues, but overall we are seen as one of the better countries and one of the better states in Australia," he said.
"But the recovery phase is going to be quite long and we need to be in it for the long haul. As like any health industry, what we need to do now is prioritise the load that is there.
"As with all of our other programs, the concern is the unmet need that's out there and how we catch up. What we will see in areas like mental health where the pressure was always there ... we're likely to see a whole new significant level of demand.
"Particularly those small rural and remote areas. I don't think tourism will happen quickly. It won't be like turning a switch on. They will see a trickle effect for it to come back. So we will have some of those issue there for quite some time."
Mr Kirwan said the new normal wouldn't be that same as it was.
- For crisis support, call Lifeline 13 11 14.
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Jessica Willard
Being a health reporter to me is about more than just reporting the problems. It's about asking why they are happening in the first place and what needs to change to fix it.
Being a health reporter to me is about more than just reporting the problems. It's about asking why they are happening in the first place and what needs to change to fix it.
