Modest Expectations – Nadia von Leiningen

I have learnt a great deal over the past fortnight about this infernal virus.

This whole incident started after we had driven from Sydney for a dinner in Broken Hill. On our way home we intended to stay with my wife’s mother, who at 96 still lives at home in Albury. As I reported in my blog two weeks ago, we all contracted COVID and we all took anti-viral drugs, despite some difficulty in accessing them. In all cases, the disease was mild, although mine has lingered with a post-viral cough.

On reflection, given how successful the antiviral treatment seemed to be especially with my 96 year old mother-in-law, I wonder why there appear to be limitations on access to these drugs.

For instance, President Biden, who is 79, received the antiviral drug, Paxlovid. In clinical trials, Paxlovid is said to reduce the risk of severe illness by 90 per cent. He has experienced a mild infection that he attributes to vaccination.

By contrast, when Trump contracted COVID in 202I, eight drugs, from aspirin to the antiviral Remdesivir, were given to Trump in what observers at the time called a “kitchen-sink” approach. Most of those drugs were probably ineffective. Trump’s infection was certainly not mild. He was lucky. Biden’s outcome is predictable, uneventful recovery. One problem is that Biden seems to have undervalued the effect of the antivirals.

When the two cases are compared there is no comment about whether there should be any restrictions on access.

Thus, why can’t the whole Australian community have access? Or is it the same case as it was with the vaccine availability, incompetent supply chain decisions covered up by a military uniform?  Not enough being ordered by government is a familiar refrain. Is it another Department of Health stuff-up? Open government, Minister Butler.

We certainly had difficulty in obtaining the drug in Albury, where there were limited supplies. But this appears to be a common problem, even in capital cities. In the discussions, there seems to be a surprising degree of passivity in the community about the restriction in access without any objective clinical explanation, although that may reflect actual knowledge in the community of the existence of antiviral drugs.

Now, seeing both how our whole family benefited and how his doctors did not muck about with President Biden, who was immediately prescribed anti-viral drugs, why the restrictions on usage? On form, incompetence by the bureaucracy would appear to be the number one reason.  But maybe I am too bleak. So please, what the hell is going on?

The second comment was that when the whole family has the virus, and you are away from home, how do you actually get the anti-viral drugs. You need a doctor’s prescription, and because of the current conditions for that prescription, you need to get your own doctor to prescribe. In both our cases, the practice was contacted, the doctor was busy but rang back and sent the prescription immediately by email or text. The difficulty then is getting the prescription not only filled but in our case, to also locate a pharmacy that had the drugs.

Nevertheless, the key response was that of our doctors – suburban Sydney and Albury. They promptly rang back. I have heard of the contrary situation occurring.  In this case, the general practitioner did not return the call, not that day, not the next, when the prescription of an antiviral drug was essential. How often does that occur – a general practitioner forgetting the Hippocratic Oath? And nothing is done about it.  How many people have died because the doctor did not ring back? One is enough!

On the Cheapside

It was a slow Saturday afternoon, and my wife was looking over a series of ship manifests seeking information about some of her relatives’ arrival in South Australia. She came across a series of ship manifests including one from the 621 ton barque Cheapside which left Plymouth Hoe on sixth July 1849 and berthed at Port Adelaide three months later on the tenth October 1849. The Cheapside was the nineteenth emigrant ship from England to arrive in the South Australian colony in 1849; it was reported in the three months voyage six babies were born and ten persons died.

On board was my grandfather John Egan, then aged five years, together with his younger brother Michael, then three and sister Mary aged one.  My great grandparents were Michael and Bridget, specified as such on the manifest.  Michael is described as a labourer originally from Co Clare. Bridget – nothing added – just the spouse of Michael. I knew she had been born Bridget Corcoran in Cappoquin in Co Waterford.

Strangely, I remember once standing on Plymouth Hoe and looking out to sea and trying to feel what it must have been like sailing from these shores, knowing that you would never to see them again. But then again, they had already trekked across Ireland to Plymouth. Their embarkation had been from Plymouth not from Ireland, where Queenstown (now Cobh) in Cork was the common embarkation point for emigrants.  But to America not Australia!

The Egan family was numbered among the 242 emigrants in steerage. To give a flavour to the “passengers” on the other hand there were a Mr. Clisby and his daughter, Mr. Farmer, Mr, Hodgkin, Revd. Mr. Wood, his wife and five children and Mr. J. Ayre, late surgeon-superintendent of the Tasman are described as being “in the cabin”, 12 in all.

As has been described, for the “emigrants”, they were lodged below the main deck in steerage quarters converted from cargo spaces. This area would have been dark, crowded and close to the water line – when seas were rough passengers were often shut in with poor ventilation.

Added to this were probably the captain and 20 crew; so life was crowded.

On disembarkation, the Egans made their way to Kapunda, where the first commercial mine had been opened in 1842. It’s copper ore was some of the highest quality.

The township of Kapunda lies 80 kilometres north-east of Adelaide, just beyond the furthest reaches of the Barossa Valley, where a landscape of grassland and peppermint scrub here is gently undulating. That was the scene that confronted Michael Egan and his family – wife and two children – when they alighted from the bullock dray. It was early summer.

Michael had been attracted to Kapunda because he knew there were Claremen working in this newly-opened open cut mine.

Michael had always been restless. He had worked as a steward on an estate in Clare owned by the Blood family. He was still in his twenties when he left Clare and obtained work near Ross in Co Wexford, but 20 miles from Co Waterford. Here he met Bridget who was the daughter of a local farmer from Cappoquin, who had been forced into service.

They had married in the years before potato blight took hold and devastated the potato harvest across Ireland. Potatoes were an essential nutrient. As a result, the famine devastated Ireland, the first wave commencing in 1845 and by 1849 those who survived were fleeing The Emerald Isle.

And in the South Australian heat, here he was with his wife and children in November 1849.

But this was a mining community, unfamiliar territory where extraction and smelting of the ore was a task Michael had never encountered. He was rubbing shoulders with seasoned Cornish miners.

Kapunda’s copper mine 1850s

Yes, I have been to Kapunda and walked the perimeter of the overgrown mine which has been fenced off. Strewn around the site there remains clear evidence that this was once a copper mine. The tell-tale pale green cupric ore with tawny iron stains abound in the rock fragments. I souvenir a few pieces and turn away and go back to the car. The first chapter of Michael and Bridget Egan’s Adventures had begun.

For Michael was 35 at the time; he was to die 53 years later, a distinguished and wealthy Melburnian. 

Taking a Taxi to Bethlehem

This is a story about my good friend, Chris Brook, who died suddenly in May. Chris was a complex person, where many facets of his personality flashed, often the light from one cancelling the other out. Yet nestling under the carapace of arch comments and disdain was a compassionate person.

He and I had gone to Jerusalem in 1995 to attend a conference where Chris was then the President-elect of the International Society of Quality Assurance (ISQua). The Conference organiser was a courtly Israeli, a long term member of the Society executive going back to when I had been President of the same institution six years before. He said very little, but I found out that he had been a veteran of the 1948 war. The veterans of this War split in two Israeli factions – Likud and Labour.

Yitzhak Rabin had been a brilliant soldier and strategist, and even though he was a hard man, he was a reasonable man. A member of the Labour Party, in 1995 he was in his second term as Prime Minister.  Just over a year before he had negotiated the Oslo accords with Yasser Arafat, which introduced a period of comparative tranquility into the relationship between Israel and Palestine. For this he and Arafat had jointly received the Nobel Peace Prize in 1994.

We were lucky to go to Jerusalem during this period of peace. One morning, Chris and a colleague, Heather Buchan, decided to go with me to Bethlehem. It was a ten minute drive by taxi; negotiating the border was quick, unlike the time it had taken to enter Israel, being quizzed endlessly by unsmiling Junior Mossadista.

Church of the Nativity

Bethlehem by and large is a nondescript town of little shade and rows of ugly yellow stucco buildings. Yet the taxi was weaving its way unerringly to the Church of the Nativity said to have been situated on the site of Christ’s birthplace. There is a photograph of us all in the Manger Square in front of the Church. On the edge of the photograph of us was a smiling lean young Palestinian, a rifle slung over his shoulder.

Like many Palestinians living in Bethlehem he was a Christian, but unbeknown to me at the time Chris struck up a conversation with him. Chris said very little about him, but after we returned home Chris corresponded with him, and whether he sent money or whether he was prepared to help him migrate to Australia I am not sure.  They continued to correspond. Then one day, he mentioned to me he had not heard from this young man. The silence persisted; Chris tried to find out what had happened. As far as he knew the young man had been killed in some street altercation with Israeli troops; but where, when or how, Chris never disclosed that information. Although he must have been affected, Chris never showed grief.

At the Wailing Wall

We had gone to Jerusalem when a calmness prevailed. We were freely able to visit Jewish, Christian and Muslim shrines.  I particularly remember walking along the Wailing Wall amid the black robes and nodding heads. There was a cave at the end of the wall, where many of these Orthodox Jews were clustered. I had entered it, even though I was obviously a tourist. Nobody seemed to mind. One of these Orthodox Jews I clearly remember was one who lifted his beard to reveal a tracheostomy hole. It did not stop him launching into a crazy tirade. I listened to the invective – vicious invective primarily directed at Yitzhak Rabin for what he had done. I excused myself.  When I walked out into the sun I felt I needed a shower.

Four months later, Rabin was assassinated by a right wing extremist, Yigal Amir, on 4 November 1995 in the Kings of Israel Square.

The Accidental Nobel Laureate

Due to their recent discovery and relative inertness, there have not been many clear establishments for the applications of fullerenes. However, there are predicted applications that are presently being tested – May 22, 2022

Dr Robert Curl died last week. Dr Curl shared the 1996 Nobel Prize in Chemistry.

As recalled in his obituary in the NYT, in 1985, Dr Curl, a Texan, along with Richard E. Smalley, a Rice colleague, and Harold W. Kroto, a scientist visiting from the University of Sussex in England, showed a new configuration: 60 carbon atoms bonded into a molecule that resembled a soccer ball. They also found a larger version made of 70 carbons.

A buckyball

The finding was serendipitous because the scientists had been looking for something else. The chemists named the molecules buckminsterfullerenes after the architect Buckminster Fuller and his geodesic domes. The name was later shortened to fullerenes or buckyballs.

What a great name to enliven an esoteric area – the concept of kicking buckyballs around the molecular framework. The problem is that no matter how enticing the name and how cute the carbon atomic configuration; they were unable to find a commercial use.

In his Nobel Prize acceptance speech in Oslo in 1996, Dr Curl said inter alia

At the outset, none of us had ever imagined these carbon cage molecules. When we looked at carbon, the single astounding carbon sixty peak in the mass spectrum and the circumstances under which it came to prominence admitted no other explanation than the totally symmetric spherical structure, and suddenly a door opened into a new world.

The fullerenes have caused chemists to realize the amazing variety of structures elemental carbon can form from the well-known three-dimensional network that is diamond and the equally well-known flat sheets of hexagonal rings that are graphite to the newer discoveries of the three-dimensional cages that are fullerenes. We have learned that the cages can be extended into perfect nanoscale tubules which offer the promise of electrically conducting cables many times stronger than steel. Or the cages can nestle one inside the other like Russian dolls. Now that we have become more aware of the marvellous flexibility of carbon as a building block chemists may ultimately learn how to place five- and seven-membered rings precisely into a network of hexagonal rings so as to create nano structures of ordered three-dimensional complexity like the interconnecting girders in a steel-frame building.

The statement at the head of the blog was published in March this year.

Ergo, a Nobel Prize awarded for a discovery they were not looking for with a cute name but still in search of a function in the nanoworld of the molecules, let alone the ongoing search for their commercial application.

No Place for the Shamus?

I receive a great amount of stuff from the Lincoln Project, an extreme group of former republicans dedicated to destroying Trump and his acolytes. I receive regular communication because I purchased a print from them of a portrait of Abraham Lincoln with a tear in his eye. It is a powerful image. Those behind the Project are no saints; they are men who have been at the heart of the US government, insiders well versed in the “dirty trick campaign” and seemingly unafraid of using the same tactics.

The critical decision for the reader to make is to whether, if you read on, are you reading fact or “alternative facts”. It is important to factor in your own bias, if you have no idea of what is actually occurring. Yet the last sentence limply reinforces a paean which unexpectedly appears four paragraphs before about the Secret service being essential and valiant; a tincture of an apologia methinks! Rick Wilson the author of this below is what, in the terms of Cain and Chandler, may have been described as “hard bitten and cynical”. But then that is my bias!

Here’s why it matters that tens of thousands of you raised your hands and demanded answers about those deleted January 6th Secret Service texts:

If reports are to be believed, the Secret Service handed over exactly one – ONE! – message. That’s like writing “FU” on a blank cover sheet, crumpling it up, and throwing it in the general direction of Capitol Hill.

To get this straight: the Secret Service let the dog eat all their text messages during, wait for it, and this coincidence will SHOCK you, the two days surrounding the most calamitous threat to our democracy. Literally every possible agency with investigatory power has a duty to figure out just what the hell happened.

It matters that a Federal agency given sweeping powers of action and discretion has quite clearly engaged in a coverup to protect Trump and his coup plot. Stay with me here, because my mind is wandering…

1) The long-rumoured and discussed cadre of Trump Praetorians in the USSS needs to get aired the hell out. This just reeks.

2) The leadership and every single person on the detail and Uniformed Division that day needs to have their personal and work devices of every kind subpoenaed and examined. They must also be deposed.

3) I hope you’ll let the 1/6 Committee know you’ll tune in for “The Long Hot Summer” series. They absolutely should add this to the docket and make it so hot even the DOJ can’t ignore it. They can skip vacation “juuust” this once and crack some skulls. 

4) I’ve noticed many Republicans get very livid lately when this whole scandal gumbo is compared to Watergate.

The Secret Service is a vital agency. Their unchallenged bravery at being the last line of defense between violence and assassination of U.S. Presidents and protectees is storied and written at times in blood. It is a brave and honorable duty. The core of their reputation wasn’t just a fearsome readiness to defend the President. It was also a cool, detached professionalism that served the office, not simply the political whims of the man who held it. 

For months, Mike Pence’s refusal to enter the VP limo has pinged the edges of my radar. I couldn’t quite sort out his reluctance. He’s not a physically brave man, to my knowledge, so what was it? What else did he know or sense? If you ask me, I think Pence knew parts of the Service were compromised and put Trump’s politics over duty.

To go deeper down the rabbit hole: I’m no Presidential staff historian, but Trump’s elevation of hyper-loyalist Tony Ornato from the Secret Service into a political role at the White House (who later planned the photo op with the Bible, and the tear gas attack on peaceful protestors in Lafayette Square…) might have been a tell. I suspect he’s rather a key element here. We also know that when President Biden took office, he felt compelled to change out pro-Trump detail members. Putting all that together leads us to some unpleasant potential conclusions, to say the least.

This is not a matter where all of us – not the Committee, not the DOJ, not every American who cares about the rule of law and the vital role of the Secret Service – can sit back and be satisfied with one lousy text message. We have to pull at these threads and connect these dots.

The danger the Secret Service faces every day in the line of duty is real. Their sworn duty is an honourable one. But it’s starting to look like the MAGA rot runs deep here. Who knows how big of a role all of this played in the January 6th insurrection?

Yes, who knows. Jason Bourne is across it, and he was supposed to be flight from reality.

Mouse Whisper

If that human crowd have not had enough pandemic, Splendour in the Mud in Byron Bay may just be a catalyst for another, especially as it is not an uncommon event as exemplified in this British report:

Unusual transmissions of gastrointestinal diseases have also occurred during large scale open air festivals. An outbreak of Escherichia coli was reported during the Glastonbury music festival in England and was linked to mud contaminated by infected cattle. Heavy rain had turned the site into a quagmire, and attendees had high levels of contaminated mud on their hands and faces.

Leptospira

Also, those coming back from Splendour in the Mud last weekend should become acquainted with the one word “leptospira”. These nasty bacteria, the bane of sewage workers, are associated with my dirty cousin rats – in their urine which they sprinkle over sugar cane and banana plantations and which is washed away when the rains come and into the mud that forms around these bacteria.

Welcome to the disease world of the unprotected youth, acquiring a disease to remember where splendour is in the eye of the beholder as they cavort to the sounds of those masters of the music world. So, as you raise your glass with the muddy hand, do I hear you cry “Here’s Mud in Your Eye”?

No, that is a toast from another era well before Woodstock, in fact it’s biblical.

Hosting a leptospirosis party?

 

Modest Expectations – SXM

Here we are in Mungo National Park. The power is off. My computer needs re-charging. Thus, after this sentence, there will be a lull. Transmission will resume after we get to Balranald.

When you write something as disconnected as that, there must be what they call in the trade a prequel, and there must be a postscript as well.

But first, the scene should be set for both.

Mungo National Park was the site of an ancient lake, Lake Willandra, dry saltbush expanse disappearing into the horizon.  On one side of this lake is a long stretch of dunes caused by the winds blowing the sand and grit into have termed “The Walls of China”. There has been differential erosion across these dunes leaving a series of obelisks in the sand. They are a small version of the famous Pinnacles in Western Australia.

I first drove around Mungo National Park 30 years ago. The Park had been given WHO Heritage status in 1981, the remains of the modern Indigenous Australian man, at least 40,000 years old, were discovered in the Willandra Lakes in 1974, with the remains of a perhaps equally ancient female having been discovered in 1968. They were labelled Mungo Man and Mungo Lady.

The bones have languished in Canberra, until Mungo Lady was returned “to country”, and is kept under lock and key in the Visitor Centre while a suitable burial site could be designated. Thirty years have passed. The then Minister of the Environment in May this year gave permission for reburial. Having been given the gravedigger role, the NSW Government has baulked.

Meanwhile Mungo Man’s remains await, to be interred in an ancient river red gum box.

The Paakantji, Mutthi Mutthi and Ngiyampaa share the land, saying their people have effectively been there forever – well for at least 40,000 years, but when I first went to Mungo, there was not much evidence of their occupation. One could freely drive around the Walls of China; you could walk around the ancient site without the benefit of an Aboriginal guide. Sensitivity towards these lands did not require a boardwalk. The country was full of kangaroos; this time there was not one to be seen.

Then there was a seasonal Lodge at the entry to the Park, where you could stay, except during the summer months, and water was at a premium. Today, there is a renovated Lodge, well set up with cabins clustered around the administrative and dining facilities. The highlight of the evening meal was the rack of lamb; after all, in the land of sheep in the saltbush, how glorious was the taste of a very generous serving. We agreed that it was the best lamb we had eaten since one memorable meal at Wanaka in the altoplano area of the South Island of New Zealand, where Canterbury lamb is raised, and until this Mungo experience was the most succulent lamb meal.

Strange, in search of an Aboriginal masterpiece, it was the product of imported fauna which provided the most memorable experience, apart from the cold which, although not unexpected, when combined with a wind chill factor pushed the thermometer well below zero.

As the reader may discern, I was disappointed being locked out of the self-drive tour, and there were suggestions that a sunset tour with two adults and two children at $200 was expensive, but then life is not cheap when you stay in the Park.

On the road to Balranald

Although it is stated that there is no need for a four-wheel drive, some parts of the road to Balranald were, as they say, challenging, especially as it seemed not to have been graded after the floods, and deep dried ruts dotted the roads and in the sandy areas, the bull dust concealed potholes in the road. On the other side of the coin, the asphalt roads are creeping outwards, especially where mining interests are concerned. On reaching the junction with the Balranald-Ivanhoe road, I was surprised by this newly sealed road.

Why? Mining means improved access.

Mineral sands mines had been opened 175km south–west of Ivanhoe. The heavy mineral concentrate (HMC) from the mine is trucked to a new rail siding just outside of Ivanhoe, then transported to Broken Hill for further processing. Unsealed roads used to go in all directions from Ivanhoe, which existed as a place where the rail fettlers lived and where once the Indian Pacific stopped at 3am to let me get off. If you want to emulate that feat just remember the station is approximately a mile from town – and there are no taxis.

There you are, the future of the NSW Far West, tourism and mining, not forgetting the traditional overlay of cattle and sheep. Just setting the scene.

The Prequel

David Lyle

We had been invited to a farewell of Professor David Lyle who, for the past 27 years, has headed the first University Department of Rural Health (URDH) created in Broken Hill. The concept was bitterly opposed at first by some elements of the Federal Department of Health and certain then influential general practitioners. The brainchild of these university departments of rural health was Dr Sue Morey, then the NSW Chief Health Officer, who believed that teaching of medical students should be available in a structured rural facility and should have a strong public health component with equally robust community involvement. Sue delegated me to sort out the structural barriers and importantly secure local involvement. As it turned out, Clyde Thomson, the remarkable CEO of the local Royal Flying Doctor Service, was that person. I have written extensively about Clyde elsewhere and it is about time that his status of being a “national treasure” is fully recognised.

Clyde trained as a pilot, but he grasped very clearly what we were about and how an air transport facility, an almost untouchable icon delivering emergency medical care to the outback, could be further broadened to be an integral part of the clinical life of the community, including most tellingly of the Aboriginal people. Clyde embraced the ideas and demonstrated very clearly the essential need for a “local champion” to work in the planning and implementation.

Although Clyde was Chair of the Hospital Board at the time and a university department of rural health being attached to the local hospital seemed an attractive option – in this case we avoided the danger of parochialism in that even if it were considered successful, there would always be a number of reasons advanced that a “Broken Hill Department of Rural Health”  would not be a generalisable model.

Also, medical education at an undergraduate level is the preserve of universities in Australia. We decided that despite a locational problem, the University of Sydney should be invited to participate in the project. At the time university medical school thinking about having a rural component was to have it located on a campus on the outskirts of Sydney, not 1,200 kilometres away in a mining town which was closer to Adelaide.

Crucially, Broken Hill was located in NSW. As time went by, the rural involvement of the University of Sydney moved towards Sydney to Dubbo, then to Orange, over a number of years. This would have been impossible if Broken Hill had been linked to one of South Australian Medical schools, which initially appeared to be the easy option given Broken Hill’s medical relationship with Adelaide, but would have assured failure. There was some academic resistance in University of Sydney Medical School; it was overcome. The Dean, Steve Leeder, helped – a crucial ally.

I was asked to do a Rural Stocktake across Australia by the Department of Health in 1999, and I reported early in 2000.

There is no doubt that Minister Michael Wooldridge’s dedication to rural health improvement drove implementation, in particular securing funding for the program in the 2000  Federal Budget, which was distributed to universities with medical schools, with the proviso that the Universities could not skim any of the funding for “administrative expenses”. All the funding went to the various programs.

The final keystone for this Broken Hill project was David Lyle. He is a public health physician who had been involved, even before his appointment, in determining the extent of lead poisoning in the children of Broken Hill. He has always had a reputation as a great teacher, and ensured that his URDH was expanded to embrace other health professionals, including Aboriginal Health workers.

He oversaw the conversion of disused wards at the back of the hospital into a tangible Department and attracted a significant amount of research funding. There are now 19 UDRHs across the country, and the fact that David, until now, has been the unmovable champion and therefore crucial in the growth of rural training of health professionals, including public health.

His replacement has yet to be named and the University of Sydney advertisement suggested that the office would be based in Camden, where apparently the university has some agricultural facility, such is the systemic idiocy in the university bureaucracy. There is a problem among medical deans where there is an obsession about ranking, largely determined by research citations. Most of the medical deans have had professional careers within academic cloisters where the sun of rural Australia doesn’t shine. It is alleged that rural health money is taken and strewn around the city campuses.

This response by the University of Sydney indicates the bane on any program – lack of corporate memory without a record of the genesis of the program.

David Lyle must leave a written legacy or podcasts to ensure that 27 years of experience is not lost, given he is the last of the original heads of the URDHs.

The Postscript – What’s in a Name!

Years ago, I was asked to review an alleged problem in the delivery of medical care at Hopetoun. Hopetoun is a small township just South of Wyperfield National Park – an area of mallee desert country which lies in the far north-west of Victoria. During my time there, a case of a pregnant woman with no access to ante-natal care, was raised with me.

It was an anecdote raised in passing as an example of the general lack of access to medical care.  Strangely over the years the name of this tiny place, Lascelles, has stuck in my mind.

This week we were returning from Broken Hill and decided to go across to Victorian border to visit the pink lake, Lake Tyrrell. Because of its colour, it has become a destination for Chinese tourists because of their association of pink with luck. When we visited the wind was blowing and sun was reflected from the water against a cloudless sky. You could pick out fragmentary pink colours in the shaded areas of the lake, but there is a far better pink lake in the South Australian Coorong. Anyway, Lake Tyrrell has put the Mallee town of Sea Lake on the map, but also on the map has been inserted the Silo Art Trail. Many of the silos in the district have murals painted on them. One of these silos was at Lascelles and at Sea Lake there was a signpost to Lascelles.

Lascelles silo art

The signpost evoked my memory of the name. I thought that it was a speck even further into the bush than Hopetoun, but for the first time I could put a face on this hamlet, where the major medical centres of Mildura and Bendigo were about two hours away. Lascelles is a pub and a few homes and on the silo wall there were beautifully painted, in sepia tones, portraits of a farming couple, the Hormans.

That is the endemic problem of small settlements, so small they do not merit any shops, but most do have a pub, a hangover from the time the trains stopped there and now a place for the locals to come and have a drink. The pub is often the only community resource and would be a perfect place for regular clinic by a visiting medical team.  As a model, the flying doctor provides  the excitement in community by arriving by air.  I remember in the 90s flying with the RFDS when they provided medical care at the Noccundra rodeo; and boy is Noccundra remote! Yet a plane on a gibber plain air strip indicates that the doctors and flight nurses have arrived.

Noccundra in Far West Queensland had a permanent population of four, but there was a pub made of stone. The RFDS provides a model for a visiting service, with provision of a regular clinical schedule and being available for outback events such as the rodeos where inevitably there will be injuries, some of which may require evacuation, either to Broken Hill or Adelaide.

There is much discussion about the lack of doctors in the bush. I believe the root cause is that there is no coherent succession planning, but for such planning there needs to be a facility which can appropriately both monitor and supply a regular flow of doctors.

To me all programs of clinical care must have a teaching component to assure the flow, as occurs in teaching hospitals.

Therefore a university facility, whether it be a university department of rural health, rural clinical school or a rural medical school, could provide a regular means of servicing the small communities with clinicians and providing two elements – one: clinical experience and two: continuity.

Much of these ideas have sprung from my own personal experience of providing a visiting medical service. For a number of years when I was newly graduated I would do evening consultations by visiting patients who, for one reason or another, could not present at the rooms for ongoing care. I did it twice a week, and if I encountered any deterioration, I would let the general practitioner know. Here the General practitioner was my educational resource and I went out on my visits -five or six patients generally had to be seen each evening.

The principle is simple – a travelling medical team connected to a teaching centre, where public health is an essential ingredient. As I have found out, if you provide a mixture of collegiality, teaching, recognition and succession planning, then you can build a coherent team of health workers.

Such a concept where you use colourful cars in lieu of aircraft to attract attention as the means of providing a regular service to remote settlements need to have a David Lyle to implement such a simple but obvious concept. But make sure that the travelling band arrives in each township with panache and always come when they said they would -punctually.

Incidentally, there was no problem with the medical care in Hopetoun, but that is another story, but instructive in trusting your on-site observations to strip away the hearsay and gossip. 

Sarah Jane Halton and her Stomach Knot

Jane Halton has bobbed up again. The incoming Health Minister, Mark Butler, has asked her to review the existing vaccine contracts and whether the country had a regular source of vaccine supply – a guaranteed pipeline.

The background is the dilemma being posed by the surge in the number of cases of the virus and the fact that the new variants seem to be more contagious. The fact that the level of vaccination including boosters has declined and there seems to be a growing complacency in the community with the removal of public health safeguards presumably is driving the review.

His action follows on from a national surge in case numbers, with health department estimates showing around 200,000 people are actively infected. He also confirmed that COVID-19 vaccines for children aged between six months and five years, which have already been approved in the United States, are progressing towards approval in Australia. Pfizer has been granted provisional approval to put in an application to provide a paediatric COVID-19 vaccine.

At the same time the impact of the transmissibility of the new variants BA.4 and BA.5 has introduced another variable, because of the unknown factor around the virulence and the effectiveness of current mRNA vaccines against these variants. That is the problem with mRNA viruses – they are fickle, mutating regularly.

Reading between the lines, Butler wants a “quick and dirty”. Despite what has been provided in the media release, and a comment that he was only interested in the future, the lessons come from the past.

Butler’s appointment of Halton is a shrewd one. She is a Howard-Abbott warrior. Therefore, her appointment has a “Teflon” quality. As a Deputy Secretary in the Department of the Prime Minister and Cabinet, Halton was convener of the People Smuggling Taskforce in the Children Overboard Affair. This was a convenient vehicle for Howard’s scare tactics in relation to the “Boat People”. She was the dummy in believing false claims, but she was rewarded with the post of Department of Health Secretary, where the then Minister, Abbott obviously saw her as a person in his own image and when he became Prime Minister Halton moved upwards into a central agency – that of Finance.

She became a member of the ill-fated Executive Board of the Australian National COVID-19 Coordination Commission in March 2020. That would suggest that she was engaged in the whole sorry process from the start, the entrails of which she has been asked to examine. Maybe she will be able to airbrush any involvement of Sarah Jane Halton from her report to Minister Butler.

After all, the Chair of the Commission, Neville Powers was convicted of breaches of COVID-19 rules. Maybe the activities of this Commission will figure in her solution. So far, the only public contribution by Halton as a result of this association was an indifferent report on hotel quarantine.

However, there is no doubt that Halton is an expert on integrity having been a member of the Board of the Crown Casino which presided over a raft of corrupt practices, the criminality of which has not been tested in the Courts.  Nevertheless, the former judge Patricia “Paddy” Bergin, who ran the Inquiry  on Crown, noted that despite her involvement in some of the deceptive practices, her integrity emerged intact.

James Packer had a business model which relied on an ongoing river of Chinese money replete with all the attendant malfeasance connected with the movement of large amounts of money, including junket tours and money laundering. It seems that ASIC is not prepared to take the matter further – “too big to fail” is the mantra.

Halton is a beneficiary in that the level of her involvement in the shenanigans will not be tested in court. Nor unsurprisingly, this involvement was not mentioned in the Butler media release, where she is described as “a vaccine expert” and Chair of an international organisation – the Coalition for Epidemic Preparedness (CEPI) based in Oslo, which is the brainchild of the Bill & Melinda Gates Foundation and the Government of India. Given the generous description of her as a vaccine expert by the Minister, the published description of the CEPI Board, acknowledges her starkly by a single word “Chair”, a position to which she was re-appointed last year for a further five years. Yet others on the Board are clearly defined as vaccine experts. It is as though the authors of the CEPI Report were unsure why she was there.

I therefore was surprised with the Ministerial comment: “I make no judgment about the existing arrangements. I think it’s entirely appropriate for us to have some independent advice about incredibly important arrangements that we have inherited.”

Excuse me for gagging on “independent”.

Now that ex-Minister Hunt has retired, also excuse me by speculating if there is now one remaining person with a target on his chest. Also let’s hope that she does not get that knot in her stomach – her own shorthand for the times she has stuffed up.

Climate Change

Ravenserodd – site of sunken Medieval town

The worst manifestation of this deteriorating climate was the Grote Mandrenke (Great Drowning of Men) of 1362, the greatest North Sea disaster in history which saw up to thirty thousand dead and almost half the population of the marshland districts along the Jutland coast drowned, not to mention the inundation of substantial chunks of the city of Dunwich and the port of Ravenserodd on the North Sea coast of England.

This above excerpt from a newly-published examination of ancient Britain settlement, Shadowlands by Matthew Green describes the changes in the British coastline because of climate change in the early part of the last Millennium. There is the description of Old Winchelsea where, over a period of a hundred years, this settlement – an important port on the Kent coast – was washed away. The intervention of King Edward 1 in acquiring land in the hills above Winchelsea was not without controversy because it meant a shift of Winchelsea being superimposed on existing settlements on this higher land.

These were turbulent times as the Northern Hemisphere moved from a calm Mediaeval Warm Period (c. 900-1200) into the turbulent Little Ice Age (c.1300-1900).  During this time, hundreds of settlements on both sides of the Channel were inundated with extensive loss of life.

As Green says, this period  was instructive for our time, when climate change is very much in the hands of manmade intervention, which as he says, it is probably much worse than the thirteenth or fourteenth  century “ever dreamed up.”

May I suggest that the inhabitants of Lismore and other places that were once ports and which are now being repeatedly flooded, read what happened to this mediaeval port of Winchelsea. It took time but, in the end,  the once thriving port of Winchelsea was no more, death from repeated flooding.

Mouse Whisper

My Bushrat relative, Rafferty, turned up the other day. He had hitched a ride on a number of trucks around the southern part of the Far West of NSW with a mate, Jack Kerourat. Anyway, he said that the Hay Plain was so flat you could see the curvature of the Earth’s surface.

The other thing he mentioned was in the bar of the Penarie pub where he heard one of locals say, “Look mate, you know what a remote place is in Australia. It’s where there’s no TAB betting agency.”

Penarie pub