Patricia McPherson (Part 1) – ‘Sister Pat’ A Legend Of A Nurse

In 1963, 25 year-old Patricia McPherson crossed Australia’s vast continent from her home in pastoral Gippsland in Victoria to arrive at Fitzroy Crossing, a tiny remote settlement in the centre of Western Australia’s rugged Kimberley region.There she would begin work as a nursing sister at the Australian Inland Mission (AIM) hospital. By the time she left her work with AIM some ten years later, she had made an extraordinary and indelible impact on the health and well-being of hundreds of people in her region, and by extension, in other remote regions of Western Australia.

Nurse McPherson became ‘Sister Pat’ a legend of a nurse who transformed the delivery of health services to a vast region of Australia’s outback and set the template for public health nursing that was adopted statewide. In acknowledgment of this work, Pat McPherson received the British Empire Medal in 1970. 

Pat McPherson’s story is one of exceptional service and far-reaching achievements.

But it’s also a story of great adventure. It is a remarkable Australian story.

Pat is now 86 years old and lives in Victoria. Pat McPherson’s own words best tell her extraordinary and heretofore not generally known story. WomanGoingPlaces is therefore presenting in several instalments, some excerpts of her diaries, letters and interviews from her time in the Kimberley. 

PAT’S STORY – BEGINNINGS

Pat became a nurse because she wanted to work  with the AIM in the Outback.

“I took the right subjects at high school to gain the right entrance qualifications to a nursing school. I sought and undertook the most comprehensive nurse training available to me at the time and I undertook further training as a midwife. And I didn’t only learn to pass exams. At every stage of learning during these years of training I extrapolated from The Royal Melbourne Hospital and The Royal North Shore Hospital to the bush. I’d say to myself, ‘If this or that happened in the bush and I was IT, what would I do?’ or ‘If I had to do this or that procedure in the bush and I didn’t have all the equipment, how could it be done?’ And so, I asked questions of nurse tutors, doctors, my senior nurses and became a bit of a pest. I also read widely and pursued some ad hoc preparation like learning to pull teeth, to suture wounds, to make bread, and to do a grease and oil change on an engine.

So, armed with these impeccable credentials and a sound Presbyterian background, I volunteered for the inland service with the AIM and, accompanied by another young volunteer nurse, Nat (Gloria Natoli), I arrived at Fitzroy Crossing at the beginning of the Wet season in 1963.”

FITZROY CROSSING, BUNUBA COUNTRY, WESTERN AUSTRALIA

“Fitzroy Crossing was a small, isolated trading post in the heart of the Kimberley cattle country, an area where white settlement was only 80 years old. It consisted of six buildings – post office, police station, AIM hospital, United Aborigines Mission, state school, and pub/general store. These buildings were widely separated from one another along two miles (approximately 2.25 km) of the banks of the Fitzroy River. In the winter (the Dry), the river was a dry gully. In the summer (the Wet), it was about 36 feet (11 metres) high and spread across the flood plain for 30 miles. The town was isolated for 3 months”.

 

THE LOCALS

“Besides we two nurses there were three other single people employed by the pub. Fitzroy Crossing’s other residents were couples at the post office, a police station, school, hotel and the United Aborigines Mission. There were no children in any of these households.

We were totally unprepared for Fitzroy Crossing. We found ourselves in a society that had a different value system to ours. People went to the session at the pub on Sundays and, whenever the Lord’s name was mentioned, it was used as a blasphemy. The other people in town – the postmaster, the policeman, the school teacher and the publican – were there for either promotion or money, or both.”

“There is no real community spirit in this small town of 23 whites. We have no one to turn to for help. There is absolutely no maintenance done here (at the hospital) other than what we do ourselves. We have had to mend doors and fences, prop up the bough shed when it sags, mend toilets and fix the engines. We couldn’t even get anyone to chop our wood for us when the Aboriginal helpers were sick so we did that too.  The partnership (2 families) running the pub has crashed and has split the town.  One family doesn’t even speak to the other. There is friction between the 2 policemen, but they still speak to each other, which is their saving grace.  The postmaster who is a recluse and uncooperative, won’t speak to anyone, and the mission folk hold themselves apart and have nothing to do with the community.  So is it any wonder that our friends and interests are the station people.  We only see them occasionally, but these meetings are full of pleasure for them as well as us, and are free of petty gossip and back biting.”

THE STATION PEOPLE 

Sixteen stations within an 80 -100 mile (129 – 161 km) radius of Fitzroy Crossing were served by the AIM hospital. Almost a thousand Aboriginal people lived and worked on these stations and fewer than two hundred white people.  

The stations in the area primarily covered by Pat were: Gogo Station, Brooking Springs Station, Jubilee Station and Fossil Downs Station, all in the country of the Walmatjarri, Bunuba and Gooniyandi peoples.

“ The station people looked to the Hospital for something else. Very few sought medical help other than in an emergency such as a suicide, burns and mustering or a motor vehicle accident. The white station community saw the hospital as their social centre. Whenever they were in town, they came to the hospital. They came for a cup of tea or a meal or just to talk and relax or to wait for the mail plane. We saw this as a very important part of our work and are pushing ahead with our policy to try and consolidate this place a social centre as well as a hospital.  We are getting to know a lot more station folk now and they show us appreciation and great respect.

 

THE HOSPITAL AT FITZROY CROSSING

“The Hospital was a shock. It was built in 1939 of unlined tin. It had cement floors, fly wire ‘windows’ and tin shutters which had to be closed when it rained, thus excluding both air and light. It had a wood stove and a kerosene refrigerator. There was no hot water system. We boiled a copper for the washing water. There was a 240KVA Southern Cross lighting plant and a water pump. We generated our own power and pumped our own water. There were two wards: a ‘native’ ward (the gauzed-in verandah) which had eight camp stretchers and a ‘whites’ ward which had two hospital beds. A divided bed in the corridor next to the lavatory served as the labour ward. 

Our nearest doctor was the Flying Doctor (Royal Flying Doctor Service) at Derby two hundred miles (322 km) away with whom we were in radio contact each day and who held a clinic at our hospital once a fortnight.

Despite my well-thought-out preparation, I wasn’t really prepared for bush nursing. The day we arrived the lighting plant wasn’t working and the kerosene fridge was smoking and the water pump wasn’t pumping. Within an hour of our arrival we set to and had fixed the lot of them. 

It was a tremendously busy hospital. We had a daily bed average of eight in-patients, all Aboriginal. They presented with anything and everything, mostly caused by infectious diseases or trauma. Most of the patients were children under the age of two with gastroenteritis. Because they were breast-fed, their mothers stayed too and camped in the shed. During some gastro epidemics, we nursed up to 22  babies, in the passageway and on the verandah, in potato crates, cardboard cartons and even in the wheelbarrow.”

THE TASKS: NURSE AND COOK

“Nat and I took turns sharing the work. For one week, one of us was the nurse and the other was the cook. 

The nurse looked after the in-patients and did the out-patients’ clinics every morning and did all the radio work ( communication with the Derby Hospital doctors, the RFDS, the stations etc.). One rarely slept for the whole seven days when one was on nursing duties. My main recollection is working night after night with desperately ill babies, getting some through and watching many others die. 

But there was another part of the work. On the week when one was cook, one cooked meals for about 20 people each day – the patients, the breast-feeding mothers, 3 Aboriginal staff and ourselves, and baked the bread every second day (6 high tins). One also supervised the cleaning of the hospital; did the washing and ironing; looked after the chooks; grew the vegetable garden in the Dry season; organised the huge bi-yearly orders for supplies from Perth; entertained the station visitors, and looked after the lighting plant and water pump. In the Wet season, one measured the river height twice a day and reported it on the Royal Flying Doctor radio to station people downstream.”

 

PIONEERING ITINERANT PUBLIC HEALTH NURSING

Patricia McPherson pioneered itinerant public health nursing in the Kimberley. Before she came to Fitzroy Crossing, the established practice was that people needing medical attention were expected to make the arduous journey of miles, to the AIM hospital in Fitzroy Crossing. Pat changed all that. 

Pat travelled hundreds of miles to introduce a comprehensive immunisation program to the whole community; Aboriginal and white. She administered all the childhood immunisations and those against other common diseases of the region such as Tetanus and Measles, as well as the Sabin oral vaccine against Polio. Pat immunised everyone and went everywhere, wherever people happened to be – in the Aboriginal communities, the stations, the cattle camps, at work on the roads, in the hotel bar and the local gaol.

In a pivotal departure from past practice, she went out to treat the Indigenous people in the camps on the million acre cattle stations where they lived and worked. She did it by driving miles every day and working from the tailgate of her donated Land Rover while battling considerable odds – environmental, bureaucratic, human and cultural.

“As God’s people, we recognise social injustice and, in the name of Christ, we move to correct it. Therefore, after years of watching Aboriginal babies die (at the hospital), I responded immediately to the opportunity to do something about the infant mortality rate in Fitzroy Crossing which was the highest in the State when the Commissioner of Public Health in Western Australia  (who had long wanted preventative health work there) asked the AIM if they would provide this service. The AIM agreed and offered me the challenge. 

I was in Perth at the time completing my Infant Welfare training. So in early 1966, armed with my Third Certificate, I set off in a short wheel based Land Rover equipped as a functional clinic and a two-way radio, a swag, and a tucker box, to become AIM’s first Itinerant Child Care Sister in the region.” 

 

THE LAND ROVER

“The trouble-free performance of my vehicle has been a great joy and I have a great affection for the ‘Gypsy’ which is my second home. At first, there was no-one available locally to do the grease and oil changes every thousand miles. After I had done one myself and bungled it somewhat, I was very glad when the new mechanic on Brooking Springs Station took over this task for me every month. I now take it into Derby for the major checks about every three months after the Mechanical and Plant Engineers (a W.A. Government workshop) who had heard about my pioneering efforts kindly offered to do the work on it.

 

I have enrolled to do a course on Motor Maintenance by correspondence this wet season and this should enable me to do minor repairs myself and give me a working knowledge of the anatomy and physiology of the vehicle. The mileage meter at the end of my first year (1966) reads 17,748 and the tyres are 50% new.”

PAT’S PROGRAM OF HOLISTIC HEALTH CARE

Pat realised that she had to expand the traditional role of nurse if she was to make any difference to the lives and welfare of the people in her care. First, she carefully observed life in the camps attached to the stations and kept meticulous records of all the infants and children. 

She researched the causes of illnesses such as anaemia, broncho-pneumonia and gastroenteritis, prevalent amongst children in the camps, and stemmed the epidemic of gastroenteritis through early detection and treatment. 

From her observations she created a new holistic program of care that engaged and paid respect to the people and their culture, especially that of the women whose cooperation was vital to its success. 

Pat also introduced antenatal care for Aboriginal mothers.

Pat’s holistic program almost completely eliminated infant mortality and morbidity rates in Aboriginal communities in her area. These rates had been exceptionally high. In three years, Pat’s program reduced the number to two deaths and cut hospital admissions by 50%.

“My instructions were to reduce the infant mortality and morbidity rate and hospital admissions by raising the standard of child care in the Aboriginal camps. My area covered six such camps in a thirty-mile radius of Fitzroy Crossing, in which 700 Aboriginal people lived – Gogo, Brooking Springs, Fossil Downs and Jubilee Stations all in the country of the Walmatjarri, Bunuba and Gooniyandi peoples.

I drove to each camp twice a week thinking, at first, that all one had to do was pick up the sick children and bring them into town for early hospital care. My thinking proved very wrong. This did become part of my work, along with daily medical checks, antenatal care, trachoma and anaemia treatments, leprosy checks, minor treatments, immunisations and perhaps our greatest role, health education.”

 

This was a rare approach at that time. Education in hygiene, nutrition, hydration, child and infant care were all key to her belief in the crucial role of preventative care to lessen the need for symptomatic or curative treatment of preventable illnesses. Her program was comprehensive. It also led to working together to clean up the living environment and planting vegetable gardens to enhance nutrition.

“The nurse became a teacher – of child care, hygiene, care of clothes, budgeting, toilet training, housekeeping, rubbish disposal and growing vegetables. One also had to teach the mothers to care for their children’s sores; treat their infected ears; give medicines, trachoma and anaemia treatments; and postural drainage and percussion – all from the tailboard of my Land Rover.”

SISTER PAT’S SCHOOL FOR LITTLE KIDS

Pat extended her concept of care to set up kindergartens to stimulate the toddlers. They were very successful and became known in the communities as Sister Pat’s School for Little Kids.

“Towards the end of my third year (1968) when this ( the health care program) had become more or less routine, one had to ask, ‘for what have I helped rear these children? Do I now abandon them because they are past the danger period health-wise?’  To me, the answer was no, so I took the next natural step and commenced pre-school play and kindergarten – this time in the shade of my Land Rover. I asked the teachers at the Gogo Station and Fitzroy Crossing schools  to help me develop this programme because the rationale was to bridge the gap between camp and school.”  

Fundamental to all her activities was Pat’s view, rare at the time, of how Indigenous people should be regarded and treated. She believed in the necessity of understanding the values and social relationships in these communities. 

“Concern for the health of Aborigines must be supplemented by increased interest in their view of life, and cultural issues surrounding health practices.”

 

CREATING THE TEMPLATE FOR PUBLIC HEALTH NURSES IN WESTERN AUSTRALIA

Pat advocated for a dramatic re-definition of Public Health, to locate it within the context and conditions of a community and maintained that the “diseases of a community – endemic infections, sub-nutrition, anaemia, growth retardation, maternal stress etc were all as destructive as tuberculosis and leprosy.” 

She pointed out that “Poverty is a disease of the community. So too is ignorance. Until the notion of Public Health is re-defined, we will continue to concentrate on infectious diseases and leave these equally pernicious situations untouched.”

“With the health of the baby and pre-schooler under fair control, the work then spread from a child-oriented service to a more public health oriented one to cover the total family unit. I introduced school medical examinations, and a more direct attack on leprosy in the adults.

At the end of three years the Aboriginal infant mortality and morbidity rate in the Fitzroy Crossing area was less dramatic and life would never be the same again for these people. 

The Public Health Department of the Western Australia Government evaluated this experiment and made a decision to spread this work to other areas where large numbers of Aboriginal peoples lived at subsistence level. 

This was a real breakthrough – Government recognition that we had delivered what the Commissioner had wanted, so we rejoiced when the Government appointed their own nurses whom they called Public Health Nurses, to work out of the hospitals in the three government towns in the Kimberley – first Derby, then subsequently Broome and Wyndham.

In order to take the work out of the Kimberley, in 1971, I myself went to Roebourne in the Pilbara, 1,000 miles south of Fitzroy Crossing. This was  iron ore country and the construction of a massive new mining facility there was rubbing off in a disastrous way on the Aboriginal community. Soon after, the Government appointed their own Public Health nurse to spread the service to a second area in the Pilbara – Port Hedland. 

They continued to do this until 1972 when an Act of Parliament was passed in the Western Australia Parliament which set up the Community Health Nursing Service. This Act set up the infrastructure to carry the development of the work to all areas of the State where people lived in low socio-economic circumstances.

We had pioneered a new service – two actually, for the pre-school work in the camps led to mobile AIM pre-schools staffed by pre-school teachers. Subsequently the WA Education Department set up pre-schools in the Kimberley towns.

It was a time of great rejoicing.”

 

 

Patricia McPherson subsequently continued her innovative work in community nursing after her return to Victoria when she worked for twenty-five years for the Royal District Nursing Service in management, service planning and the policy sector. During these years she also did an Arts degree in Sociology and Politics and achieved a Masters Degree in Nursing Studies. 

In 2001, as part of Australia’s Centenary of Federation celebrations, Patricia McPherson received the special honour of being included on the inaugural Victorian Honour Role of Women – Women Shaping the Nation. She was one of 250 Australian women who were honoured because they made key and enduring contributions to Victoria and the Nation.

 

Patricia McPherson’s story is continued in the next instalment: Becoming Sister Pat

 

 

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