The Colonoscopy
When shit gets real living in remote rural New Zealand.
I’m pretty sure I said to the surgeon just as the camera was about to be inserted; “We’ve only just met - it feels to soon for us to be doing this,” and “make sure you get my best side.”
I’m going to blame the cornucopia of pharmaceuticals.
It has nothing to do with my personality.
But how did I get here?
Why am I getting a colonoscopy/endoscopy double hitter on a slightly grey Wednesday October morning in Warkworth?
In mid-December 2022 I got hit with a dump truck of a virus ( and no, not that one) that lasted for months.
Lets just say it was very grim and very serious, I was mess and I was lucky to be able to finish up a research contract just as I got really ill.
My employers at the time were super supportive - Thank you Steve and Rhonda!
Till then I had persisted.
I live in remote rural New Zealand close to Mount Ruapehu with the closest full hospital in Hamilton about three hours away.
The staff at the local ED at Taumarunui “hospital” helped me when I went in but it needs to be acknowledged that the local health service is totally and utterly under funded, unstaffed and under resourced with everyone doing their best with what is available.
Local health statistics reflect this with health outcomes in Northern Ruapehu being the worst in what was the Waikato DHB geographic zone.
Mortality rates for Northern Ruapehu were 1.5 times higher than the rest of the Waikato in 2021 with emergency presentations and hospitalisations also significantly higher. (WAIKATO DISTRICT HEALTH BOARD NORTH RUAPEHU LOCALITY PROFILE 2021)
I suspect that these data points have only worsened in the last two years- with the overnight ward at Taumarunui Hospital closing earlier this year and a local medical clinic also shutting it’s doors.
Another GP in Taumarunui recently resigned from a local medical clinic which on my count means there are around six GPs for the 13,000 residents of Ruapehu.
Flipping dire.
Its not a good place to live if you need to access services for complex or longer term health issues.
St Johns Hato Hone and volunteers do a lot of heavy lifting to breech the ever widening gap due to lack of access and recently advertised for another hospital transfer officer.
I got by through accessing a GP in Auckland remotely - which is now possible with the Te Whatu Ora model, and doing blood tests locally, with a couple a of friends and my Mum coming down to support me and drive me to Auckland when I wasn’t able too.
As part of the process I was referred to a top specialist who after a barrage of blood tests and an x-ray diagnosed me - as I heard it as “being full of shit” -or as they put it having an “impacted bowel” - after a serious inflammation event with “bazaar” and “chaotic” blood test results that were “normalising”.
Being diagnosed as full of shit when one has a journalist string to their bow has it’s appeal.
To rule out cancer an endoscopy (through the mouth) and colonoscopy (not through the mouth) was ordered.
After a 15 week wait my appointment arrived as a public patient referred out to the private sector.
Duncan Bliss, Te Whatu Ora Group Manager, Planned Care, Hospital and Specialist Services says 11,211 people have received colonoscopies through private sector referral in 2022/2023.
This is in addition to the 45,900 done within the public system with 57,111 done overall.
I received my results a couple of days ago and I have thankfully have the all clear.
I am healing from what ailed me - things have normalised - and I am receiving the medical care I need remotely to resolve any malingering issues.
It needs to be said I am in a privileged position, in that I had access to out of district health services, had a good internet and cell phone connection to access them and the finances to support that.
That is not a given in Ruapehu.
I’ll be right - but the health services in rural New Zealand and communities like Ruapehu aren’t -and nor will they be - unless our new government fundamentally addresses the health concerns, lack of funding , resources and staffing issues affecting rural New Zealand.
I’m skeptical.
Till then my friends and neighbours will pay the price with poorer health outcomes, longer wait times and higher mortality rates.
Please note this is not a negative take on Te Whatu Ora ( who I know are working hard behind the the scenes to address these issues - abet slowly - system change is a slow, costly and cumbersome beastie and at the whim of political trends), primary health providers, GPs, nurses or medical staff within Ruapehu.
This is an observation and from my informed lived experience of a rural health system that has been chronically understaffed, under-resourced, underfunded and deconstructed in the name of centralisation of services over decades.
The state of our rural health system is the result of ideology and underfunding that does not meet the needs of remote and rural communities and its peoples across the motu.
For further information and comprehensive data sets on the issues affecting remote and rural communities check out the Impact Collective rohe profiles and Pūwhenua Ki Ruapehu and full disclosure I worked on both of these studies.