They promised me that I would get to work on Broadway, so that drew me in. Broadway Healthcentre, in Kaikohe, is the clinic at which I will be working for the next year. Yes, it is located on Broadway, the main road through town. No, I did not get a banner on the marquee, as I am just one of a decent sized line of locum docs who have passed through here.
Kaikohe made international headlines in 1991, when during the Christmas parade, local children threw stones instead of candy at Father Christmas. Since then Kaikohe has found other ways to displace any pent up anger during traditional christian holidays. If you get a chance, search out the DVD "Kaikohe Demolition Derby" produced in 2004 by Florian Habicht. It gives a whimsical look at the town of Kaikohe, coupled with breathtaking shots of the surrounding countryside and highlights of the Christmas and Easter demolition derby. (Google search gets to a site to view it online.)
Like Ben Haretuku, a local star of the movie, who refers to his profession as being a doorman instead of a bouncer, a description of Kaikohe depends on the labels you apply. In reality Kaikohe is primarily farming community located in the central Northland of the North Island, nearly equidistant from both coasts. Since I have recently practiced in Oregon, I do include marijuana as a cash crop in my definition of farming. It is home to the Nga Puhi of the Maori. Nga Puhi is the largest Iwi, or subtribe, of the Maori in New Zealand. Historically, Nga Puhi were considered the fiercest warriors. Many of the Kaikohe whana (family) tree reach back to Hone Heke, the most well known warrior of the Nga Puhi. To some of the New Zealanders we encountered in Auckland and Wellington, Kaikohe is a wild, remote, uncultured region of the Northland. I hope they keep thinking that, because Northland really is beautiful.
If you exclude the Pakeha dominated tourist communities of Kerikeri, Russell, and Paihia, the Northland is considered one of the poorest regions in NZ. Yet the people I have the privilege of seeing as patients in Kaikohe, much like Ben describes himself in the movie, are happy to be here. Broadway Healthcentre, which serves as the only medical facility (ie ambulances arrive here, really sick people can show up here) for a service population around 8,000 people, is a busy place. The Healthcentre is staffed by our multicultural "League of Nations" group of 8-10dedicated physicians, 12-14 nurses and a few allied professionals, who are here for reasons I will detail in a later post.
I had some initial anxiety about the my skills in managing the spectrum of illness and disease that I may find in this subtropical impoverished community. So far, I am happy to say that the majority of things I have seen here are exactly the same as those that present to family practice clinics in the US. I have had to adjust some thinking due to the early onset of disease amongst the Maori. Gout, asthma, diabetes, horrible pediatric eczema and cardiovascular disease are much more prevelent and severe than some of the cases I have cared for in the US.
Suprisingly, I have found a couple of things about practicing medicine here, that I had not realized were distressing to me in the US. Due to the Pharmac program, I can send an economically challenged family out the door knowing that it will only cost them $3 for the prescriptions to help control their children's asthma. A burden that most families are able to afford. I can refer patients for laboratory and specialty care, knowing that it will not result in bankruptcy for the family. Just a couple of golden nuggets in medical practice found at the end of the rainbow.
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