John and Helen Niven recount the incredible story of taking dental care to the remote villagers of Nepal.


Our dental volunteer trips to Nepal were initiated by my meeting Ang Tshering Sherpa in May 2011 whilst on a trip through Tibet with World Expeditions. He was the chairman of the committee that ran the Kushudebu Public Health Mission Nepal at Junbesi, a remote village on the original route to Mount Everest.

While the clinic was able to cover many medical problems the nearest dental service was five hours walk away. After many conversations and emails with Ang I decided to come to KPHMN and attempt to set up a basic dental facility.

In April 2012 Helen and I arrived in Kathmandu with many kilograms of portable dental equipment and supplies. We were met by Ang’s brother Ang Nigma who was our guide for our visit to Nepal. A visit to a local dental supply house to collect further supplies, followed by an interview with the Nepal Medical Board to obtain my dental registration, saw us ready to set out to Junbesi.

I had managed to put together a simple transportable dental surgery, consisting of a portable dental unit, a suction unit I found in Kathmandu, and a suitable quantity of instruments and supplies provided by generous dentists and dental supply houses in Australia.

As the saying goes, a week is a long time in politics, while three months is an eternity. Since the last edition of GPSpeak the Coalition's second proposal for changes to GP Medicare funding has come and gone. We also have a new Minister for Health, Sussan Ley, whom we wish well in this challenging portfolio. 

The proposal to increase the minimum length for a standard consultation from 5 to 10 minutes took the profession by surprise. While the average "Level B" GP consultation is 14 minutes, 25 per cent are less than 10 minutes. The government’s aim was to eliminate so-called "6-minute medicine" but the proposal contained several potentially adverse effects for general practice.

Since its inception eight years ago, the Better Access to Mental Health Care program has significantly improved the management of mental health problems. While the program allows for the treatment of a broad range of mental health disorders, the great majority of issues managed by general practitioners under the scheme relate to depression and/or anxiety. 

The Better Access program is open to all GPs and replaced the previous Better Outcomes program that was available only to GPs who had undergone specific psychological training. 

BEACH data analysis has shown that compared to Better Outcomes, the new program significantly increased the rates of depression management in primary care, with a halving of the referral rate to psychiatrists, a six-fold increase in referrals to psychologists, and no change in medication rates. 

Callcarpa Berries at the Rainforest Botanic Gardens

Long known as the Lismore tip, or even less attractively, the town dump, the facility that manages the city’s wastes is now called the Lismore Recycling and Recovery Centre.

The change is not just in the branding, but in reality, with the well managed facility becoming the envy of many a local Council.

An equally dramatic transformation has taken place at the adjacent Rainforest Botanic Gardens. Here, on a sizeable patch of once unappealing scrub, characterised by weeds, fallen trees, and illegally dumped rubbish, knowledgeable and enthusiastic volunteers are creating a network of walking paths through regenerated sub-tropical forest.

Such a project was long the dream of Friends of Lismore Rainforest Botanic Gardens, a group formed well before a site had even been identified. A founder member was plant enthusiast and long-serving retired local GP, the late Calder Chaffey (see separate story).

Today, the gardens are a protected space where representatives of all the unique plant species of our sub-tropical area can be grown in an ecosystem where they will thrive.

Construction teams working with contractor Brookfield Multiplex are rapidly transforming the site.

The chosen 6 hectare site at Ewingsdale, on the approach road to Byron Bay, is being rapidly transformed into the new Byron Central Hospital (BCH), scheduled to be opened by mid-2016.

The enabling and early works stage has included the completion of internal road base preparation, site in-ground drainage, bulk excavation and cut/fill, and installation of temporary site sheds.

More than 15,000 cubic metres of earthworks have been completed, and over 1,500m of stormwater pipe installed to date.

Taking shape is a new facility to replace the smaller hospitals in Byron Bay and Mullumbimby, estimated to cost $80M. Its aesthetic design incorporates a range of enviro-friendly features.

Services to be offered will include 24-hour emergency attention, with 14 ED acute treatment spaces; 43 overnight inpatient beds; low-risk maternity services, 20-bed, non-acute mental health unit; X-ray, ultrasound, CT, and OPG (dental imaging); 4-chair dental service, 4-chair chemotherapy unit, and ambulatory care services.

There will be expanded ambulatory clinic space for visiting medical services, allied health and community health clinics, plus co-location of community and allied health.

BCH will have over 2,400 power points and 700 data points, and some 102,000m of communications cabling and 95,000m of power cabling.

The construction contractor, Brookfield Multiplex, has a strong commitment to Aboriginal participation in its workforce, and using local contractors wherever possible.