FOR THE LAST YEAR at the monthly cattle sales in Yea on a Friday primary producers from across the region have mixed the business of selling livestock with an all-important health check, the pop-up clinic an initiative of the Yea and District Memorial Hospital.
Created in partnership with the Murrindindi Shire Council and the Yea Saleyards Committee of Management, the Yea Saleyards Healthcare Program was initially to support farmers affected by the October 2022 floods.
Funding for flood recovery from both the state and federal governments prioritised projects that improved community health and wellbeing, and it was this criteria that served as the impetus, driving a program that had previously only been a long-held aspiration of the Yea hospital.
Council had successfully secured funding to deliver a project targeting the farming community, however they were struggling with engagement, the demographic traditionally one to shy away from such initiatives or participate in self-care activities.
Elizabeth Sinclair is the CEO of the Yea and District Memorial Hospital (YDMH) and she is also a farmer.
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Based in Molesworth she was one of the very farmers who had been flood-affected, so when council approached her for advice she already had some ideas.
Council had been running barbeques and other similar events and uptake had been limited, and so the hospital pitched an alternative, instead of asking farmers to come to them why didn’t the hospital take healthcare to the farmers, at a place they would all be gathering.
“The Yea Saleyards was the suggestion,” she said.
“As an organization we’ve talked a lot about taking health outside the walls of the hospital, which is quite a non-traditional approach to health delivery.
“Our ambition has always been to increase the accessibility of healthcare to all cohorts in our catchment through a place-based model of delivery.
“The monthly cattle sales are always a bustling community event and the saleyards represented a consistent monthly location, so we thought we’d give it a go.”
Talking about mental health was always going to be a challenge, with community health manager and mental health nurse Sarah Austin - who co-hosted the first clinic at the saleyards - prepared for a slow-build, content with building familiarity and awareness in the initial stages of the project.
“I wasn’t sure anybody would talk to me especially about farming issues,” said Sarah.
“It’s a heavily male populated space, and I was something of an unknown.”
But what she discovered was an openness and a comfortableness in the space to talk.
From discussing euthanising stock during the floods and being beset by guilt and regret, to more ingrained family trauma and pressures of farming, the clinic provided a gentle and informal introduction to discussing mental health issues.
“It was really incredible how people opened up so willingly and this was in amongst everyone just buying and selling cattle as the sale was going on,” Sarah said.
Whilst Sarah was talking mental health, hospital cardiac nurse Shona Miljkovic was concentrating on cardiovascular health, doing assessments and checks.
And walking away from that very first sale they both knew they were on to something - there was a need and they had found the best means of delivery.
“We realised from the outset it was something we needed to continue,” Sarah said.
It has only grown in popularity since its October 2023 inception, with specific clinics drawing a stronger uptake than others.
Skin cancer awareness was on the agenda this December, returning to the saleyards after the popularity of this particular clinic warranted an annual slot in the clinic roll-out of checks, education and interventions.
Referrals are also now trickling into the hospital, as are follow-up appointments and bookings for more structured consultations, with these benchmarks only one indication of the program’s success.
Benefits of the program are manifold and with interventions conducted on-site - skin checks, excisions and burn-offs are all managed at the yards, along with vaccinations, ophthalmology and audiology reviews, and dietetics amongst other services – there often may be no need for additional appointments, whilst healthcare pathways become streamlined and treatment more targeted with concerns already identified.
And sometimes just the chat in the first place is all that is needed, providing a space to vocalise what’s going on.
“By organising these targeted events and fostering community engagement, the YDMH strives to make a lasting impact on mental health awareness and support within the farming community, ensuring no-one suffers in silence,” Sarah said.
Agriculture is the largest industry in Murrindindi Shire.
“We know that farming in Australia is one of the most dangerous occupations, both physically and mentally, with suicide rates up to 94 per cent higher than for non-farmers,” said Murrindindi Shire mayor Damien Gallagher.
“After the floods, crisis recovery specialists raised concerns about how the isolation and increased stress would impact farmers and their wellbeing.
“Mental health was already a highly concerning statistic in the shire, with 11.3 per cent of residents living with a chronic mental health condition compared to the 9.5 per cent Victoria average.”
Murrindindi also registers other sobering health statistics, with the shire well above the state average for both heart disease and cancer, along with figures that put residents living with kidney disease above the Victorian average.
“The Yea Saleyards Healthcare Program aims to address some of the most urgent chronic health statistics in our area,” the mayor said.
“By connecting our community with healthcare services and professionals, we are directly addressing these issues, providing free skin checks, mental health education and referrals, blood pressure and diabetes checks.”
And there are plans for additional services, cervical and prostrate screenings were the focus in November, with the program trialing a variety of clinics in its first year to determine community demand.
Throwing their support behind the initiative local and metropolitan-based healthcare practitioners have contributed their time and resources, driven by a desire to improve rural health outcomes and a fundamental belief in the project itself.
“Council is also a strong advocate for improvements directly informed by deteriorating health metrics in our communities,” the mayor said.
“The shire’s municipal health and wellbeing plan focuses on and guides projects that promote positive health outcomes whilst building a resilient and connected community.
“We are very proud to have been a founding partner and to have provided support throughout the establishment of the saleyards program.
“We commend the hospital for expanding this vital program and attracting new funding for its continued success,” the mayor said.
Going into its second year and with the program exceeding expectations, the YDMH sought funding to continue delivering this vital initiative.
The funding through the Violet Vines Marshman Centre for Rural Health Research, provides grant opportunities for projects that directly improve the health and wellbeing of people living in rural and remote locations.
The Yea Saleyards Healthcare Program is doing all this and more, for just as important as the funding is perhaps the validation.
For with the local success comes a vision to develop a transferable healthcare model that can be expanded into other rural communities.
Dr Jennfier Keast is a research coordinator with the University of Melbourne Rural School of Health and she is based in Yea at the hospital.
Her role at the YDMH is to develop of a culture of research, evaluation, improvement and innovation, with the Yea Saleyards Healthcare Program the very innovation the university is seeking to support and foster.
“Being awarded this prestigious and highly sought after grant really validates our saleyards program and will enable us to evaluate it, expand it and promote it to other organisations and regions to support farmers’ health and wellbeing more broadly,” she said.
An unlikely meeting of clinical healthcare with Blundstones and hooves, this grassroots initiative started by a small hospital as a trial in a country saleyard has pioneered an Australian-first model of healthcare that’s not just reaching and engaging farming communities, it’s making a real difference in improving regional health outcomes.
And as one local farmer said “We all think we’re bulletproof and only see a doctor if we’re really crook.
“But this is right here under our noses at the sale – it’s a wonderful service.”
