Making a difference on the path less travelled

When it comes to medical pathways, Dr Mikaela Seymour has taken the road less travelled.

Graduating medical school with surgical aspirations, Dr Seymour says she eventually realised the hospital pathway was not for her.

Instead, she was drawn to practise medicine in one of the most disadvantaged parts of the world.

“I'm one of those creative careers doctors you've probably heard of. I've certainly had an unconventional pathway,” Dr Seymour says in her keynote address at the 2023 AMAQ Junior Doctor Conference.

Dr Seymour says her interest in developing world medicine started with a final year elective to undertake tropical medicine in the Western Province, Papua New Guinea district hospital.

“I gained my general medical registration in Papa New Guinea and Australia simultaneously. I was this medical Batman, living dual identities in two different worlds,” she says.

“Whilst I was here in Australia, I was assisting in advanced surgeries working in perfectly sterile theatres, with supply cupboards full of various types of sutures, dressings, and every sort of equipment that you can imagine, by comparison, my reality in Papua New Guinea was very different.”

She cites findings from the Independent State of PNG Health System report, published in 2019, which found only 40 per cent of health facilities have a form of electrification, 55 per cent have any access to water, and only 33 per cent can transfer a sick patient to a higher level of care.

Dr Seymour says that maternal mortality rates were approximately 43 times higher in PNG compared to Australia.

“Another example in Australia that we take for granted is the absence of vaccine-preventable illness, and obviously, as a public health registrar, that's something very close to my heart. But again, these circumstances are very different in our immediate region,” she says.

A tale of two countries, close in proximity but with health systems miles apart

Dr Seymour continued to be drawn back to the Western Province, taking leave from Queensland Health.

When asked about the PNG national measles outbreak that she treated whilst abroad, she says, “These kids were covered in a rash, they were suffering high fevers, and they were just completely miserable. Carers were travelling, in some cases, literal weeks with their kids,” she says.

“They often had concurrent, severe acute malnutrition. They were overlapping malaria cases, other bacterial and fungal infections, TB, and HIV.”

Dr Seymour has been involved in multiple national vaccination campaigns in PNG, travelling on foot to rural and remote villages to administer immunisations.

She says it became clear that it was insufficient to treat the sick patients presenting in the remote clinics in the western province with antibiotics alone.

“The medical conditions with which they were presenting reflect the circumstances in which they were born, raised, and lived. We had to address the underlying cause, improving water, sanitation, and hygiene”.

“Although we were clinicians, we had to be health advocates for the villages we visited. It was our job to try and determine ways to improve disease determinants in the broader community.

“And these are wicked problems. There was no single solution that could completely resolve or affect the result.

“Back in Australia, it was becoming increasingly difficult to reconcile these two different worlds … I was becoming increasingly frustrated by what I saw as an unequal clinical world,” she says.

“We are so focused here medically on what we can do for the single patient in front of us that it's easy to forget the bigger picture. As a medical community, we are increasingly using more advanced technologies to get that part of a percentage improvement for that individual, but at what cost?

“Where does this journey end? In Australia, will we live forever in perfect health while our Pacific neighbours fight for simple interventions like immunisation for their children?

“I increasingly felt that something was wrong. And in 2019, I left Queensland Health with this idea that I need to try and contribute something to decrease inequality.”

Volunteering with Australian Doctors International, Dr Seymour travelled to Western Province, PNG, to work with the Sustainable Development Project Health Program delivering primary and preventative health care, including childhood immunisation and well-baby checks, antenatal clinic family planning, and water and sanitation hygiene consultation.

Dr Seymour challenged the medical students and doctors in training who attended the 2023 AMA Junior Doctors Conference in Townsville to be mindful of the broader issues which affected patients’ health outside the hospital.

She urged them to advocate for greater equality in healthcare across the entire Western Pacific region.

Dr Seymour currently works at the Townsville Public Health and Tropical Medicine Unit, where she works in health protection and promotion, with a focus on communicable disease control.

She particularly enjoys influencing policy and broader practice, which affects the health of larger communities due to the long-term benefits. She is passionate about rural and remote medicine, primary care, and global health equity.

NQRTH connects medical students, intern and junior doctors with a network of opportunities and resources designed to create a supportive and clear path to specialist (including general practice) training, and beyond, in our regions. Our network works together to strengthen medical specialist training with the view to build a health workforce prepared to meet the health needs of our regional and rural communities in Cairns, Central West, Mackay, North West, Torres and Cape, and Townsville. NQRTH is facilitated by James Cook University, who partner with hospital and health services and training providers to create a connected career pathway beginning at the medical undergraduate level right through to fellowship.