*Please refer to Dr Sandra Hirowatari’s Rural Health column (16 April 2018 edition) for an explanation of the below story. 

Esther is exhausted. She can hear her two little grandsons in the kitchen scrounging for something to eat. She knows she should get up, but knows the throbbing headache she has now will be pounding once her feet hit the floor. “They’ll manage,” she says to herself. Manage or perish is kind of how it is around here.

She promised herself this month’s cheque wouldn’t be used to buy grog. She would have kept that commitment if her youngest son hadn’t showed up yesterday. Another bad week for Junior. He struggles with depression that gets so bad she worries he will someday just put an end to his life. She has seen so many young men in Port Good Hope commit suicide she shudders to think what her son may do if things don’t turn around for him.

Esther knows alcohol isn’t the solution to her son’s depression and she knows her sugars will be bad today after everything they drank last night. At least there is no reason to prick my finger, she thinks. I know what the number will be.

She remembers she’s supposed to go to the clinic today. Marie called to tell Esther about the appointment they have for her. Something about a new diabetic program. Esther’s heard that before. The doctors and nurses at the clinic are more concerned about my blood sugars than I am. They don’t have the rest of the stuff to worry about that I do. Finding money somehow to pay this month’s rent and buy a new electricity card to keep the power on and that damn collections agent threatening to take the ute back if I don’t come up with my payments before the end of the month. Let him come and try and find that truck. Good luck.

She hears the toddlers pulling a chair up to the kitchen cupboard looking for cereal to eat. She really should get up; those boys are too little to be climbing. “Why are they here with me?” she wonders. The memory is unclear but she thinks her daughter dropped them off late last night. Her son-in-law bought some alcohol from Albert the grog runner and Elizabeth was worried for the children’s safety. If I don’t get my fat arse out of bed, they might fall and that would be awful.

Esther pulls back the blanket and slowly gets up. The room spins for a while, her head feels like it’s going to explode, her mouth is dry, the sweat under her arms dripping. She steadies herself on the edge of the dresser until her head clears and then heads towards the kitchen.

Later in the morning, Esther is feeling a little better. She found some kangaroo meat to eat and had some tea so her heart isn’t racing quite so badly and she is no longer sweating. She needs to get to the clinic. Maybe one of those lazy home care workers could pick me up, she thinks. They pick up Doris when she needs a ride to the clinic. Why not me, I need a ride. “You’re not on our list,” they’ll say. How do you get on the bloody list, anyway? Helps if you’re a friend of a relative, I suppose. She looks out the window, the sun is bright and the air looks still and hot, no wind. She will walk to the clinic even though it will mean she’ll be late for her appointment again. So sue me, she thinks – who cares other than you if I’m late or on time?

Esther’s surprised by what she sees at the clinic this morning. There is a big sign over the receptionist’s desk saying the Homelands Health Centre exists to serve the people of Port Good Hope so they can achieve physical, mental and spiritual wellbeing as individuals, families and community. Humph, that’s a new idea. They are going to serve me? Seems to me with all of these appointments they set up for my diabetes that I’m serving them with my blood!

Another surprise, that counsellor I’ve been trying to get my son to see is here in the waiting room just visiting. I don’t think I’ve ever seen him outside of his office in the two years he’s been in Port Good Hope. I wonder what’s going on.

Marie asks me if my phone number has changed lately. I don’t remember her ever asking me that before. I do have a new number. My daughter Bella thought I should cancel my home telephone when I took over the contract on her mobile phone. I tell Marie the new number and turn to go sit in the waiting room. “Esther?” she calls, “would you like a cuppa while you’re waiting?” Wow, they really are going to serve me.

Arlene is the nurse’s name. She says we’ve met before but I can’t remember them all. Arlene is quite excited today. She says the staff are working on three new programs that are being created to work in each individual community. Diabetes, addictions, and home care are the three, Arlene says. “We’re meeting with everyone in Port Good Hope that has high blood sugars or diabetes,” she explains. “We want to know from each person what is the most important aspect of their health – mental, physical or spiritual health. Which is most important to you, Esther?”

I don’t know what’s she’s talking about – health? I don’t know if I’ve ever really thought about my health. They told me I was diabetic when I was pregnant with my second child. I had another four after that, all huge babies that looked so odd in the nursery they have at the hospital for babies who aren’t doing so well when they’re first born. What’s my goal for health? How do I even begin to think about that? I would like to say to her, I want enough money that I don’t have to worry every month if I can pay my bills. I would like to tell Arlene that I’d like someone to take my son out on the land so he can feel the peace and know he is worthy. I’d like someone to help me look after Marla. She’s driving me crazy with all of her demands. I know she’s lonely and scared. Hell, I’m scared.

“I don’t know what I want,” I tell the enthusiastic nurse. I’m so tired. “My kids aren’t doing well,” I say. “They are always at me to rescue them. How can I rescue them when I can’t even take care of myself?”

“Tell me about your kids, Esther” she says.

An hour later I emerge from the nurse’s office with red eyes and a list of ideas. Arlene and I have made a list of options for my kids and for me. As I stood up to leave, Arlene says to me “Is there anything else I can help you with today?” I want to know what they’re putting in the tea around here – the staff seem to really care.

“No,” I say, “I really appreciate you listening to my story, I can’t remember the last time someone just listened to me.” She promises to meet me at my mother’s house on Friday so we can talk to her about some options too.  Junior is just getting up when I get back to the house. He doesn’t look good. Doesn’t smell very good either. “I think there’s enough water for a shower,” I say to him. He looks at me with eyes that are barely open and heads for the shower.

I call my mother. “Marla,” I say. “The nurses at the clinic are looking at how they can improve home care, they want to talk to you”.

“I don’t get no home care, I’m not on the list,” she says.

“I told her that and I told her you weren’t doing so well all alone. She says they are going out and meeting all the Elders and talking about options. I told her we could meet at your house on Friday.” I wait for her to process this message. She will be pleased to have someone visit but she won’t say so.

“What do they want to talk to me about?” she grumbles.

“Options,” I say. “It’s the new word they are using with everyone. They say they want to talk to you about what options you might like. I don’t know what they’re talking about. I know you wanted to know how you get them to give you a ride sometimes. I also know you would like to play bingo again. Maybe those are some of the options.”

“When on Friday?” she says with more interest.

“Eleven,” I reply.

Junior emerges from the bathroom smelling like soap, a big improvement over the smell he went in with. His eyes are a little clearer. I boil water for tea. “The nurse at the clinic says they are starting a men on the land program,” I tell him.

“Nurses don’t know nothing about the land,” he says. “I don’t need any nurses hounding me in town or out on the land”.

“It’s for young men with addictions. Charlie is working with the counsellor to set it up,” I say. “I think you should think about it.” He gives me a dark look and heads for the bedroom, slamming the door behind him. I pour the water for the tea and think about Charlie.

Charlie had a worse time at the Mish than me or any of my brothers or sisters. Charlie seemed determined to bury himself with grog. He’s been through more treatment programs than you could count. It looks like once he figured out how to manage his drinking back here in Port Good Hope he was ok. If he’s part of a program for young men here in town, I think Junior would do well to give it a try. Junior really missed out on having a strong man to look up to. The older boys had my dad before he passed. Junior only had his deadbeat drunk dad to follow around and drag him home when he passed out.

“How can I help you today, Esther?” Kindness again, what’s up with these people? I’m back at the clinic today. This time I’m seeing the social worker for the first time. My kids won’t have anything to do with her because she’s the one that takes your kids if you’re caught drinking. Normally you have to go see her at the other building – no one likes to go there because they think you have to be crazy or a drunk to see anyone there. Arlene told me the social worker would see me anywhere I wanted her to – my house, the clinic or the wellness centre. I figured the clinic wouldn’t stir up any talk. I’m always going to the clinic for my diabetes.

“The nurse says you might be able to help me with the bills I can’t pay,” I say. I didn’t believe Arlene when she said the social worker might be able to help. I know they’ve helped Elders with forms to fill in but I’ve never heard of them working with people who have bad debts.

“Well, let’s start with looking at the money you have coming and the money you have going out every month,” she says. I’ve brought some of my bills and cheque stubs so she can help me figure out what I might be able to do to get out from this mess I’m in. Arlene surprised me when she said that sorting out my bills so I didn’t have to worry about running out of electricity or getting evicted from housing was a good start on a goal for my health.

“Marla, why are you still in bed?” I say. The nurse, counsellor and home support worker are in the living room. I think my mother is doing this on purpose. “Get up, we have people here,” I say to her in Kriol.

“Magdalene, we’re here to learn how things are going for you. We have a few questions and then we hope you will ask us lots of questions. My name is Arlene, I’m one of the nurses at the clinic. I share my job with a nurse named Claudia. You may have met her, she has an Adelaide accent. This is George, he’s a mental health counsellor and you probably know Monette, the home support worker.”

My mother nods and sits in her favourite chair. I bring her some tea with lots of sugar, just the way she likes it. Arlene says they’ve been going around interviewing all the Elders in the community and anyone else who will need some help at home, to keep them safe and well in their own homes. My mother is one of the last ones they are interviewing. With all the information they’ve collected they will be looking at the programs and services that people think they need and then make some decisions.

It’s not just the health centre staff that will be making the decisions. There’s going to be a committee made up of three people from the community and three from health and social services. I won’t hold my breath. I’ve seen many committees try and do things differently for the people.

What I like from the interview with my mum was the counsellor speaking up about ideas he has to help Elders deal with abuse. Elder abuse is a big problem in Port Good Hope. Everyone knows when the pensions come into their accounts and then all of a sudden the children and grandchildren come for a visit. My son Elwood is bad for this. Marla wants him to come for a visit but not just to humbug her for money. She depends on him to get the roo skin she needs to make her beaded vests. She can’t say no to him but she can’t get through the month any better than I can if she gives him any money.

Some of the ideas the committee is thinking about is a day program for Elders at the wellness centre. Hot lunch and bingo with fruit and vegetables for prizes is the idea they are thinking about. Marla perked up at that idea. Marla asked how many times a week they would play bingo.

The clinic people also said they might get out of transportation support all together. The clinic staff plans to be making more visits to people’s homes so there won’t be as much need to bring Elders to the clinic. It takes up too much time of the home support workers and it’s too hard to provide it to everyone. The clinic is partnering with the land council office to see if this is a service the council could take over.

No one has asked me about my blood sugar all week. I know it’s down from where it usually is. I can feel it. The social worker gave me some ideas of how I can pay my bills and Junior has an appointment with Charlie and the counsellor to see about the men out on the land program.

If Marla goes to bingo even twice a week it will mean two days that she’s not calling me complaining about her back or her shoulders or whatever other body part is aching. I finally feel like maybe I could think about my health now. What would my goal be? I’d like to be able to paddle a canoe again. Maybe I could even teach my grandsons.