Locums for a Small World Blog

From the Top End of Down Under, it's a new year with Dr. Starkey.

Posted by Saralynn White

By Kathryn Starkey, MD, and Molly Evans

Molly Evans and Dr. Kathryn StarkeyHappy New Year from the Top End of Australia

G'day from the Top End,

Over 60,000 years ago, when the sea level was much lower, people walked from New Guinea to Northern Australia and these wanderers were the origin of the Australian Indigenous Aborigines. By the time Europeans arrived in 1788, the Aborigines—scattered throughout the continent as hunters and gatherers—may have numbered close to a million people. They are the oldest continuously maintained culture on earth and now number about 455,000. However, homelessness is highly visible among Aboriginal people.

We witnessed this first hand while working in a small remote 60-bed hospital in an outback town called Katherine (where 2011 Tour de France champion Cadel Evans hails from). I worked alongside an outreach nurse specialist who provided gynecology care to our patients, whom she called “the women from the long grass”. Often found living in the surrounding fields, these women lack education and have nowhere else to live. The government has tried to supply housing, but the demand outweighs the supply, so housing eventually becomes crowded and unsanitary.

Dr. Starkey delivered twin Australian girls just before the New Year

Molly Evans poses in Katherine, home of cyclist Cadel Evans

While the Aboriginal people now receive what they call “sit-down pay” (deposited into bank accounts for their use) this monetary support means the younger generation has lost the ability to live off the land; they have no “need” for work, nor do they see a role for education. As I found out, healthcare is also on the back burner. Clinics and transportation are available, but the people find it difficult to attend. Both preventive care and early detection are not yet embraced; unemployment is six times the rate of non-aborigines; and truancy in the primary schools is at 60%.

Cultural practices are also profoundly different; we do try to understand but find it difficult. This is demonstrated by the following story: I recently had a patient arrive with internal bleeding that occurred as a result of repetitively jumping out of a tree onto her abdomen. This was her way to demonstrate grief over the death of a grandparent and - coupled with an undiagnosed bleeding disorder - it almost cost her life. Also, once a person dies you can no longer view their image or say their name. This practice to honor family ties is just one instance of cultural differences.

A "mob" of Aborigines in Katherine

Journeys of the Dreamtime, Aboriginal Art Exhibit 

Despite the aforementioned “doom and gloom", the Aborigine culture is slowly gaining ground - with the granting of full citizenship in 1967 and the return of their traditional ancestral land. If there is any area that has defined the renaissance of Australian Indigenous cultural globally, it is visual art. We have enjoyed learning about and collecting art from the different regions where we have worked. One of the most telling films of Aboriginal history is the film The Rabbit Proof Fence depicting a time when half-caste mixed blood children were taken from their homes and placed in missions in the hope of educating them and eventually “breeding out” the black color. It is a very powerful story.

On another note, the rainy season has arrived with its hot humid conditions and rain that comes in horrific downpours, but we're enjoying the adventure as always.

Happy New Year to All,

Kathy and Molly

Dr. Kathy Starkey, an OB/GYN, and her partner, Molly Evans, have chosen locum tenens as a permanent lifestyle (they're currently on their seventh assignment). Their adventures have taken them to New Zealand's North and South Islands, the Cayman Islands, Western Australia, the small Australian state of Tasmania and now the Top End of Australia (in the Northern Territory). Read more of their adventures right here. And if you haven’t subscribed to this blog yet - do it now!


Topics: Dr. Kathryn Starkey, Molly Evans, Cadel Evans, Top End of Australia, Katherine AU, The Rabbit Proof Fence, Australian Indigenous Aborigines

Crikey, Cadel! Grit powers “Old Man Evans” to Australia’s first Tour de France Victory

Posted by Saralynn White


Cadel Evans has dreamed of winning the Tour de France ever since he was 14 years old. His historic win
last weekend — the first ever for Australia — has been hailed as one of the country’s finest ever sporting achievements, ranking alongside Rod Laver’s tennis exploits and their 1983 America’s Cup yachting triumph.

Our Australian friends and locums spent their time glued to the telly last week, sleeping just a handful of hours; and growing legions of fans have urged a public holiday in Evans' honor (though Prime Minister Julia Gillard, who called to congratulate the country’s new hero, has ruled that out).

Although Evans has a high profile in his home country, he is publicity shy and a bit of a mystery to most Australians. He grew up around Katherine in the Northern Territory, Armidale in New South Wales and Barwon Heads in Victoria, where he got used to riding alone. Beyond that, not much is known of his motivations. His Mum, Helen Cocks, says, “He is a simple man who likes simple things. He will be the same Cadel [after winning the Tour de France], probably just relieved,” she said. 

new zealand triathalon bikers 123rf


Evans' Italian wife, Chiara, was admittedly consumed by emotion during the race. "You don't want to know.
I was really, really bad. Crying and everything, and calling to everyone 'How many seconds?',” she said — at times unable to bear the suspense. This was a very different Tour from the ones of the recent past — which were dominated by a single rider — Lance Armstrong or Contador. Seven or eight riders were still in competition for the victory during the climbs of the Alps in the final week. Evans looked at one point to have lost his chance, when Andy Schleck rode away from the others on the Galibier pass. But Evans held his nerve and made up the seconds to wrest the coveted yellow jersey from the younger Schleck brother. Evans' final margin of victory was a mere 1 minute, 34 seconds.

The 34-year-old Evans, the oldest champion since before World War II (and only the third non-European in the Tour’s history), stood on the podium wrapped in his national flag, his eyes tearing up as he listened to the Australian national anthem. He then embraced Andy and Frank Schleck.

 "I hope I brought a great deal of joy to my countrymen, my country," Evans said Sunday after climbing onto the winner's podium on the Champs-Elysees. "It's been a pleasure and an honor to fly the flag over here." Evans says he's now keen to put his hand up for next year's London Olympics - though a major issue is whether the Olympic road race and time trials courses will be hard enough to suit his strengths. 

Back home in the Land of Oz, a glut of cyclists has filled the country’s roadways, causing some to claim the Evans win may be more of a national tragedy than triumph, citing an unprecedented increase in the popularity of Spandex and a glut of children named Cadel and Cadelle...oy, oy, oy!



Topics: Rod Laver, Lance Armstrong, Tour de France Victory, Andy Schleck, Frank Schleck, Armidale, Barwon Heads, Katherine, Cadel Evans, America's Cup

Locums for a Small World Blog

Twice a month, our inquisitive locum tenens community asks us to tackle topics ranging from cuisine and culture to recreation and entertainment. We also include great storytelling from our doctors. Have a topic you’d like to read about? Let us know.

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