Locums for a Small World Blog

Two turtle doves and one well-traveled doctor: Guess who’s back at the Top End?

Posted by Saralynn White
Hello again from Australia,

It is wonderful to be back living and working at the Top End of Australia–our tropical paradise. Despite the daily humidity and temperatures reaching the high 90s, we feel “at home” slipping easily back into our routine of work and play (the customs officers were skeptical about Kathy's work visa when they explored her bag and found snorkeling equipment, a bike helmet, multiple swimsuits and several pairs of walking shoes!)

We are enjoying the same condo, the same lovely oceanfront swimming pool, and wonderful young doctors eager to learn and care for their patients. The mix of Asian/Australian influence is what makes this place unique from our prior Australian experiences. Here, Kathy cares for patients from East Timor, Papua New Guinea, the Philippines Islands, Sri Lanka, China, India and refugees from as far as Iran–to name a few. In fact, one in eight Australians now speak an Asian language. This exposure to other cultures has piqued our interest to travel to these regions in the future.

Weather and natural phenomena continues to be a “hot topic”. Nightly spectacular lightning shows that are leading us to the eventual wet season dominate.

Our native Australian Aborigines will now enter the 21st century with their own television station. Going mainstream introduces their culture to a wider audience and breaks down multiple barriers. We eagerly await this chance to learn more about the first people of Australia and hope that sometime in the future the Constitution of Australia is ratified to recognize them.

The Northern Territory outlawed the use of plastic shopping bags last year and one year later, it is nice to see everyone parading into the stores with reusable bags in tow. It shows that it can and should be done. Molly even takes an “esky” (cooler) when she shops for things that need refrigeration.

Rafting the ColoradoAussie friends




Our time back in the USA brought a visit from Australian friends who spent part of their 77-day U.S. holiday with us. We caught up with them in the Grand Canyon after we spent five days rafting down the Colorado River, sleeping under the stars and hiking the nine miles out. The grand finale of their holiday was five days with Kathy’s brother in New Jersey during Hurricane Sandy....with no electricity.

In the spirit of the holiday season, two turtle doves have built a nest in a palm tree just outside our window. What makes it unique is that this same couple attempted a nest here last year but it was blown apart by a typhoon. Hopefully, they will have better luck this year. To ring in the New Year we’re sailing Sydney Harbour aboard the
James Craig–a tall ship built in 1874. The Sydney fireworks spectacular is world-renowned so watch for us on your television news!

Happy Holidays & Happy New Year!
Kathy and Molly

Dr. Kathy Starkey (far right) is an OB/GYN from Buffalo, New York who gave up a practice in the Finger Lakes region in 2007 to take her first locum assignment with us in New Zealand. She’s now on her 8th assignment–at the Top End of Australia in the Northern Territory (for the 2nd time) where they just arrived. Dr. Starkey says she’s sticking with locum work because she get to practice medicine–which she loves–versus working so hard at the “business” of medicine. Her partner in life and crime, Molly Evans (second from right) has been with her from the beginning and the pair’s locum adventures–which we tell often–have also taken them to New Zealand's North and South Islands, the Cayman Islands, Western Australia, and the Australian island state of Tasmania.

Topics: Dr. Kathryn Starkey, Molly Evans, Northern Territory, Top End of Australia, Sydney Harbour New Year's Eve

70 years later, Darwin is an all-new frontline; just ask Dr. Starkey.

Posted by Saralynn White

Darwin, the capital of Australia's Northern Territory


Hello again from the Top End of Australia,

We toured the Darwin Military Museum this past month and learned details of Australia’s role in World War II.
My father, Army Air Force Master Sergeant Joe Starkey, was an aircraft mechanic on various islands in the region (New Guinea, Solomon Islands, and the Philippines) and spent time in Australia. In fact, I still have a 1943 Australian dollar bill he brought home.

If you’re not familiar with the details, on February 19, 1942 Japanese aircraft brought fury down on Darwin. A total of 683 bombs were dropped killing 243 people in the first raid—though to prevent panic spreading throughout the country, authorities at that time played down the number of deaths. It was the first and the largest single attack mounted by a foreign power against Australia. Incidentally, the raid was conducted by the same pilots who had bombed Pearl Harbor less than three months earlier—and they flew from the same aircraft-carrier fleet! Ultimately, 64 raids occurred in the Northern Territory over the next three years, prompting ain influx of some 250,000 military personal from Australia, Great Britain, Canada and the USA to the region. The USS Peary destroyer became a watery grave for 91 brave US sailors who died during the attack; the sunken ship remains in Darwin.

Tragically, the city of Darwin was destroyed again in 1974—on Christmas Eve no less—when Cyclone Tracy came ashore. Now rebuilt, it is the most modern city in the country and has a young, growing population of about 120,000. The city itself is built on a low bluff overlooking the harbor, and the region (like the rest of the Top End) has a tropical climate with a wet and a dry season. We finally had our worst bout of rain with 4 inches falling in 8 hours, so our grand total for January was 20 inches. This made for wild wave action in front of our home when the tides were their highest. Molly caught a shot of a bloke who didn’t seem to be bothered by tidal waters as he fished!

Molly Evans atop "The Hanger"
This month, Molly also checked off two big items on her “bucket list”: she climbed the largest steel span bridge in the world over Sydney Harbor, “The Hanger” (it’s affectionately called that because it looks like a clothes hanger), and she took a two-day railroad journey on the famed “Ghan” train. She rode in the Kangaroo Red class with a backpack from Adelaide to Katherine

The famed Ghan, and nearly famous Molly EvansWe both enjoyed a coastal weekend fishing trip with new friends, including a sand dunes cruise in an open-air utility truck. We didn’t catch any fish, but we did see a magnificent sunset. I was completely enthralled by the "mudskippers" living on the mangrove and in water. These amphibious fish use their fins to move around in a series of skips—up to two feet into the air! Unbelievably, they breathe through their skin, which must remain moist. They pretty much blend right in here!

We are loving thA mud skipper in the mangrovee hot, humid experience at the Top End of Australia and have met so many wonderful people. We’re heading home soon, it's not the end of our locum tenens adventures - not by a long shot.

Dr. Kathryn Starkey and "Izzy"Cheers,
Kathy & 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 Australian island state of Tasmania and now the Top End of Australia.

Topics: Darwin, mudskippers, Dr. Kathryn Starkey, Molly Evans, Top End of Australia

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

You can't rain on Dr. Starkey's locum parade (well, maybe during the wet season)

Posted by Saralynn White

By Kathryn Starkey, MD, and Molly Evans

Dry season at the Top End of Australia

G'day All!

We are currently enjoying Kathy’s seventh medical locum assignment and have adapted quite easily to our new location at the Top End of Australia.

As the cockatoo flies, we are closer to Papua New Guinea and Bali than Sydney! We arrived at the beginning of September, which is toward the end of the dry season. During the "dry", the weather is near perfect with warm temperatures and very little or no rain, so we're enjoying sunrise swims at the local Nightcliff Beach pool, sunset bike rides along the foreshore path, and alfresco dining at our beachfront condo (pictured at the end).

Everything seems perfect, except for the ever-looming “wet” season. The locals speak of a constant vigilance: Keeping mold and mildew from invading your home, leather shoes from disintegrating before your eyes, and restaurants and businesses from closing their doors. Once the monsoon or “tropco” rains do arrive, it’s more difficult to get around. The rains make rivers impassable and some areas inaccessible. During the "wet", the flooding also cuts off many remote bush communities (we're noticing an increased AborA wet season storm over Darwiniginal migration into the area). Alongside the rain, there are wild electric storms that turn the sky into a spectacular light show. Having survived hazardous snow blizzards at home, it should be interesting to live through this coming weather pattern.

Molly and Kathy, Litchfield National ParkWe’ve also been busy exploring both Darwin City and the surrounding National Parks. A few weekends ago, we enjoyed a relaxing day at Litchfield National Park. The Park is known for two things: Its 2-meter tall termite mounds that point north-south (to minimize sun exposure) and its waterfalls with their beautiful, cool swimming plunge pools. We enjoyed swimming at Wangi Falls, but as the floods arrive, so do the Saltwater Crocodiles or “salties” (be crocwise)!  

A "Salty" captured on film by Dr. StarkeyTo celebrate Molly’s birthday, we cruised Corroboree Billabong, which is part of the Mary River Wetlands and adjacent to World Heritage Kakadu National Park. The Park is huge and exactly the same size as Ireland. Aboriginal rock paintings here have been dated to 20,000 or more years old. Kakadu also boasts the largest concentration of saltwater crocodiles in the world - and the birdlife here is fantastic! Ibis, Brolga, Jacana, Egrets, Herons, Kites, Sea Eagles, Whistling ducks and Magpie Geese can be seen gathering among the
flowering lA flowering water lilyotus lily. There are also large flocks of Jabiru.

Kathy is busy at work seeing patients and supervising/teaching the younger doctors in training at a large public hospital. Patients arrive from the far corners of the remote Northern Territory, which stretches for miles and is 2 ½ times the size of Texas - with a population slightly less than the city of Buffalo (226,000 people). Imagine traveling that distance for medical care! Darwin has an interesting World War II history, having been bombed by the same Japanese fleet several weeks after Pearl Harbor. It is also the most modern city in Australia, as 80% of it was destroyed by Cyclone Tracy on Christmas Day in 1974 and has been newly rebuilt since then (more about the city in another letter home).

All in all, we are happy and once again so grateful for this opportunity to work, travel and experience! For now, we have PBS and a few NFL games to remind us of home (go Bills!). Molly is also very happy with a new pet chameleon that wandered into the condo. Staying dry for now...cheers!

Temporary Territorians,
Kathy and Molly

Dr. Kathy Starkey, an OB/GYN, and her partner, Molly Evans, have chosen locum tenens as a permanent lifestyle. Their adventures have taken them to New Zealand's North and South Islands, the Caymans, Western Australia, the small Australian state of Tasmania and now the Top End of Australia. We love to tell their tales here (read more stories from Kathy and Molly). Watch for future installments here, and if you haven’t subscribed to this blog yet - do it now!



Topics: Kakadu National Park, Litchfield National Park, Darwin City, Dr. Kathryn Starkey, Molly Evans, Top End of Australia

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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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