Flying doctors

flying doctors - australia

The Royal Flying Doctor Service of Australia is a not-for-profit charitable service providing aero medical emergency and primary health care services together with communication and education assistance to people who live, work and travel in regional and remote Australia.

There are eight RFDS entities that provide the service and fund raise for the RFDS nationally. These entities are called the RFDS "Sections" and together they form the Australian Council of the RFDS. The Australian Council is the national coordinating body and through this Council, the Service communicates with the Commonwealth Government on national issues, including negotiation for funding.

The National Office is situated in Sydney and manages and distributes Commonwealth Government funds to RFDS Sections and coordinates national strategies on health, aviation, communications, public affairs, fundraising, legal and industrial matters.

This is the story of how medicine, aviation and radio were combined to bring health care to the people who live, work and travel in the more remote areas of Australia.

Established in 1928 and developed on a national basis in the1930s, the Service soon provided not only emergency medical aid to the people of the Inland, but also a comprehensive health care and community service.

The development of the Inland was in many ways made easier by the presence of the Flying Doctor. Previously, serious illness or accident often meant death and the Inland holds many graves of people who might have lived had they been able to receive medical aid quickly enough.

The late Sir Robert Menzies, Former Prime Minister of Australia 1939-41 & 1949-66, once very aptly said that the Flying Doctor Service represented the 'greatest single contribution to the effective settlement of the far distant back country that we have witnessed in our time'

The RFDS was the first comprehensive aerial medical organisation in the world and to this day remains unique for the range of primary health care and emergency services it provides and for the huge area of sparse population and climatic extremes over which it operates - 24 hours a day, 365 days a year

The story of the Flying Doctor Service is forever linked with its founder, the Very Reverend John Flynn - it is a story of achievement that gave courage to the pioneers of the Inland.

In 1911 the Reverend John Flynn took up his first appointment at Beltana Mission in the north of South Australia. Flynn became very close to the people of the outback and in 1912 he was appointed as the first Superintendent of the Australian Inland Mission (AIM), the 'bush department' of the Presbyterian Church.

He began his missionary work at a time when only two doctors served an area of some 300,000 sq kms in Western Australia and 1,500,000 sq kms in the Northern Territory.

Flynn began establishing bush hospitals and hostels in remote outback areas which alleviated much of the dread associated with the great loneliness of the inland. But while they provided an important service, they were only really scratching at the surface of the problem of caring for people in the outback.

The problems of distance and communication remained with many people dying from the lack medical treatment.

Flynn told many tales to illustrate the need for medical care in the outback. One such story was that of Jimmy Darcy, a stockman hurt in a fall near Halls Creek, Western Australia in August 1917.

The tragedy elbowed even war news from manyAustralian newspapers and more than any other single event attracted nationwideattention to the urgent need for doctors, hospitals and nurses in outbackAustralia. In 1903 the first powered air flight hadtaken place and by 1918 the aeroplane was beginning to prove itself as areliable means of transport. Radio, then very much in its infancy, was alsodisplaying its remarkable capability to link people thousands of milesapart. Flynn saw the potential in thesedevelopments along with Lieutenant Clifford Peel, a young Victorian medicalstudent who had developed an interest inaviation. Peel, hearing of Flynn's ideas, combinedthem with his own and wrote to John Flynn from the boat which took him to thewar raging in France. The gist of Peel's letter, dated November 21, 1917, wasthat aeroplanes would overcome many of the transport problems of the inland. Inparticular, he saw 'a missionary doctor administering to the needs of the menand women scattered between Wyndham and Cloncurry, Darwin and Maree'. Peeloutlined the costs of adopting aircraft for the AIM's medical work, the speedand distances the early planes flew, and the support facilitiesneeded. Flynn was immediately impressed by the ideaand published Peel's ideas in the Church's 'Inlander' magazine in 1917. Peelunfortunately did not live to see the enormous impact it was to make - he waskilled flying over German lines in France shortly before WWI ended in 1918, buthis remarkable vision lives on today in what is now the Royal Flying DoctorService.

John Flynn had set his considerable fund raising abilities to use for several years, and by 1928, the AIM had sufficient money to establish a flying doctor scheme. Supporters of the project included the industrialist HV McKay, manufacturer of the Sunshine Harvester, Hudson Fysh at QANTAS, and, on the ground, Dr George Simpson, a young Melbourne doctor who had heard Flynn speak many years before.

On 15 May 1928, the Aerial Medical Service was established as a one-year experiment at Cloncurry in Queensland. After many years of dreaming, hard work and planning the Flying Doctor Service was a reality.

John Flynn was born at Moliagul in Central Victoria on 25 November 1880, the same year famous Australian bushranger, Ned Kelly, was executed. His father, Thomas Eugene Flynn, a schoolteacher, married Rosetta Lester in April 1876. The couple had three children - John was the youngest. Rosetta died in childbirth, when John was only three, and for several years he lived with relatives, until the family was reunited at Snake Gully, near Ballarat.

The Flynn family later moved to Sunshine in Melbourne's western suburbs. Here young John first heard romantic tales about Australia's vast outback when his father's business partners mounted an unsuccessful business venture to the far north of the country.

John graduated from secondary school in 1898 and began school teaching. In 1903 he decided to train as a Presbyterian minister. Initially he financed his studies working at Church Home Missionary centres around Victoria, and in 1907 commenced a four-year course in divinity at Melbourne University. Flynn graduated in 1910, and was ordained as a Minister of Church in January 1911.

Throughout his training, Flynn continued to develop an interest in working in the Outback, and helped other Presbyterian Ministers like Donald Cameron and Andrew Barber with missionary work in rural and remote areas in Victoria and South Australia. In 1910, Barber and Flynn published The Bushman's Companion, a small book of information and encouragement for people in the bush which quickly became a best seller. In early 1911, however, John was on the road to the real outback.

In February, John Flynn arrived at the tiny Smith of Dunesk Mission at Beltana, over 500 kilometres north of Adelaide in South Australia. At Beltana, he saw at first hand the rigours of Outback life, learnt there was no medical care available to inland residents and travellers. Within a year he was commissioned to prepare a report on life in the Northern Territory, to be presented to the Presbyterian Church in 1912. The General Assembly acted upon Flynn's recommendations and appointed him the head of a new organisation, the Australian Inland Mission (AIM).

The Australian Inland Mission (AIM) furthered Flynn's idea of a 'Mantle of Safety' for Outback Australia, by establishing, over the next few years, several nursing homes, and recruiting a team of 'Boundary Riders', ministers who travelled vast outback parishes by camel or on horseback, visiting communities and households, and tending to all the people of the inland. Another great Australian, Fred McKay (later to be leader of the AIM), joined Flynn's team of 'patrol padres' in 1937.

John Flynn was 51 when he married the secretary of the AIM, Miss Jean Baird, in 1932. The years to follow saw Australia struggle through the Great Depression, and the no-fuss and knowledgeable Mrs Flynn became a great support to her visionary and hard-working husband.

John Flynn, who was twice moderator General of the Presbyterian Church died in 1951 and is buried at Mt Gillen near Alice Springs, the very centre of the vast territory to which he brought communication, medical comfort and pastoral care.

RFDS founder Reverend John Flynn is featured on one 'face' of the Australian $20 note. (Image used by permission.)

The Australian Council Office collaborated with the Reserve Bank of Australia on the design of the new twenty-dollar note, one face of which features the Royal Flying Doctor Service of Australia and its founder Reverend John Flynn. 

In 1928 the dream of a flying doctor was at last a reality but Flynn and his supporters still faced many problems in the months and years to come. The first year's service was regarded as experimental, but the experiment succeeded and almost miraculously the service survived the Great Depression of the late 1920s and early 1930s.

By 1932 the AIM had a network of ten little hospitals across the centre. As for the flying doctor service, a succession of doctors and pilots followed Welch and Affleck and the Cloncurry operation continued to grow over the next few years.

The Service suffered severe financial difficulties during this period, but the continuing success at Cloncurry caught the imagination of people around the country and the world and prompted John Flynn and Dr Alan Vickers, a flying doctor, to push for a network of flying doctor bases spread across the continent, with government support.

In 1934 the Presbyterian Church handed the service over to a new organisation, the Australian Aerial Medical Service. Over the next few years Sections were established across Australia with their operational bases at Wyndham, Port Hedland, Kalgoorlie, Broken Hill, Alice Springs and Meekatharra along with two additional Queensland bases at Charters Towers and Charleville.

In 1936 a coordinating Federal Council was created. In 1942 the Service was renamed the Flying Doctor Service and the Queen granted use of the Royal prefix in 1955.

The growth of the Service made heavy demands on available funds and repeatedly John Flynn and his associates had to launch public appeals for donations. While some Government financial aid was made available on occasions in the early days, regular Government subsidies (both Federal and State) only became an established practice later on.

Even today the Service continues to rely heavily on money from trusts, donations and public appeals for part of its annual funding. Fundraising remains an integral part of the working day for the Service and volunteers, who played an important role in the establishment of the Flying Doctor, are still the backbone of the organisation.

Throughout the seventy year history of the flying doctor there has been a gradual increase in the number of Bases and the area that the Service covers. As needs have changed a number of Bases have also closed down or been relocated to more central areas to the people they serve.

When the Service first began, the responsibilities of the Flying Doctor were to fly to urgent cases, render first aid and, if necessary, transport the patient to hospital; give advice by radio; fly a regular clinic circuit to areas without doctors and consult with rural and remote doctors. In essence these are still the objectives of the Service today, however with improvements in technology telephones are used more than radios and increasingly the Service is taking advantage of video-conferencing technology.

Over the years the practice has developed and expanded to take along on clinic flights medical specialists, dentists and various health related professionals.

Sister Myra Blanche was the first nurse employed by the RFDS in 1945. Sister Blanche worked for the New South Wales Section in the 1940s and 1950s undertaking home nursing, immunisations, advising on prevention of illness and general health care and, on occasions, filling in for the doctor.

Although she was called a Flying Sister, most of her travelling was in a utility instead of a plane and on occasions she even travelled on horseback. Flight Nurses as we know them today were not used by the Service on a regular basis until the 1960s.

Today, based on the judgement of the doctor authorising the flight, up to 80% of medical evacuations are made with only the flight nurse and pilot on board.

Remote control medicine became a reality when medical chests were introduced to outback stations in 1942.

Costing 12 pounds, each chest was identical and contained numbered drugs, bandages and other first aid materials.

The RFDS body chart, drawn by Sister Lucy Garlick in Broome, Western Australia in 1951, is still included in all medical chests and remains a vital tool in assisting with a patient's diagnosis via remote consultations.

A doctor speaking from anywhere, including an aircraft, can ask, by number, where pain is being felt, and then instruct the caller to use medication or treatment by referring to numbered items on the lid list of the chest.

Many tall stories grew up around the service and one about the medical chests is typical. A station manager was told to give his wife a number nine tablet. Later he told the doctor, 'We'd run out of number nines, but I gave her one five and one four and she came good right away!'

Aviation was still a new and wondrous endeavour in the years after WWI. Flynn began a campaign within the Presbyterian Church to find the money to buy some aircraft for the Australian Inland Mission (AIM). He met Hudson Fysh, a WWI fighter pilot who founded Qantas, and together they developed the idea further.

The first flight, on 17 May 1928, was made using a De Havilland model DH50 aircraft hired from the fledgling Queensland and Northern Territory Aerial Service, later to become Qantas.

The aircraft was a single engine, fabric covered, cabin bi-plane capable of carrying a pilot and four passengers at a cruising speed of just under 80 miles per hour.

For the first trial year Qantas charged two shillings per mile flown and also provided an engineer based at Cloncurry. The Federal Government paid half the cost of maintaining the aeroplane with the other half funded by donations.

On its first official flight the DH50, appropriately named 'Victory', was greeted at the Julia Creek airstrip by more than 100 people. The distance travelled was 85 miles.

'Victory' went on to fly 110,000 miles in the service of the Flying Doctor until 1934 when it was replaced by Qantas with a DH83 Fox Moth.

The DH50 was sold to another organisation, the Rockhampton Aerial Service in 1934. On 8 December 1935 it unfortunately crashed into the sea off Caloundra, north of Brisbane while on a regular newspaper run. The pilot was unhurt and was helped to shore by the Caloundra Lifesaving Club.

It is significant that over the years the Flying Doctor has maintained a very good aviation safety record. This record is maintained despite the sometimes very difficult conditions under which aircraft have to operate.

In 1928 Flying was still in its early days. Airstrips often left much to be desired and there was a lack of navigational facilities and airstrip lighting.

The first Flying Doctor pilot, Arthur Affleck, had no navigational aids, no radio and only a compass and inadequate maps, if any. He navigated by landmarks such as fences, rivers, river beds, dirt roads or just wheel tracks and telegraph lines. He also flew in an open cockpit, fully exposed to the weather, behind the doctor's cabin. Airstrips were, at best claypans or, at the worst, hastily cleared paddocks.

Flights were normally made during daylight hours although night flights were attempted in cases of extreme urgency. Fuel supplies were also carried on flights until fuel dumps were established at certain strategic outstations.

In the 1930s and 1940s aircraft used by the Sections were predominantly British - most were De Havilland types like the DH-50, DH-83 Fox Moth, the DH-84 Dragon, the DH-104 Dove and the Australian built DHA (Marks I, II and III) Drover.

Later, American aircraft predominated like the Beechcraft Baron, Travelair, QueenAir and Duke, the Cessna 180, 182 and 421B, the Piper Cherokee, Chieftain and Navajo.

Since the 1980s the RFDS has been using Beechcraft Kingair 200C's, B200C's and C90s, Conquest C425, Conquest II. The newest types of planes to be included in the RFDS fleet are Pilatus PC12s and Cessna Titan 404s.

Aircraft developments have seen great changes. Prior to the mid 1980s, RFDS aircraft were all piston engines. The introduction of the twin engined Kingair B200Cs in the late 1980s and the Pilatus PC12s in the mid 1990s show the great benefits of turbo prop aircraft.

Speed, pressurisation, the ability to fly above turbulence and longer distances, larger cabins and integrated medical fit outs greatly improved the level of patient care possible as well as the comfort and safety of both patients and flight crews.

Compared with the cramped interiors of the earlier models, the new aircraft have much more space for doctors, nurses and patients. They carry all the required medical equipment and are fitted out rather like a flying intensive care unit.

Fortunately navigational aids and aircraft have improved over the years allowing all-weather and night flying so that there are hardly any remote areas the RFDS cannot reach - safe landing at the remote areas is another issue however.

Airstrip length requirements vary with the different aircraft used. They range from 800m to 1100m. Because most strips are not used continually, it has been the practice to test them by driving a motor vehicle over it prior to each landing to make sure it is safe for the aircraft to land.

Many of the outstations have some form of airstrip lighting but there are occasions when car headlights or other methods must be used to light the strip for a night landing.

Until the 1960s, the Service rarely owned aircraft, using contractors to provide aircraft, pilots and servicing. The RFDS progressively began to purchase aircraft and employ their own pilots and engineers.

Although the aircraft are guided by satellite navigation systems, landings must often be made in difficult circumstances on remote dirt airstrips or roads, lit at night by kerosene flares or car headlights.

As when the Service first began the Pilots continue to be responsible for determining if the flight can be safely undertaken in the prevailing weather conditions.

In the early 1900s most city dwellers viewed the Australian Outback with a sense of romanticism, in part fuelled by tales of the goldrush and promises of fortunes from the land. The reality was quite different - for every successful adventurer striking it rich a hundred more struggled to survive.

For many the isolation and loneliness could cause terrible depression and in the case of sudden sicknesses or serious accidents the brutal fact was that death was often the result.

Communication was virtually impossible. Basic telephone and telegraph links existed only near larger towns, radio communication was practically unknown and neighbours could be hundreds of miles away.

'Without a wireless transmitting station at every isolated homestead, an Aerial Ambulance Service would be 75% futile.' JOHN FLYNN

One of the greatest problems when the Service first started was the lack of radio communications between the base at Cloncurry and outstations. The Flying Doctor service relied on telephone links between towns and settlements and on people physically travelling long distances for help.

What was needed at the outstations, which could include cattle or sheep stations - huge grazing properties, small settlements, missions and police stations was a portable, cheap and reliable two-way radio, with a range of 500 kms. It also needed to be simple enough to be operated by an untrained person and have its own power source.

This was a tall order in those days when radio was still in its infancy.

Flynn had developed an interest in the emerging field of wireless around 1920 and he saw the potential for wireless to provide outback communication. The early technology, however, was cumbersome, complex, expensive and unreliable - wholly unsuitable for the tough inland conditions Flynn was so familiar with.

Flynn and some other enthusiasts began to build more portable, robust equipment and took several wireless sets into the outback to experiment. Voice communications proved impossible due to the low power levels available, so Morse code was used.

In 1925 John Flynn met Alf Traeger, an Adelaide engineer, and soon Traeger was employed as a radio expert and electrician by the Australian Inland Mission (AIM). Within a few months the pair had established Morse code communications across a distance of 140 kilometres.

Traeger next set his mind to the problem of power generation for wireless transceivers. Previous experience with generators, and his engineering qualifications, led him to invent a hand-cranked generator, a cheap and durable solution which provided sufficient power, but required two operators - one for the generator, and another for the radio itself.

A spectacular demonstration of the new system was staged at Cloncurry, in far western Queensland for Melbourne Cup Day 1927. The excitement and possibilities for these new inventions were obviously enormous. After various experiments, Traeger found that it was too difficult for an operator to use one hand to turn the handle while the other hand was used to operate the Morse key. Traeger overcame the problem by equipping the generator with pedals and so the famous pedal wireless was created.

Flynn, and Australia, had the solution to the communication problems of the Outback.

The Cloncurry Base radio station became operative in 1929 and the first of the outstations were equipped with Traeger pedal transceivers that year.

When the first pedal radios were distributed, the wives and daughters on stations who operated them had to learn Morse Code. The first major development in the manufacture of the pedal sets was the introduction of a keyboard transmitter which when the required key was pressed, sent out the correct Morse signal.

In the mid 1930s voice communication made the task even easier and the radio sets could be operated with car batteries replacing the need for pedal power generation.

The advent of Alf Traeger's Pedal Radio in the late 1920s and early 1930s brought a significant change to life in remote places. This change was more far reaching than providing help in emergency medical situations - it also helped reduce the isolation and loneliness by enabling people who lived hundreds of kilometres apart to speak with each other. People were still physically isolated from each other but the loneliness for many was eased as help and friendship was now only a call away.

Women took on the role of Radio Operator on the stations and quickly developed a bush community over the air. In time the 'Galah Session' developed which allowed a chat among neighbours who could be hundreds of kilometres away. This Session was named after the noisy, chattering, grey and pink native parrot. The Very Rev Fred McKay who succeeded John Flynn as Superintendent of the Australian Inland Mission said of Traeger:

'He created a social revolution. Human relations were transformed. In a very real way he made Outback Australia.'

For many years the RFDS was the key communication point for people with Flying Doctor radios, both fixed in homes and portable in vehicles.

In the 1970s the Service faced a major re-equipment program with the introduction of the single sideband mode of transmission. These new sets were more reliable and efficient and less subject to static interference.

With the development of telecommunication systems, the telephone is increasingly taking the place of radio communication and there is a gradual decline in this area of the Flying Doctor service.

Whereas a few years ago, all calls for medical assistance were received by radio, today this represents only about 2% of all such calls.

Despite this decline, communications continues to be the vital link between a patient requiring medical assistance and the RFDS.

With the onset of satellite technology which now offers satellite telephones both for vehicles, and in the near future, hand held telephones, it will have an even greater effect on the decline in HF radio usage. There is still the need to protect the small number of people who must by circumstance rely on our HF radio network - small communities who cannot connect to the standard telephone, mobile users including exploration camps, Aboriginal outstations, tourists and as a backup to the standard telephone in remote areas.

When an emergency call is received by a Flying Doctor Communications Officer, they can be in contact with a doctor, nurse and pilot within 30 seconds and an aircraft can be airborne within 45 minutes. Today people are still isolated but with the RFDS network of bases across Australia, no one is more than two hours away from medical help.

The famous 'School of the Air' which began in 1951 in Alice Springs has until recent years utilised the Flying Doctor Radio network to link children and their teachers and conduct a program of education which includes all the usual subjects taught in city primary schools. With improvements in technology there is now no need to use the RFDS radio network; telephones and the internet have become the methods of communication. The organisation was also re-named in the mid 1990's to become The School of Distance Education. They are still permitted however to use the more romantic name of 'School of the Air'.

High frequency radios are still recommended for people travelling in remote areas. When tourists and 4WD enthusiasts are planning outback trips they should contact a Flying Doctor Base to ensure they are equipped with the appropriate communications equipment and information.

Since 1928 the Service has grown into one of the most respected organisations in the world. Covering an area equivalent in size to Western Europe, it now operates from 20 Bases, 24 hours a day, 365 days a year.

No longer is the RFDS just for the people of the outback. Flying Doctor territory is just one hours drive out of most capital cities in Australia.

With the improved condition of roads and facilities in the outback, the Service is also becoming more involved with the ever increasing number of tourists visiting Australia's remote locations.

Today Flynn's dream of a 'Mantle of Safety' continues to be there for us all.