On Wednesday we thought three counties in a day was good but today we did five, and the miles travelled now stands at 399 (half tempted to drive along the road to make it a nice round 400!). Following breakfast at the hotel, Ruth and I travelled to Dungannon, where we joined the Farm Families Health Check team for the day at Dungannon Mart, where a machinery sale was taking place.
This is an initiative, now in its fifth year, which was set up to allow farmers and their families to undergo simple health checks in a purpose built van housing two consulting rooms, in the community rather than having to travel to a hospital, which they are less likely to do. The service employs trust nurses and travels all over the province to shows and marts. It is part funded by the Public Health Agency and the Department of Agriculture, Environment and Rural Affairs and more information can be found here: http://www.publichealth.hscni.net/farm-families-health-checks-programme.
With the long summer break, this was my first ‘patient contact’ as such since May, and being in a van surrounded by loud working machinery certainly added something to the consultations. I was worried about my skills being a little rusty, but they weren’t as rusty as some of the machinery being bought and sold! Each client would have their cholesterol, blood pressure, weight, height and waist circumference measured, along with a questionnaire and a diabetes risk assessment. I was thrown in at the deep end and soon carried out all the tests while the nurse asked them all the questions. It was good to be dealing with patients again, although once again my small stature proved comical as I attempted to raise the bar to do the height measurements! Today was an opportunity to see just what a diverse collection of people farmers are, but also the varied problems they face, from physical health to mental health. One farmer remarked on how he’s eaten the same amount of food for his whole life, and his father before him, but it is only over the past 20 years that they have put on weight, and this is probably a consequence of the increasing mechanisation of the profession. While the farmers are there, the nurses take the opportunity to do general health promotion, with one of the main issues being skin cancer awareness. None of the farmers I saw ever wear sun cream, with many of them stating that it’s never that sunny. The Pubic Health Agency have developed something I think really useful – a little card with a UV ray detector, which tells you the level at which you should be wearing sun cream. They also talked about farm safety courses offered online, although computer skills did seem to be an issue for some, and gave them information about the services offered by Rural Support.
It is clear that this team do valuable work amongst the community, but still the majority of the farmers there showed no interest in finding out more about their health and looking after it. Although part of this can be attributed to the fact that many are male (I decided such a mart was the only place you would find where the queue for the men’s toilets was longer than the one for the women’s!), their profession and accessibility of services certainly play their part too. The more I see of different aspects of farming life, the more I think that the way to tackle health issues in farmers is at least partly through getting alongside them and getting them to champion your cause among their peers – one man appeared today flanked by two friends with a bad cut, and it was his friends’ ‘nagging’ that made him come into the van to receive first aid on it.
Week 1 is over today, and I think my highlight of the week was the day on the farm yesterday. Although it has been great to hear about the rural community in Northern Ireland, all of what we heard made a lot more sense to me and resonated on a deeper level once I had spent time with actual farmers. It was also good today to do some practical medicine, and to be reminded of why we are actually doing this module – because there is a real and deep need for better provision of healthcare for rural dwellers. Next week, I start off in a rural GP surgery where I’ll get to see the relationship between the primary care givers and the community they serve. You’ll have to wait until Monday for more moo-velous stories.