Dermatologist’s dream became flood nightmare

Dr Ken Gudmundsen is the only full-time dermatologist in the NSW Northern Rivers area. In the aftermath of the worst flood in modern Australian history, his personal story highlights the plight of healthcare workers in the Lismore area – especially the frustrations dealing with bureaucratic inaction and delays – but also provides inspiration and resilience leadership to many others in the face of adversity.

Running your own business is many practitioners’ dream – but things don’t always work out the way you planned.

On 28 February 2022, the biggest flood in modern Australian history inundated the city of Lismore and the rest of the Northern Rivers district of NSW.

Lismore – 734km north of Sydney and200km south of Brisbane – has a population of 29,000 and sits on a low floodplain on the banks of the Wilsons River near its junction with Leycerster Creek; both are tributaries of the Richmond River, with a catchment area of 6,860km2 (6th largest in NSW) and entering the Pacific Ocean 30km to the east at Ballina (population 18,600)

The majority of homes on the Lismore flood plain are two storeys high, placing them safely above the previous record February 1954 and March 1974 floods from the Wilsons River which reached 12.15 metres.

However, during the four days leading up to the February 2022 disaster, three rain episodes occurred. ‘Under usual conditions each would have generated a moderate flood, but cumulatively they created a catastrophe, particularly the last downpour, when freezing raindrops described as the size of a small fist fell with ferocity,’ reported The Sydney Morning Herald.

As the 28 February flood level peaked at 14.4m, ‘homes and businesses in parts of the city that had never been flooded before found themselves under water for the first time, in a flooding event that affected more than 31,000 people across the local government area’.

Lismore’s CBD was cut off, with major roads in and out of the area closed, including the region’s major link across NSW’s Northern Tablelands, the Bruxner Highway.

Atop a hill two blocks from Wilsons River, St Carthage’s Cathedral sat well above the highest flood levels recorded in the city’s history (the 12.15m in 1954 and 1974). With its floor height nearly 13.9m above sea level, the cathedral also sat far higher than the 1 in 100 year flood level of 12.38m and slightly above the forecast maximum level for a 1-in-500-year flood event of 13.4m.

But on February 28, the height of floodwaters exceeded the worst-case scenario – and the landmark cathedral was engulfed for the first time since it opened in 1907.

Down the hill, alarmed at the ‘speed of rising waters’ and with ‘SES volunteers overwhelmed’, an impromptu and untrained local community flotilla – featuring tinnies, jet skis and surfboards – was cobbled together and began the urgent and risky task to rescue hundreds of trapped residents. Eventually the bodies of four people who died in the Lismore floodwaters were recovered.

Twenty-four hours after Lismore went under water, residents downriver at Woodburn, Coraki, Broadwater and Wardell were similarly overwhelmed and had to be rescued, with people in low-lying parts of South Ballina initially warned to ‘prepare to evacuate’, before being told it was too late to leave as floodwaters began cutting off exit routes.

Nearly 10,000 people were immediately left homeless across the Northern Rivers – and 12 days later the deadly deluge returned and a fifth body was recovered among the debris. As well as the urgent necessity to house 10,000 homeless citizens, the Herald noted that with ‘essential business decimated and key infrastructure failing, all levels of government will need to act to rebuild from this catastrophic event’.

And that’s when Lismore dermatologist Dr Ken Gudmundsen’s campaign began.

‘Financially, physically, mentally broken’

After the February floods, AusDoc (ausdoc.com.au) highlighted Dr Gudmundsen’s story under the headline: ‘I am financially, physically, mentally broken: Dermatologist’s plea for help after floods.’

The story explained how he had used up all his savings and taken out a loan to stay open after the ‘worst natural disaster’.

The floodwaters had ‘destroyed most of his dermatology equipment, along with computers, furniture and practice rooms which were all uninsured’ – if ‘you’re in the 2480 postcode, that’s Lismore, insurers won’t offer you cover’. He doubted he can keep going with the minimal government assistance on offer’.

In desperation Dr Gudmundsen had written to his colleagues in the Australasian College of Dermatologists outlining his predicament; a colleague shared his letter on the GoFundMe website in an attempt to raise some of the $50,000 he needed to stay in business.

Who is caring for the carers?

Dr Gudmundsen posed a poignant conundrum to both authorities and the wider community: ‘We care for the community and patients. Who is caring for the carers?’

He described ‘an inland tsunami, a flood of disastrous proportions, a horrific rain storm that swirled above us for a week dumping a frightening and seemingly never-ending cascade of water… the destruction and chaos and life-threatening situations… the horror of it all and the heartache, despair and shock left in the wake’.

Accompanying those scenes were ‘the bravery of the community performing rescues and the generosity of people supporting and sheltering others… the professionalism of the medical and pharmacy fraternity coming together in makeshift emergency shelters… but amongst it all the destruction of Lismore’s private medical practices and pharmacies and paramedical practitioners – a significant occurrence, as Lismore is the hub of the region’s medical services’.

After the first emergency weeks, while ‘the clean-up continued, much of Lismore’s private medical structure lay in tatters, half destroyed as a functioning entit’: and in addition, Dr Gudmundsen now ‘felt a double whammy of both personal-financial ruin’ and the medical profession’s ‘helplessness to be able to assist the community to its full extent’.

Three months after the flood ‘many of us had suffered incredibly: the stress; the uncertainty; the financial impact; the cleaning; the planning of rebuilding… the recognition there will be no government aid coming to help Lismore’s private medical practitioners dawned on me’.

‘The government was seemingly unaware that a post-disaster emergency response – involving practical and financial support to doctors, nurses, paramedics, pharmacists and so on – given quickly and freely is essential to help them get back to work to provide care to patients and the community, in huge need of their help.’

A year spent campaigning

It was the start of Dr Gudmundsen’s year spent campaigning to gain financial support for flood-affected doctors and pharmacists. ‘Initially, you think someone will come and help, that some government agency, will offer money and support. We kept on waiting and waiting and still nothing happened.’

The first major event to call publicly for help was a Flood Crisis Meeting organised by the AMA on 16 September in Lismore: an emergency summit of healthcare leaders, AMA representatives, local politicians, doctors and pharmacists calling for a Healthcare Flood Recovery Grant.

‘It generated a lot of publicity and media coverage, but no government response – and that also came to nothing,’ said Dr Gudmundsen. ‘So it was all this oscillating between hope and despair for months and months, until we got to more of a realistic phase: that no one’s going to come and help us. We realised we’ve got to start pushing hard ourselves.’

In December the AMA issued a statement and declared: ‘state and territory governments are missing in action when it comes to supporting communities to access health care services following recent natural disasters’.

AMA President Professor Steve Robson, who had visited Lismore for the September summit, said 10 months on ‘there has been nothing from either the Federal or NSW Governments to assist healthcare providers in that region.

‘It’s been a horrific year for communities impacted by flooding… and both governments’ abject failure to support the ongoing healthcare needs of residents following these events is disgraceful.

‘Ten months ago, residents in Lismore NSW were hit by the worst flooding the area has ever experienced… Seven months after the disaster I was shocked to see many private healthcare services had received little to no funding from government and were still struggling to rebuild. Ten months on and I’m appalled. The lack of response from governments is a kick in the guts to the hardworking healthcare professionals in this region.

‘GPs, specialists, pharmacists, allied health professionals – all of whom provide vital care to the community – cannot offer the same service to residents because they lost thousands of dollars’ worth of medical equipment and millions in property damage.

‘This means many traumatised residents in the Northern Rivers region are not getting the healthcare they desperately need at this time.’ In early February 2023 – 354 days after the flood – Federal Minister for Health Mark Butler, Federal Assistant Minister for Rural and Regional Health Emma McBride and NSW Health Minister Brad Hazzard finally announced $5 million would be provided (via Health Practitioner Flood Grant) to Lismore health service providers, including general practices, specialist medical practices, pharmacists, dentists and other allied health providers.

Aftermath leaves $500,000 debt

In a second interview with AusDoc a year after the flood, Dr Gudmundsen shared how ‘time had stood still’ and that he was still not back in his original practice site due to the large amount of destruction of the building, and cost of repair.

‘I’m currently working at St Vincent’s Hospital, the local private hospital. We have three rooms to work out of, compared to eight rooms available before the flood. We have managed to rebuild a good specialist dermatology service in the hospital, but have had to stop a few services, such as phototherapy for skin diseases and patch testing to allergens due to space restrictions.’

He described his despair, depression and financial losses of more than half a million dollars. ‘As I waited for about 15 months before any financial assistance arrived, I took out a $200,000 loan and I used all my savings to keep going forward. I know other practices and pharmacies had similar or greater financial losses and really struggled.

‘Frankly, many practices like mine faced the stark choice of bankruptcy or fighting on, hoping for help and that things would get better eventually. That has had a huge impact on practitioners practically and philosophically. The feelings of being abandoned by government that this area has experienced will linger for a long time.

‘We were all in a kind of limbo for a long time and we’re all mentally traumatised. I think we’ve all got some form of post-traumatic stress syndrome.’

Strength through adversity

We spoke with Dr Gudmundsen most recently in August this year. ‘We have all come a long way, but I personally have a lot less energy and enthusiasm left. I am not the same person I was before the flood,’ he shared.

When asked what has given him the strength to keep fighting, he responded: ‘First of all my staff have been incredibly loyal and helpful, and my patients have been sympathetic, supportive and appreciative. The AMA was tirelessly supportive in advocating for us with the government agencies and politicians, as were our local politicians, Janelle Saffin and Kevin Hogan. The Grant would likely not have happened but for their efforts. The Medical Benevolent Association of NSW and the Rural Doctors Association of NSW were also incredibly kind and supportive.

‘In addition, Medpro Finance were really great to us. Ross Andrews, the director of Medpro, personally visited us a few days after the flood, and toured the areas of devastation with me, and offered help in the form of deferring repayments, refinancing and a low-interest loan. He has been a true friend in our times of need and financial low-points.

‘My hobby for the past few years is writing songs and playing guitar, and that is one thing that has kept me going over the last year after the flood. I perform a few originals at an Australian Songwriters Association night once a month in Lismore. Everyone is welcome to come along.

‘I look forward to the day that the flood and all its consequences are a distant memory.’ AMP