Medical staff in northern NSW have described the emotional toll the flood rescue and recovery has had on them.
"The tears take you by surprise at different times."
Nina Robertson broke down and cried as she recalled the events of the last fortnight in Lismore, where she, as a doctor, operates the Keen Street Clinic.
Floodwater inundated the surgery on the morning of February 28.
Dr Robertson was soon onboard a boat, responding to reports of a man having epileptic seizures on a roundabout in the middle of the flood zone.
Once he was stabilised and taken to hospital, she headed to the Goonellabah Sports and Aquatic Centre, where an emergency evacuation centre had been set up.
"So, I rendered first aid and started to set up a point where I could write scripts for people to get essential medications.
"Many of these residents had literally left with the clothes on their backs, or they'd packed some belongings which had floated away."
Makeshift clinic
Other medical professionals in the area had the same idea, with several GPs, surgeons and nurses also heading to the centre.
"So, within eight hours, we had a little operation set up in a small room to try and administer to the medical needs of these evacuees," Dr Robertson said.
"It's a constant triaging process. Who's in front of me now, who needs the most help, where is my emergency?
"We had some acute withdrawal from medication, seizures. We had chest pains, we had people on insulin who didn't have their insulin, so that can be quite dangerous."
Planning on the run
Just as the rescue effort on the water relied heavily on civilians acting on their own initiative, Dr Robertson said the immediate strategy to deal with the medical needs of those in evacuation centres was also made up on the run.
"Definitely in those first hours, and even day or two, there was no coordinated response," she said.
"That is something that will have to be looked at by people who have got more time, energy and pay than I do."
The record-breaking natural disaster, which came on the back of the COVID crisis, which came just after the Black Summer bushfires, has taken a toll on many of those who work on the frontlines.
"I recognise if I can take a broad view of what's happened to me that I'm having a very typical trauma response," Dr Robertson said.
"There's been that adrenaline and fight-or-flight response that's been buzzing for the last two weeks.
'Close to breaking point'
The welfare of frontline staff is an issue of concern for Healthy North Coast, which oversees the delivery of primary healthcare outside the region's hospital system.
"The cumulative stress that people have been under is really quite amazing," CEO Julie Sturgess said.
"It really is getting close to breaking point for some people.
"We've seen especially general practitioners just stepping up and being available in those evacuation centres, and it's just so critical.
Help on the way
Streetside Medics, the mobile medical service founded by 2022 Young Australian of the Year Dr Daniel Nour, is opening one of its medical vans in Lismore today.
It will provide a temporary hub for local GPs whose facilities have been damaged by the floods, allowing them to consult with patients in a purpose-built facility.
"I think there are so many pieces to the puzzle, and we are just one of those pieces," Dr Nour said.
"But I really do think that a purpose-built mobile GP centre, with all the equipment, consumables and resources ready to deliver a GP-led service, is exactly what the community needs at the moment."
Dr Robertson has now returned to her general practice, which has about 8,000 local patients, although she is working out of temporary rooms at the nearby St Vincent's Hospital.
Computer experts are trying to retrieve thousands of medical records from hard drives which were damaged during the flood.
But the practice may not have a long-term future.
Dr Robertson said the business did not have flood insurance because the premiums would have been about $200,000 a year, and the $50,000 being offered in recovery grants to private operators will not be enough.
"Fifty thousand dollars is nice, but it is nowhere near enough to keep us alive as a business, so in the longer term, we're going to have to have a very serious discussion about whether we continue to provide the care needs for this community."
"We're committed to the next six months to see our patients through safely, but they may lose us as a medical clinic in this area."
