Emma Lenz had painful, unexplained blisters on her hands for three weeks before she could get an appointment to see a doctor.
She was diagnosed with shingles, a virus that can cause extremely painful sores but can be treated with a simple dose of antivirals — if it's diagnosed within three days of symptoms appearing.
"It is really difficult when your hands are blistering and you need to get swabbed to find out what it is and then you have to wait three weeks, and by then the blisters are gone," she said.
Ms Lenz lives just outside Warwick, a two-and-a-half-hour drive south-west of Brisbane.
Like so many other people across Australia, she has often had no choice but to go to her local hospital emergency department to seek medical treatment because she has been unable to get an appointment with a GP.
"It's embarrassing because you have it drilled into you that ED is for emergencies only, and in the city, that's fine," she said.
"You're putting all that pressure on the hospital system, just for prescriptions and for painkillers."
Ms Lenz moved from Sydney to Warwick four years ago, following the allure of cheaper housing.
Her son Bodhi, who has autism, came with her but has since gone to live with his father because there are not enough support services for him in Warwick.
Now, Ms Lenz is homeless and is not sure that the trade-off of sacrificing affordable quality health care for a chance to find a cheaper home was worth it.
"They sell you this myth that 'move to the country, it's cheaper for housing'," she said.
"But you can't get sick out here, you can't have a kid with a disability out here, because you'll lose everything. You're on your own."
Ms Lenz lives in a caravan on a friend's property out of town, a situation she blames on her poor health.
She was working in two part-time jobs when she became ill, but was told not to come in to one while she was sick, and has been on unpaid sick leave for a year from the other job.
"Sometimes my left arm just doesn't work. To get a diagnosis I need a test that costs $700 and I just can't afford that," she said.
She said that applying for new jobs was not realistic as she didn't know what days she would be sick or unable to use her arm.
To add to her misery, after three years and 11 bouts of painful illness, she discovered she had been misdiagnosed, and was actually suffering from Whitlow virus, which could lie dormant and reappear at anytime.
She has been navigating the complicated Centrelink system to receive some cashflow, and is living off about $400 per week.
Specialist appointments can run to $300 per visit, plus the drive can cost $70 in petrol.
"To be shut out of health care because I'm poor is devastating. I just think, 'How much harder do I have to work?'," Ms Lenz said.
"I just … have to live with it now and wait and see if it's going to kill me or if it's just going to go away on its own."
The ABC wants to hear your story
Stories like Emma Lenz's are common across rural and regional Australia, which has faced a health worker shortage for years.
Today the ABC is launching the Regional Health Project, an initiative that is asking the nearly 30 per cent of Australians who live outside the big cities to share their stories of trouble accessing the health system when they needed it.
The investigation is not about focusing on one hospital, or a town that's been left without a doctor — it's about showing how the whole health system is collapsing across rural Australia.
Anyone involved in the rural health system, including patients and friends or families of patients, is welcome to share their story with the ABC here or on the form at the end of this article.
While larger country towns on average slightly exceed the number of GPs compared to cities per 100,000 people, those categories include most of Australia's coastal fringe, which experts say attracts a disproportionate number of doctors.
In smaller country towns, the number of GPs is much lower and in the most remote parts of Australia, GP numbers are chronically low and continuing to fall.
Rural and regional Australians also have worse health outcomes and shorter life expectancy rates than their city cousins, according to the Australian Institute of Health and Welfare.
The median age of death for men in capital cities is 79.6 years, compared to 65.7 years for men in very remote parts of the country.
For women, the gap is even bigger at 85.2 years in the cities and just 66.2 years in very remote communities.
Regional and remote GPs are also more likely to be planning to retire in the next 10 years, according to the Royal Australian College of General Practitioners.
Crucially, they are not being replaced, which means the healthcare crisis is only going to get worse.
Travel puts huge strain on families
It's not just access to GPs causing issues; all parts of the health system have been failing regional Australians for years.
Daisy Williams, who lives in Broken Hill in far west New South Wales, needs to see a range of specialists to treat multiple health issues.
Each appointment means she has to fly to Adelaide, and stay for at least two nights.
"The more complex neurology they can't do here, but things like the kidney stent that I had put in in December, I don't understand why they couldn't do that in a place like Broken Hill," she said.
Ms Williams, a single mother, said the constant travel was putting a strain on her family life.
"I had to get flown to Adelaide just before Christmas and I was really worried that I would miss Christmas with my family, and my son was really upset that he wouldn't have me there," she said.
"He gets really upset when I have to go every time and I thought he was old enough to mask it.
"But this last trip away he got really, really angry that I had to go and he just unpacked everything out of my suitcase and told me, 'You're not going'.
"I had to go down and see the neurologist, it was an appointment that I'd been waiting on for months.
"It's not something that I can put off and I had to repack my suitcase and apologise and explain to him that yes, I did need to go."
While Ms Williams gets most of her travel expenses refunded through a NSW government scheme for isolated patients, she needs to find about $900 up-front for flights and accommodation.
That's a big ask, as she is routinely relying on family members in Broken Hill to help her out with things like groceries.
If she forgets to take a form to Adelaide, or forgets to have a doctor sign it, she can be left further out of pocket.
"I'm low functioning in some areas and doing things like getting paperwork done is one of those areas where I don't function so well," she said.
Like Ms Lenz, that puts her in a precarious housing situation.
"I'm frequently behind in my rent and then I have to make up for that when I get the the money back."
Ms Williams' son also needs to travel to Adelaide to see specialists, but he has a sensory processing disorder, which means they can't fly.
Instead they must catch a bus for the 500-kilometre road trip to Adelaide.
"If he was living in Adelaide, a specialist appointment for him would be maybe a couple of hours off school," she said.
"It's really frustrating for him, that's a whole chunk out of his education that he's missing and he misses his friends."
She said she frequently wondered whether she should just move away from her home town to Adelaide to access health care.
"[But ] I've got my safety net here and my mum, and it's a big move," Ms Williams said.
A spokesperson for the Far West Local Health District said in a statement that kidney stent procedures could be done in Broken Hill, depending on the type of stent needed, the patient's circumstances and the availability of visiting urologists.
The spokesperson said anyone needing a kidney stent would be transferred to a different facility if there were no urologists visiting at the time.
'I was terrified'
For Cheryl Malloy, not being able to see a doctor was life-threatening.
She spent about four hours waiting in an ambulance on a ramp outside a regional hospital as a bleeding internal ulcer caused her to drift in and out of consciousness.
After first being taken to hospital in Ballina on the NSW north coast, where she lives, Ms Malloy was sent on to the larger Lismore Base Hospital.
"I've since found out that a bleeding ulcer is actually life-threatening," she said.
"I was terrified, not at the time, but afterwards.
"I got post-traumatic stress disorder and anxiety after that particular episode that needed to be treated, because I just became very, very anxious about whether or not, if I had another episode, I would actually make it to the hospital."
Ms Malloy was emphatic in her praise for the hospital and ambulance staff, but said the system failed on the day she needed it most.
"It was just that the hospital was jammed full of people and they couldn't get any more in," she said.
Ms Malloy has since had another bleeding ulcer, but was rushed straight to the emergency department without any delay.
While hospital ramping is common in big cities, Ms Malloy said the distances involved in transferring patients from small rural hospitals to larger base hospitals put country people at a disadvantage.
"I don't know whether it's worse in the country or worse in the city, but I certainly feel that the distances in the country and having to rely on ambulances to get you from one hospital to another hospital probably makes it fairly time critical," she said.
A spokesperson for the Northern NSW Local Health District said in a statement that the number of people heading to the Lismore Base Hospital emergency department increased by 28.7 per cent in the quarter Ms Malloy was ramped, compared to the same time in 2020.
The spokesperson said increased precautions due to COVID-19, plus staff furloughing, placed significant pressure on the hospital.
If you can't view the Regional Health Project survey on your phone, click here.
