Q&A with Emma Lawrey

Questions and Answers

What do you do in “EM Out There”?

The stuff that I do, I feel like it’s slightly different from development emergency medicine, because it’s often not based in an emergency department, and it’s more around how to set up a health facility in an austere environment where you don’t have water, power, roads, communication… so it’s more about emergency response than it is about pure emergency medicine. I’ve learned heaps of stuff about WASH and generator kVAs and power and what power level a hospital sucks and what water amount a hospital needs…

What’s WASH?

Water, sanitation and hygiene. If you look at global inequities in health, what will make one of the biggest differences will be clean water. It is almost the basis of health – water and sanitation. If you really want to improve those health care facilities and global health, in many places it is about water and sanitation and having power… being able to provide lighted facilities where people can work at night, but also lighted community facilities, like toilets, that are safe for people, particularly women. And things we take for granted, like oxygen  – we had seen that in Samoa with the measles outbreak. And again in the pandemic in India. Doctors and nurses are great but they can’t work without their tools.

How many countries have you been to, in the South Pacific?

Working? Some of it is capacity building, and some of it is response, so it is probably 3 or 4 response, and then capacity building… most of the South Pacific. And some of the Northern Pacific as well… Fiji, Tonga, Cook Islands, Samoa, Solomon Islands, Papua New Guinea, CNMI, Vanuatu… haven’t been to the Marshall Islands, or Tuvalu, Kiribati…

What’s your favourite?

Ooh! That’s a politically… I have a soft spot for the Solomon Islands. I made some good friends there. It was the first place I went to do capacity building, not response, it was really different for me, a real eye-opener.

Do you ever wear flowers in your hair?

I do. Sometimes. In the right environment. Sometimes put there by my children. I wear a ring of them like at a music festival…

You helped deliver a COVID vaccine programme in the Cook Islands. Are there any anti-vaxxers there?

Only a few. Very few. They probably have one of the highest vaccine coverage rates, certainly in the South Pacific and possibly in the world. They are generally pro-vaccine. We were supporting them to do their own vaccine roll-out. It was very organised, very effective. Interestingly they were much less affected by the rumours and the social media that affected Papua New Guinea, for instance.

Where did you grow up?

Canada

Choose: sand or snow?

Mountains. Snow or not.

What sort is your dog?

She’s a retriever poodle mix. A retrodoodle.

What was your toughest deployment?

Emotionally, the measles outbreak in Samoa. Because it was a paediatric emergency. Almost all of the people who were dying were young children, and that was emotionally very draining for the team. Everyone came back feeling pretty horrendous. But the vaccine programme they delivered was really effective.

Are Australasian EDs ever anything like real disaster zones?

Emergency departments across Australasia are under a huge amount of pressure at the moment. We’ve had a really bad week, last week, influenza A, but it’s not just that. These are unprecedented numbers presenting, incredible wait times, we don’t have enough staff for these patients, not enough beds. It doesn’t compare to a sudden onset disaster like a tsunami or an earthquake… But there’s an end in sight for a disaster. Measles, there was a vaccine that worked. The crisis that is happening in Australasia, it doesn’t have an end. There is no vaccine against not enough beds, not enough staff.

What is your favourite comfort food?

White bread with butter.

SCUBA or snorkel?

I love SCUBA but it’s got too much equipment. Snorkel.

Have you ever broken a bone? One of yours.

I broke my ankle rock climbing. And I blame it for the complete deterioration in my running. Now that entire side of my body doesn’t seem to work so well.

So what are you doing today?

Bike ride.

Emma Lawrey will be presenting at the Spring Seminar on Emergency Medicine, Noosa, 18-21 October 2022