Medicine at the Mill

A GP at the Kawerau and Tokoroa timber mills, Dr. Sarah Gardiner, 38, took over the in-house clinic when it was about to close. Sarah (Ngāti Hine, Ngāpuhi, Te Aupōuri, Te Paatu) is also a mum of three tamariki ages twelve, six and one, and has since ventured into telehealth to bolster medical support for remote workers.

Tell us about your upbringing. I grew up in Kaeo with my dad. He worked as a skipper on Whangaroa Harbour. Before high school I moved up the road to live with my nana on our whānau farm in Orauta. She was the farmer and it was my job to look after visitors and the house. It was a working farm, but not commercial. We’d sell our cows to pay the rates, and Nan still shoots possum skins to generate income as well.

When did you decide to become a doctor? It wasn’t ever something where I didn’t think that’s what I was going to do – I just knew. I remember I saw an article in Mana magazine about Jeremy Stanley, who was the first All Black to become a doctor. At the time, there was nobody around doing both sport and medicine – so that article affected me a lot. I also remember Nan had these anatomy colouring-in books, which seems weird, but they were so good because they were the same ones we ended up using in med school. I also think I have a strong empathy for people, that’s just my natural personality to try and be helpful, so that was the main driver for me to study medicine. Back then Mana magazine and books were my window to the world.

How did your upbringing help you at med school? My nana and her sisters are all quite nurturing, and they brought me up as a group. There were a lot of experiences I’d had that were like healthcare. I learnt Reiki when I was seven, rongoā as well, and being part of circles and spiritual development. When I went to med school, on the first day of working with human bodies there was a nanny who took us through a pōwhiri and did karakia because there were fifty dead bodies on the tables. It was definitely overwhelming, but I’m so glad she was there to do that. Some dealt with that with humour and detachment, but those of us with the kinds of upbringings that I’d had, we found our own ways to cope using our tikanga.

What led you to the mill? I did my training in Tauranga and Whakatāne hospitals and spent a couple of years there. My husband is from here. We met at med school and started as friends. After our big girl was born, we went to Whakatāne for three years, bought a house there which we loved, but when Te Puna Ora o Mataatua were sending GPs over to the mills in Kawerau and Tokoroa, I was just like, “I’m going!” Over the years I got really attached to everyone at the mills. When the clinic was closing, they asked if I’d take over and run it. Over a weekend I hired the nurses, became the account holder for all the technology, they sold me all the equipment and I’d leased the space! The rest of the mills carried on, and I signed contracts with them for three years so we’d have income, because there was no public funding.

And now you do telehealth – how do you manage that as well? People think I do a lot, but I’ve got things pretty automated. There’s a great group of local nurses at both mills and we are a team. When I fell pregnant with my third child I hired another doctor and everyone loved him, so I’ve kept him on. He travels from here a few days a week, and so do I, but the nurses handle the day to-day walk-ins and first aid. These companies lose so much on inefficiency – absences due to waiting for scans, ultrasounds, med certificates – when you’re actually safe to do certain levels of work. We ended up becoming, I think, New Zealand’s first fully remote workplace clinic, where we’d connect with remote workers on video conference. It’s meant that I get to spend a lot of my days back in my māra kai and with my tamariki.

What does this medical model mean for remote workers? When there’s no doctor in the town, when you’re it for hundreds of guys, it just works. A lot of the guys are Māori, so are already in that deprivation space. They might have good incomes, but it doesn’t go to their health. If I can get international investment in that, I will, because then they’re getting skin checks, prostate and cancer checks, bloods, ECGs, hearing tests – everything. Now physios are coming to us with guys they’re working with and we can all get on a call and hybrid what their return to work looks like by working collaboratively. Not relying on the government has meant I get to design a service that the people need, and that’s the really great part.

Glossary. Karakia, ritual chants. Māra kai, gardens/gardening. Pōwhiri, welcoming ritual. Rongoā, traditional medicines, plant medicine. Tamariki, children. Tikanga, customs, lore, correct procedure. Whānau, family.