Air Travel in Australia: Royal Flying Doctor Service
The Royal Flying Doctor Service of Australia, which provides emergency and primary health care services for those living in rural, remote and regional areas of Australia who cannot access a hospital or general practice due to the vast distances of the Outback, is one of the largest and most comprehensive aeromedical organisations in the world.
Its founder, the Reverend John Flynn, had worked in rural and remote areas of Victoria and was commissioned by the Presbyterian Church to look at the needs of Outback people. His report to the Presbyterian Assembly in 1912 resulted in the establishment of the Australian Inland Mission (AIM), of which he was appointed Superintendent. In 1928, he formed the AIM Aerial Medical Service, a one-year experiment based in Cloncurry, Queensland. This experiment later became The Royal Flying Doctor Service.
Flynn's missionary work involved the establishment of hospitals in bush communities. This, however, did not help those who lived far from any major community. In his public speaking he would often retell the tragic circumstances that had befallen several bush settlers. The fate of Jimmy Darcy, in 1917, was one of these stories.
Darcy was a stockman at Ruby Plains, a remote cattle station in Western Australia. After being found injured, with a ruptured bladder, by some friends, he was transported over 30 miles (12 hours), to the nearest town, Halls Creek. Here, Darcy was met by FW Tuckett, the Postmaster, and the only man in the settlement trained in first aid. Tuckett said there was nothing he could reliably do for injuries so serious, and tried unsuccessfully to contact doctors at Wyndham, and then Derby, by telegraph. He eventually got through to a doctor in Perth.
Through communication by morse code, Dr. Holland guided Tuckett through two rather messy bladder operations using the only sharp instrument available, a pen knife. Due to the total absence of any medical facilities, Darcy had been operated on strapped to the Post Office counter, having first been made insensible with whisky. Holland then travelled 10 days to Halls Creek on a boat for cattle transport, a Model T Ford, a horse-drawn carriage, and even on foot, only to find that Darcy had died the day before. The operations had been successful, but the stockman had died from an undiagnosed case of malaria and a ruptured abscess in his appendix.
It was from stories such as this that Flynn, and his following at the AIM, became inspired to develop a route of communications that could solve the problem of remoteness. However, no feasible technology seemed apparent.
Victorian pilot Lieutenant (John) Clifford Peel had heard Flynn's public speeches, and on being shipped out to France for World War I in 1917, sent Flynn a letter explaining how he had seen a missionary doctor visiting isolated patients using a plane. Assisted by costing estimates by Peel, Flynn immediately took the idea of using aircraft to begin his idea, and published Peel's idea in the church's newsletter. Peel died in combat in September 1918, probably not even knowing the impact he had in the creation of an Australian icon.
Along with motorised flight, another new technology was being developed that could replace the complicated means of communication by telegraph. Together with Alfred Traeger, Flynn began experiments with radio in the mid-1920s to enable remote outposts to contact a centralised medical base. The pedal radio was the first result of this collaboration. These were distributed gradually to stations, missions and other human residences around Cloncurry, the base site for a 50-watt transmitter.
Experimental aerial medical services commenced in 1926 and an injured miner was transported by air from Mount Isa to Cloncurry in November 1927. By 1928, Flynn had gathered sufficient funds through fundraising activities to launch the experiment of the AMS on 15 May. Its supporters included industrialist HV McKay, medical doctor George Simpson, and Hudson Fysh, one of the founders of Queensland and Northern Territory Aerial Services, the company which would go on to become Qantas. Qantas supplied the first aircraft to the fledgling organisation, VH-UER a De Havilland DH.50, dubbed "Victory". On 17 May 1928, two days after inception, the service's first official flight piloted by Arthur Affleck departed from Cloncurry, 85 miles to Julia Creek in Central Queensland, where the plane was met by over 100 people at the airstrip. Qantas charged two shillings per mile for use of the Victory during the first year of the project.
Within the first year of operations, the service flew approximately 20,000 miles in 50 flights, becoming the first comprehensive air ambulance service in the world. The service persisted through difficult first years, dealing with postwar Australia and the Great Depression of the 1930s. During its first few decades the service relied heavily on community fundraising, volunteer support and donations. Nowadays, the service is supported by the Commonwealth, State and Territory Governments, but still relies heavily on fundraising and donations from the community to purchase and medically equip its aircraft, and to finance other major capital initiatives. Until the 1960s the service predominantly hired aircraft, pilots and service technicians from contractors. After this point, the service moved on to purchasing its own equipment and employing its own pilots and mechanics.
In 1932, the success from its operations in Cloncurry, and the increasing public awareness to this vital rural service, resulted in a push for a national network of flying doctors, hopefully with sponsorship from the government. In 1934 this was realised with the new Australian Aerial Medical Service opening up "Sections" across the nation. Bases were set up in Wyndham, Port Hedland, Kalgoorlie, Broken Hill, Alice Springs and Meekatharra. The Queensland experiment was expanded with two additional bases opening in Charters Towers and Charleville. An official Federal Council for the organisation was formed in 1936. In 1937, Dr Jean White became the first female flying doctor in Australia, and the world, when she started work at Normanton. In 1942 the service was again renamed as the Flying Doctor Service, with Royal being bestowed upon the service in 1955. On 22 October 1958, Holden car manufacturers donated their 500,000th vehicle to the service in Melbourne.
Sister Myra Blanch was one of the first nurses, known as "Flying Sisters", to join the service. She was key in the New South Wales Section operations during the 1940s and 50s, even though Flying Nurses didn't actually become regular until the 1960s. Many patient transports are conducted with an RFDS nurse and pilot only on board. Nurses have been responsible for many innovations to the service, including an addition to the RFDS medical chest to incorporate a "body chart" (1951). The chart was an anatomical representation of a human being, with areas clearly numbered. With such a chart, a remote doctor can ask the patient "where is the pain felt?" and receive a comprehensible reply. The medicines contained in the chest are similarly numbered for ease in communicating medical instructions.
The service is still heavily reliant on community support for funding, and is well respected across the country as an organisation that has contributed much to rural, regional and remote communities.
A Hawker 800XP2 at Broome Airport. The aircraft is sponsored by Rio Tinto Group.
The first aircraft operated by the "Aerial Medical Service" in 1928 was a de Havilland DH.50 hired from the fledgling Queensland and Northern Territory Aerial Service (Qantas). It was replaced in 1934 by a DH.83 Fox Moth.
During the 1930s and 1940s the fleet consisted of a mix of de Havilland DH.50s, DH.83 Fox Moths, DH.84 Dragons, DH.104 Doves and the de Havilland Australia DHA-3 Drover.
From the 1950s to 1970s, the fleet included the Beechcraft Baron, Beechcraft Travel Air, Beechcraft Queen Air, Beechcraft Duke, Cessna 180, Cessna 182, Cessna 421, Piper Cherokee and Piper PA-31 Navajo.
Aircraft were provided by contractors until the 1960s. Subsequently, the RFDS owned its own aircraft and employed its own pilots and engineers.
In the 1970s and 1980s the RFDS base at Broken Hill operated the Australian-made GAF Nomad. From the 1980s to 2000s, the fleet included the Cessna 404 and Cessna 441.
For a time in the mid-2000s the aeromedical evacuation aircraft used were either the Pilatus PC-12 or the Beechcraft King Air 200 series. The internal configuration of these two aircraft varies in the different RFDS sections. Typically they are configured with two rear-facing seats which look onto two stretchers. In some aircraft, one stretcher can be removed quickly and two seats slipped into place instead.
Both the PC-12 and King Air are pressurised and so can be used to safely transport patients who would not otherwise tolerate the decreased atmospheric pressures involved in non-pressurised aircraft. By flying at a lower altitude than usual, the internal cabin pressure can be maintained throughout the flight at sea level. This is important for patients critically sensitive to pressure changes.
In addition, pressurised aircraft can fly at a sufficiently high altitude to be above turbulent weather conditions. This is of great benefit in providing an environment safe for the patient and staff, and also limits complications of aeromedical transport such as motion sickness and exacerbation of injuries such as unstable fractures.
In October 2009 the standardisation on the two aircraft types ended when two Cessna 208B Grand Caravans and a Hawker 800XP joined the fleet.
Rev. John Flynn OBE
John Flynn OBE was an Australian Presbyterian minister who founded the Australian Inland Mission which later separated into Frontier Services and the Presbyterian Inland Mission, as well as founding what became the Royal Flying Doctor Service, the world's first air ambulance. Educated at Snake Valley, Sunshine and Braybrook primary schools, he matriculated from University High School in Parkville in Melbourne, aged 18. Unable to finance a university course, he became a pupil-teacher with the Victorian Education Department and developed interests in photography and first aid. In 1903 he began training for the ministry through an extra-mural course for 'student lay pastors', serving meanwhile in pioneering districts of Beech Forest and Buchan. His next four years in theological college were interspersed with two periods on a shearers' mission and the publication of his Bushman's Companion (1910).
Always thinking of the needs of those in isolated communities, in September 1910 Flynn published The Bushman's Companion which was distributed free throughout inland Australia. He took up the opportunity to succeed E. E. Baldwin as the Smith of Dunesk Missioner at Beltana, a tiny settlement 500 kilometres north of Adelaide. He was ordained in Adelaide for this work in January 1911.
The missioners visited the station properties in a wide radius of Beltana, and their practical and spiritual service was valued in the isolated localities. Flynn used it as an opportunity to look at the potential for something bigger. By 1912, after writing a report for his church superiors on the difficulties of ministering to such a widely scattered population, Flynn was made the first superintendent of the Australian Inland Mission which became Frontier Services. Flynn's vision was to establish a 'Mantle of Safety' for the people of Outback Australia. As well as tending to spiritual matters, Flynn quickly established the need for medical care for residents of the vast Australian outback, and established a number of bush hospitals.
By 1917, Flynn was already considering the possibility of new technology, such as radio and aircraft, to assist in providing a more useful acute medical service, and then received a letter from an Australian pilot serving in World War I, Clifford Peel, who had heard of Flynn's speculations and outlined the capabilities and costs of then-available planes. This material was published in the church's magazine, the start of Flynn turning his considerable fund-raising talents to the task of establishing a flying medical service. The first flight of the Aerial Medical Service was in 1928 from Cloncurry, Queensland. A museum commemorating the founding of the Royal Flying Doctor Service is located at John Flynn Place in Cloncurry.
He retired and died in Sydney on 5 May 1951. He was 70 years old. He was cremated and his remains were placed under a large boulder from the Devils Marbles. The Northern Territory Department of Public Works had taken the rock from a site sacred to its traditional owners, but after many years of negotiations the rock was returned to its original location in 1998. It was replaced with one acceptable to the Aboriginal people, both of the original rock's home and the people on whose land his grave lies.
The land adjoining the grave site was proclaimed as a reserve on 21 March 1957 and became a historical reserve known as the John Flynn's Grave Historical Reserve on 30 June 1978.