University of Melbourne Magazine

Podcast transcript – The War Zone Doctor

Val McFarlane: It wasn’t until her plane was touching down in Afghanistan that Dr Kat Franklin, a paediatrician from Melbourne, really started to think about what she’d let herself in for.

Dr Kat Franklin: I was trying to figure out how to put a headscarf on in a way that wouldn’t fall off. And I’d watched a lot of YouTube videos about how to pin it properly and tie it round, but actually trying to get it on in the plane, getting ready to get off and kind of start in Kabul, that was the moment where it kind of felt real to me.

Val McFarlane: How to fix a headscarf in place wouldn’t be the most serious problem she would face over the next six months. But it was something to focus on as she prepared to start work in one of the most unstable countries on earth.

Dr Kat Franklin: And in all honesty it fell off so many times and always in the middle of some kind of an emergency, where we were resuscitating a baby and I would be trying to ventilate the baby and get my headscarf back on. It was never an opportune moment when my headscarf was in the right place.

Val McFarlane: Kat had wanted to be a doctor from a very young age. She liked the idea of humanitarian work, and as a medical student at the University of Melbourne, she’d spent some time volunteering in Ethiopia. But she’d got horribly sick, and at the time thought it was one of the worst decisions she’d ever made.

She graduated, and went on to work at the Royal Children’s Hospital in Melbourne, and loved it. But then she went to a presentation on Medecins Sans Frontieres – MSF, or Doctors Without Borders. She decided to apply, setting her career on a very different path.

Dr Kat Franklin: I thought I’d be somewhere in Africa and I got this email saying we’ll be sending you to Afghanistan for six months to run a neonatal project. And I had a pretty big freak out.

Val McFarlane: Kat was based at an MSF maternity hospital in one of Kabul’s poorest suburbs. It was 2016, just months after an MSF hospital had been bombed in a US air raid.

When she arrived, the security situation was still precarious. But while it was the war that was grabbing the headlines, Kat found that the women there were fighting their own battles.

Dr Kat Franklin: We had a very well set up hospital, and I think the work that the staff did in Afghanistan, or still continue to do is amazing. They work very hard but they don’t have the resources that we have in Australia. So, in Afghanistan we had portable oxygen, so we could give babies oxygen. We could give babies antibiotics and keep them warm. We had feeding tubes to be able to feed them. But we didn’t have any of the extra support that you’d have in Australia. So if a baby was struggling to breathe with the basic level of oxygen, there was nothing more we were able to do for those babies

It was something that I’d expected. you understand that the resources you have in Australia are nothing like what you’re going to have overseas. We worked very hard with the team to get the best outcomes and sometimes it was stopping treatment which was something that I know the Afghan staff really struggled with because it was something that we spent a lot of time talking about and discussing and how we would manage it because it was something that’s not routinely done in their hospitals. It was something that they found particularly challenging.

Val McFarlane: After six months Kat returned to Melbourne and to the Royal Children’s Hospital. She was shocked by the contrast.

Dr Kat Franklin: I think I cried on that day actually. I was looking after a baby that had had the exact same problem that a baby had died from in Afghanistan because there was nothing that we could do for it. And to see a baby in Melbourne get surgery within maybe five hours of presenting, it was just so quick with all of the surgical teams, all of the nurses, and neonatologists and everything and just so different.

Val McFarlane: But she was hooked on working overseas. After Afghanistan, she lined up an assignment in another trouble zone – South Sudan. She was about to fly out when she learned she’d been shortlisted for a Sir General John Monash Scholarship, which supports Australians with leadership potential to study abroad.

Dr Kat Franklin: The second interview was the day I left for South Sudan. So I arrived to the interview with my North Face bag on my back and that got put in the corner and I sat an interview in a very, very fancy boardroom and then jumped on the plane. When I was in South Sudan I found out that I got this scholarship to go to Oxford to do my Masters, to study international health and tropical medicine. Getting to go to Oxford, and experience life in Oxford, was crazy and something I never, ever thought would happen.

Val McFarlane: See that’s what amazes me, because that’s not the crazy bit, that’s seriously not the crazy bit.

Dr Kat Franklin: Until you arrive in Oxford. So I get to Oxford and we go to our President’s house in our college and he takes us up the stairs and he takes us past this beautiful Assyrian relief that’s just on the staircase and past a 15th century tapestry and then he takes us up to the old library and presses on a bookcase and the bookcase swings back and it’s a secret passage. Like we were in Oxford and there was a secret passage just like Harry Potter.

Val McFarlane: When we met, Kat was getting ready to head to Iraq for a second time.

Dr Kat Franklin: It’s pretty tough in terms of my friends and family and getting to see the people that I love. I realised I hadn’t seen my sister for about three years.

Val McFarlane: Is it something that you would recommend to medical students?

Dr Kat Franklin: One hundred per cent. The elective program that’s setup through the medical school allows you a chance to experience that. I meet so many people who say they wish they had of done it but then they ended up with family, or children, or a mortgage, or whatever it is, and didn’t get the chance. So it’s something to consider, and if it fits with your personality and it’s what you want to do, then go for it.

I don’t think you can ever be prepared because you face situations where really you just have to Macgyver some kind of a solution from whatever it is you have around you and you have to think outside the box and make things work with what you have.

It’s fun and it’s crazy and it’s hard but in the end, I feel like we’re proving medicine in a place where there wouldn’t otherwise be doctors or hospitals, and people wouldn’t have access to health care.

Val McFarlane: When she’s away, Kat misses Melbourne coffee, and Diet Coke, and the ordinary freedoms of life in Melbourne. She recalls only being allowed to go running where she lived in South Sudan if she had three security guards watching her.

But it’s all worth it when she sees the patients doing well. In particular, one little girl in South Sudan has stuck in her mind.

Dr Kat Franklin: She came to us and she was almost twelve months old and weighed as much as a newborn baby. She was horribly malnourished and she had tuberculosis. And her mother ended up passing away from HIV AIDS and tuberculosis. This little girl was so sick she couldn’t breathe. She was one of the sickest kids I’ve ever seen. And the sound of her breathing every day I was sure it was going to stop. I was so worried about her all of the time and it took probably two weeks before she started to breathe just a little bit better. Then she got to the point where she could just sit up if we wrapped her in enough blankets to give her some support. Then she started to reach out for things and then she’d always stare at you with these huge eyes but she’d never, ever, ever smile. I left and one of the national staff sent me a photo two months later of this chubby girl that I hardly recognised aside from these two beautiful eyes and they were those eyes that were always staring at me and she kind of was just smiling and I never thought she’d get better. And so I’m not gonna forget her. She’s my super special patient.

Val McFarlane: You’ve been listening to the 3010 podcast, written, presented and produced by me, Val McFarlane. Music by Rory Clark. Chris Hatzis was our audio engineer.

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