My Dad sang a song to me as I was growing up.

“It’s the same the whole world over, isn’t it a bloomin’ shame,
It’s the rich what gets the pleasure, and the poor what gets the blame.”

When you look at the state of healthcare around the world, it’s the poor what gets the blame alright, and the rural poor even more so.

Driven by the four horsemen of the rural apocalypse – distance, poverty, workforce statistics, and stoicism, rural health statistics across the globe are appalling.

Rural communities by definition are distant from the services available in urban areas, it takes longer for people to access care. Rural communities tend to be poor communities, people live a hand to mouth existence at the mercy of weather and crops. It can be hard to attract people with health care skills to work in rural places, and the “she’ll be right, mate” attitude of many people who live and work close the the land can add to delays in accessing healthcare.

Rural people, even in a sophisticated country like New Zealand, have worse expected outcomes for their health than people who live in an urban environment – worse suicide statistics, worse cancer statistics, worse heart disease statistics.

Rural communities and the governments that serve them would do well to listen to the voices of the health professionals who work in rural areas. Often the people who are living and working within a resource poor environment are the ones who have worked out the best, most pragmatic solutions to deal with the challenges they are facing.

Attending WONCA world rural health conferences has been a fantastic opportunity to listen to stories of rural practice from around the world.

Listen to the story of the Australian outback town where an aboriginal health worker, trained in a classical apprenticeship model, developed the skills to perform effective and safe general anaesthetics and surgery under supervision without ever seeing the inside of a surgical OSCE.

Listen to the story of the medical school that takes illiterate sons and daughters of fishermen and gradually trains them through midwifery, nursing and medicine into dedicated rural generalists capable of providing medical care in extremely resource poor environments.

Listen to the story of the medical students on elective charged with providing immunisations to a poor village, seeing the bigger picture and spending their time building boats to get the children from the village they lived in across the lake to the school, saving a two hour round trip through forests.

The Wonca Working Party for Rural Practice has over its 21 years of life developed an amazing resource of stories, pragmatic and evidence based solutions to the issues that face rural communities. Over the next year we will be revisiting many of these documents and thinking about what needs to be done to make sure that those stories are effectively heard.

Look at the Health for All Rural People statement, think about the role of women in a rural provider community, consider how best to support and develop effective teams of health care workers in rural communities.

We should all aspire to be like the WONCA expert “Five Star Doctor” – care providers, decision makers, communicators, managers and community leaders.

If you have an interest in rural communities, the documents available on the Wonca Working Party on Rural Practice page will help you.