Donning a black western hat and dressed in statement pink, Ella Brady holds herself as a stoic Queensland woman.
But her strength runs deeper. Ms Brady lives with debilitating endometriosis while working on a 22,6000-hectare cattle station in western Queensland.
The 22-year-old said it was still a taboo topic in the male-dominated agriculture industry.
“I feel like we’re raised [as though] ‘Cowgirls don’t cry’, ‘toughen up’, ‘you’ll be right’, ‘get back on the saddle’,” she said.
“In metro [areas], I feel like there’s more awareness coming forward, so they’re more understanding towards it, whereas rurally it can be trickier.”
Long way from health care
Endometriosis causes tissue similar to the lining of the uterus to grow in other parts of the body.
According to QENDO, an organisation that advocates for people with endometriosis, symptoms include pelvic pain and heavy or irregular bleeding and can only be diagnosed through laparoscopy surgery.
A laparoscopy is a surgical procedure that inspects and operates on organs inside the abdomen and pelvis.
For many people in rural areas, the distance to vital healthcare services can be a major concern – something Ms Brady knows all too well.
She received her diagnosis after collapsing in pain and being flown hundreds of kilometres by the Royal Flying Doctors Service (RFDS) for emergency surgery in a regional hospital.
“I was in there for two weeks, and the surgery showed stage three endometriosis at the time, it’s now progressed,” she said.
To manage her illness, Ms Brady takes 13 different medications and sees a specialist doctor in Brisbane, 1,400km from her home near Longreach.
“It’s been really tough … a lot of telehealth and contacting RFDS,” she said.
“But it’s an internal disease [so] there’s only so much telehealth can do.”
Major services gap in rural Australia
Despite the federal government expanding pelvic pain and endometriosis clinics across the country, they’re all based in major cities or regional centres and rural people need to travel substantial distances to access specialised treatment.
Michelle Hannan, RFDS’s state medical lead for primary care, said inequitable access to health care in rural areas meant people didn’t always seek out medical help.
“Access to health care for people in rural and remote areas is just nowhere near on par with what people in metro areas are able to access,” she said.
As Kirstin Stokes, 26, pushes her energetic three-year-old daughter Ellie Hoddle on a swing on their cattle station Glenariff, south-west of Longreach, she’s grateful for her family.
Ms Stokes says Ellie’s existence is almost a miracle.
She and her partner have been trying for a second child for two years but are struggling with infertility caused by her endometriosis.
Her previous job was as a sheep shearer, and Ms Stokes said working with a crew of men in such a physically demanding job while dealing with the incurable disease was difficult.
“Working in such a male-dominated field, you don’t want to be seen as: ‘I can’t do that because I’m a lady’,” she said.
Like Ms Brady, Ms Stokes couldn’t access treatment at home and in February, she travelled to the Gold Coast, an almost 15-hour road trip, for her third surgery.
“[My daughter] had to stay home and mentally, it takes a huge toll for such a big operation,” she said.
“You’re on your own, the travel, the time away from home, the money.
“Being in a city [alone] can be quite uncomfortable, a quite daunting experience [for people from the outback].”
QENDO’s CEO Jessica Taylor said people in rural areas needed access to specialised treatment services, particularly those who had difficulties leaving remote stations to access health care.
“We certainly see an issue in the metro regions but when we go out west, it’s even more amplified,” she said.
Women’s health and endometriosis received an $18.2 million boost from the 2024 Queensland budget, with some of that money helping to support non-government organisations that deliver vital services across rural and remote locations.
A Queensland Health spokesperson said the funding, which was supported by the $250 million Queensland Women and Girls’ Health Strategy 2032, aimed to break down the barriers people with endometriosis faced in receiving a diagnosis and timely care.
“As part of implementing the strategy, Queensland Health is leading the development of a service delivery model for pelvic pain and endometriosis for Queensland,” the spokesperson said.
“Comprehensive statewide consultation on this new model is expected to commence later this year.”
Connection in isolation
For endometriosis sufferers in the bush, the disease can be isolating, forcing people to take time off work and travel long distances for treatment with little support.
Like Ms Brady and Ms Stokes, Korrine Akers relies on treatment hundreds of kilometres from where she lives.
The 34-year-old is a station cook on a property in western Queensland. She feeds ringers and stationhands three meals a day, sometimes in excruciating pain.
But she feels less alone now having found an online community through social media.
“It’s a lot easier now with the social media than it was growing up, so I think it’s really vital and super important,” Ms Akers said.
Ms Brady went a step further during a “rough patch” earlier this year, and looked for an online support group specifically for rural people with endometriosis but came up empty handed.
So, she created her own Facebook page called Rural Endometriosis.
“I feel like I have my chicks, and I can talk to them, and they can talk to me,” Ms Brady said.
“I may be 100km from the closest town, but I’m not alone.”
Stories from farms and country towns across Australia, delivered each Friday.
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