‘You sure can’t miss it,’ says Louise Holland. ‘Especially when we’re parked right next to the local footy club’
The idea of travelling to Victoria’s most remote corners, hopping between small towns every few weeks and living out of a suitcase doesn’t sound like everyone’s dream job.
But when Louise Holland heard about the opportunity to run a mobile women’s health clinic that involved just that, she jumped at it.
For the past month, the nurse practitioner has been travelling on board a hot-pink coloured trailer fitted out as a medical clinic on wheels, named Nina.
“You sure can’t miss it,” she says. “Especially when we’re parked right next to the local footy club.”
Inside, there’s a small reception area, an X-ray room for breast screenings and a compact office where she offers free, 45-minute appointments. Services include cervical screenings, treatment for sexually transmitted infections, prescriptions for long-acting, reversible contraception and referrals for mental health or alcohol and other drug support.
Holland also provides prescriptions for medical abortions – a drug-induced termination that can be carried out up to nine weeks gestation – and offers referrals for surgical abortions.
She says that while Victoria is the “nation-leader” in abortion access, it can still be challenging for women, particularly in remote and regional areas, to receive timely care.
“There are some well-serviced towns with GPs who would provide abortion services to their client base – but some don’t take on new clients, even in these circumstances,” Holland says.
“Then there’s others who don’t provide the services at all and then there’s towns without GPs. I usually work in Bendigo and we have women who call us from two to three hours away, from Deniliquin across the NSW border, trying to access abortion services.”
Her account is backed up by data. A report by the not-for-profit Women’s Health Victoria, published last year, found seven out of 10 Victorian local government areas had no surgical abortion provider and one in five had no medical abortion provider in 2023.
Meanwhile, 17% of Victorian GPs provided access to medical abortions and less than 20% of pharmacies in the state dispensed the drugs for medical abortions.
“This is why the van is just so brilliant,” Holland says. “People can come and see me, I can tell them what their options are.
“For some women, who track their cycles on apps and know that they are in the very early stages of pregnancy, they can come in and say, ‘I don’t want to wait until I’m six weeks to have an ultrasound’ and I can provide medication.”
For others, she says, it might require a follow-up visit or a referral to another service: “Everyone’s story is different and individualised and you need to be very mindful of that. It’s not a one-size-fits-all approach.”
The areas the van will visit have been chosen based on demographics and demand. So far, Holland has visited Edenhope, a remote town in western Victoria about four-and-a-half hours from Melbourne, as well as Daylesford and Bendigo, where she is working alongside the local Aboriginal community-controlled health organisation.
Holland has focused on building relationships in each place she visits. This includes working with schools, where she has offered sexual education classes for senior students, and meeting with pharmacists to discuss access to emergency contraception and medical abortion drugs.
“I’ll ask the pharmacist questions like, ‘Would you give emergency contraception to a 15-year-old if they walked in and asked for the morning-after pill?’ Because in my experience, that’s not happening,” Holland says.
“And of course, I’ll ask about medical abortion medications – if they dispense MS-2 Step. If they say yes, then that’s great. I give them my provider number, tell them to get in touch if there’s any issues while I’m in town. Or, if they don’t, then I need to look elsewhere.”
In Edenhope, Holland met with Jo Grant, the primary health coordinator at Grampians Health, to ask for a private clinical space to conduct pelvic examinations.
Grant agreed – and booked in to see Holland herself. She says the town has one male GP, who is generally booked out weeks in advance, with the closest female doctor 45 minutes away at a clinic in Naracoorte, in South Australia.
“Visiting the doctor is the sort of thing you put off if you’re a woman living in the area, because you probably are going to have to drive, and you’ve got to fit it around school pickup, kinder drop offs, or whether you’re shearing or whatever is going on in your life,” Grant says.
“Women’s roles are very complex, and they often do put their health needs on the back burner.”
The mobile clinic is a joint project between the Victorian government and BreastScreen Victoria, which has been conducting mobile breast checks for years.
It forms part of the state’s $153m women’s health package, which also includes funding for 20 new women’s health clinics, a dedicated Aboriginal women’s health clinic, a virtual women’s health clinic and the doubling of the number of laparoscopies for endometriosis and related conditions.
The health minister, Mary-Anne Thomas, said the package – and other initiatives such as an inquiry into women’s pain – came from meetings of Labor’s female MPs.
“I have no doubt whatsoever that the massive increase in representation in our party has changed what we prioritise and focus on,” Thomas said.
“We bring to the parliament our own lived experience of being dismissed, being told that the pain that we’re experiencing is not real, not being able to access the services that we need.”
She said she was working to improve abortion access in Victoria and that the US supreme court overturning Roe v Wade should serve as a reminder of the need for vigilance in Australia, especially as “far-right politicians aligned with conservative groups” continue to stir up the debate.
Nina will travel to St Arnaud (17-28 March), Birchip (31 March-11 April), Warracknabeal (14 April-2 May), and Nhill (5-15 May).