Rural women with endometriosis fight stigma and isolation in the ‘man’s world’ of farming

Wearing a black western hat and dressed in striking pink, Ella Brady sees herself as a stoic Queenslander.

But her strength runs deeper. Ms Brady lives with debilitating endometriosis while working on a 22,600-hectare cattle station in western Queensland.

The 22-year-old says it is still a taboo subject in the male-dominated farming sector.

“I feel like we’re raised to think, ‘Cowgirls don’t cry,’ ‘Be tough,’ ‘It’s going to be okay,’ ‘Get back in the saddle,’” she said.

“In metropolitan areas I notice that there is more awareness and understanding. In rural areas it can be more difficult.”

Mrs Brady has set up her own social media page to bring together women with endometriosis from rural areas.(ABC National: Maddelin McCosker)

Far away from health care

Endometriosis causes tissue similar to the uterine lining to grow in other places in the body.

According to QENDO, an organization that advocates for people with endometriosis, symptoms include pelvic pain and heavy or irregular bleeding. Diagnosis can only be made through laparoscopic surgery.

A laparoscopy is a surgical procedure in which organs in the abdomen and pelvis are examined and operated on.

For many people in rural areas, distance to essential health services can be a major challenge, something Ms Brady knows all too well.

Because Mrs. Brady lives and works on a rural livestock farm, it is difficult for her to get medical care.(ABC National: Maddelin McCosker)

She was diagnosed after she collapsed in pain and was flown hundreds of miles by the Royal Flying Doctors Service (RFDS) for emergency surgery at a regional hospital.

“I was there for two weeks and the surgery at the time showed stage three endometriosis. Now it’s more advanced,” she said.

Mrs Brady was flown to hospital by the RFDS for emergency surgery.(Supplied: RFDS)

To manage her illness, Mrs Brady takes 13 different medications and visits a specialist in Brisbane, 1,400km from her home near Longreach.

“It was really tough… a lot of telecare and contacting RFDS,” she said.

“But it’s an internal disease, so telehealth can’t do everything.”

Ms Brady says there are limits to telehealth.(ABC National: Maddelin McCosker)

Major shortage of amenities in rural Australia

Although the federal government has expanded the number of pelvic pain and endometriosis clinics across the country, they are all located in large cities or regional centers. In addition, people in rural areas must travel great distances to receive specialized treatment.

Michelle Hannan, RFDS’s medical lead for primary care, said unequal access to healthcare in rural areas meant people were not always seeking medical help.

“Access to health care for people in remote and rural areas is not nearly as great as for people in metropolitan areas,” she said.

a woman in a blue shirt, jeans and cowgirl hat pushes her young blonde daughter on a blue swing in a garden — Farmer Kirstin Stokes has to travel 200 kilometres to get to a pharmacy.(ABC National: Abbey Halter)

As Kirstin Stokes, 26, pushes her energetic three-year-old daughter Ellie Hoddle on a swing at their Glenariff cattle farm, southwest of Longreach, she is grateful for her family.

Mrs 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 due to her endometriosis.

Mrs Stokes and her partner Lachie Hoddle are trying to conceive a second child, but without success.(ABC National: Abbey Halter)

Her previous job was as a sheep shearer. Mrs Stokes said it was difficult working with a team of men in such a physically demanding job, while also battling the terminal illness.

“When you work in a male-dominated field, you don’t want people to think, ‘I can’t do that because I’m a lady,’” she said.

Like Ms Brady, Ms Stokes was unable to seek treatment at home. In February, she travelled to the Gold Coast, almost 15 hours away, for her third operation.

“(My daughter) had to stay home and mentally such a major operation is a huge burden,” she said.

The nearest pharmacy or supermarket to Glenariff Station is almost 200 kilometres away in Longreach.(ABC National: Maddelin McCosker)

“You’re on your own: the travel, the time away from home, the money.

“Being alone in a city can be quite uncomfortable, quite a daunting experience (for outback people).”

Jessica Taylor stands up for women with endometriosis. (ABC News: Dean Caton)

According to Jessica Taylor, CEO of QENDO, people in rural areas need access to specialized treatment services, especially those who have difficulty leaving remote areas to access health care.

“We certainly see a problem in the metropolitan regions, but as we go west it’s even greater,” she said.

Women’s health and endometriosis have received an $18.2 million boost from Queensland’s 2024 budget, with some of the money going to support non-government organisations delivering essential services in remote and rural areas.

A Queensland Health spokesperson said the funding, which was supported by the $250 million Queensland Women and Girls’ Health Strategy 2032, was aimed at breaking down the barriers people with endometriosis face in receiving a diagnosis and timely care.

“As part of the implementation of the strategy, Queensland Health is leading the development of a pelvic pain and endometriosis service delivery model for Queensland,” the spokesperson said.

“It is expected that an extensive national consultation on this new model will begin later this year.”

Connection in insulation

For patients with endometriosis living in the bush, the disease can be isolating. They often have to take time off work and travel long distances for treatment, with little support.

Like Ms. Brady and Ms. Stokes, Korrine Akers relies on treatments hundreds of miles away from her home.

Endometriosis can cause severe pain for Korinne Akers.(ABC National: Maddelin McCosker)

The 34-year-old is a station cook on a property in western Queensland, feeding ringers and station hands 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 because of social media than when I was growing up, so I think it’s really important,” Ms. Akers said.

Ms Akers says she has previously quit her job because she did not fully understand her condition.(ABC National: Maddelin McCosker)

Mrs Brady went one step further during a ‘difficult time’ earlier this year and searched for an online support group specifically for people with endometriosis in rural areas, but she couldn’t find anything.

That’s why 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 away from the nearest city, but I’m not alone.”

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