Pharmacy student changes life plan after rural placement opens his eyes to healthcare inequities

Sunday, 29 June 2025

Sir Ashley Bloomfield discusses the importance of a long-term, bipartisan health plan. With a focus on optimism and clear goals, he calls for sustained action to improve New Zealand's healthcare over the next decade.

Sendhil Rungasamy, a pharmacy student, has pledged to work in rural communities after seeing first-hand healthcare inequities during a rural placement.

The Rural Health Interprofessional Programme gives undergraduate students experience in rural clinical settings.

Rungasamy observed patients travelling long distances and facing barriers to access healthcare services in rural areas.

In the first week of his placement at a rural hospital, pharmacy student Sendhil Rungasamy met a patient who had been prescribed an inhaler but didn't know how to use it.

“The job of a pharmacist is to make sure you know how to use the medication and what you're using it for. She said ‘I don't know any of these medications. I don't know what I'm taking.’”

Sendhil Rungasamy, 22, has made a pledge to work only in rural communities after a placement in Whakatāne opened his eyes to the healthcare inequities smaller areas face.

Rungasamy, a fourth-year University of Auckland School of Pharmacy student, encountered several similar situations during the five weeks of his rural health placement.

When he’d ask patients why they didn’t know anything about medications they had been prescribed: “They'd say, ‘I had a quick appointment with the doctor, but I had to get going as my place is two hours away.’”

It’s an experience that has forever changed Rungasamy’s outlook on healthcare and, at just 22 years old and in his final year of university, he has made a pledge to work only in rural communities.

A noho marae at Ōwhakatoro Marae, Rūātoki was one of many life-changing experiences for Rungasamy.

“I've applied for mostly rural hospitals and I'm looking at rural settings in terms of community pharmacies around New Zealand… I've even looked at rural communities in Australia,” Rungasamy said.

“I want to delve deep and be able to connect and build partnerships with indigenous communities and advocate for equity.”

Rungasamy has recently returned from his placement at the Whakatāne Hospital dispensary pharmacy as part of the Rural Health Interprofessional Programme.

Started in 2012 by Te Whatu Ora Hauora a Toi Bay of Plenty and Waipapa Taumata Rau, University of Auckland, the programme gives undergraduate students, from different health disciplines and tertiary institutes, experience in rural clinical settings.

Each cohort lives together, and they work in placements at both the hospital, primary care and community settings in Hokianga and Whakatāne.

Placements start with a noho marae (a marae stay) to immerse participants in Māori health and to help them understand health inequities from tangata whenua. Then come placements under the guidance of local healthcare professionals and academic staff, as well as outings to see local communities.

Rungasamy said the noho at Ōwhakatoro Marae “was one of many life-changing experiences” where members of local iwi Ngai Tuhoe shared their healthcare experiences.

“One of the children was in a motorbike accident, had to get healthcare and was told an ambulance was an hour away. They had no other choice but to wait because the one car they had was being used on the farm to make a living… It was really emotional.”

Seeing first-hand how healthcare was not readily available to people in a rural community was different to learning about disparities in health from a lecture, Rungasamy said.

During his placement he observed patients travelling for hours to reach the hospital, he said, some paying multiple bus fares due to a lack of private transport, all while unwell.

“In Auckland, if you’re needing an MRI you can get a scan in two or three days… Whakatāne Hospital doesn't have an MRI machine so patients needing a scan had to transfer to Tauranga Hospital which is an hour-and-a-half’s drive away with results pending four to six weeks.”

Rungasamy said the experience made him realise how much support is needed for rural communities.

“That's really what I want to do in rural. I want to make it more equitable and decrease that barrier to access.”

Pauline McGrath, Hauora a Toi Bay of Plenty group director of operations, acknowledged some patients do travel long distances to hospital, a challenge in many rural areas.

National Travel Assistance programme funding was available for eligible patients, she said, alongside transport support from some Māori/iwi providers and the hospital’s outreach services.

McGrath said clinicians did their best to accommodate patients’ needs but for rural patients under distance and time pressure, telehealth appointments were an option that could be used for education on the use of medications.

And there was good news for Whakatāne on the MRI front, with plans in place to provide MRI services there “in the near future”, she said.

“Currently, Priority 1 MRIs are all completed within the one-week timeframe, with a report received within 48 hours, Priority 2 all within the two-week timeframe, and Priority 3 are all within the six-week timeframe.”

As part of Budget 2025, the Government announced it would invest $164 million over four years to strengthen urgent and after-hours healthcare nationwide including for more than 70 rural and remote communities.