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Keeping Australia Alive -

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(generated from captions) To increase breast support
during periods of physical activity, the bra incorporates newly developed
artificial muscle technology. This is the artificial muscles that Professor Wallace's team
has developed. So, what these do is that
when the sensor sends a signal, these then actually contract
to pull the bra in and to increase the compression
on the breasts. So these can really be put anywhere. It's 100 times stronger
than human muscle and it's made from fishing line. WALLACE: It basically
takes fishing line and by twisting it
and subsequently coiling it we can amplify the inherent
thermal contraction properties. And so fishing line, of course,
is incredibly strong, and so we can create
incredibly strong muscles. So, for example,
one gram of artificial muscle is capable of lifting
six kilograms of weight. I mean,
that's incredible performance from a very simple material just because of the way
it's fabricated. And we can amplify that even further
by taking those muscles and braiding them together
into your textile structure. So it's a very scalable technology.

The muscles are made to contract by heating conductive elements
wrapped around the fishing line.

But this requires battery power and conventional batteries
aren't a long-term solution.

So Professor Wallace's team
is developing thread-like batteries that can also be woven
into the structures.

PROFESSOR WALLACE: In fact the
threads are the battery components. So we would have a thread that's the equivalent
of the positive electrode, then a conventional battery, one that's the equivalent
of the negative electrode. And other fibres
that are the electrolyte that you would find
in a conventional battery, but here we've transformed them
into fibres that have that capability. And now we have the possibility
of braiding that into a structure and optimising the positioning
of each of those fibres so as we get the best performance.

The aim is to develop a bra that can
be customised for the individual, using 3-D printing technology.

You know, everybody's a different
size, everybody's a different fit. And so the fact
that you can be scanned and have your garment,
let's say the bionic bra, personalised for you in terms of
where the sensors might go, where the artificial muscle
technology might be incorporated within the bionic bra, it's all about personalisation. Not just so it looks good, that
personalisation's very important for getting the maximum performance
out of the structure.

They're confident the technology
will leave the lab and have applications
in many other wearable technologies such as a sleeve that massages limbs
affected by lymphedema.

I think all the materials,
all the componentry is there now. We have very stable and very rapid
sensing technologies. We have the artificial muscle
technology. Now we need really clever ways to
integrate these through fabrication to build new technologies
that of course in the short term we'll use to create the bionic bra, but will be applicable
in a wide range of applications once they're realised. Eight. One to go. STEELE: I think the technology
has come to a point where we can actually make
wearable technologies that we could only dream about
before.

Next time on Catalyst, rethinking modern medicine
as we face antibiotic apocalypse. MAN: It's said this is
one of the most serious threats to human health. Without antibiotics
we could end up in meltdown. Captions by Ericsson Access Services

(HEART MONITOR BEEPS)

(RAPID BEEPING)

NARRATOR: 28 October, 2015. Across Australia, 100 cameras capture the inner
workings of our health system on a single day. It's the ambulance.
Can you hear me? We're gonna look after you,
alright? (COUGHS) It's not quite as bad
as it used to be. No other system is challenged
by such distance and diversity. You're a tough old fella, aren't ya?
(CHUCKLES) Today, more than 800 babies
will be born.

400 of us will die. (CONTINUOUS BEEP)
No, no, no! We rely on our health system... Your breast cancer is all clear.

..often take it for granted. We're going to stop
the heart from beating. The demand for care is increasing... So I'm going to use
some sort of scary words now. ..but can we afford it?

I'm not allowed to die. If we could see what really happens
in a single day...

..what would we think? It's one of the biggest gifts
that you can ever give anybody. How would it make us feel? Geez, you are tough.

This entire series tells
the story of our health system... We'll take really good care
of him. ..in just one day. Aren't you just
the most beautiful thing? (HEART MONITOR BEEPS)

(ABC RADIO STING) RADIO ANNOUNCER: Good morning,
this is AM... (TRIPLE J STING) ANNOUNCER: It is Wednesday
October 28... Good morning... ANNOUNCER: The Statue of Liberty
was dedicated on this day in 1886... Where is the car, by the way? ANNOUNCER: ..the sculpture
was Auguste Bartholdi...

I've probably blown that one.

I'll just have a coffee, darling.

We've got too many cats
at the moment but it helps
with the snakes a bit, so...

Morning. You need to get up. I'm gonna head off to work. Sandwiches are made
and you're right to go. Yeah. Thank you.
See ya. See ya.
Bye. (PHONE RINGS) Typical teenagers -
hard to get out of bed. I'd better answer that
in case it's the hospital. Louise Baker is a rural generalist - a GP with advanced
obstetrics training.

Hello? Good. How are you going? She's on call
at the local hospital maternity unit. OK, bye.

Steven forgot
to put the garbage out. (LAUGHS) I look forward to delivering babies. There's always a degree
of anticipation - good and bad - because you never really know
what's going to happen. So, most of the time
it's lovely and normal but sometimes
you have to get your skates on and really jump up
and deal with emergencies. It can get the adrenaline going,
well and truly.

We're on our way into the hospital - I've got a girl
that I need to induce, which means bring her baby on. She's not due to have a baby
for another four weeks, but a couple of days ago
her waters broke.

Yeah, this time of the morning
it's still very nice on the roads. And the sun's out. Look at that. Professor Roy Kimble
is Director of Paediatric Surgery at Brisbane's Lady Cilento Hospital.

Our first case is Masoumeh, who's been with us for...
oh, this is two years now. And she very unexpectedly arrived
in my outpatient clinic one day, totally unannounced, and it was one of these moments where you saw the next few years
of your life flashing by. (LAUGHS)

She and her mother and
her little brother are UN refugees and they're from Afghanistan
originally but they fled to a refugee camp
in northern Iran. And one day
their dwelling went on fire and, unfortunately,
Masoumeh's father and brother died in the fire.

Masoumeh and her mother went to the local hospital...

..and got some basic treatment but as they had no money at all,
they got discharged after a week and Masoumeh was left
to heal on her own.

Since 2001, the burns unit Professor Kimble leads
has treated 10,000 patients without a single death - the best survival rate
in the world. Hello! Hey, Masoumeh. Masoumeh is hoping to get
her driving licence soon but for now,
her hands can't grip the wheel. What we're going to try to do,
Masoumeh, is try and free this area here... ..and bring your thumb...

..try and bring your thumb
more into joint. Yes? So...I'll remove a block of tissue
from here...

..and then taking a little bit
of skin from your thigh and put it there. How many minutes is it taking? The operation?
The operation, yes. The actual operating
will probably take about an hour, which means
that you'll be in theatre for maybe an hour and a half. OK. Thank you.
Excellent. Good.

Since arriving in Australia, Masoumeh has undergone
more than 30 operations. OK. It's good.

OK, let's put the tourniquet at 150. Thanks. And it can go up any time.
Yep.

So, I've been slowly reconstructing
her fingers so that she can get movement back
into these joints here, your knuckle joints. And so now
she can actually flex them. But, as you can see, her thumb
is still very much dislocated. 50% of your hand
is actually your thumb, and it's so important to do this,
this movement here, to grasp things. And this is incredibly difficult
for her.

In an operating list, you always try and do
the most fiddly thing first. And then, as the day goes on, the operations should become
easier and easier.

Not that the last operation's easy,
but it... I don't think any are easy. It doesn't involve an awful lot
of concentration. Whereas this, you're dealing
with tendons and nerves and important blood vessels.

It's always best
to put this one first.

Birth complications account for 50%
of infant deaths. Morning.
Morning! How are you? Like many smaller rural hospitals, Cowra doesn't have
an obstetrics specialist. Even so, Dr Baker's patient
is insisting on having her baby here, close to her family. Morning. Because of being a moderately-risk
pregnancy, and early, I advised her that she should
go to Orange to have the baby. And she basically refused, and said
"No, I'm having the baby in Cowra." You have to balance safety
and people's wishes. But you have to respect
their choice. Morning, Jasmine. How are you? Good. I'm a little bit too good,
actually. No contractions overnight?
Mm-mm. And you're still leaking water?
Mm-hm. How much?
As Jasmine's waters have broken, her unborn child is vulnerable
to infection. The safest course of action
is to deliver the baby. She's had two episodes already
of premature labour. One, she got airlifted to Sydney, and the second one, she was sent
by road ambulance to Orange Base. OK, so the head's really well down,
it's nice and engaged. So, hopefully, yes,
this baby will be fine. So we're just going to start
this drip at 10mL an hour.

Hello, sweetheart, how are you? Um, and...hopefully, you'll start getting some nice,
gentle contractions and build-up. If it's possible, if you can give me a little bit
of warning before you start to push, so I can be here for this delivery.
I'll try to.

OK. RADIO: Shares in retailer Dick Smith
have plunged almost a third after... ..Fell 2m from the back of a truck. Bit of a bump there,
I don't know if that's gonna... Ready for the day?
See you when you wake up.

Good.

Hello. Did you sleep well? This is Dashell. Little Dash. Very squirmy. Dash is five months old. He'll be eight months
in the next few weeks. Six months, not eight months. Um... I always wanted to have children
and I want a big family. I want...four. I'd have five kids,
Nick says three, so we might have four. Hopefully. He was born on a Friday and then two weeks later,
our paediatrician... He just came out with it,
Didn't he, Nick? He just said Dash might have CF.
Have cystic fibrosis. And you have to get into Emergency
first thing in the morning. But we went into Canberra Hospital and the doctor was like,
"Yeah, he does have CF." And then I still thought maybe there
was a chance that it was a mistake. Just because he's so beautiful
and healthy.

(BLOWS)

(COUGHS)

So, I've got cystic fibrosis
and, um...I, um... I'm about to start my morning regime
of nebulisers and physiotherapy. I'll just get into
my box of goodies here. There we go. It'll take Adam 2.5 hours
to prepare himself for the day. I start off with
a Ventolin nebuliser and that generally
gets the secretions going that have built up overnight so I can start to breathe
a bit easier.

Cystic fibrosis
is a genetic disease. Sufferers produce an abnormal amount
of thick and sticky mucous in the lungs, airways
and digestive systems. The resulting infections
lead to lung damage and ultimately to a shortened life.

(BABY COUGHS)

He has trouble clearing the mucous. So he sounds wheezy
and he has to cough all the time. And then if he gets a cold
or a chest infection, then that bacteria gets in his lungs
and stays in that mucous and it's really hard to get out. (DASH SQUEALS)
Yeah! Dash needs a cocktail of drugs
to prevent him getting sick.

Every morning, we get up and he has
antibiotics and multivitamins and he also has liquid vitamin E. (DASH COUGHS)
Good coughing. He might like some banana
this morning. Also, they have a problem
with their pancreas. They don't produce the enzymes
to break down fats.

So, before every meal, every feed, what we have to do
is give Dash his Creon, which is the enzyme replacement. Half a scoop... ..and a little bit of salt in there. He does lose a lot of salt
through his sweat. And so we do this
eight, ten times a day. He needs all of this
because he doesn't really digest all of the nutrients
from the food that I give him. We just do sputum clearance, the physiotherapy,
so tapping on his chest, until he's old enough
to do it himself.

CF is Australia's most common
life-threatening genetic disease. It affects one in every
2,500 babies. More than a million Australians
carry the faulty gene. And, like Carly and Nick,
most don't even know. It was a massive shock to find out
that you are a carrier and then the chances that
two of us met up and had a child and then there was a 25% chance
of him having CF, so there's a few different odds
there that were into play. I think that was a big shock. Got all your stuff? Good boy, bubby. Good boy. Carly and Nick
want to have more children but need to weigh up their options. Well, the plan today
is to go and have a consult with one of the doctors
from the IVF clinic in ACT. Advances in genetic testing mean they now have the option
to screen their embryos for CF. And then we basically selectively
only choose the embryos that are CF negative.

That's what we're doing today.

Hello, beautiful girl. (SIREN) Troublemaker. I'm not troublemaker
but I'm known as troublemaker. Did the seizures stop?
ALL: Still going. RADIO: So, stick with us
after 10:00, the latest news coming up
for you now though.

It's quite quick, really. Yeah, well they reckon 1.5 hours
in total, including the... ..uh...discussion with the doc
at the start. And the procedure itself
is 30 minutes. Yeah.
So, that's 15 minutes per testicle. (LAUGHS) Really? I don't think so. I reckon it'll be like five minutes. Mmm.
All they're gonna do is slice, chop. OK! OK. Happy thoughts.
Mmm.

Sorry, darling.
You're gonna be fine. Today, Campbell Fletcher
will be one of 80 Australian men to undergo a vasectomy.

Campbell and wife Jane
already have two children. Alright.

Love you.
Love you too, drive safe. Bye!
Bye. Definitely don't want any more kids, so Campbell steps up
to do the contraception. I've done it up until now,
so it's his turn.

Campbell, nice to meet you.
Good morning, doctor. How are you?
I'm good, thank you, and yourself? Good, good. You all geared up?
Yep, ready to go. You're here for a same-day vasectomy
consultation and procedure? Correct. Which I'm happy with providing you convince me
you didn't wake up this morning on the spur of the moment
and decide to have a vasectomy. No, I've been thinking about it
for a while. Good. The procedure is done in a way
where we'll take our time, we'll give you some
local anaesthetic, which you might just feel
a bit of a mosquito bite, maybe a North Queensland mosquito.
Yep. And we talk about using a clamp and refer to that
like a little kick in the nuts, but most patients will say, "Doc, that's not a kick,
that's a little flick." Yep. It's not uncommon to hear that
women have been on the pill, "My partner's been on the pill
for a very long time." And males are concerned about that. They're concerned
that their partners have gone through childbirth,
caesarian, and certainly they think it's
ready to step up to the plate, 'man up' and have the procedure. And we find our patients
are quite interesting chaps, like Campbell. They're gentlemen. They're ready to have a vasectomy
and do it for the team.

Now, Campbell,
you're not driving today, are you? Correct.
Perfect. We're gonna use our inhalant
analgesic, which is really good. I'm gonna pop it on your arm here. Hold it like a pen,
pop that bit into your mouth, have a couple of little breaths
to get used to it. And you'll feel
nice and light-headed there as well. Patients are very anxious
when they come through that door. In fact,
the biggest challenge for them is getting through that front door
first. And it's nice to tell them that
from here on, it's all downhill. They can really relax.

So, if you pop it in your mouth and you're feeling comfortable
with the taste,

try taking five deep breaths for me.

Good, I'm just gonna do that blood
pressure again there, Campbell. Now, you'll feel me handling you.
Don't be alarmed by that. Vasectomies cost between
$500 and $1,300, depending on the method used. Up to $420 is covered by Medicare. OK, a little bit of handling now,
mate. So you might just feel that
little bit of a kick sensation. You OK with that?
Yep. Well, that's the worst
of the procedure over. Then, mate, then you can kick back
and relax and enjoy yourself. I couldn't think of a better
environment to do that. OK, just a little bit of handling
again.

RADIO: These are not all people
that are coming into the country who are refugees
who are genuinely seeking... We played golf on the Wednesday.
Jeez, it was a great holiday.

I remember hearing
all my bones break. I could physically hear them
cracking.

Professor Kimble has finished
Masoumeh's hand operation. OK, so that's a new piece of skin
on there. And you can see that she's got
a lot more movement in her thumb. She'll get there. I'm fully confident she'll be able
to drive a car with these hands. And, of course,
when she came to us originally, she wouldn't even be able to eat
with these hands.

In your ear.
That's perfect, thank you. Outside, in the admissions lounge, Professor Kimble's next patient
is being prepped for surgery. Right. There we go. Three-year-old Jada was born
with an omphalocele - an abdominal defect where
the intestines and other organs remain outside the abdomen. Her mum Mariah was 18
at the time of Jada's birth and her baby was given
little chance of survival.

We didn't know anything at all. And then at the 20-week scan,
they picked up something.

And then they asked if I wanted to
medically terminate her. Yes, come on in. That wasn't an option.
I said no straight away. OK, Jada.

Dr Pirate, yeah.
We all look like pirates. It wasn't until she was born where we actually saw
how big it was. No-one knew how bad it was
until she came out. And it was a lot. Yeah.

So... This is what we were faced with
when Jada was born. Um... As you can see...

..everything which you expect
to be in the abdomen was out. This is her spleen.
This is her liver. That's her stomach there. This is all her bowel. That's her urinary bladder,
a bladder full of urine. So, everything which is inside
the abdomen is out. And there was no space in her tummy
to put this all back in again. So, we had to keep it out. And what we've done
over the last few years is by using negative pressure,
which is actually positive pressure, pushing everything
back into her tummy, we've gradually made this bag
more and more floppy and then excised skin from it, putting more and more organs
back into her tummy until you've got the situation
just now where she's... Her tummy's almost normal. But we've got a little bit to go.

JADA: Yeah!

And...pop.

Oh, no, Mummy's here. Look. Look, bubba.
(JADA WHIMPERS) Do you want to hold her hands, Mum?
Come on, Jada. Please? Aw, sorry.

It's alright, sweetie.
It's alright, baby. Mummy's right here.
Mummy's right here. Open the valve right up. Aw, great.
Do you want to give her a kiss? Yeah.
We'll take really good care of her. Thank you.
Oh, that smells. Thanks, Mum.

Only one in 10 kids with this
condition normally survive. So, she's a very lucky girl.

She'll be a totally normal
little girl.

And she wants a little bellybutton
like everyone else, so eventually I'll give her that.

OK - will we do a time-out?
Yep.

OK, let's do it. So, you can see the remains of that very large hernia
and skin graft, which we did. So, I've been doing what we call
serial resections of this. And today,
I'll take away more of this. And you can see that
if you pinch her skin, you can pinch a bit. And that's exactly what
I'll be removing. I don't think I'll be able to remove
the whole thing today. So, I think she'll probably require
a couple more operations. But we're getting there. And eventually I expect her
to have a totally normal tummy. Good. So, we're just cutting out
an ellipse of skin from the middle of her tummy where the old skin graft was, then closing up the sides. So, really quite a simple thing. Now, the difficulty
in this operation or the thing you've got to be
aware of in this operation is that there is no muscle
underneath this skin. So, you go from skin
straight to bowel. So, obviously, if I cut too deep, I'll be into bowel
and that's not good.

Lovely day for it.
Bloody hell, it's perfect. Nice big breaths,
you're doing really well. (SHOUTS) RADIO: We can talk Corsica as well,
of course. I've never been there.
Well, we won't then.

We're heading over to an outreach
clinic at the Yalbillinga Preschool.

Here's some of our community. Brand-new baby.

Good morning.
Um, can I ask you something? You can.
I need drugs, so... I'm desperate.
Medical drugs? Yes.
Yes. Morning. How are you?
You're looking pretty flash. You're filming.

Louise has been running
a weekly clinic at Yalbillinga for the last three years. Wow, you've got a baby. Yep. I was wondering
if you can just check to see... We'll check that.
And I'll check you and check her. Is there anything particular
for you? It's not just a doctor's surgery.
It's more important than that. People come here and they sit down
and listen to each other and sit down, have yarns,
have a cup of tea. Can I use a paddle-pop stick?
Is that alright? Yes.
Big wide mouth. Good boy. Say, 'Ah.'
Ah. Again. It's Dr Baker's relationship with
the Aboriginal community here. She has... Like, I've... She's brought children... Delphine's child has been brought
into the world from Dr Baker. She's been around for a fair while.
So, you know... (LAUGHTER)
I'm old. Not saying she's old,
she's just been... She's known in the community. Well-known and well-respected
in the community. The background of it
was when I had breast cancer. At the time, only Jackie
was looking after the preschool and she rang me and she said, "We're really missing the twins.
Can they come five days a week?" And it was just wonderful and it really was such an important
thing for me at the time. And, um... Anyway, gave me an opportunity. I'm going! She's gonna cry.

Working in the clinic gave me
an opportunity to... ..sort of pay it forward
or pay it back, I suppose. And it has. I get more out of it
than I'm sure I give to anyone else. But it really has been great. And thanks for what you've done,
Dr Baker. Louise.
Louise. Oh, now I'm crying. (LAUGHTER) Oh, no, don't film it.

OVER PHONE: Cowra Health Service.
Susan speaking. Hi, Susan, it's Louise. How's Jasmine going? Any pressure? Yeah, I'll just find out for you,
Louise. Are you thinking of heading back? Well, I've got patients
down at the rooms. The first one was
for five minutes ago. Alright. I'll go in and see
the girls in the labour ward and if they need,
I'll get them to ring you. OK. Do you wanna have a chat with them?
Yes. See what's going on?
OK, I'll get them to ring you. Thank you.
OK, bye. (HANGS UP) With no sign
of Jasmine's baby coming, Louise has time to see patients
at her general practice. Hello.
Hello. How are you? Come in. I'm sorry I'm running late. Apparently, I was her first baby
that she delivered in Cowra. Luckily, she got to deliver
my first baby as well. Everyone thinks you're special,
don't they? She's gorgeous. And so we decided to name Ava
after Louise. Ava's middle name is Ava Louise. I guess you could say
we're one big family. Yeah.

RADIO: Good afternoon.
It's 1:05 and it's Wednesday... I used to complain
that my office has no windows. OK, go back on white, please. I want to know how much it is
for one. Cost and rebates. Nick and Carly are on their way
to an IVF clinic to find out about
genetically screening their embryos for cystic fibrosis. I want to know
what do they do with the embryos. What, the ones we don't use?
Yeah.

Since the mapping
of the human genome, genetic tests have been developed
for thousands of diseases. (WHISPERS)

Nick just thinks of them as cells but I think of them as embryos
and what they could be and if they're like Dash. So that hurts. How do we get out of here?
I don't know.

There is no cure for cystic fibrosis.

The average life expectancy for
a person with CF is in their mid-30s. Adam is 36. PHYSIO: So you're doing well. See if you can maintain this
for another 30 seconds. Sure. I'm getting a lung function which is a bit too low
to sustain everyday life. Like work, and I guess, all my other
responsibilities and commitments. I'm approaching a stage
where I need a lung transplant.

Doctors need to determine if Adam is healthy enough
to cope with the transplant and recovery. But it could take around nine months
for him to receive his new lungs. Working you a bit harder,
your oxygen's 91%. Yeah. So we are seeing
a little drop in that. And your pulse rate is a bit higher.

Come through. Carly, my name's Toby.
Hi. Nice to meet you. Nice to meet you.
And welcome. Come through. How old's Dash?
Dash is five months. Going on...about a year, by size. He's doing well.
He's a bit of a unit. Yeah.
We're very proud of that. So Dash has cystic fibrosis. Yeah. What IVF does is that... We can essentially take some cells
from an embryo which is about five days old. Five days. We can biopsy those cells. And we can select embryos
which don't have CF. So what happens
to the other embryos? So the other embryos, embryos that are found
to have this defect are discarded. Discarded? Yep.
Right. I hate it.
Yeah? Hate it all.
I hate the whole situation. I know that's a funny idea,
given that Dash is here and with us. And if it's any consolation,
there is options for those embryos to be used for training of
scientists and for other research purposes where there can be
some meaning derived from... Again, that's something that
you'll have some time to consider.

The difference in all this is that
we're avoiding gene mutations resulting in disease
in your offspring. And that's really -
that's the whole point. That is the whole point.
To have healthy babies.

Today, your lung function
is around this mark, so over that two years, you've lost
about half of that lung function. Yeah. So you've dropped from that 30-40%
down to just around 20%. Sure. So... And you've needed more oxygen, so now's the time to keep you
as well as possible. And the fitter you are going into
a major surgery like this, the better
you'll come out the other end when you need
to get up and moving again. Uh-huh. Alright, no worries. Well, I'll keep hitting
the treadmill. Yep. Alright, mate.
Thank you. Thanks, Jamie.
Bye. See you, mate. At the moment is probably when CF
will probably impact us the most, because this is the...
probably the hardest time because Adam's lung function
is so low. And we're preparing
for the lung transplant, so... But to be honest, we've just been
thinking about afterwards and what we're gonna do afterwards.
Yeah. And all of the things, the extra
things we're gonna be able to do after he has a lung transplant,
which will be amazing.

CARLY: It actually
has made me feel better. I hate the whole idea of it, but I don't want to put more babies
through what Dash has to go through. I think my main concern
was being selective and I just didn't feel that
that was up to us. But I think in the end
we're actually... We're doing the right thing
because...

..it's better for the baby,
it's better for us, it's better for the health system. Hopefully, it is the right choice.

You're so cute, Dash.

RADIO: A Commonwealth Bank
whistleblower has told a Senate... Last week, we had a guy
who'd been shot in the bottom.

So, out of ten, if ten was the worst pain
you've ever experienced, what would you say your pain got to
at its worst? Oh, 0.5? 0.5?
0.5. Can I tell you when your wife
asks you that question, you should not be giving her
that answer. You'll get no sympathy, my friend.

And now, we're just
gonna put a bag of peas in there. Mate, well done. Thank you kindly, sir.
I appreciate it. Good on you. You're welcome. OK.
Cheers.

WOMAN: There you go.

Hello.
Hey! Look at you!
You're like the patient. I am the patient. How are you? Good. How are you going?
Going good. Feel good?
Yes. Top of the world. Yes, no worries. It's easy. I might go back for another one. That's a very pretty gown.
Maybe they'll let you keep it. I have more.
Oh!

I met a serial entrepreneur
last year who was on his fourth company. But he was only 12 years old.

He employed a team of engineers
out of India. I'm not a good waiter.
I tend to get really fidgety. RADIO: ..resulted in a roll-over.
Oh, there it is.

(CRYING)

3-year-old Jada has woken up
from the anaesthetic and is waiting for her mum. (JADA CRIES)

Professor Kimble's next case
will be 8-year-old Caleb. Caleb suffered
50% full-thickness burns in June. He has had almost 50 operations and spent three months
in Lady Cilento. Today will be Caleb's first
reconstructive surgery and his first time back in hospital
since going home a month ago. Well, back on 7th of June, we had a drum fire burning
on the back of the property. Caleb's decided he wanted
to put some rubbish in it, he's gone down there,
he's lifted the lid, he's placed a bottle in the bin. And the fire's come back up
and caught his pyjamas on fire. They've ignited. He ran back up, about 60 metres
back to the house, and came up through the front stairs and just yelled, "Mum, I'm on fire." And he was in flames. Catch you later, Caleb. Say, "See ya." What?
No! I'm not gonna see them!

Caleb's autistic,
so he's always on the go. And he's always asking
a million questions and yeah, so,
he's finding it hard now to actually deal with
what he has to deal with now.

(CALEB SHOUTS)

NURSE: Don't do it yet.
Good boy. When you're ready. (ALL TALK AT ONCE)

He won't want me to do that after...
Thanks.

My youngest is only three and last night, as I was putting
her to bed, she said, "Don't go." And I said, "I have to.
I have to take him." She doesn't...

She doesn't understand.

So, we can see that he was very
badly burned in the shoulder region. And that went
all the way round this area. And it's almost inevitable
with kids that they develop
some sort of contracture. So he can't get it above
about 45 degrees. And so we're going to divide that so he can actually get his arm
above his head and then we'll fill in the gap
with skin from his leg.

I think burn surgery
is a very visual thing. WOMAN: That it? Burn surgery's all on the surface and everything you do is seen
by the child and the parents.

So we can make huge differences
to kids' burns with very simple
surgical techniques.

I've spent many hours
sitting on this level, waiting for the doctor to come out
and say he's done, he's OK, and everything's fixed.

You have a lot of time during this
time to go back over what you've...

..what you've been through
and everything, but... OK, have we got a saline soak?

(MACHINE BUZZES) A piece of skin
is taken from Caleb's thigh to cover the wound in his armpit.

That's a lovely piece of skin there
that we can use for his axilla.

It's perfect.

We put this great big piece of skin
from the upper wound in the thigh and eventually he'll be able to put
his arm round the back of his head.

So, that's a new armpit. The cost of Caleb's
ongoing operations and treatment is likely to exceed $1 million, all covered
by the public health system.

These kids only survive
in First World countries. Anywhere else, this sort of child
just wouldn't survive. The amount of resources
you've got to put in to keep these kids living
is absolutely enormous. So we take it for granted here but elsewhere
these kids aren't so fortunate. Yep.

OK, then. Thank you. Bye.

Hey, look. Mum's here. Hello. Hi. I'm Imogen, the recovery nurse.
This is Mel. Hi.
Hi, nice to meet you. Caleb. You OK? You good?
(CALEB GRUNTS) You're not good.
See? He says he's fine.

Downstairs, Lady Cilento's emergency
department sees 175 children a day.

Three-year-old Fateh
has been brought in by his mother.

So we know there's a little
styrofoam ball in that ear. So essentially we've just got to
work out a way to get that out. I think the best way to do that, since we can see
it's right at the edge there, is to just use a little suction.
OK. And basically we'll just
suck it out, hopefully. Yeah.
And that's the goal. OK, no worries.
OK? Manufacturing our own special
little tool just to get this out.

He just found from the sofa,
and just...

Playing. And by playing,
he put it in his ear. And he want to take it out, and while he's taking out
he's just... ..pressing with his finger, and... Ready to see my light?
..get it deeper. Look what I've got here. See this? (MOTHER AND CHILD SPEAK
IN FOREIGN LANGUAGE) Look.
(MAKES FUNNY NOISES) It's tickling? You try it. Ooh.
This is funny, isn't it? OK, you give Mum a big cuddle.
Give Mum a hug! (SPEAKS IN FOREIGN LANGUAGE)
Good boy. It's OK. Can you see the TV? Good boy. Look at the TV. (MOTHER MAKES COMFORTING SOUNDS)
(FATEH WHIMPERS)

(YELLS)
Good boy, it's OK.

It's OK.
Good boy. (COMPLAINS AND CRIES)

Oh, it's OK, it's OK. (MOTHER SPEAKS REASSURINGLY)
(FATEH CRIES) It's alright, darling.
(SOBS) (SCREAMS)
It's OK, it's OK. Have a little break. I'll have a go.
(CRIES) Good job. Hey! It's OK. It's scary, isn't it? It's an amazing number
of different things that we fish out of
kids' ears and noses. Sometimes it's the kids
who put them down there themselves, sometimes it's the older siblings
who are actually to blame. I'll go get you some bubbles.
It always seems they just... They never put them in there, they just seem to fall in there
while they're playing with them. Aw, hey. I've just got some little
tiny grabbers, OK? We'll just go in there,
'cause it's stuck in the wax. We'll grab the little ball
and pull it out. Very important we keep him
nice and still when we do it.

So, legs going this way. That's it. That's it. Sitting up.
(CRIES) That's good. Now, you look after
this hand here, is the main thing.

(MOTHER SPEAKS TO CHILD
IN FOREIGN LANGUAGE)

(SQUEALS)

(SCREAMS)

Hey!
Good boy. Do you want to see? Very good. High five!
Yay! High five!
High five! Yay! Woo-hoo!
Thank you.

We'll make sure
we have that other look down the ear just to make sure there's no other,
you know, foreign bodies down there, but otherwise
he'll be right to go home. You want something nice to eat? Ice-cream?
Yeah. Do you think that would be OK?
Ice block always does the trick. What colour? (ASKS CHILD IN FOREIGN LANGUAGE) FATEH: Orange. Orange.
OK. We might be able to do that.
We could sort that out, hey? We might be mates again, then.
Yeah! Broken the big bone here. (SPEAKS INDISTINCTLY) I said, "You allergic to anything?"
He goes "Pain and women." If any more pressure goes onto it,
they will separate. (SIREN WAILS)

I've just got a feeling
that she's... She should be very close, and if I get that sort of need
to move and get there, it usually means I walk in and they're either
just about to deliver, or... ..very close,
or there's something going on.

(RINGTONE)
Hello? Hi, Louise, it's Junie. Um, Jasmine's felt
the last couple of contractions and they've actually got a bite
to them. OK. I'd love your advice as to whether
I need to be up there now or if I've got half an hour, but you can't trust
a labouring lady, can you? Can't trust her.
At the moment I would say no. But hey, in two minutes
I might change my mind. OK.
OK. Thank you. Bye.
Bye.

She's in established labour.
She is. She is, I like it.

Knock, knock. Jasmine's using the gas and she's getting some
really strong contractions. She's not far off having this baby. I think
she's just about to start pushing, so I'd better go and do my bit. I'll just go and grab a gown.

Just made it.

Just put something
over the top of my clothes so I can go back to work
after we finish. But I'd better run!

Louise delivers 100 babies a year and has done so
for the last 27 years. There you go.
(MOANS) (BABY CRIES) We've got a little boy.
He's all well, everything's great. So I'll just go in
and finish the last bit.

OK, we'll pass you over. Come to your dad. Can I have this beautiful boy? We'll see how much he weighs. Congratulations, Jasmine.
You've done a beautiful job. With all your family here.
Lovely. Hey. Kissy baby.
Let me have a little look at him. I think people in city areas need
to realise what the challenges are. There's a lot of distance
for people to have to travel. And to allow doctors and nurses
to practise at the top level of their ability, and not be compromised by the fact
that you're not a specialist. I'm a rural generalist. And I'm very proud of the fact
I'm a rural generalist. And I'd like to think that what we
practise in Cowra is safe medicine, and if that can continue to happen, I think that's going to be a benefit
for rural communities. Wow, he's a big'un. 3.45. 7lb 9oz. Very good. Just going to give him his vitamin K
and his hepatitis injection.

Very excited and happy.

I think she's happy too.

Yeah, when I come up I said,
"If I have to go to Orange, "if you're going to send me away,
I'm just gonna go home." 'Cause I just don't... I'm not comfortable having him
anywhere else. I feel safe here,
with all the midwives. And the doctors. I've had all my other babies here,
so... I didn't want to have him
anywhere else. Nowhere else I'd rather be.

Oh, my God, that's so cute. (MUTTERS QUIETLY) 26 minutes to seven on... (RADIO STING PLAYS)

We did sort of jump on Google, which probably wasn't
the best thing. We tried not to. The first thing you see on Google, it tells you what
cystic fibrosis is. But then they always love
to quote the stat that the average life expectancy
for someone with CF is 38 years. Or at least
it is at the moment. So that was probably
the most upsetting thing.

But then the more
we've come to learn about CF is that life expectancy is based on
people who were born 38 years ago where the treatment for CF
was pretty poor, and it's only been in the last
maybe five years that they've had CF-specific
treatment and medication for that. I mean, it's a pretty...um,
pretty horrible statistic, but I think
it's a bit of an old stat now. I think, you know...
Well, I hope, at least... That's what we tell ourselves,
anyway. ..that he'll outlive us all. Which would be nice.
Mmm.

RADIO: First step in digitalising
Australia's health system... (BUZZER SOUNDS) RADIO: The United States sent
a guided missile destroyer...

So... That looks fine. There's a little bit of staining
on it, but that's absolutely fine. At this rate,
you'll be going home tomorrow.

She'll go home
with the negative pressure device. And we would plan to take that
off... I think just in our clinic in a week's time.
OK.

Good, no, just to say
everything went really well.

Hey, Caleb. Yeah, it's working nicely. Just get you to turn around
this way.

(MOANS)
OK. That's good. You've done well.
I think that means 'go away'.

I'll see you tomorrow morning,
Caleb. You have a good night.
Thank you. Especially with burns surgery,
you can see the direct results.

These kids go from really quite
damaged or deformed kids to normal kids. Alright. How are you? OK. Everything went really well. I have got your thumb straight,
this joint all back in place, and I've positioned it sort of
that way, you can probably feel. Yeah? You might find these joints
are a little bit sore, 'cause I was doing
a bit of manipulation. Yeah, can you feel that?
Yes. But you don't look very sore
at all. Nah, I'm...
It's OK?

Excellent. Well, I see no reason why you wouldn't be able to go home
tomorrow. OK. Thank you.
Do you have any questions at all? Mmm...no.
No. It all went really well.

Thank you.
No, thank you.

One step closer to driving.
Yeah.

RADIO: This week in music,
that Adele story. How big is it?

Hopefully now I can get some sleep. RADIO: Tomorrow's capital city
weather. Brisbane, showers, 21. Sydney, partly cloudy, 22.
Canberra, sunny and 25.

(KNOCKS)

I suppose, having had
a fairly serious illness... I had cancer,
and one of the things I wanted to do was to try and have as much of
my healthcare as I could in Cowra. And I pushed at the time to be able to have some
of my chemotherapy here, which they allowed me to do. And maybe it wasn't optimal
from the specialist's point of view, but it certainly was
much better care for me. And I suppose that's why
I do tend to advocate on behalf of our community, to provide as much care as possible
locally. And maybe that is why
I've put that extra bit in to trying to see if people can have
their care in their own town, as long as it's safe. So what did you do today, Will? Sat around and waited for concrete,
didn't you? Were you pouring your verandah?
He didn't get home until 7:00. Oh, didn't you? Were you working
right up until then? You're nearly as bad as a doctor. Actually, you must have worked
longer than I did today, maybe. (WILL SPEAKS INDISTINCTLY)

I'm going to go to bed early, in
case this girl has a baby tonight. It's already twenty to nine. (RINGTONE)

Maternity.

Hello? Good, how are you going?

Do you think you can
bring your arm up? No, no. (ALARM BEEPING) We're just gonna take baby over here
just for a second, OK? He said, "I'm not scared,
I'm not worried, "but if this gets me, I want you
and the kids to be alright." Big 'ah'.
Ah. (PEOPLE ALL TALK AT ONCE)

I don't have any fear of death. It's just the timing.

Captions by Ericsson
Access Services

This program is live captioned by Ericsson Access Services.

Partinico on the north coast
of Sicily.

This may be modern Europe, but the people here still live
in the grip of the Sicilian Mafia - the Cosa Nostra. Eight out of ten businesses
pay protection money.

But a few are taking them on. Leading the charge,
a tiny community TV station daring to name, shame, and inspire
defiance - and they get results.

In a culture
where family is everything, the Telejato channel
is a family business. Its godfather is Pino Maniaci, who, with his wife, children,
and a team of volunteers, defies dangers and dreams
of changing the world. Why do you do this? What drives you?

Only once on holiday.
A long time ago.