It’s 5:30 pm and the patients at the medical centre are starting to dwindle. The television near reception is on Channel 9 news. Children’s toys are strewn across the grey carpet and tabloid magazines have been hastily discarded on the wooden tables and various seats. I can hear the sounds of traffic outside, the angry honks at the nearby Hungry Jacks’ drive thru, and the squealing of rubber tyres on the concrete.
There’s another television on the wall next to the long stretch of hallway that leads to a large vaccination room and various doctors’ offices. This television is different. It hosts a simple PowerPoint showcasing the various doctors working in the centre. There’s Flann Morgan*, female, who specialises in women’s health. Next to her is Kevin Christler*, a white man with silver hair. He specialises in general practice.
I see him, gently placed between his five colleagues. Dr Matthew Ado*, stares straight at the camera with his brown rimmed reading glasses pushed against his eyes. I lean a little closer to see his specialities: general practice and dermatology.
At 6pm, he says goodbye to a patient and calls my name. He apologises for being late as he leads me to his office. “I don’t like pushing my patients out the door.” He’s dressed in jeans, a pastel pink shirt, and wears enclosed brown shoes. His reading glasses are attached to a brown string which he wears around his neck. They bounce on his chest as he walks.
Dr Ado’s office is the same as the other offices in the centre with its white walls, thick carpet and study table which houses a computer and stacks of medical books on diabetes, hearts, and childhood obesity. There’s a scale and a height measure behind the two chairs near the study table. A blue bed stands at the back of the room, next to a small sink featuring gloves, hand sanitisers and a laminated sheet about the importance of proper hand hygiene.
‘Thank You’ cards signed by children and adults have been pinned to the board next to the office door. There are six hand drawn pictures, coloured in with markers and crayons for Dr Ado (thank you for being nice to me!). A half emptied container of jellybeans is on the desk. “It’s for the children,” he says, when he sees me looking. “Children love jellybeans.”
Dr Ado is one of the 75,000 foreign doctors residing in Australia. With a twenty-seven-year career under his belt, he is one of the 68% of doctors working in major cities.
Growing up in Nigeria, he had been a sickly child and often spent most of his time in hospital —something that would later influence him to become a doctor. “When I went to the hospital and I saw the people there, I thought I’d like to be a doctor and be able to help other people when I’m sick,” he says.
He spent seven years studying medicine at the University of Ille-Ife and interned in several hospitals for two years where he learnt to specialise in dermatology, obstetrics, surgery, laparotomy and general practice. In 2003, he moved to Australia and began working as a bush doctor in the Pilbara.
Australia is one of the top countries most heavily reliant on foreign doctors. 40% of Australian doctors are trained, overseas with the largest influx of doctors arriving from the Indian subcontinent, south-east Asia and Sub-Saharan Africa. According to the 2011 census, “less than a third of Australian doctors work in rural and remote areas, but they make up almost half the medical workforce in those areas.” In one doctor towns, they are often the only physician. Bush doctors have been credited by the Rural Doctors Association of Australia for preventing a “catastrophic collapse in the medical workforce in rural and remote areas.”
Australia’s heavy reliance on foreign doctors was the result of a self made disaster. The 1990s saw both labour and liberal governments freeze local medical schools amid fears of an oversupply of doctors. However, their fears failed to account for Australia’s growing population and the reluctance from Australian doctors to work in rural areas. So, the mass recruitment of foreign doctors began.
However, there was a catch.
In 1997, the Howard government barred doctors who entered Australia from billing under Medicare for ten years unless they worked in areas of need. So, the conscription of foreign doctors in the bush began.
Dr Ado spent eight years working in the Pilbara towns of Roebourne and Wickham, before moving down south to Perth, five years ago when his children began high school.
Former Australian Medical Association president, Andrew Pesce has repeatedly critiqued the rural policy against foreign doctors, saying, “Giving the lack of support, and the nature of rural practice, there could not have been a worse place” to send doctors unfamiliar with Australia.
When I inquire Dr Ado about his experiences of racism in the medical field, he shifts in his chair and falls silent.
Dr Charlie Teo, a world-renowned neurosurgeon and two-time New South Wales (NSW) Australian of the Year finalist famously stated in 2012: “Racism is still very much alive in Australia. I don’t quite like it when I hear politicians reassuring [foreigners] there’s no racism in Australia. That’s bullshit.”
In 2006, The Australian Doctors Trained Overseas Association (ADTOA) warned overseas doctors about practising in NSW. The Association had received a letter of complaint from the NSW Resident Medical Officers’ Association (RMOA) alleging foreign doctors were targets of widespread prejudice, were given no support to adjust to the Australian health system, were negatively assessed, and made to feel they were a burden on their medical team. They were frequently humiliated at work, and the situation was often worse in city areas.
In an interview with the AAP General News Wire, ADTOA president, Andrew Schwartz, said he knew of overseas trained doctors leaving Australia because of unfair treatment: “Anybody from a non-English speaking country is targeted,” he said. “At a minimum, we’re telling [foreign doctors] ‘Don’t come to NSW’.”
A Queensland experimental study found that a Pakistani doctor with the same qualifications, education and personality as an Australian doctor is less likely to be hired by employers. In a 2013 interview with The Herald, Coordinator of the Overseas Trained Doctor’s Network of Australia, Dr Ghaleb Jaber, detailed his experiences of prejudice. He had spent fifteen years working as a gynaecologist and obstetrician in the Middle East. After he received his Australian College of General Practitioners scholarship in 2007 to work in Australia, he applied for “countless” general practitioner and junior hospital positions, only to be told there were “gaps in his experiences” or no places available.
After sometime, Dr Ado clears his throat and begins recounting an incident that took place whilst working in Roebourne. “I had been called into the ward to fix a shoulder dislocation. When I walked in, the patient’s countenance fell.” Dr Ado briefly falls silent. “I know what I’ve been trained,” he says. “My training in Nigerian was not wishy washy training. It was real good training. Solid training.
So, I explained to the guy what I was going to do. I would pull his shoulder down, rotate it outwards, and bring it back.” He illustrates his point by mimicking what he says. “And when I moved his shoulder, I felt a clonk. The patient looked surprised and couldn’t stop exclaiming, ‘He’s done it!’. I just walked out.”
Earlier this year, in an essay titled Dealing with Racist Patients, authors wrote that “for many minority healthcare workers, expressions of patients’ racial preferences are painful and degrading indignities, which cumulatively contribute to moral distress and burnout.”
Dr Ado tells me about the time his employer singled him out, offered him a workshop flyer, and encouraged him to attend it.
The main focus of the workshop was to teach doctors how to make incisions and tie knots. “[He] thought I didn’t know basic stuff. I know more than basic stuff. I know advanced stuff,” Dr Ado says. “Back home, I would do caesarean sections, laparotomies, [and] hip abscesses. Look, I can fix tendons. I don’t know how many GPs who can fix tendons.
“People think that because you’re from overseas, you’re not as good as [they] are, here. It’s nonsense. Complete nonsense. I see what some people do here, and I just wonder…”
There is a widespread culture of foreign doctors keeping their experiences of racism in the work place private, mostly due to a fear of being ostracised by their peers or not being taken seriously.
When I ask Dr Ado if he has ever reported his experiences of racism to senior staff and medical associations, he shrugs his shoulders and days, “I like my job. I really enjoy it. I’ve stayed [in Australia] long enough and I’ve worked with different people. People are different in terms of skin colour, but in terms of emotions, the person inside, they’re all the same.”
I am about finishing the interview when he says, “People should know that the many people who come from overseas are the cream of their country. So when they come here, it’s not that they don’t know anything. They know lots. And you just see them as they are.”
*Some names have been changed to protect people’s privacy.