I recently broke my arm by ignominiously falling in my own living room and landing on my elbow. The force of the impact on the muscles and tendons in my shoulder broke the bone.
When I presented at the nearest emergency clinic, I entered the extraordinarily diverse world of a large Australian public teaching hospital. It was a busy night. After going through several sets of paperwork I was finally given painkillers and sat down to wait. In a blur of pain and shock only partially dulled by medication, I sat through “Four weddings and a funeral”, some hard-sell cosmetics ads and a Christian fundamentalist promo on the TV before the Canadian duty nurse called my name, took another medical history and sent me to another set of uncomfortable seats to await the hard-pressed Anglo-Aussie intern. She sent me on to an Irish nurse who took X-Rays. I left at 4.00 am with my arm in a sling and an appointment at the fracture clinic.
In a hospital outpatient clinic time passes slowly. My initial idle observations of its coming and goings turned into real interest and some serious people-watching (aka ethnographic observation). Let me describe my interactions with Queensland’s multicultural medical doctors.
Recent census data shows that overseas migration now makes up half of Queensland’s population growth, a trend predicted to continue. Reflecting this pattern, 1 in 10 Queensland Health employees comes from a non-English-speaking background. One visit to the fracture clinic of this busy hospital makes it obvious that without immigrant medical staff this hospital simply would not function. I was assigned to a consultant with the Anglo-Celtic name of Robinson but I only ever saw him in the distance, his role seemingly being to oversee the decision-making of the doctors under his supervision. Every one of the people mentioned here evidently had the right to work in Australia and, since they were all relatively young, it would be safe to assume they were recent arrivals or “new Australians”. In mentioning that they were all of non English-speaking background I don’t intend to ‘other’ them but rather to emphasise that my hospital experience was an encounter with Australian multiculturalism and ethnic diversity.
The nurse with the Italian-Aussie accent called me into the consulting area. The first doctor who treated me was a young Malaysian woman in a mini skirt. Call me old-fashioned but I still expect medical doctors to wear white coats. It seems I am hopelessly out of date. She confirmed the nature and extent of my injury, showing me some blurry X-Rays that I could not really make out. At my four-week appointment, I met a jolly Sri Lankan doctor in scrubs. He showed me a CT scanned image of my broken shoulder, this time in graphic detail. He told me I might not regain full range of movement in my arm, instructed me to keep my sling on and my shoulder still and said that I wouldn’t be driving for at least three months. At my six-week visit, my doctor was a suave Egyptian in a crisp, striped shirt, with a dry sense of humour: “Should I see my GP?” I asked him. “If you miss him”, he replied. I suppose laughter is the best medicine. The good news at this visit was that I was not a candidate for surgery. At my eight-week visit, my doctor, of possible Swiss or German origin, gave me the news that the bone had started to heal! I could remove my sling and start active exercise, I could swim but not drive and I could start physio. Judging by her accent, my physiotherapist originates from Singapore. We’ve been working together for two weeks now and I can get my arm up to almost 90 degrees with her help and encouragement.
These medicos, with their variety of Aussie ethnolects, came from an amazing range of cultural backgrounds. While I might have preferred continuity of care from one doctor, the consistency with which I was treated by a range of different doctors was reassuring. While English, which they all spoke perfectly, was the common language, they also all spoke the language of orthopaedics and rehabilitation. I was well looked after and reminded that I am lucky to have easy access to hospital care and services, a benefit that does not apply to all Australians equally.
These thoughts prompted a quick Internet search for some information about multiculturalism and healthcare in Queensland. I found plenty of encouraging material. According to the Queensland cross cultural learning and development strategy, the increasing cultural diversity of the Queensland population means that to be safe, health services need to be culturally appropriate and responsive. One of the eight core Queensland Health targets is culturally competent staff. The Queensland Health guidelines for multicultural health policy implementation also include a language services policy. Yet many people still miss out on health services or access them too late for effective preventative intervention or treatment. The Queensland Council for Social Services recognises that three at-risk groups are Aboriginal and Torres Strait Islanders, people in rural and remote areas, and culturally and linguistically diverse communities. It proposes a number of strategies for training staff to deal with diversity.
But the Queensland government recently abolished some 14,500 public service positions, claiming that cuts will reduce unnecessary red tape and top-heavy administration. Like many Queenslanders, I find it impossible to accept that cutting support services will increase efficiency, improve access to health care or make the jobs of front line staff any easier. For many Queenslanders the future looks uncertain and what it holds for multicultural policy development, an equitable health service and quality health care remains to be seen.