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And why appropriate credit/acknowledgement of health consumer work matters
Recently, an interview on a podcast featured a prominent midwife researcher, and a WA maternity consumer, who described the health advocacy by our organization in collaboration with the migrant community in WA as "loud, protesting, and angry."
An approach they didn't agree with or align with and was the reason cited that they didn't want to work with us at the time we were collecting women's experiences of maternity care earlier in the year, after a series of catastrophic outcomes for migrant women in WA hospitals.
The approach taken by the migrant community and our minority committee members in addressing systemic racism in healthcare in this particular podcast was dismissed with the explanation that WA is a "reserved place with its own culture." It was also implied that this particular consumer group were the only ones on the 'ground'’ in WA so to speak and we are outsiders (ignoring the fact our organization actually have consumers in WA assisting, mostly Migrant and Cald men and women plus midwives-in the background from different organizations.
We have discussed this rhetoric previously on our website about this notion of WA not liking outsiders and I will quote it at the end.
However, some points need to be made because there has been a huge lack of acknowledgement of the work of CALD and Migrant communities in bringing changes to WA Health this year alone.
The migrant community has been desperately trying to address systemic racism for years, particularly through the efforts of WA health advocate Suresh Rajan. He was the former President of Ethnic Council of WA and even helped write some WA's anti-discrimination policies.
In 2022, we started lodging complaints with WA hospitals, and in 2023, we focused on implicit racial bias in healthcare after the near-death experience of Neethu Thomas during her maternity care. It came to light in 2024. Her story can be found here: https://www.abc.net.au/news/2024-04-10/neethu-thomas-king-edward-hospital-trauma-birth-maternity-care/103652548
It became clear that ethnic women and children were suffering the impacts of systemic racism, as they were dying unnecessarily in WA hospitals. The most notable cases include Supreet Kaur, Monika Mann, Sandipan Dhar, Aishwariya Aswath, and Baby Amir Hulow, among many others. While these cases are devastating, it’s a poorly kept secret that First Nations people are likely experiencing even worse outcomes.
Supreet Kaur's death: Alleged negligence by a Perth hospital led to her tragic passing after childbirth. Her family continues to seek answers about the care she received. Read her story here.
Sandipan Dhar's death: Sandipan's family is pushing for a new investigation after the 21-month-old tragically died in care. Read his story here.
Monika Mann's death: This young mother died after giving birth at Fiona Stanley Hospital, raising questions about gaps in maternity care. Read her story here.
Baby Amir Hulow: An expectant mother felt let down by an independent medical review after her baby died in utero. Read the details here.
These cases reflect the severe and often fatal consequences of systemic racism and neglect within WA's healthcare system.
So, why are we, people of colour, labeled as "loud, angry, and protesting"?
It’s common for the concerns of people of colour to be dismissed. When advocating for themselves, they often have to resort to extraordinary measures to be heard.
For example, Aishwariya Aswath’s father, whose daughter died due to negligence and whose deteriorating condition was ignored in an emergency room, had to go on a hunger strike just for the WA Health system to take her death seriously. His actions led to a proper investigation, updates on how sepsis is assessed, and the establishment of independent phone lines to handle medical emergencies when patients aren't being listened to.
This is just one example of how people of colour are forced to go to extraordinary lengths to bring about change.
It might also have to do with the fact that you know, young women and babies from ethnic communities are f*cking dying. Sounds like a justifiable reason to be loud and angry, but I digress.
In 2024, during the MCN’s advocacy for Neethu Thomas, who nearly died due to multiple failures in her maternity care and alleged racial bias, I met with many health advocates—mostly white, both midwives and consumers and those in politics.
Time and time again, I was told that WA is its own culture and doesn’t like outsiders telling them what to do. I even heard this from individuals in high political offices (also white).
Though I brushed it off at the time, I began to realize this was part of a much larger issue of implicit racial bias in WA Health because I did not hear this rhetoric from the CALD and migrant communities.
During our advocacy for Neethu, we had to contact two journalists to correct their coverage of Neethu’s case and ensure they acknowledged her and her husband’s tireless work to bring change. This was just one of the many barriers we faced in trying to get WA Health to take racial bias seriously through the media.
We also had to make stringent efforts to make sure their work was not forgotten on our social media for their story, bringing forth 140 women to submit their experiences of maternity care/obstetric violence between two consumer organizations. Their experiences were submitted in briefs to parliament by different maternity consumers, including ourselves to both the liberal and labour parties. This wouldn't have been possible without Neethu and Jestin going to media and asking the women WA through us to help their plight for better maternity care.
Another significant issue was Neethu’s ongoing case with a health regulator regarding the racial bias she experienced in her care. Despite having documentation from a South Asian midwife with relevant training, as well as input from the former President of the Ethnic Councils of WA, it took two formal complaints and a meeting by us just to get the regulator to write a proper letter to the hospital addressing her concerns. There was no misunderstanding in the documentation, but there certainly seemed to be a lot of “misunderstanding,” by this regulator on what constituted as ‘racial bias.’
Despite being unacknowledged, we are going to share what the "loud, angry, protesting" migrant consumers, along with us, have achieved for WA healthcare—particularly in maternity and pediatrics—throughout 2024:
Neethu Thomas’ horrific trauma and Monika Mann’s tragic death (both brown women and victims of systemic racism) were spotlighted in campaigns and on social media, prompting 140 women to share their maternity care experiences with both major political parties. (This significant reason for the interest in women sharing their experiences was notably absent from the podcast discussion.)
In response, Health Minister Amber Jade Sanderson supported the MCN’s informed consent training initiative in WA hospitals in an offical letter to Neethu and Jestin
Additionally, Fiona Stanley Hospital implemented a maternity working group with consumers—though we are still awaiting confirmation of whether migrant women are represented on this group, despite repeated requests. They have not been featured to our knowledge in any photos on their social media.
These outcomes demonstrate the tangible progress driven by persistent migrant advocacy, even in the face of systemic dismissal and bias.
Five CALD organizations—Navodaya, Kerala Cultural Association of WA, Perth United Malayalee Association, Malayali Association of Perth, and the Federation of Indian Associations of WA—joined forces and wrote letters to the Hon. Roger Cook, Hon. Amber Jade Sanderson, and Hon. Libby Mettam, urging them to address the alarming rates of perinatal and maternal mortality and poor outcomes affecting women and children in their communities due to implicit racial bias in healthcare.
One of their key requests was the establishment of a health ombudsman to ensure better oversight and improvement in hospital care. The government listened, and as a response, conducted a statutory review into increasing the powers of the health regulator, HADSCO (Health and Disability Services Complaints Office).
A grievance to Parliament was raised by Neethu Thomas and Jestin George regarding the way WA Health conducts SAC 1 investigations (Serious Adverse Event Clinical Incident investigations). This matter remains ongoing with the Health Minister.
Thanks to the advocacy of Sandipan Dhar’s father (Sandipan was a child who tragically died in an emergency room, allegedly due to negligence), a petition was tabled in Parliament to push for legislative changes that would ensure greater accountability for doctors. Jestin George, Neethu Thomas’s husband, and other migrants worked within their communities to gather signatures in support of this petition.
Ramsay Healthcare—the organization managing Joondalup Hospital, where Sandipan and Baby Amir passed away—has begun implementing some changes to pediatrics
Neethu Thomas, through our efforts, had asked the Health Minister’s office to follow up on CALD and migrant training being implemented in WA Health, especially since the death of Aishwariya Aswath. We had a couple of meetings with the health ministers office seeking this information and are still awaiting what training is being done.
Health advocates, including South Asian midwife Sharon Stoliar and Suresh Rajan, contributed to the creation of the document ‘South Asian Lives Matter,’ which provides essential guidance for ethnic communities navigating racism in emergency rooms. This vital resource was personally passed on to diplomats in India by Neethu Thomas and saw widespread distribution, with hundreds of copies shared through the South Asian Catholic Church and at the 2024 October Diwali Festival by the South Asian community in Australia. We joined ISWA (Indian Society of Western Australia) in order to do this.
Learn more here.Read additional details here.
These achievements, all from 2024, are a testament to the work done by these minority advocates, with us and I want to acknowledge their efforts.
But how did they do it?
By being loud, angry, protesting, rude, relentless, and uncompromising in the face of racism.
Basically, not giving an inch to the claims by multiple white people we have encountered there that ‘WA is a “special ,conservative, reserved place that doesn't like outsiders.” And having no tolerance for that mindset.
Let’s also remember the monumental work achieved back in 2021 by Aishwariya Aswath’s parents, who resorted to hunger strikes and protests outside the Perth Children's Hospital hospital:
An investigation into Perth Children's Hospital was conducted by the Australian Safety and Quality Commission in Healthcare.
Recommendations from WA Health to better capture the experiences of CALD and migrant communities, although implementation remains an issue.
A very publicized coronial inquest into Aishwariya Aswath’s death.
Changes to the pediatric care protocol for diagnosing sepsis via the parrot chart.
Improvements to staffing at Perth Children’s Hospital.
The creation of an independent phone line, Aishwariya CARE Call, to organize independent clinical reviews in emergency situations when patients are ignored.
These actions, led by the migrant community—some in collaboration with us—represent incredible milestones in the fight against systemic racism within WA’s healthcare system. Their contributions have been invaluable, demonstrating the power of relentless advocacy.
But the question remains: why does it always take so much more for people of colour to be heard? Why are their efforts barely acknowledged or credited? Why is their advocacy dismissed as a nuisance, despite the tangible changes they bring to the system?
And most critically, why does this lack of acknowledgment and the continued insult to their fierce advocacy persist, when it is the women and children from their communities who are paying for this racism with their lives?
To finish off, to quote this trope I have been hearing constantly from WA healthcare providers, those in politics and health advocates:
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