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The names of the children who have died are Aishwarya, Amrita and Hiyaan.

These children were residents in Perth, Melbourne, and Queensland respectively. And there are many common elements that have contributed to the deaths of all three children. Sadly, these children were aged seven, eight and six.

In the case of Aishwarya, I was involved in the External Inquiry that examined some of the issues at play. And, I have been asked to assist the family of Amrita in their discussions with Safer Care Victoria, the government agency established to deal with these matters.

There has not been a language barrier in respect of any of the three families of the children listed above. All the family members who attended the hospital were comfortably conversant in English.

But what are some of the common elements that we can try and adapt to and accommodate in our approach to these patients?

I believe that a critical issue in this respect is the lack of understanding of the cultural issues, particularly around South Asian communities and their propensity to complain.

Our cultural upbringing means that in our formative years we were advised not to complain but to “make adjustments”. However, if we are predicating the efficiency of our health system on the ability of a patient or carer to create a scene, then we have a major failing immediately.

In another case, not involving a child, a 92-year-old Italian speaking lady was denied an interpreter and because of a lack of understanding, became agitated. This eventually led to a Code Black security incident being declared, morphine being administered to the lady and two weeks after she was admitted to hospital for a glaucoma related matter, she was released from the system for her funeral.

This led to several enquiries on my part, and the overriding impression I gained was a complete lack of understanding across the system of the circumstances under which an interpreter should be engaged.

There is a comprehensive language services policy in this State, yet it is fair to say that most practitioners in hospitals are not aware of the detail of this policy. When the COVID-19 pandemic was declared, I took the view that the likelihood of my communities (CaLD) being impacted disproportionately was going to be higher.

This was because we were the ones more likely to have contact with overseas travellers or have family members who were overseas in high-risk areas. Additionally, the impact on international students was always going to be significant, and flight bans existed at the peak of the pandemic against particular countries.

The communication in this regard came down to a blame shifting process. Intriguingly, if we were to examine the infection rates currently in India versus that in Australia, India would be well within their rights to ban all flights from Australia.

The health system is the one area that all of our CaLD communities will have some involvement with.

A critical issue in this respect is the lack of understanding of the cultural issues, particularly around South Asian communities and their propensity to complain.

Yet the support and service provided to these people is provided within a “White Anglo-Celtic” paradigm.

When you predicate your service delivery on that paradigm, there is every likelihood that you will not engage with either the people of CaLD communities nor that of First Nations.

Finally, there are services that we, at the Ethnic Communities Council have been advocating for a long time. The most important one in this post-peak pandemic environment is that of transcultural mental health services. WA is one of the few states that does not fund such a service.

Yet we know that the likelihood of suicide in our communities is much higher than that of mainstream communities.

In Perth we’ve had a number of these recently, and a lot of this can be attributed to stigmatisation associated with mental health issues. In several languages that I am familiar with there is only one word to describe anxiety, depression or any other mental health issue, and that word often suggests that you are mad.

These languages do not have the nuance of English. Consequently, there is a reluctance for people to accept that they may have a mental health issue. Therefore, undiagnosed depression or anxiety can have fatal consequences.

While our health services in Australia are at the cutting edge of world systems, it must be said that the difficulty is that they are all predicated on a white Anglo Celtic paradigm.

This then, by definition, will exclude those of us not from the mainstream and until governments recognise this, we will see the consequences of this well into the future.

There is much to be done to change this for the common good of all, no matter what their ethnicity… because the consequences of not doing so are catastrophic.

This article first appeared in the October-November edition of Medicus magazine: www.amawa.com.au/medicus/november2022/#page=28