‘I found my calling’ Grassroots change
Life turned upside down when Kali found out she was pregnant at 16 years old—she had just left school with dreams of playing the trumpet professionally—Kali did what she thought was the right thing and went straight to her GP.
“I went to the GP’s office and was told ‘yes, you’re pregnant’ and then in the next breath they said ‘but you should be ashamed of yourself’, because I was only 16.”
“That really impacted me as an individual, because prior to that I had never placed shame on being pregnant. But someone who was in a position of power had decided for me that I should be ashamed.”
“That experience really made me sit there and say, ‘I can do a better job than you’. So I always say that I got into medicine through spite, because of that experience.”
When Kali’s son was three years old, she finished year 12 and enrolled in a science foundation course at Adelaide University. Here, she met other Aboriginal medical students.
“It was the old adage, ‘you can’t be what you can’t see’. Finally meeting Aboriginal people who were on this journey made me think ‘I can do this because someone else has gone before me’.”
After enrolling in medicine and doing placements in general practice, Kali found her calling.
“I became a GP to work closely with my community and to give back to my community.”
“I’m at the ground level, working with the community and living in the community, and I can see my patients not just in crisis, but when they come back and then we can work on their health and their life journey.”
Kali completed the majority of her GP training at Nunkuwarrin Yunti, an Aboriginal Medical Service in South Australia, where she has now worked for the past ten years.
After Fellowship, Kali became a medical educator, “paying it forward” by supporting the next generation of Indigenous GPs.
‘Some of the medical students had never met an Aboriginal person before’
While many Australians like to think the days of racism are long gone, Kali’s experiences as an Aboriginal medical student showed otherwise.
“On the first day myself and my fellow Aboriginal medical students were told to leave our culture at the door…that made me feel different, that my culture wasn’t valued in medicine.”
While negative comments were made by Kali’s peers, she used the experience as a teaching moment.
“Most of the students [in my undergraduate course] were still teenagers, they had their parents’ opinions and really hadn’t formed their own. So I was able to sit down and talk to some of the medical students who have never met an Aboriginal person before.”
While Kali’s experiences in university were not always negative, they were often sobering—such as the moment when she learnt that many of her fellow students had never been to a funeral before.
“It shocked me because I had been to so many funerals over my lifetime, and it’s just such a sad state of Aboriginal community…that made me so passionate about becoming a doctor so that I can do something to stop that from happening.”
Thankfully, Kali had the peer support of four other Aboriginal medical students.
“We stood up and said, ‘the teaching around Aboriginal health is not so great, why does the [patient scenario] on alcoholism necessarily need to be an Aboriginal person?’ So there were some changes that were being made.”
‘An Aboriginal health training post is valuable to any GP registrar’s training’
Kali says that working in Aboriginal health is suited to those who look at health in a holistic way—factoring in the health of someone’s family and community into the equation.
“I know that my mainstream patients really appreciated that type of medicine that I brought to that practice.”
“What you learn during your training time in an Aboriginal health training post you can take to your mainstream practice.”
A good starting point is to talk with your RTO to discover the prerequisites required, and to talk to someone working in Aboriginal health to understand the type of service they are entering.
The key to a successful placement in Aboriginal health, Kali says, is good supervision; as many GP trainees are afraid of making cultural mistakes, cultural mentoring is important.
“A lot of our patients struggle with the healthcare system and institutional racism.”
“Change is needed from the top down and GP trainees can be a part of that change… [we need to] stand up against racism, not only in medicine, but in everyday life.”
“I try to teach trainees how our words can impact on the lives of people. We can say something differently or off the cuff, but we don’t know what our patients are taking away.”
“We need to really be mindful of our own cultural biases and try not to instil that onto our patients.”
Despite the challenges, Kali loves what she does.
“I really haven’t had a terrible day in Aboriginal health where I didn’t want to go back…I have people around me that I can sit down and debrief with who are in similar positions and know exactly what I’m going through.”
“I strongly encourage any GP trainee who is thinking about Aboriginal health to put their hand up for it, even if it’s just for the six months. The support, learning and teaching that they’ll get is fantastic. Those skills can translate anywhere.”
“Change is needed from the top down and GP trainees can be a part of that change... stand up against racism, not only in medicine, but in everyday life.”
Passionate about change
During her GP training, Kali was the only Aboriginal GP registrar in her Regional Training Organisation (RTO).
Kali has been a long-time member of the Indigenous General Practice Registrars Network (IGPRN), a network for Aboriginal and Torres Strait Islander GP registrars which provides professional and cultural peer support.
“It was so great to be able to sit with other Aboriginal and Torres Strait Islander GP registrars who were going through the same things I was going through, and to be able to have a safe place to be able to talk about our issues.”
As a member of IGPRN, Kali was able to see other Indigenous GP registrars achieve Fellowship, which encouraged her on her own journey to Fellowship.
“Seeing people who are having similar struggles to you being able to achieve [their Fellowship] goals means that you can do that too.”
“[Going to IGPRN] was like going back to family and being rejuvenated and ready to fight for the next semester. It is vital in that regard to keep you going, keep you energised and passionate.”
Passionate about creating change, Kali was elected President of the Australian Indigenous Doctors’ Association (AIDA) in 2015.
“I saw great change…we now have someone with an Aboriginal voice [on the AMA Federal Council] actually sitting around that table and saying ‘No, hang on, this is how we feel about this’.”
While being the president of a national organisation is not for everyone, Kali says all doctors are called to be advocates in whatever level that they can participate in—locally or nationally.
“The role of a GP is more than clinical medicine, it is about advocating for your patient, it is about education and improving the health literacy of your patient.”
Kali says a big part of being a GP is sitting, listening, and advocating.
“If an Aboriginal patient comes in and shares a negative experience within the system, ring up, make a complaint on behalf of your patient… sometimes that patient would appreciate that person making that complaint for them, because if people don’t hear complaints, there is not going to be change.”
“I love seeing the change at ground level that really impacts on my patients, where they come in and say, ‘Thank you so much for talking to that person for me because otherwise I wouldn’t have done anything about it’.”