Australia’s public health care system is one of the best in the world and therefore fascinates most new migrants, and it is the first and most important thing that gives them reassurance about their healthy future in their new homeland.
Despite the development of the health system, and the diverse, safe, and affordable services it provides, even free of charge, dealing with it may be difficult at first for the new migrant.
February 1, 1984 is one of Australia's most important national dates. It is the date on which former Australian Labor Prime Minister Bob Hawke established the health care system known as Medicare, as the primary health care umbrella for all Australians.
Many health care providers in Australia fall under this system, the most important of which is the General Practitioner (GP), who is considered an essential part in the patient's access to the most complex health services. Regardless of the type of pain or disease that you may suffer from, you will not be able to reach a specialist or specialised medical care, as in the Arab countries, except through a GP.
"In our country, if I feel that my eyes hurt, I will contact the ophthalmologist directly," says Fatima Shams.
From left to right: Tuqa Almanasiri, Mohamed Elgohary, Ola Aly. Source: Tuqa Almanasiri, Mohamed Elgohary, Ola Aly.
"But here all our health complaints must go to the GP first," Malda Karsli said.
Mohamed El-Gohary says: "I consider the idea of a general practitioner to be a strange idea. How can there be a single doctor capable of diagnosing all diseases?"
This is one of the major shocks or differences in the way healthcare is accessed in Australia, because most Arab migrants come from countries where it is not common to start treatment with a GP.
GP Dr Antoine Barrish says that his role is to link health services together in the country.
"The Australian health system is clear and states that you as a patient have nothing to do with diagnosing your condition and choosing the specialty of the doctor you want to see,” Dr Barrish said.
“A specialist is dedicated to seeing a patient who has been referred by a GP."
He adds, "Don't try to get a specialist appointment without going through the GP and that’s not because we want to humiliate the patient, but this is the country's health system, and we must all abide by it."
Prescriptions
So, if your health condition does not require seeing a specialist doctor, the GP will, from his or her point of view, save effort, time and money for you and your family.
they will provide the best advice and guidance for dealing with your pain or illness in most cases, without prescribing medication.
Maryam Elias says: "In Iraq, we are used to the doctor prescribing a few medications for treatment. I was shocked in Australia that a doctor refused to prescribe medicines or antibiotics for my child."
Muhammad added, "Often, the doctor prescribes us to drink water only."
One of the funniest stories you'll hear in Australia about Arab migrants dealing with medicines will be about complaining about the doctor's reluctance to rush for antibiotics.
In Arab countries, antibiotics are considered a solution to most health problems, and in addition they are easy to buy “over the counter” without a doctor consultation or a prescription.
Georgina Maurice says: "I was shocked that antibiotics in Australia are only prescribed by a doctor and after a specific examination to find out the appropriate type of antibiotic our illness needs. In our countries, we buy them from the pharmacist, and we buy some other types of medicines to treat ourselves."
Ola Ali agreed with this: "It's true, we can buy any medicine except for drugs that may lead to addiction."
Sameh Al-Gawadi noted: "The doses prescribed by the doctor here start from a low dose and are gradually increased over time whereas in our country, the doctor prescribes the highest dose for us immediately. So, I realised that dispensing antibiotics here is a very thorny and complex issue."
Right and Left: Sameh Algawadi and Duaa AlSheikh Source: Duaa AlSheikh and Sameh Algawadi
The pharmacist as educator
Here, the Australian pharmacist has a role to educate migrants more about how to buy and take medicine in Australia. They provide clear and explicit advice for the new migrant to visit a recommended GP to diagnose their condition and the appropriate treatment for it, as it is the case in Arab countries.
Pharmacist Ahmed Al-Lubaidi has gone through many similar situations in his career.
“I met a lot of migrants here who come into the pharmacy and ask for medicines from the dispensary or behind the counter,” Mr Al-Lubaidi said.
“When I direct them to make an appointment with a GP, they would tell me ‘we used to buy this medicine constantly and other medicines in our country’s pharmacies.’ I would reply that this could never happen here.”
“Over-the-counter vitamins, for example, and medicines on the shelves are only available in Australia to buy without a prescription.”
The pharmacist has a prestigious place in the Middle East. Unanimously, the guests of the podcast considered the pharmacist the closest description of the concept of the general practitioner or the family doctor in most Arab countries, and that it is the first stop on the patient's journey to obtain treatment, especially if he or she is not well off.
Duaa Sheikh Omar says, "My brother is a pharmacist who works in Jordan. When I encounter any health problem, I contact him to advise me, direct me, and educate me about the type of medications available for treatment."
"This contrasts with the situation in the Australian pharmacy. In addition to the strange waiting period for them to prepare the medicine, which can be up to about half an hour," Malda adds.
Ambulance and medical staff attend to a patient on an unusually quiet saturday night at St. Vincent's Hospital Emergency Department, Sydney Source: AAP Image/Dean Lewins
Specialists require a GP referral
Going back to the GP in another scenario, involving getting a referral letter to see a specialist, the new migrant is likely to experience another kind of trauma here -- the long waiting times for an appointment.
Also, the costs of consulting a specialist doctor are very expensive because it is not fully subsidised by the government as is usually the case with the costs of visiting a general practitioner.
Azza Ibrahim says: "This is a very cumbersome process, firstly looking for a good specialist and then getting an appointment to visit them soon. The waiting period for an appointment may reach three months, not to mention the high cost, which may reach $500 or more."
Iman Nabil adds: "In Australia, we can recover a small part of the high cost of consulting a specialist. However, we must have an online account connected to the Medicare health system to receive this amount."
"This is a very confusing process. The system shouldn't assume that everyone is able to figure out how to get it done. If we could, it would still make a lot of us nervous."
And the long waiting times have reasons, of course. Dr Barrish says the most notable is the shortage of specialists in Australia.
"The process may take a full six months. Therefore, the general practitioner provides assistance to the patient until an appointment becomes available and to prevent their condition from deteriorating, he said."
Right to left: Georgina Maurice and Safa Samoun Source: Safa Samoun and Georgina Maurice
Emergency Room (ER) at hospitals
The long waiting times don't end with doctors' appointments in Australia. There is almost an equivalent number of waiting hours per day when visiting emergency rooms (ER) in hospitals.
"Sometimes we are ready to spend an hour or two in the emergency room," Fatima says. "But I never expected in my life to spend nine hours in it."
Tuqa Al-Nasiri on the other hand spent 10 hours in ER with her son.
"Delays are not normal. During the waiting hours, my son's condition began to improve. So, after 10 hours passed, I decided to go home without seeing the doctor," she said.
"The emergency department called me to ask where I was, so I told them we're back home and we're fine."
Whether it be migrants or locals, waiting times in emergency departments are a crisis for many Australians.
"The way the emergency system operates in Australia has changed in the last 10 years," says Dr Barrish. "The state governments that fund and manage it have made a strict decision that this service is only for emergencies that may put a patient's life at risk."
Other than this, the government considers that the services of the GP and other after-hours health services available in the suburbs of the states are sufficient to take care of non-life-threatening cases.
"Criteria that applies to everyone"
The Australian health system is very different from the similar systems in Arab countries.
The migrant will need some time to get used to it and the best thing about it is that it is available to everyone.
Whatever your financial circumstances. Australia is proud that this system is a major reason why its people enjoy one of the longest life expectancies in the world.
"There is no hospital for the poor and one for the rich," says Mohammed. "We will all get the same service and the same standard of care."
"I like that there is a criteria that applies to everyone to obtain the service. Therefore, I can understand the long waiting times, and that my turn will come based on pre-established criteria and my health compared to others."
Australia provides mental health services to all Australians. Its services are not considered secondary and mental health illness is not underestimated, and they are not linked to a great social stigma compared to the culture of dealing with the mentally ill in most Arab countries.
Safaa Samoun says: "In our country, they blame everyone who goes to see a psychiatrist. Some consider it a taboo or accuse us of being insane."
"When I immigrated to Australia and went through difficult circumstances, and my GP advised me to see a psychologist, I liked the idea and the service."
"I hope that in the Arab countries we will reach the idea of accepting mental health therapy as in Australia."
For Aboriginal and Torres Strait Australians, health refers not only to the physical well-being of an individual, but to the social, emotional and cultural well-being of the community as a whole.
Indigenous people view health from the perspective of whole life.
Therefore, health care services must strive to achieve the state in which each individual is able to realise his full potential as a human being, to achieve the full well-being of his community.
Listen to Australia Explained in Arabic on , , or . Tailored for new and recent migrants to the land Down Under, the podcast helps demystify the quirky habits that embody the Aussie way of life. Listen in as SBS Arabic24 delves into the culture shock experienced by migrants in social spaces, the workplace, school, and more.
