Blog

  • The Nurses’ and Midwives’ art exchange
    Image: We are the Front-line (2022), by Xander Savage

    It has been a privilege to be a part of the team who created The Nurses’ and Midwives’ art exchange, at the RMIT Design Hub Gallery as part of the Big Anxiety Naarm/Melbourne. The exhibition highlights creative responses and stories from nurses and midwives who worked through the pandemic in Australia and the US. We wanted to surface nursing and midwifery ways of knowing beyond the dominant empirical models of positivist science, to include: the ethical, aesthetic, and personal (Carper, 1978).

    We also wanted an archive of the pandemic that was from them rather than about them. These works are accompanied by responses from RMIT art students and staff. Our team wanted to develop experiential and embodied pedagogical approaches through material making for artists to respond to social justice challenges beyond and within the classroom and studio. We used an inter-professional/inter-sectoral approach to teach students for a semester and matched them with nurses working in diverse healthcare settings.

    So, this exhibition is an innovative project, it is a love letter to Nurses and Midwives who have been front and center of the action, and also to those “informal” caregivers feeling the deep exhaustion of providing care during the pandemic. These professions stepped up to be there with those in need, despite the risks, lack of supplies and threats to their own health and that of their loved ones. But the pandemic also highlighted the gaps, the exclusion of Nurses and midwives’ voices at policy tables, the workforce shortages (three-quarters of nurses declared an intention to leave over the next two to five years), the horrible gaps, the lack of support, not being heard, the grind, the wear, and tear. We are grateful for support from RMIT Culture, CAST, the Australian College of Nursing, Eastern Health, Creative Care, and staff and students in the RMIT School of Art.

    At the launch, we had the amazing Corona Choir perform from Eastern Health. Here are a few snaps from the night.

    Mark Edgoose with a student, talking about their work. Photo credit: Emily Short
    Me and some of our guests. Photo credit: Peter Mellow
    The project team from left to right: Mark Edgoose, Kelly Hussey-Smith, Moi, Fleur Summers, Grace McQuilten (not pictured). Photo credit: Emily Short

    Project team
    Dr Kelly Hussey-Smith is an artist-researcher focused on photography as a social practice, the politics of representation, and community-oriented education. She is a Lecturer in Photography at the RMIT School of Art.

    Dr Fleur Summers is the studio coordinator in sculpture at the School of Art, RMIT. She focuses on teaching developmental working processes with reference to spatial practice. Fleur has experience in a range of technical processes and has a strong conceptual approach.

    Dr Mark Edgoose is the studio coordinator of Gold and Silversmithing, at the School of Art, RMIT. Mark works at the intersections of craft, design and architecture and is fuelled by an interest in both traditional and high-tech materials and processes.

    Associate Professor Grace McQuilten is a writer, curator and artist with expertise in contemporary art and design, public art, social practice, social enterprise and community development.

    Dr Ruth De Souza is a Fellow of the Australian College of Nursing and a Registered Nurse with a PhD, MA (Nurs), Grad Dip (Counselling) and Diploma in Nursing. Ruth has extensive experience as a clinician, researcher and academic in Aotearoa New Zealand and Australia. She is a 2020 RMIT University Vice Chancellor’s Fellow and is based in the School of Art.

  • Birthing and Justice: From intimate, asynchronous, mobile media to a scheduled live audience

    When I was twelve years old I went on a work experience trip to a Radio station 1ZM in Tāmaki Makaurau/Auckland with my pal Mandy Cunningham. I had big dreams of being a DJ and radio announcer but I was disappointed that DJs were not autonomous. They had to play particular songs. That was not for me. Fast forward to 2020 when I started my podcast talking with people from First Peoples and People of Colour about birthing in settler societies. I love having autonomy to produce (with great producers like Nicola Harvey and Jon Tjhia) and distribute, as well as the intimacy and random relationships listeners develop with interviewees (check out the feedback at the bottom of the podcast episodes page).

    Me with a mike. Talking.

    I recorded series 1 in one day in a studio with guests ensconced in studios in Australia, Aotearoa New Zealand, and the United States. I recorded Series 2 and 3 in my home studio (code for dining table which is now my office desk) on the Bass Coast in Victoria, Australia due to lockdowns. So it’s super fun to go from communal listening to communal engagement vis a vis talking to podcast guests in person with audiences. Podcast lovers, I am hosting two panel discussions in October. I am excited about amplifying the voices of five podcast alumni in person at the Big Anxiety Festival in Melbourne next month. The first is a Panel: Caring for the caregivers: Mothers and birthing parents on October 5th, and the second is a discussion after a screening of Perinatal Dreaming on the 6th.

    Podcast cover for Birthing and Justice. Artwork by Atong Atem
    Design by Ethan Tsang

    Caring for the caregiver, mothers and birthing parents on 5th October 2022 from 10-12
    I am talking to Dr Helen Ngo, Writers Dr Natalie Kon-Yu and Eleanor Jackson at an event called Caring for the caregiver, mothers and birthing parents on 5th October 2022 from 10-12 . To register follow this Eventbrite link

    Care was a big buzzword during the early part of the pandemic. For pregnant people, disruptions in care became a feature. Whether it was the inability to enjoy the physical and social support of family and friends, or that health care became virtual as services were scaled back or reconfigured. The impact for new parents was an increase in responsibility and stress and anxiety, rather than through a system of collective care. In this free event, attendees are invited to virtually listen to the podcast series Birthing and Justice hosted by me, in their own space and time.

    Panel members
    Eleanor Jackson was my guest on Season 2 Episode 7 and we talked about the poetics and politics of birthing. Eleanor is a Filipino Australian poet, performer, arts producer and community radio broadcaster. She is the author of Gravidity and Parity and A Leaving, both by Vagabond Press. Her live album, One Night Wonders, is produced by Going Down Swinging. Eleanor is committed to developing and hosting events and experiences that showcase the diversity of both poetic language and writers and audiences. She is a former Editor in Chief of Peril Magazine, Board Member of Queensland Poetry Festival and Vice-Chair of The Stella Prize. She is currently Chair of Peril Magazine and Producer of the Melbourne Poetry Map.

    Natalie Kon-yu was my guest on Series 3 Episode 4 and we spoke about writing, birth trauma and medical sexism. Natalie is a writer, academic and editor whose work has been published nationally and internationally. She is the co-commissioning editor of #Me Too: Stories from the Australian Women’s Movement (Picador, 2019), Mothers and Others: Why Not All Women are Mothers and All Mothers are Not the Same (Pan Macmillan, 2015) and Just Between Us: Australian Writers Tell the Truth about Female Friendship (Pan Macmillan 2013). Her latest book, The Cost of Labour, is out now through Affirm Press. She lives and works in Naarm.

    Helen Ngo was a guest Series 2 Episode 6 and we spoke about bilingualism, the habits of racism and embodied experiences of parenting. Helen is an academic philosopher and DECRA Research Fellow at Deakin University. She works in phenomenology, critical philosophy of race, and feminist philosophy, and has written on topics such as: racialised embodiment and temporalities, anti-racist activism, white privilege and white supremacy. Her 2017 book, The Habits of Racism, explored the different ways racism is taken up and experienced through our bodily habits and habituations. A daughter of Chinese-Vietnamese refugees and a mother to three young children, Helen’s recent work explores questions around language and bilingual parenting as part of a bigger research project on racialised non-belonging and home-making. She lives and works on the unceded land of the Wurundjeri Woiwurrung people of the Kulin Nation.


    Perinatal dreaming: On justice, reclamation, and transformation 6th October at The Big Anxiety Forum
    Join me in conversation with Gina Maree Bundle, Storm Henry and Marianne Wobcke to reflect on Marianne’s Roadtrip: Perinatal dreaming  workshop and talk: Reclamation, healing, and transformation in our birthing institutions.

    https://www.youtube.com/embed/W1UWmxZJTLA
    Check out this award winning work


    Gina and Storm were guests on Series 2 Episode 1 where they spoke about trust in hospitals. In the episode, we talked about working at “The Women’s” (Royal Women’s Hospital, Melbourne), which has a complex history involving the enforcement of the ‘Aborigines’ Protection Act (1869) causing First Nations babies and children to be removed from their families, community and culture. Storm and Gina work to create an intersectional, culturally safe service at multiple levels and promote a whole of hospital approach.

    Artist and Program Coordinator of Badjurr-Bulok Wilam at the Royal Women’s Hospital Gina Maree Bundle

    Midwife Storm Henry and nurse

    Artist and midwife Marianne Wobke

  • NEW MOTHERS AND APPS DURING COVID-19


    Sukhmani Khorana, Bhavya Chitranshi and I recently completed research about the experiences of six cisgender South Asian-Australian women who gave birth during the COVID-19 pandemic.

    Design by Georgia Hodgkinson.

    A note about language in this report: The South Asian “women” in our study identified as cisgender. However, we have used a gender-additive approach to language to be respectful and inclusive of trans, genderqueer and intersex people by using gender-neutral language alongside the language of womanhood. For example, both ‘maternal’ and ‘parental’, ‘breast- feeding’ and ‘chest-feeding’, and so on (Green & Riddington, 2020).

    Prior to the pandemic negatively racialised women experienced barriers to healthcare and a lack of social support, which were further exacerbated during the COVID-19 pandemic. International border closures in Australia combined with local mitigation strategies inhibited social and cultural support from families, impacting many migrant mothers who gave birth for the first time in Australia. Many hospitals in New South Wales and Victoria instituted restrictions to birthing services as a way of reducing exposure to the coronavirus during the pandemic. These restrictions varied, but included not allowing partner attendance for antenatal appointments, reducing support people to one person that could be present during the labor and birth, and sometimes not permitting partners on postnatal wards.

    South Asian women were recruited via social media, and qualitative semi-structured interviews were conducted between May and October 2021 via video, following ethical approval from the RMIT University Ethics Committee. Findings from our in-depth interviews indicate that perinatal experiences were adversely impacted by:

    a) limited face-to-face support from healthcare providers;
    b) limited access to partner support during appointments and in childbirth;
    c) isolation and mental health impacts of not having access to family networks, particularly to those who could provide culturally specific perinatal knowledge and postpartum support;
    d) increased reliance on an ecosystem of online support including apps, social media groups and credible websites, which had mixed results in terms of being culturally appropriate.

    Our research suggests that pre-existing limitations of healthcare providers, services and apps with regard to culturally and linguistically diverse (CALD) women in Australia have been amplified during the pandemic. Disruptions in the physical and social presence of family, friends and healthcare workers, caused by international travel restrictions and changing healthcare practices during the pandemic, add significantly to the everyday stress, anxiety and challenges faced by new parents. That responsibilization – the shifting back of responsibility from health services to mothers and their families – has led to mothers shouldering many of the burdens of a new transition by themselves, rather than in a system of collective care by wider family or partners as they might have expected.

    These health system reconfigurations combined with the absence of support from family could have longitudinal adverse consequences for new parents and their children. Online Facebook groups from the mothers’ countries of origin or cultural backgrounds, or for mothers who had babies due in the same month, represented a significant source of information and support for the participants. This was particularly important at a time when women’s capacities to engage in traditional cultural practices, which provide practical, emotional and informational support, were compromised by the inability to garner familial support. In the context of a long-term pandemic, we suggest that health services: use flexible harm reduction approaches to facilitate parental support (rather than institute blanket bans), engage in active outreach, and that services are better integrated and smartphone enabled.

  • Book review: This Bridge called my back

    I have been a long-time fan of the New Zealand Mental Health Foundation. Starting in 1996 I did some workshops in Northland and around for the community about Depression, while I worked in perinatal mental health. Later, I co-produced a brochure about perinatal mental health for them. So, when the fabulous Kim Higginson asked me if I would feature in a new section on their website, I had to say yes! In My Kete features book reviews and stories from people in the mental health sector sharing what they have found most helpful in their own work and lives. The word/kupu “kete” symbolises the sharing of knowledge and prosperity.

    Ceramic kete gifted to me with found sulphur crested cockatoo feathers

    Long before social media, my family would eagerly watch the 6pm news. As new migrants to Aotearoa, we would watch with anticipation for even a tiny glimpse of the places we had left behind, that we were connected to. Goa, our turangawaewae, the home of our ancestors, or Tanzania or Kenya, where we had all been born and lived. But it was the seventies, and the closest we ever came was hearing about the famines in Ethiopia and civil war in Angola, until the Montreal Olympics of 1976. We couldn’t wait for the Kenyan and Tanzanian runners like Filbert Bayi to absolutely smash all the other athletes. We knew they were the best!

    Our anticipation was thwarted by bigger events. The New Zealand All Blacks had been playing rugby in apartheid South Africa despite the United Nations’ calls for a sporting embargo. 28 African countries led by Tanzania decided to boycott the games after they had asked the International Olympic Committee (IOC) to exclude New Zealand from the Games and were refused. The United Nations secretary-general said he recognised the “deep and genuine concerns” felt by African countries but, “at the same time I wish to point out that the Olympic Games have become an occasion of special significance in mankind’s search for brotherhood and understanding.”

    The story about the Olympics shows how keen I was to see anything of my world reflected to me through the collective sphere or mass media. But this was rare, and when I did see something, it was often a globalised reflection of famine, disease or deficit. So I turned to literature. I was a frequent visitor to Titirangi Library in West Auckland, where I discovered Ms Magazine and read every issue I could get my hands on. Through authors like Germaine Greer and Andre Dworkin, I read that white feminism was good and brown women were oppressed by their cultures. I struggled to reconcile this idea of brown men as bad. The men I knew in my community (who were very few in NZ in those days), were also struggling with racism, economic disadvantage and white supremacy. My Dad worked two jobs (as a teacher and then as a cleaner) so that my mother could study to become a teacher. He then came home and did the cooking, while my three sisters and I administered the household so that my mother could study, and our collective free time could be spent on family outings.

    Reading This Bridge Called My Back was life changing. For the first time, I saw women of colour foregrounded. They were powerful, knowing, wise, and full-bodied; not deficient, in need of rescuing or pathological. I saw them navigating complicated worlds that were not built for them. I saw collective struggles and collective joy. These stories resonated with me so much I developed a desire for collective solidarities, which led to conference organising (for refugees and Indian social service professionals) and connecting and bringing diverse voices together (the Aotearoa Ethnic Network). I moved beyond exploring gender and incorporated other axes of difference including race, class and sexuality into my academic life. I still carry this work with me as I think about race and health as a researcher. I remain indebted to the solidarities that were brought together in this anthology, for giving me hope and pride in my differences, while also reminding me to always think about who and what is missing from the room, whose voices are not heard and how this can be remedied.

    Book Details
    Moraga, Cherríe., & Anzaldúa, G. E. (eds.). (1981). Frist edition. This bridge called my back: Writings by radical women of color. Persephone Press. ISBN 978-0930436100
    Moraga, Cherríe., & Anzaldúa, G. E. (eds.). (2021). This bridge called my back: Writings by radical women of color. Fortieth Anniversary Edition. Suny Press. ISBN: 9781438488288

  • Lessons on exclusion from past pandemics

    I wrote a piece for the Summer 2021/22 edition (Issue 36) of the Hive (the Australian College of Nursing’s quarterly publication). Cite as: De Souza, R. (2021). Lessons on exclusion from past pandemics. The Hive, 36, 16–17. You can also download a pdf of the article for your own personal use.


    I have three pandemic stories about health inequity. The first is a painful family one. In July 1961 in Moshi, Tanzania, my aunt died of hospital-acquired smallpox caused by the variola virus five days after giving birth to her newborn son, who died a day later. She left behind her devastated family and a thirteen-month-old daughter. She had been immunised while at school, so we don’t know what happened. We know that some vaccinations in East Africa at that time were unsuccessful because the liquid vaccine had to be refrigerated otherwise it became inactive within three days. The smallpox vaccine was produced in Nairobi or England and it is possible that temperatures were not maintained during shipping or when the vaccine was transported to distribution centres or health clinics. It could also be that a more severe form of smallpox was present in Tanzania at the time.

    Closer to home there were the smallpox epidemics of 1789, 1829-32 and the 1860s in Australia (McWhirter, 2009). Smallpox arrived with settlers fifteen months after the first fleet arrived in Australia. Macassans were originally blamed for its arrival, but there was no smallpox in Macassar at the time of the First Fleet. Smallpox was widely believed at the time to come from Asian countries because Asians were thought to be diseased and different. However, smallpox was endemic to Britain and to a lesser degree Europe. The three epidemics all had a major impact on Aboriginal populations but less so on European settlers.

    Smallpox was managed in different ways in the various Australian colonies. Vaccinations became available during the 1829-32 epidemic, but there was no legislation with regard to smallpox in Aboriginal communities. Rather than having compulsory vaccination imposed, vaccination occurred in an ad hoc manner if an individual settler or doctor was concerned about an Aboriginal person. In Victoria, where I live, the smallpox epidemic of the 1860s had a devastating impact on Aboriginal people. In the racial hierarchy of the time, white settlers were seen as superior to Aboriginal people and people of color. Aboriginal people were thought to be already at risk of dying, both individually and as a “race”, and were not seen as a threat as a vector of disease or of being in need of a public health response.

    Chinese people were also seen as inferior and unsuitable for integration into colonial society. However, they were seen as a threat to British dominance, by virtue of their industriousness and because their numbers swelled through the gold rush era and they were characterised as a source of disease. A smallpox outbreak in 1857 in Melbourne, singled out Chinese people as the source of the threat, despite it being traced to a sailor from Liverpool, led to demands for the compulsory vaccination of Chinese. An outbreak of smallpox in 1887 was attributed to Indian hawkers or to recently arrived Chinese. The Tasmanian Chinese Immigration Act 1887 required that all Chinese entering the colony be compulsorily vaccinated, and this was carried out by the Superintendent of Vaccinations, C.E. Barnard, even as compulsory vaccination was being challenged among the European population on the grounds of contravening individual liberty.

    And now to the present. In Victoria, where I live, where the unfair structural arrangements in our society have been exposed. Nine public housing towers with high populations of migrants and people of refugee background in North Melbourne and Flemington were put in lockdown without notice (Ghumkhor, 2021). This racialised response was also seen in Sydney, where people in the western suburbs were policed heavily compared to the eastern parts of the city.

    These pandemic examples from the past and recent present show that although we might be in the same boat “some people have yachts and superyachts” (Siouxsie Wiles). There’s the global inequities of vaccine distribution, which are as evident now in terms of Covid as in my Aunt’s time. At the time of writing this (December 2021), Canada had a total vaccination rate per 100 people of 155.67 while Tanzania had a rate of 1.63, compromising the effectiveness of vaccination as a public health strategy (Carey, 2021). We know that this massive disparity will have far reaching impacts. Low vaccination rates mean that the virus can continue to spread and increase the risk of new variants emerging globally. Considering health equity would ensure that the places that needed the vaccine the most could be supported with resources. This is true also of Australia where there was a lack of prioritisation of vaccine supply for the people with the most need (e.g. essential workers in precarious work, people living in high density housing). An equity lens would require targeting people living in ‘LGAs of Concern’ with early intervention to promote understanding of restrictions, vaccine uptake, and Covid-safe work practices (Reeders, n.d.).

    The second and third examples show how race and racial hierarchies have played a part in how infectious diseases are managed in settler colonies like New Zealand and Australia. Fueled by fear, we have turned to carceral responses and policing particular areas rather than making public health responses toward equity. These responses rather than community led solutions have been traumatising and reduced trust in population groups that already are distrustful or disengaged from health services (Liddle, 2021). The lack of financial assistance for international students and essential workers spread across different contexts has also exposed how some communities are seen as less worthy of respect or care.

    Bringing in an equity lens reveals the limitations of health communication during the pandemic. Firstly, health messaging has not always been accessible for people from culturally and linguistically diverse communities. Initial messaging did not take into account fluency in a language other than English or take into account low health literacy, or diverse work and social contexts that such communities live in, such as the prevalence of precarious essential labour, irregular shift work or multi-generational households. The pivot to digital technologies has also made life more difficult for marginalised communities. Whether for accessing online consultations, or the requirement to use apps to check in at venues and facilities using QR codes, to home schooling and working from home, the mandatory use of unevenly distributed technology has widened existing health inequalities. Once again, the assumption that middle-class, English speaking communities are the Australia public health needs to serve have prevented us from achieving positive outcomes for all. We need far more engagement with marginalised groups and to welcome their participation in producing healthy outcomes for their communities if we don’t wish to repeat the exclusions of the past.

    Footnote
    10 January 2022 from Dr Nadia Chaves, Clinical lead and Chair of C-19 Network clinical governance committee, Infectious diseases specialist

    Thank you for this article, Ruth. I just wanted to mention re your latest article – the C-19 consortium (made up of a consortium of 5 community health organisations – IPC, DPV, EACH, Star health and cohealth) was contracted by Vic gov in 2021 to specifically target vaccinations for at-risk and underserved communitiues including people in social housing, people who are experiencing homelessness, asylum seekers and refugees and people from CALD communities.

    We set up vaccination clinics in all the housing towers who were locked down. This has enabled a very high double vax rate in these housing estates. It was great they were able to be prioritised- the main rate limiting step was access to enough vaccine through federal government and also the lack of staff.

    I do believe there are opportunities to better engage and empower people with intersections of being underserved outside social housing as well. This includes- people with mental health issues, disabilities, people with preferred language other than English, those with low health literacy and low socioeconomic backgrounds. With Omicron, boosters and children’s vaccinations, unless we better care for these communities they will continue to bear the largest burden of COVID-19 pandemic.

    References

    Carey, T. A. (2021, November 14). The number that matters in the COVID pandemic is a relative one: vaccine inequity. The Conversation.
    Ghumkhor, S. (2021, October 4). Pandemic policing in “multicultural” Australia. Al Jazeera.
    Liddle, C. (2021, September 29). Get rid of curfew to restore public confidence in health leadership. The Age.
    McWhirter, R. (2009). Smallpox and vaccination in Tasmania. Papers and Proceedings: Tasmanian Historical Research Association.
    Reeders, D. (n.d.). We ought’ve known – Bad Blood. Retrieved October 1, 2021, from