A Pacific labour scheme has been transformative for Kiribati families but the loss of nurses has hit the country’s hospitals hard
Every night, sitting in her room in the remote Queensland town of Doomadgee, Bwerere Sandy Tebau calls her husband and daughter 4,300km away in Tarawa, the capital of Kiribati.
“There is no sea!” Sandy says, when asked about the difference between her new home in the red desert of Australia and her island home in the central Pacific. “There is just a lake and in the lake are crocodiles!”
Sandy is one of three nurses from Kiribati who have been brought in to work at an aged care facility in Doomadgee, a town of about 1,500 people, 85km from the border with the Northern Territory.
Her employment is part of the Pacific labour scheme (PLS), a program that enables residents from 10 Pacific Island states and Timor-Leste to work for approved Australian employers in sectors such as meat processing, tourism and aged care. The program aims to tackle labour shortages that plague rural Australia.
Securing a position in the program can be transformative for Pacific families, especially in remote and sparsely populated island states such as Kiribati.
“I am going to save money to send back home,” Sandy says. “I will also save money for [my family’s] visa and plane ticket to come to visit me here.”
A few weeks in and Sandy is enjoying the work at a facility called Ngooderi House. “We are getting to know the residents and we love the work... We are getting good feedback from Health X, who tells us we are hardworking and that they want to hire more i-Kiribati workers.”
Past participants have returned to Kiribati with enough money to build sturdy concrete homes, reinforce wells, buy cars and fund their children’s education.
With so much on offer in Australia, many recruits hope for pathways to stay. But back in Kiribati, the loss of the nurses to Australia is having severe impacts on the country’s healthcare system.
On a humid Tarawa night, Albert O’Connor has received an all-too familiar phone call. A patient has presented at the hospital and is being prepped by O’Connor’s colleagues for an emergency C-section. Despite the fact he has only had a few hours’ sleep, hospital transport is on its way to take him back in to work at Tungaru central hospital, the country’s largest health centre.
“Staff across all wards are working more double shifts,” said O’Connor, a nurse who studied with Sand. “There is no one to take our place, and we are even unable to assist shortages in other wards.
“High birth rates and increased instances of non-communicable diseases stress limited resources and lead to long hours for the understaffed nurses… We often do not spend much downtime with our families.”
Mereua Eete, Albert’s colleague in the obstetric ward, added: “With less staff and due to the number of patients in the obstetric ward, sometimes on our day off we are not off – we still must work overtime.”
The hospital has struggled to cope with the growing needs of the community. According to sources at the ministry of health and medical services, the hospital is often overcrowded, having only 85 beds, including a 10-bed antenatal care unit housed in a tent. Kiribati has a population of about 120,000.
In addition, Kiribati nurses receive low pay compared with their counterparts outside the country. The average fortnightly wage for nurses in Kiribati ranges from A$350-$500. As a result, registered nurses with skills and training are turning their sights to better paying and less intense opportunities in the Australian aged-care industry.
With the arrival of Sandy and the 15 other nurses late last month, a total of 25 nurses from Kiribati are now employed in Australia through the PLS.
The departure of the nurses has also come at a particularly bad time for Kiribati, as remaining staff confront a whooping cough outbreak and with fears that Covid could arrive in Kiribati – the country has so far remained Covid-free – as it plans to open borders in January.
The ministry of employment and human resources said concerns about a brain drain from the country were overstated given that under PLS terms, contracts were fixed at three years and did not provide pathways to permanent residency.
“At this stage, there is little concern about brain drain as these nurses will not stay in Australia permanently as they will return [to Kiribati] at the end of their contract,” the ministry said in a statement.
For Sandy, while the work offers huge opportunities, it is unlikely she will look to stay longer than her posting, if it means being separated from her husband and daughter. The job is fulfilling but a tough commitment, especially during a pandemic that has made it nearly impossible to travel between Kiribati and Australia.
“We miss her a lot, especially our daughter,” said Sandy’s husband, Tevevere, who remained in Kiribati. “But also we are happy for her and support her because we know she’s fulfilling one of her goals now.”
“[Doomadgee] is a small town,” Sandy says. “There’s not much to do so we go to work, go shopping in the supermarket, and spend my free time in my room calling my husband and daughter. I really miss them a lot.”