Five years after migrating to Australia to work in agriculture, Chilean-born Lisbett Lillo was making progress towards becoming a permanent resident.
But two weeks before Christmas, Lisbett received a diagnosis of breast cancer, throwing her years of planning into disarray.
As a temporary visa holder, the 33-year-old does not qualify for coverage of her medical expenses through Medicare.
She's also been informed that the nature of her diagnosis will likely make her ineligible for permanent residency.
"I've been told it would be too expensive, so even if my boyfriend can apply for sponsorship, I will never be able to get a partnership visa with him because of that," she said.
"It's been very hard to handle both news. It's heartbreaking."
Lisbett worked on Victorian farms as a tractor driver throughout the pandemic and has since settled in Stratford in south-eastern Victoria with her partner.
"I worked as an engineer back home, but I wanted to travel and change my routine," she said.
"I decided to come to Australia and fell in love with the country … I enjoy using the big machinery like the tractors, excavators and forklifts, and seeing where the produce goes."
Having secured stable work as a farmhand in Boisdale, Lisbett and her partner were poised to apply for a partner visa that would give them a pathway to permanent residency.
Passing the health test
All temporary visa holders in Australia are required to meet a set of standards laid out by the Department of Health and Aged Care before they can progress to permanent residency.
This includes a health check, where an individual's estimated medical costs are calculated over a 10-year period.
A department spokesperson said that any application would fail that test if total medical costs were estimated to exceed $51,000 over that period.
"The current migration health framework is pragmatic and balances compassion and cost containment by imposing a standard health requirement for visa applicants, while making health waivers available for some visa subclasses," the spokesperson said.
In Lisbett's case, the chemotherapy she requires to treat her breast cancer is likely to cost more than $130,000.
Australian residents with the same diagnosis would be eligible to have those costs covered through Medicare.
But Lisbett, who is on a temporary visa, is awaiting word from her insurance provider as to how much cover, if any, she is entitled to.
'Harsh and blatantly discrimination'
The Migrant Justice Institute's co-executive director Laurie Berg described the health requirements as a "notoriously harsh" barrier that regularly curtailed migrant families seeking permanent residency.
"Australia's system [of immigration] is much more rigid than some overseas, and much more black and white," Ms Berg said.
"Lisbett seems like she's left in a situation here, where she's a temporary resident so she's not protected by Medicare, and then she's not able to transition into residency, because she actually needs the coverage.
"It is harsh and blatantly discriminatory.
"She received a COVID-19 visa precisely because the regional area needed her skills in agriculture," Ms Berg said.
According to government data from 2021-22, more than half of all surveyed Australian horticultural farms faced difficulty recruiting staff.
The issue was most severe in Victoria, where 70 per cent of farms reported recruitment difficulties.
"On balance, she's contributed so much to the community that she should be allowed to stay," Ms Berg said.
Calls for reform
For Gippsland-based Valerie Shaw, who works in the clinical development of drugs, Lisbett's story has encouraged her to advocate for changes to Australia's system of immigration.
Over 32 years in medicine, she has seen how migrants have struggled to access essential treatment such as chemotherapy.
Ms Shaw says the system should allow for visa holders to pay an additional upfront fee that would allow them access to Medicare in certain cases, without having to rely on insurance.
"They are very disadvantaged not having Medicare, there is usually no way around it other than paying the full price," she said.
"I think we need to relook at how we treat people who are on visas from non-reciprocal countries. As a nation we need to make sure they have the right to healthcare while they're working with us."
For Lisbett, who received her life-changing diagnosis just two months ago, spending time poring over the details of her immigration prospects is the last thing she needs.
"Still, reading the two words 'breast cancer', it gives me the cringe," she said.
"Nothing in life is easy. I really love this country, I can see myself here, and I would like to stay longer if I can."
