When Destiny Kynuna was growing up in Yarrabah, a remote Indigenous community in Far North Queensland, she didn't know any Indigenous doctors.
So when an Indigenous patient recently asked for the now-26-year-old medical student to take care of her in hospital, the request resonated with her.
"Growing up in Yarrabah, you see a lot of chronic health conditions," the proud Koko-bera and Wunumara woman says.
"But you also see a lot of mental health issues as well. Even within my own family, I've seen issues with drug and alcohol and suicides."
Witnessing the over-representation of Indigenous Australians within the medical system compelled Destiny to take up a career in health care.
And her experience has made it clear just how important it is to encourage more Aboriginal and Torres Strait Islander people to practise medicine.
Support and self-belief
Destiny is now in her fifth year of medicine at the University of New South Wales, and she also works as a psychiatric nurse at Sydney's St Vincent's Hospital.
But at times, she has found it challenging to pursue a tertiary education.
Destiny graduated from high school in 2012, one of eight graduates from her community that year.
It wasn't common for students from Yarrabah to graduate, let alone receive a tertiary education, she explains.
"I think my sister — she went to university and did a social work degree — she was the only person I knew from my community that had pursued tertiary education," she told ABC RN's Life Matters.
Her career advisors suggested that she consider TAFE, that "maybe university wasn't the best idea," she says.
But Destiny stuck to her guns. "I [said] 'Oh, I don't know, because my dad was always like – 'it's not if you go to uni, it's when you go to uni'.
Despite the mixed messaging she received from her advisors, Destiny stuck to the guidance she'd been given by her family and enrolled in a nursing degree at Brisbane's Queensland's University of Technology.
"I was doing quite well and then my nursing professor actually said: 'Hey, Destiny, you should really think about doing medicine'," she recalls.
She took the advice of her professor — also an Indigenous Australian — and, with some additional support from the Australian Medical Association's (AMA) Indigenous medical scholarship, she has almost finished her medical degree.
Once she graduates in 2023, she plans to continue her studies and become a psychiatrist.
Culturally appropriate care
Set up in 1994, the AMA's Indigenous medical scholarship aims to reduce the shortfall in First Nations doctors in Australia, as well as support the few existing medical students who have an Aboriginal and Torres Strait Island background.
More than 30 Indigenous students have received the scholarship so far and some of the recipients have gone on to become surgeons or leading researchers.
Dr Omar Khorshid, the AMA's President and a practising orthopaedic surgeon, says it's important to offer culturally appropriate care to Indigenous patients. This will only improve by having more Aboriginal and Torres Strait Islanders working in medical professions.
"The best way to deliver that is with at least population parity, [so] at least another 3,000 odd doctors who identify as Aboriginal and Torres Strait Islander. That makes that connection so much easier and stronger," Dr Khorshid says.
He says there's more that needs to be done to eliminate the casual and overt racism in our health system, which he agrees has contributed to a legacy of distrust in health care for many Indigenous people.
There's also evidence to suggest that Indigenous healthcare workers may help to improve the attendance of Indigenous Australians at appointments, reduce discharge against medical advice and increase patient contact time.
Recently Destiny has seen the difference her presence as an Indigenous healthcare worker can make.
"[In my cardiology unit] there was an Aboriginal client and she was always discharged against medical advice," she says.
Her patient struggled with being confined to a hospital bed, but she told Destiny that if she looked after her, she would stay in the hospital.
"I was like, 'oh Auntie, I'm just a student but I'm on this team for the next six weeks so I'll definitely check in with you', and she's like, 'Okay Bub, come and see me tomorrow.'"
When Destiny reflected on that, she says she felt "so privileged".
She had a similar experience when she was working as a psychiatric nurse with a patient who distrusted the medical system.
"She had bipolar [disorder] and was given a medication within the hospital system previously where she had lost her baby. So [her trust] within the system itself was really poor.
"I was the one that always looked after her and it was a lot of pressure on me. But I felt really privileged that I could do that and connect with her on a cultural level [and] on a personal level, where we didn't need to restrain her and give her medication."
'Domino effect'
Destiny says she's grateful to have had such a great support network, including her family, her nursing professor and the AMA, who have all given her confidence to pursue her career path.
"That's what's really drove me to think about it and planted that seed in my head to say, you can really do it," she says.
She's seeing a knock-on effect, as those around her also become more confident.
"Even my own nieces and nephew are now thinking about doing medicine," she says.
"Whereas before, maybe if I wasn't doing medicine, they wouldn't think about it. So it definitely has that domino effect."
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