Kelvin Kong: Your Māori elders are my heroes

Kelvin Kong is Australia’s first Indigenous surgeon, and was this year voted Australia’s Indigenous Person of the Year.

A proud Worimi man, he works as a head and neck surgeon in Newcastle in New South Wales, on Awabakal and Worimi Country. 

Professor Kong was recently in Auckland, at a hui for surgeons and surgical trainees of Māori, Aboriginal and Torres Strait Islander descent, organised by the Royal Australasian College of Surgeons.

He spoke to Connie Buchanan about why Indigenous surgeons are so important to good healthcare provision both here and across the ditch.

 

You can count all the Indigenous surgeons we have in Australia on one hand. There are five. That’s from more than 6,000 surgeons, so we represent 0.01 percent of the workforce.

It’s obviously not because of our lack of ability. It is certainly the result of a lack of opportunity and a lack of willingness for us to be part of the workforce.

Compared to Aotearoa, we have so much to do. In Aotearoa, you had your first Māori surgeon many, many years ago. When I was going through my training, I was lucky enough to learn about Dr Ru Douglas. He was one of my heroes and even back then he was nearing retirement. It was like: “Wow, we’re just so far behind.” And he wasn’t even your first Māori surgeon.

So, you fullas over there are my professional family and my heroes. People like Papaarangi Reid, Maxine Ronald, Jonathan Koea, and Margaret Mutu are people I have so much admiration for. When I walked into the Royal Australasian College of Surgeons hui in Auckland, I can’t tell you how big the smile was on my face. To walk into a room full of brown faces who are surgeons, and who are my heroes, was an incredible, exhilarating feeling.

My Nan would have just fallen over, if she was alive, to see close to 50 Indigenous people in one place, where everyone is a doctor. There were even professors among us.

I’m an ear-nose-throat (ENT) surgeon or an otorhinolaryngologist. I specialise in both paediatric and adult ENT issues. In my work, I see how hearing loss, often caused by otitis media (middle ear disease) creates an environment destined for difficulty. If you can’t hear, you can’t learn. It leads to poor educational outcomes for children, resulting in limited life opportunities and higher unemployment rates in adults.

When we work with communities and reduce the risk of hearing loss, we can have a direct impact on a child’s ability to learn and develop. We can take them from limited hearing and language skills to becoming fully functioning teenagers with real employment and career prospects.

My focus on community health comes from being a very proud Worimi man. Worimi Country is about two hours north of Sydney in a beautiful part of coastal eastern Australia. I have strong spiritual and family links to home, so I work in the nearest place I can be to Worimi Country, in a hospital in Newcastle on Awabakal Country.

My family endured part of the White Australian policy. It was a policy that was predicated on assimilation and controlling Aboriginal people in this country. When my mother was born, she wasn’t counted as a citizen, but rather counted as fauna or flora. My Nan was separated from her siblings when she was a teenager, and she didn’t see them again until she was over 50 years old.

My Nan and Poppy truly lived off the grid because she was always terrified of the authorities showing up and taking away her family. My mum was quite fortunate and managed to study nursing despite all the obstacles. She became the first one in our extended family to graduate into the health profession.

When we were growing up in Worimi country, a lot of our family and extended cousins would come to our house for Mum’s help. They needed help with wound dressings, removing sutures, bandaging, providing health information, among many other things.

So, me and my older sisters, who are twins, would help Mum with whatever was going on. That was fantastic as a kid growing up. Our house was the hub of activity with cousins, extended family, and everyone coming and going. It wasn’t until my high school years that I started questioning why people came to our house and didn’t go to the public clinic, hospital, or local doctor.

I started realising that our non-Indigenous friends didn’t have the same health experience. That laid a strong belief and passion in me and my sisters that we should contribute to better health in our community.

We were lucky, early on, to be part of programmes that assisted high school kids with access to university programmes. We got to meet two Aboriginal medical students, at a time when the media was only ever about Aboriginal sporting heroes. So, the first time we met academic heroes like Louis Peachey and Sandra Eades, we thought: “Wow, this can actually be done.” They continue to be leaders in medicine and research, and we feel so fortunate that they influenced us so early.

Both me and my two sisters managed to get through medicine. One sister is Australia’s first Aboriginal obstetrician/gynaecologist, and one’s a general practitioner. And I went into surgery. I feel very lucky. I had these two amazingly talented, smart women who looked after me through high school and through medicine, to be where I am today.

You can take out the word Aboriginal, or the word Māori, or Pacific, and put in any Indigenous nation in any country across the globe, and all the same things about our journeys will be true. The disparities and inequity in healthcare. Issues with access, bias, unconscious bias. Barriers that stop us joining the professional health workforce.

Certainly, when I was going through, there was no way that you could say you wanted to be a specialist as an Aboriginal person. That wasn’t even heard of. It was like: “Why are you even dreaming about that?” The message we got was: “Just get yourself through school. Get a good job. You’ll be a good man. Everyone likes you — you’ll be fine. No problem.” Rather than anyone wanting to know about your true aspirations.

From an individual perspective, part of solving that issue is being able to see what we want to be. Putting our academics and professionals up on pedestals, like our sporting heroes. When you walk around among Māori medical students in Aotearoa, they all talk about Maxine Ronald. She’s a hero. They see her and go: “You know what, I can be like that.” And you need only one or two people like that for a ripple effect among an Indigenous community. It’s incredible how powerful just one person doing amazing things can be.

For example, Maxine just won a College of Surgeons medal. That’s a big deal within the college. When we tweeted it out, there were tens of thousands of impressions on social media across the globe about this beautiful surgeon from Whangārei.

That’s a really powerful statement. A girl who’s in high school thinking about her career and not knowing what to do might see this powerful Indigenous woman get these accolades, and think: “Wow, she has a family, she’s a surgeon, and she’s a beautiful, humble person.” That girl might be totally inspired. I certainly want my own daughter to feel like that. So, the celebration aspect is very important.

The second part of solving the issue is that once our kids know the dream is possible, we need to make sure lateral violence in the system doesn’t cut them down.

So, it’s crucial for us to contemplate how our medical institutions address bias in their selection procedures. Most of the conventional admissions into the field of surgery tend to favour individuals who are well-off and white, and affluent males.

This is, in part, a consequence of the selection process showing a real preference for things like a strong CV. And how do you build a commendable CV? If you have the resources and time, you can opt to take a three-year hiatus to pursue a PhD, engage in research endeavours, and ultimately publish a research paper.

The vast majority of our community members simply don’t have the luxury of time, financial resources, or personal connections to make a decision like this — to be able to say: “You know what? I’m going to contemplate for three years, earn a PhD, and then engage in research leading to publication.”

This path often relies on having the advantage of knowing someone, perhaps a friend of a family member, who’s actively involved in research that aligns with your own interests. This connection might lead to opportunities for presentations or research publications.

In contrast, our children are fortunate if they even have the chance to meet a professional, let alone someone willing to invite them to participate in research activities. These are the kinds of disparities that place our community members at a significant disadvantage from the very beginning.

But the fix is not simply to have a good heart and be progressive and take some Indigenous people into your programme. We don’t want that. We want to set up an environment which is structurally sound. So that when those of us who’ve made it through the current system retire and move on, there are structures in place that support our Indigenous applicants in a permanent and transparent way.

I always say to my candidates who are applying for surgeries that there is a way to apply and there is a way to apply. And the real way is not necessarily what you see on the website. The reason we need positive discrimination options now is because the mechanisms aren’t in place to allow that unconscious bias to be exposed and broken down.

Being able to support each other as Indigenous professionals when we’re all up against these same systemic and structural boundaries is so important. The motivations we all have are the same.

First and foremost, Aotearoa and Australia need good surgeons. And if you really want to increase the ability of your country to have incredible surgeons, then you want to make sure the pathway is accessible to everyone. So that you get the best, not just a select few who are privileged. It’s so important for us and our communities that we’re getting the best people for the job, which includes acknowledging Indigenous knowledge.

So, the number one reason that having Indigenous surgeons is important is purely because Indigenous people are amazing.

I had the privilege of interviewing Māori surgeon Professor Jonathan Koea recently. And I asked him: “What’s your favourite operation?” And he started talking about a very complex hepato-biliary procedure, a liver resection operation. It has anatomical components to it that brought a beautiful smile to his face. He’s an extremely intelligent, amazing, gifted surgeon.

For people in Aotearoa, this is someone we should be revering and thinking how lucky are we to have him in our country? He’s helping all people, whether Indigenous or non-Indigenous, with such incredible skill. Plus, his surgical skillset is complemented by his Māori heritage and cultural perspectives of family and kinship, which patients and their families also benefit from.

So, ensuring equity in the surgical professional means we’re getting the best people. Full stop.

Then, if I put my government funding hat on, I know that by employing an Indigenous surgeon in my DHB or in my hospital network, I’m going to get a lot more value out of them than just the operations they perform.

I know that I’m going to get someone committed to community. I know that their elders, their family and their community structures place a sense of responsibility on them, and that will ensure holistic care models. You can walk through the hospital of any Indigenous doctor in the community, and you’ll get 10 people pull you up and talk about their family connections. That’s a huge value add for the hospital, and for the fabric of community.

The goal is that we want good community outcomes. Diversity in our health workforce will do that. I can’t emphasise enough that if you just have one type of person in surgery, then you’re going to get just one type of limited outcome.

One of the really nice things about the Royal Australasian College of Surgeons focusing on these issues of equity and diversity is that there’s a real strong understanding coming through that we can’t keep doing more of the same, because more of the same isn’t working.

And one of the beautiful things is that they’re not telling us the answer. They’re saying that Indigenous focus committees should talk it out and come back to them with what’s needed. We’re in the process of systematic change to increase and improve diversity.

I gained so much strength from my visit to Aotearoa. It was really special. And I also curse that trip. Because when I walked away, I thought: I’m not doing enough. I’m already so time poor, but I’ve got to find a way to do more.

  

Professor Kelvin Kong, MBBS (UNSW), FRACS (OHNS), MD (UoN) is a paediatric and adult otorhinolaryngology, head and neck surgeon. Kelvin completed his studies at the University of NSW in 1999 and earned his fellowship from the Royal Australasian College of Surgeons in 2007. He is proud to be the first identified Aboriginal surgeon within the college and is a member of the Australian Society of Head and Neck Surgeons. Kelvin’s practice is in Newcastle, situated on Awabakal and Worimi Country.

As told to Connie Buchanan, made possible by the Public Interest Journalism Fund

© E-Tangata, 2023