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‘Camaraderie, love and affection’: migration and the making of the NHS – a photo essay - The Guardian

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Since its creation in 1948, people have come to Britain from all over the world to work in the NHS. Today, about one in six people working in the NHS are non-British and many others are the children and grandchildren of migrant healthcare workers. Without its international workers, the NHS would not have become the institution it is today but their crucial role has largely been ignored.

Heart of the Nation is an immersive multimedia exhibition which asks: who are the people who care for us? And do we care enough? The exhibition features personal stories contributed by NHS workers from the 1940s to the present day, brought to life through photography, film, oral histories, singing and storytelling.

The exhibition is on at Leicester Museum and Art Gallery until 29 October – the first leg of a national tour. Future locations include Leeds and London. The exhibition can also be explored at www.heartofthenation.co.uk

Lillian Tan

Lillian Tan

Arrived in 1959 from Malaysia | Retired nurse

“I arrived in Tilbury dock in October 1959. It was very gloomy. The British Council were there to receive us and send us to our hospitals. I was homesick, but before I came, my Auntie said I would never complete my course because I had never done any work. And that upset me a lot. She always looked down upon my father for being poor. I was so determined to prove to her that I was not stupid, that I was not worthless.

Working in the community was nice: you’d see all types of people with very different lives. I never cared about status or wealth. I used to work with a GP who was gay, and he was involved in Lighthouse, where Princess Diana went. Oh I loved all the Aids patients. At the time a lot of people wouldn’t nurse them. A lot of them were very scared, they wouldn’t go in. To me, they didn’t ask for the virus: it was just there and they needed to be cared for.

After my nurse training, I went on to become a midwife and a staff nurse before working at the Western Ophthalmic, the Chelsea hospital in gynaecology, and eventually in the community.

I’m glad my children and grandchildren grew up here and that they can accommodate eastern and western culture. That helps in life, wherever you go, to adapt to any situation. Because if you aren’t flexible, your life will be very miserable.”

Allyson Williams MBE

Allyson Williams

Arrived in 1969 from Trinidad | Retired midwife

“I came to London in May 1969 from Trinidad to train as a nurse at the Whittington hospital in Highgate. To get over the loneliness, I met up with the friends in my set as often as I could. This was usually in the dining room at meal times. The food was full of carbs and very heavy but we had no choice but to eat it. As a result, we all put on loads of weight in a short space of time.

I always made sure I was invited out. We went to house parties in places like Wood Green, Tottenham, Golders Green, Brixton and Croydon. When we worked late on Saturday night and early on Sunday morning, we still went out. We would party all night and return to the nurses home about 6am, shower and then go on duty for 7am.

No one prepared you for how the patients were going to treat you. They’d slap your hand away and say, ‘Don’t touch me, your black is going to rub off on me.’ One day I stood up in the ward and said, ‘I know I am black. I have been black for 21 years. So tell me something I don’t know.’ And there was silence.”

Dr Aye Aye Myint and Gordon Paw

Gordon and Aye Aye

Dr Patricia Aye Aye Myint and Gordon Paw | Arrived in 1989 from Yangon, Myanmar | doctor and nurse, Lancashire and Newcastle/Sunderland

Gordon is a retired mental health nurse from Hopewood Park, Sunderland; Pat works as a consultant psychiatrist in old-age psychiatry at Bensham hospital in Gateshead.

“We both came to the UK for postgraduate studies and chose the NHS for its proud history of providing healthcare from ‘the cradle to the grave’.

We made our own decision to come to the UK after the events of 8/8/88 in Rangoon, for our children to have a better life. We both chose psychiatry and Pat passed the PLab exam and the Royal College of Psychiatry exams to work as a psychiatrist.

Gordon trained as a mental health nurse for three years. We weren’t scared of leaving home, but we missed our family terribly. Pat came alone first to work as a junior doctor in Burnley, and Gordon followed with our sons a year later.

We always thought we could speak English but discovered we could not always understand the different regional accents.

The English culture is easier to adopt and we’ve grown to enjoy rituals like tea breaks, fish and chips, and summer time with strawberries and cream. Also the kindness and understanding of colleagues who helped us adapt to living and working in England and the NHS.

The hardest to adapt to professionally were the tea breaks, which couldn’t be interrupted even if a patient needed something done, and the slowing down of services around holidays and school half-terms. The grey, cloudy weather was also difficult, as was having to wear layers of clothing when going out. The values we held on to were having Burmese family meals together and maintaining our Baptist faith.

We love to help patients and to work with great teams. The hardest moments are when we lose someone we’ve been helping or when our best efforts were not good enough to help a patient regain their mental health.”

Dr Arnab Seal and Dr Sunita Seal

Dr Arnab Seal and Dr Sunita Seal

Dr Arnab Seal, consultant community paediatrician, Leeds community healthcare NHS trust | recently retired; Dr Sunita Seal, consultant neonatologist, Bradford teaching hospitals NHS foundation trust | recently retired | arrived in 1992 from India

“The first thing that struck my wife and I when we arrived was how quiet it was. We were staying in a small village north of Darlington and it was very rural; we didn’t see anybody on the streets or hear any noise. It was also cold. The house had log and gas fires, but no central heating. The cold and damp came as a shock!

Racism was really overt back then. We’d caught a bus from London Victoria to Darlington and arrived around 11pm. While we were waiting to be picked up by our friends at the bus stop, a group of lads were walking down the street, smashing shop windows. As they passed us, they shouted abusive, racist language and threatened us, saying: ‘Remember, you saw nothing!’ Thankfully, they didn’t do anything to us, but it wasn’t a great start to our time in the UK. Society is very different now, but there’s still some way to go.

Following our exams, I got a job in Rochdale, at Birch Hill hospital. My wife got a job down in Exeter. Everyone within the NHS was so kind to us and so polite: they would use ‘please’ and ‘thank you’ several times in the same sentence. I did struggle with the Rochdale accent, but everyone was so helpful. Other than getting used to accents, we didn’t really have any struggles. Mostly, we had to get used to processes and how things were done in the UK.

Overt racism in the NHS in the 1990s was not uncommon. There would be families where the parents or grandparents would swear at us or tell us not to touch their children. ‘Paki’ was a common derogatory term used to refer to anyone of Asian heritage. Thankfully times have changed. Back then we’d walk off and get someone else to treat them. While overt racism is no more, there is still the issue of bias that needs to be addressed. However, the vast majority of colleagues are extremely distressed if they witness any racist incidents and are very supportive of co-workers who have migrated to the UK to join the NHS: the camaraderie, love and affection across the staff is incredible.”

Dimov family

The Dimov family.

Prof Dr Galina Velikova-Dimova, professor in psychosocial and medical oncology | Leeds teaching hospitals NHS trust

Dr Doytchin Dimov, consultant physician, respiratory disease | Leeds teaching hospitals NHS trust | Arrived in 1995 from Bulgaria

Michael Dimov, head of community health improvement, NHS England | Arrived in 2004 from Bulgaria via New Zealand

Stefanie Dimov, senior project manager | outpatients transformation programme, NHS England

Tsanko Dimov, senior implementation manager | Greener NHS, NHS England

“My wife, Donia, and I had left Bulgaria with our young son Tsanko in 1995 to settle in New Zealand where we lived for nine years and where our daughter Stefanie was born. I had studied speech-language therapy and psychology at the University of Sofia and joined a neuro-rehabilitation centre in Hawke’s Bay, New Zealand, before developing my career in the New Zealand health system and later on studying health service management at Massey University.

We moved to the UK in 2004. My brother Doytchin and his wife, Galina, both physicians, had moved to the UK from Bulgaria a few years earlier. We had all been attracted by the professional opportunities in the UK and the NHS was a natural choice. My wife and I were also excited by the prospect of being closer to family in the UK and Bulgaria, and to Europe.

I arrived in the UK under the highly skilled migrant programme, while my brother and sister-in-law had arrived earlier via a different route – Galina on a grant from the EU Tempus programme. They both started their careers in the NHS on the Royal College of Physicians programme for specialist training for visiting doctors.

We had to leave our home in Christchurch, New Zealand, which we loved, and all our possessions, to move to the UK without guaranteed jobs and with a “no recourse to public funds” stamp in our passports. My wife and children left a bit earlier and stayed at our parents’ home in Bulgaria, while I finalised our departure from New Zealand and followed them to Bulgaria.

We then came to the UK, without the kids, to find jobs and a home. It helped that we could stay initially at my brother’s home in Leeds. My wife, the children and myself ended up being separated for about six months, which we all found very difficult as we hadn’t been apart for more than a few days until then.

My children Tsanko [31] and Stefanie [27] have now joined the NHS family. My daughter, who was eight at the time we moved, remembers a feeling of happiness for our family being back together and learning to understand that our lives weren’t going to be the same as they were in New Zealand.

People’s politeness and kindness, country walks and Sunday pub lunches come up high on the list of easiest things to adapt to for all of us. My brother remembers people being too polite to express disagreement in a conversation, making it difficult to navigate interactions. There is also certain formality and order in social and family relations here that took a bit longer to get used to – the need to book a get-together with your friends weeks, if not months, in advance.

We all feel grateful and humbled to be part of such a great institution. I feel privileged to have been able to work in different roles and in many NHS organisations, delivering direct care to patients and planning or coordinating important aspects of the way the NHS operates. My son, daughter and I all feel excited and motivated for being involved in the development and implementation of key policies and improvements transforming the NHS and the way care is delivered, making it more responsive, efficient and sustainable.

Jessica Anne Filoteo

Jessica Anne Filoteo

Arrived in 2014 from the Philippines | Cardiac cath lab sister, St Bartholomew’s hospital

“When I was in my 20s, I read the book Eat, Pray, Love by Elizabeth Gilbert. She talked about her travels in Italy in such detail, by the time I finished reading it I decided I wanted to travel around Europe and experience their culture, and the best way for me to do that was to work and live in the UK.

I didn’t have any idea what the NHS was, but I was advised by colleagues to read up on it because I would be asked about it in my interview. At that point, it didn’t really matter to me where I worked in the UK as long as I got to step on English soil. It was only when I started working here that I came to understand what the NHS stood for.

Moving to the UK from the Philippines was relatively easy. A recruitment agency from the UK worked closely with one based in the Philippines and handled much of the logistics. I was one of the first cohort of Filipino nurses hired by Lewisham and Greenwich NHS trust. They sponsored my visa and shouldered some of my expenses moving to the UK, which later on were deducted from my salary throughout my first year with the trust.

Leaving home and moving halfway across the world was one of the most terrifying, yet exciting, things I’ve done.

The first few months were definitely challenging. We arrived at the start of winter, so that may have been my first experience with winter blues. It was cold and grey, and it took a while for me to find the people I would eventually call my second family, so there were definitely some moments of loneliness. It was especially hard when I missed out on special occasions like Christmas and birthdays. I’ve settled in very well, but I do find that on days when I get sick, I couldn’t help but wish I had my mum around to make me soup and make a fuss over me!

I never wanted to be a nurse but looking back at my journey, it was probably one of the best decisions I have ever made. Leaving the comforts of home and spending years as a nurse in the NHS – with all its ups and downs – has definitely moulded me into the kind of person I could only ever dream of becoming. Sometimes I can’t help but look back on how much I have grown as a nurse, and as a person. I think about that shy, timid, and terrified girl about to board the plane and I want to tell her: ‘Girl, get ready for the biggest adventure of your life!’

Ironically, working during Covid and getting through it is something I am really proud of, and makes me feel like I have done my fair share of good in the world. The resilience of the staff I have worked with, the kindness and admiration strangers have shown me when they found out I’m a nurse, the strength and compassion I’ve managed to find deep in myself – all these remind me that there is a silver lining in every dark cloud.”

Precious Joy James

Precious Joy James

Staff nurse at Royal Brompton hospital under the heart and lung critical care division of Guy’s and St Thomas’ NHS foundation trust | Arrived in 2022 from Nigeria

“I felt strongly that it was the right time to move abroad and broaden my horizons. I had some reservations about being so far from home alone, but was deeply convinced it was the right decision, and I relied on God’s direction the entire way. In addition, my confidence was made stronger by the support and encouragement I got from my loved ones and family.

I chose the NHS because I’ve always believed that people deserve equal access to healthcare services – and the NHS actualises that. I wanted to make my parents proud by doing something that would bring them joy – a national service does just that.

Working for the NHS has been a rollercoaster of highs and occasional lows, but the overall experience has exceeded my expectations. The staff, my manager, the support system, and patients have all been incredibly gracious, creating an environment where I have thrived. My current place of practice has given me some of the most fulfilling days in my career as a nurse. I know there are a thousand and one rooms for improvements within the NHS, but it’s also important to recognise that this system is a blessing to millions of people who continue to benefit from it one way or another.”

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