Order of Australia winner reflects on SA Jewish roots

Professor Karen Zwi may have left South Africa more than 20 years ago, but she has carried the ethics and ideals that she grew up with to her new home in Sydney, Australia. There, she works with the most disadvantaged and underprivileged children and their families – often unseen and unheard by fellow citizens, the government, and the rest of the world. Last week, her work was recognised by the Award of the Queen’s Birthday Medal of the Order of Australia (OAM) for service to paediatric medicine.

Zwi says her Jewish and South African identities have played a role in getting her to where she is today. “Being raised in the South African Jewish community and going to a Jewish school like King David embeds the values of compassion and social justice. And it gives you the confidence to actually speak out and realise that you have the capacity to make a difference. That’s a very precious gift.”

She is a consultant community paediatrician at Sydney Children’s Hospital, conjoint professor at the University of New South Wales, head of the department of community child health, and the clinical director for priority populations at Sydney Children’s Hospitals Network.

Her work in community paediatrics is rich and varied, including research, outreach work, and treatment of very vulnerable children who are often abused. She describes it as “child public health”, and says that much of it is a continuation of what she did in South Africa, including her time at Chris Hani Baragwanath Academic Hospital.

One of Zwi’s major passions is working with refugees and asylum seekers. “Australia has a very strict policy towards refugees arriving by boat, often described as ‘boat people’,” she says. “For example, this could be someone who has fled Somalia, gone to Indonesia, and arrived by boat in Australia. The Australian government has become very punitive towards them. They can’t apply for permanent refugee status or asylum, and they get detained in prison-like conditions. They are kept there with little certainty as to what will happen. Amongst them have been thousands of children. For me, locking up kids without access to normal life is untenable. They have committed no crime, and are just seeking asylum.”

She has devoted herself to advocating for them, conducting extensive enquiries into their health, and researching how detention is damaging to them. Much of her advocacy has meant that these children are no longer detained. “Most are out of detention now. It’s taken 15 years. We are working with them to get them back on track.”

Her Jewish identity has been a major motivation in this work. “My grandparents arrived by boat in South Africa as refugees searching for a better life. They were given that opportunity. If it wasn’t for that, I wouldn’t be here today. I see it in these families – they are so motivated, they just want to create a better life for their children. But languishing in detention, they just become more depressed. That is why we intervene.”

She emphasises that she hasn’t done it alone. “We have got organisations to make statements, speak to the media, and pressurise government. It’s made a big difference. They’re a small proportion of refugees compared to those fleeing to Europe. Australia could easily afford to accept and integrate them. It’s not impossible. It’s not a flood. It’s just a few people fleeing difficult circumstances. And they’re really exceptional, resilient, tough, and clever. They could make it here.”

Working with “boat people” and their children is just one aspect of her work. Asked about her average day, she says, “I do clinical work which includes seeing kids who may have problems with their behaviour or development. I also train registrars and give talks to medical students. I’m involved in research looking at the health outcomes of the most vulnerable in Australia. This includes very poor children, refugee children, and Aboriginal children. My work also includes the management of services across networks at two big hospitals and other sites in Sydney.”

From South Africa, Australia looks like the picture of a middle-class paradise, but as Zwi explains, “There is a segment of the population that struggles to meet its potential, including children. Aboriginal and refugee children are very high risk for social issues. Refugees also may come with degrees and qualifications, but these aren’t always something they can use. It’s very hard to re-establish yourself with the same earning potential.”

She says that while there is welfare, it “tends to be very basic, so it’s hard to live in an established neighbourhood, send kids to school, and invest in children. Some children that we treat have been abused and removed from their parents. But foster care means they don’t always have a stable childhood. It can have a major impact, and then carry on in the next generation.”

Although it may seem overwhelming, Zwi devotes her time and energy to turning this kind of situation around. “The first thing is to make health services accessible. But creating this access isn’t always easy. Once this is established, we can address the social determinants of health and what’s holding the family back. This could be a need for stable housing, addressing parental drug addiction, abuse, domestic violence, and parental mental health. It means getting kids into school or day care and helping teachers understand where the kids are coming from so that everyone is on this child’s side. It means motivating parents to find work or apply for benefits.”

Zwi says the work is rewarding because it can make a big difference. “Almost all children have amazing potential. It’s hard to watch when that potential isn’t able to be expressed. It’s a very natural thing to want to see a child flourish. It’s not easy to get education, employment, and schooling all ‘lined up’. But if the child gets that support, especially in early childhood, then the chances are high of them becoming a resilient, well-functioning adult. If we don’t start early, we’re just wasting time.”

She says her South African background continues to influence her work today. “I did community work and outreach even as a medical student. I learnt about going out, getting the community involved, asking people what they need and want, and engaging with them. I do the exact same here, and it really works. People want to feel valued and respected and asked to help deliver the services that they want.”

Zwi is proud and honoured to receive this award, and she wishes that it had a direct impact on the children who so desperately need her help. Meanwhile, she is carrying on with her extensive outreach, activism, and engagement.

“I haven’t achieved everything I wanted to achieve. I hope the award gives this type of work a little more recognition, and shows that even in a wealthy country like Australia, people are suffering. But in a country like this, one can resolve it. So it should be done.”