arts and design

'I brought skills with me from a war zone': the long history of migrants in the NHS

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Nitha Naqvi’s parents had only recently arrived in the UK from Pakistan when they had her. Both were overworked junior hospital doctors who, cut off from their family support systems, had no idea how to combine their jobs with raising a child. “So my father did what everyone does if they have a problem – he asked the nurse in charge on the ward for advice,” she says. “And the nurse replied: ‘Oh, don’t worry, my sister will look after your baby!’”

Naqvi’s “Auntie Frances” always had a bed ready in her home if both parents happened to be working late. The family themselves lived in a succession of hospitals until she was nine years old. She reels off the names: “Wigan, Leigh, Billinge, Whelley.” Most were in the north-west of England, though there was a brief spell at St Thomas’s in London where, years later, she would meet her future husband in a lift. By that time they were both doctors. “He had this really cool stethoscope, which was square and made of platinum, and when I remarked on it, he thought I was chatting him up.” Between them, the two generations have clocked up 150 years’ service to the National Health Service – with a 15-year-old daughter looking set to follow them.

Naqvi’s story is one of 30 recorded by the Migration Museum for a new exhibition, Heart of the Nation, which celebrates the role of migrants in the NHS. Among other contributors are Mae Appleton, who is pictured arriving from the Philippines in 1969, looking a million dollars as she strides across the airport runway to take up her new job as a nurse.

Looking a million dollars ... Mae Appleton pictured arriving from the Philippines in 1969.



Looking a million dollars … Mae Appleton pictured arriving from the Philippines in 1969. Photograph: Courtesy Mae Appleton

Muhayman Jamil, meanwhile, tells a more sombre tale of arriving from Iraq in 1990 to impress his interviewers for his first hospital job with neurosurgery techniques learned on the battlefield. “It was very unpleasant, messy work,” he recalls, “But those were the skills I brought with me from a war zone.” Now in his 60s and a consultant in palliative care at a London hospice, he skated to Belgium two years ago, pushing a wheelchair, for a charity he co-founded, Wheels and Wheelchairs.

The online exhibition, which will go live on 5 October, also includes fly-on-the-wall photography of life in Peterborough city hospital by Chris Porsz, whose Polish parents arrived penniless in the city in 1947. After dropping out of a sociology degree, Porsz was a porter there for 13 years, before going on to combine street photography with work as a paramedic.

An animation specially commissioned from the Russian artist Tribambuka, AKA Anastasia Beltyukova, is narrated by the former children’s laureate Michael Rosen who, as well as being the descendant of Jewish immigrants, recently became one of those who would have lost their lives to Covid-19 without the care of the present-day NHS. “The NHS saved my life this year,” he says simply. “Actually they saved it several times. In my daydreams I see a crowd of people who don’t know me but who use their knowledge and compassion to care for me. It overwhelms me to think about it.”

Though the majority of the exhibition centres on the seven decades since the foundation of the National Health Service in 1948, curator Aditi Anand is keen to emphasise a longer story of migrants not only safeguarding, but transforming, the health of the nation. A timeline traces a colourful history back to the year 1123, when a fever dream inspired the Anglo-Norman monk Rahere to found St Bartholomew’s hospital in London.

Pioneers such as Mary Seacole and Sigmund Freud are well known. But who remembers the Huguenot refugees who are credited with the invention of obstetric forceps in the 16th century? (Two centuries later they founded London’s French hospital, which moved to Rochester in 1959 and runs to this day as almshouses.) And how many know about the Jamaican-born doctor Harold Moody, who set up his own medical practice in Peckham in 1913 because nobody would employ him despite his first class qualifications, and went on in 1931 to found the pioneering League of Coloured Peoples?

A Spotify mixtape of 72 tracks, celebrating the 72nd birthday of the NHS, underlines a deep emotional attachment to an institution that, as Anand points out, “is a source of national pride and is often painted as a distinctly British success story.” The choices – one for each year of the NHS’s life, nominated by its workers – reflect its diversity, from Doris Day’s 1954 performance of Ready, Willing and Able to Sister Sledge’s 70s hit We Are Family and Stormzy’s latest single, Superheroes. “So often, NHS workers and migrants are presented as labels rather than as individuals,” says Anand. “We were really keen to get a rounded sense of people’s lives, interests and passions at work and away from the workplace, too.”

Vince Howlett circa 1983.



A source of national pride … Vince Howlett circa 1983. Photograph: Chris Porsz

But there is a darker side to the story with racism that prevented earlier generations from realising their potential, and sent many out to deprived or remote regions where they were spurned by their white peers. Some of those destinations were in Wales where, in 2003, it was reported that 73% of GPs in one particular south Welsh valley – the Rhondda – were south Asian.

After Hargun Khanchandani arrived in the UK from India in 1954, he landed a job in Denbigh, north Wales. “My father loved the Welsh, but thought the food was terrible because he was a vegetarian. We were the only Asian family in town,” says his son, Raj, who recalls a woman walking up to him as a small boy and scrubbing at the back of his hand “because she wanted to see if the colour would rub off”.

The family moved on to Hatfield, England, where Hargun worked as a consultant in the now defunct Clare Hall hospital, South Mimms, before making a shift into general practice in Luton. In 1981, Raj joined his father’s practice in the Bedfordshire town, where he still works one day a week in a surgery that now has six partners – all of Indian or Pakistani heritage. Two were born in the UK, two came over as children and two qualified on the subcontinent. “We don’t have any white doctors,” he says.

Around half of all NHS doctors are from migrant or minority ethnic backgrounds, according to statistics compiled for the exhibition. “But in Luton you can’t get white doctors to apply, even though we’re a huge training area and we’re only 35 miles outside London,” says Khanchandani. “This is a relatively new thing, because when I started out in the 80s, there were lots of white doctors and you would be lucky to get a partnership if you weren’t one. But now, they’ll go to Harpenden, which is five miles away, but not Luton, and you have to ask yourselves why. It’s intriguing.”

On the positive side, it has meant a continuation in the town of the vanishing NHS tradition fondly known as “family practice”, which, in its original sense, not only involves doctors treating families, but following those families through generations. Four Luton surgeries have GPs who have taken over from their parents, Khanchandani says. “There are patients whose great-grandparents were in the practice in the 1940s, and who are very happy that they’re seeing the son of their original GP.”

Heart of the Nation: Migration and the Making of the NHS launches on 5 October.

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