Geraldine Fela. Photo: supplied / Kyisoe Han
A postdoctoral research fellow at Macquarie University, in 2017 Geraldine began work on an oral history honours thesis that grew into a PhD and, ultimately, the book: Critical Care: Nurses on the frontline of Australia’s AIDS crisis.
Her impetus for the research was the absence of nurses in the historical record. ‘There’s a lot written about HIV in Australia,’ she tells ANMF, ‘and almost nothing written about nurses, which is quite shocking when you consider they were at the frontline of care. It’s also typical of histories,’ she adds, ‘that women, and particularly working-class women, get overlooked. So I wanted to correct that.’
The other important factor, she says, was that many of the nurses who were on the frontline of care at the time are coming to the end of their careers. ‘So I wanted to record their stories before they got lost.’
From the start of her research, Geraldine conducted it with a book – not just an academic thesis – in mind. ‘These stories are so important,’ she explains, ‘and the thought of them sitting in a university library and no one ever looking at them was just too sad. The people who shared their stories were generous enough to open up to me, so I wanted the research to be accessible.’
Via the many personal stories recounted, the book builds a compelling picture of the Australian model of AIDS response – an approach ‘characterised by community participation; collaboration rather than coercion’. The advocacy of affected communities and their nursing allies in the union movement resulted in ‘ground-breaking and politically courageous public health policy’, Geraldine writes.
‘There were a few factors to our success,’ she explains. ‘Often it’s talked about as if we just got lucky but I don’t think it was a question of luck. What was much more crucial was the level of political organisation in the community at that time, through community groups and strong unions like the nurses’ union.
‘It’s four years after [the first Australian] Mardi Gras that the first Australian AIDS case is diagnosed,’ she explains. ‘So this is a community that is really ready to fight for their rights.’ Meanwhile, ‘the nurses have just come off these huge industrial activities in ’86 [the 50-day strike in Victoria].
So slap bang in the middle of the AIDS crisis, you have this highly politicising moment with all these nurses who have come up through the tertiary system and been shaped by the social movements of the 70s – feminism, gay liberation – and they’re ready when this hits. That confluence of factors is, I think, really important in shaping Australia’s response.’
Continuing, Geraldine says ‘the leadership of the nursing unions was crucial. But there’s everyday union members also pushing back on doctors and surgeons, in particular, when they felt it best for their patients. That history from below is often a little bit forgotten in the story.’
Ultimately, the story told in Critical Care is the story of how Australia’s health system was reshaped by this period of time, and ‘reshaped in lots of ways by nurses pushing back on doctors, pushing back on the medical hierarchy, and how important that was’.
AIDS and COVID
It was somewhat surreal for Geraldine to have all this research at her fingertips as the response to COVID played out. ‘In hindsight I wish I’d made more of it [in the book] because it was shocking in lots of ways to see so few lessons learned,’ she tells ANMF.
‘Part of what I write about in the book,’ she explains, ‘is the role that nurses and nursing unions played in advocating against punitive public health measures’ and advocating instead for universal precautions and a patient-centred approach to care.
‘What we saw during HIV at its best was the building of trust between the community and the healthcare system,’ she adds; that forgotten ‘history from below’ of everyday nurses and union members caring for and advocating collaboratively with affected communities. This underscores the need for the stories documented in the book, because the nurse-led Australian response to HIV set a tone for how public health should be conducted.
Geraldine has dedicated Critical Care: Nurses on the frontline of Australia’s AIDS crisis to ‘the nurses and their unions, who chose compassion, care and solidarity over fear’. It is published by UNSW Press, and is available in bookstores, or in the ANMF (Vic Branch) library, now.
One of the nurses mentioned in the book is Warrnambool’s Barry McCluskey, Australia’s first nurse to be diagnosed with HIV. Read Barry Mcluskey’s Story.
