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Chinese Migration & Medical Stories ACMA Seminar Professor Manying Ip ONZM, FRSNZ 3 May Chinese Migration & Medical Stories ACMA Seminar Professor Manying Ip ONZM, FRSNZ 3 May 2015

Outline of talk q The link between migration & medical services. q My personal Outline of talk q The link between migration & medical services. q My personal interest: a) The HKG medical doctors admitted into NZ in the early 1970 s. b) Intriguing words of an old Mangere gardener, 1980 s. c) 1990 s request from haematologist on alpha thalassemia. • Chinese migration to NZ– broad outline & characteristics • Features of medical stories chosen

When Chinese were unwelcome The lack of status hampered taking up of higher education, When Chinese were unwelcome The lack of status hampered taking up of higher education, not to mention the medical profession. • 1881 Anti-Chinese Act, Poll-tax introduced. • 1908 Chinese barred from Citizenship Quite unthinkable that any Chinese could become health professionals in NZ!

First Chinese Dentist 1900 Otago First Chinese Dentist 1900 Otago

William Lo Keong—first dentist • The eldest son of Matilda and Joseph Lo Keong, William Lo Keong—first dentist • The eldest son of Matilda and Joseph Lo Keong, the earliest Chinese couple to settle in Dunedin. They were naturalised in 1882, and therefore full citizens. • The parents were fluent in English, and had strong ties to the Presbyterian Church. • All six Lo-Keong (Low) children were highly educated, and graduates of Otago University.

Kathleen (Pih) Chang – Ophthalmologist 1929 • Almost 3 decades later, NZ had its Kathleen (Pih) Chang – Ophthalmologist 1929 • Almost 3 decades later, NZ had its first Chinese medical graduate. • Kathleen came to NZ in 1908 at age five. • Named after Lord Plunket’s daughter, and grew up in Dunedin as Margaret Reid’s adoptive daughter. “I was the only Chinese, they looked down on me…everyday I took the shortest possible route to the medical school”.

First Chinese medical Graduate Kathleen Anneui Pih. Chang, graduated Otago School of Medicine in First Chinese medical Graduate Kathleen Anneui Pih. Chang, graduated Otago School of Medicine in 1929. She taught at universities in Shanghai and Singapore, and practised in South China and Hong Kong.

Kathleen in Tauranga 1988 The moon-gate was built by her husband, Professor Francis Chang. Kathleen in Tauranga 1988 The moon-gate was built by her husband, Professor Francis Chang. “ In Tauranga Francis built a Chinese garden at home, with pines, maples, and bamboos. …He told the architect to build the moon-gate, not in the genuine traditional way, but just made round on a concrete frame. ”

Hurdles --taking up medicine • The future of the Chinese in NZ not certain: Hurdles --taking up medicine • The future of the Chinese in NZ not certain: no citizenship (until 1952) • Families saw their children’s future in ‘China’, Taiwan or Hong Kong. • Much ‘safer’, and financially secure, to be running family business, to be self-reliant. “Anti-education, pro-financial security feelings of the post-war united families. ”

Dr Roy T. S. Law 1947 The first Chinese GP in NZ • The Dr Roy T. S. Law 1947 The first Chinese GP in NZ • The only son of Pastor F. L. Law who was baptised in NZ in 1902. • Roy Law had a successful general practice in Wellington, well-respected by patients.

Frank Kwok 1929 -2014 ENT Specialist Among the first ethnic Chinese to become a Frank Kwok 1929 -2014 ENT Specialist Among the first ethnic Chinese to become a specialist Consultant in Wellington Hospital. Hurdles to rising in a public institution.

Frank William Kwok “For a long time, [Father] “When I was about 12, expected Frank William Kwok “For a long time, [Father] “When I was about 12, expected me to take over I met Roy Law who the shop, I suppose…It was nd year was doing 2 family business. ” medicine. He told me “The medical school class about dissection, and had 120 places. Those what he did in the years were when the anatomy class…so returned servicemen came smart, and I admired back in large numbers… him…” We were told we might as well forget about it (doing medicine). ”

Discrimination in the Profession Late 1940 s • After a B Sc in 1948, Discrimination in the Profession Late 1940 s • After a B Sc in 1948, a letter from the Registrar of Otago declined Frank’s application. • “…not opened to foreigners…medical education was for British subjects only” • Frank defended his right of entering medical school by showing his birth certificate. • After graduation and internship, he became the first ethnic Chinese to be a medical registrar in 1955 only after a struggle.

Early NZ Chinese at Otago 1946 Early NZ Chinese at Otago 1946

Contemporary Medical Scene In 2010, around 13, 000 doctors and 47, 000 nurses in Contemporary Medical Scene In 2010, around 13, 000 doctors and 47, 000 nurses in the NZ health system. • Among the doctors, those from overseas make up 40% of the total. • The doctors comprised 15% of the total health force. • A third are GPs, a third are specialists, and a third ‘junior doctors’.

The Chinese in the ethnic mix Ø Pre-1987 ‘Model Minority’ Small in number, low The Chinese in the ethnic mix Ø Pre-1987 ‘Model Minority’ Small in number, low profile, inoffensive, making positive contributions, fluent in English Were the Chinese considered ‘New Zealanders’? Ø Post-1987 ‘Asian Invasion’? An ‘alien element’ which has made everyone uncomfortable. Ø 2013 census The browning of New Zealand, still a ‘Yellow Peril’?

Corresponding developments 1990 s • Need for Chinese-speaking GPs. ACMA founded. • Access to Corresponding developments 1990 s • Need for Chinese-speaking GPs. ACMA founded. • Access to equitable health services • Mental Health, Problem Gambling, and family violence issues • CAHRE (Centre for Asian Health Research) Centre for Asian and Ethnic Minority Health R.

Ethnic Group (Total Responses) by Birthplace Recode - NZ Born/Overseas Born and Sex NZ Ethnic Group (Total Responses) by Birthplace Recode - NZ Born/Overseas Born and Sex NZ Born Overseas Born Not Elsewhere Included Total Total Chinese 45213 124494 1704 171411 Japanese 3933 10059 129 14118 Korean 3294 26616 264 30171 Indian 36015 117207 1959 155178 Sri Lankan 1665 9510 96 11271 Afghani 870 2505 42 3414 Pakistani 840 2382 39 3261 Bangladeshi 372 1239 15 1623 Nepalese 210 1365 15 1590 Total South Asian 39843 134073 2166 176085 Total Asian 105729 360894 5088 471708

Chinese distribution 2013 S. E. Auckland: Botany Downs Dannemora, Meadowlands. Central: Remuera/Epsom West: New Chinese distribution 2013 S. E. Auckland: Botany Downs Dannemora, Meadowlands. Central: Remuera/Epsom West: New Lynn, Roskill North Shore

Changing Asian Age Structure Between the 2 recent censuses 2006 -2013, the changes: • Changing Asian Age Structure Between the 2 recent censuses 2006 -2013, the changes: • Asians under 5 years old increased by 50% • Those aged 25 -34 years increased by 59% • The older age group of 55 -64 increased by 85% • Those aged 65+ increased by 70% Therefore, health issues of children, young people, the elderly, and women should be the focus in the near future.

Age-sex structure total Auckland Chinese Auckland 2013 Age-sex structure total Auckland Chinese Auckland 2013

10 largest languages in Auckland, 2006 Census 1. English 2. Samoan 6. Cantonese (Yue) 10 largest languages in Auckland, 2006 Census 1. English 2. Samoan 6. Cantonese (Yue) (4 th in 2001) 7. Tongan (5 th in 2001) 3. Hindi (8 th in 2001) 8. Korean (9 th in 2001) 4. Maori (3 rd in 2001) 9. French (7 th in 2001) 5. Mandarin (6 th in 2001) 10. German

Top Surnames 2003 (11668) 2013 (11760) 1 Lee Wang 2 Smith Li 3 Williams Top Surnames 2003 (11668) 2013 (11760) 1 Lee Wang 2 Smith Li 3 Williams Chen 4 Brown Liu 5 Chen Smith 6 Li Zhang 7 Patel Lee 8 Zhang Patel 9 Kim Huang 10 Wang Singh 11 Jones Taylor 12 Wilson 13 Huang Jones 14 Hall Brown 15 Taylor Wu 16 Liu Yang 17 Campbell Wong 18 Walker Xu 19 King Kim 20 Lin Zhou Top 20 Surnames Of newborns registered in Auckland

THANK YOU FOR YOUR ATTENTION! Professor Manying Ip For comments and queries please contact THANK YOU FOR YOUR ATTENTION! Professor Manying Ip For comments and queries please contact