Foreign doctors in the deep south have found themselves in an unusual position: beloved in communities that voted for Trump and where anti-immigrant sentiment can be rife

When Dr Rommel Go moved to rural Alabama in the mid-1990s, he worried his new employer might fire him. People didn’t want to see the doctor from the Philippines. The internal medicine practitioner would only get the problematic patients, he said.

“I started out, you know, cutting toenails for patients,” he added, because “I [had] to make myself valuable.”

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He knows other doctors, who weren’t immigrants in the deep south, didn’t have to do that.

Go came to the US in the early 1990s and has ended up in the tiny Alabama town of Boaz. Like many foreign doctors who study in the US, he was able to remain and practice by serving in a designated, medically underserved rural community for a number of years. It’s mostly a win-win, he said. People who lived in underserved areas would have quick access to medical help, and the foreign doctors would be able to move along the immigration process and obtain green cards. Nearly all of Alabama is underserved, save for a couple of large cities, according to the Alabama public health department.

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But now, at a time when immigration is at the center of America’s fractious politics, foreign doctors like Go find themselves in a unusual position. As Donald Trump pushes for limits on legal immigration to the US and warns of an immigrant “invasion”, he and others like him find themselves beloved by the very communities that voted Trump into office in droves and where anti-immigrant sentiment can be rife.

“Our role is to be compassionate and be non-judgmental,” Go explained. Though the first few years were tough, he said, “there was still some racism when I came over here. I don’t think you can get over that. Just because of your accent, your look.” Go even voted for Trump in 2016 – and loves his tax cuts – but draws the line at his contentious immigration plans.

Now, his patients bring him prized southern pecans and fresh vegetables from their gardens in the summer to thank him, though many of them, he says, are poor and can’t afford to give away their crops.

Facebook Twitter Pinterest Dr Rommel Go lectures one of his regular patients about taking his medication. Photograph: Khushbu Shah/The Guardian

As he makes the morning rounds, Go sits with Tommy Gibson, who has been coming to him for years. Today, Gibson has an infection in his mouth.

“Everybody loves him. He’s helped a lot of people. Word gets around. He might talk a little funny, course he probably says the same about us, but he’s been good to me and helped me a lot,” said Gibson, who has come to get antibiotics and painkillers.

Alabama’s healthcare system would flounder without these immigrants. According to the US Department of Health and Human Services, nearly a quarter of the American population is underserved for doctors. For Alabama, 50% of the population falls in that designation.

The challenges of living and working rural communities, such as longer work hours due to the small number of other physicians and professionals in the area, “limit the ability to recruit American-trained physicians who generally prefer to remain in an urban environment, with a fixed work schedule and all the social amenities,” said Chuck Lail, director of the office of primary care and rural health.

He might talk a little funny ... but he’s been good to me and helped me a lot Tommy Gibson, patient of Dr Rommel Go

That’s where these foreign doctors come in – and hopefully – stay.

“My first impression was, coming from New York, man, this is Little House on the Prairie,” Go said. His accent switches into a southern drawl as he laughs. After he spent two years working in rural Alabama, he was free to move anywhere in the US. But he decided to pursue the American dream deep in the American south in a town of fewer than 10,000 people. He ended up raising two kids there.

Go’s experience is common among rural foreign doctors.

An hour north, through graveyards of lawnmowers, classic pickup trucks and tires, past towns peppered with American flags, Dr Muhammad Ata – another J1 visa waiver recipient 25 years ago, runs his practice in neighboring Jackson county’s town of Scottsboro.

Initially, Ata had planned to do his two years to get the visa waiver and leave for what he thought would be friendlier turf in a bigger city.

“Alabama didn’t have a good reputation and I thought people were not going to be very friendly to foreigners,” Ata, 56, said, in between seeing a long list of patients on a cold November evening. He was wrong, he admits. “People were like family. They embraced us, even after 9/11 and even the 2016 election,” he added.

Though he has heard people in Alabama say they don’t like immigrants, he has never had a bad experience in the decades he has raised his two children and sent them both off to medical school in Birmingham.

In the end, he couldn’t leave the community. Most people who come to see him are working- and middle-class patients. He remembers an instance when someone came to see him desperately needing insulin and couldn’t afford the $200 dollars a month prescription.

Facebook Twitter Pinterest Dr Muhammad Ata in his office in Scottsboro, Alabama, one of the few practices in the county. Photograph: Khushbu Shah/The Guardian

In one of the check-up rooms, two sisters, 75 and 77 years old, wait to see Ata after traveling 20 miles.

“A lot of the people are poor, and some have never left the county except to go see a doctor. Some people are so poor, they don’t have transportation or money for gas,” he said.

The average income in areas like Scottsboro is about $10,000 lower than the national average, according to National Rural Health Association.

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Ata continued: “In Scottsboro, rich is if you are able to pay the bills.” Both sisters burst out laughing in agreement. He makes sure the two have their flu shots, telling them to take multivitamins and do some exercise, before he bids the women a fond goodbye.

Even though it’s nearly 6pm, the waiting room is filled with patients and a stolid scent of cigarette smoke.

Ata asked his next patient if he smokes, giving him a lecture on the negatives of sucking on a cigarette. The only thing he wants, the patient said, are painkillers for his back. Ata hesitated, telling him they’re addictive, not wanting him to get hooked, referring to north-east Alabama’s opioid epidemic.

“I’ll give you a few pain pills but I won’t write too many,” he told the man. “Two hundred people die each day with overdoses on those pills.”

Ata’s concern was obvious. “We thought about moving to Atlanta, but you prefer to stay,” he explained, adding: “Here, the patients grow old with you.”