What does it take to help others with little expectation of reward? Our new series The altruists focuses on those who do just this, starting with a Brisbane GP moved to help refugees on Christmas Island and Nauru

As usual, Dr Ai-Lene Chan stopped off at Carlton Gardens, to decompress after a day of consultations at Fitzroy’s Victorian Aboriginal Health Service. It was 2007, and she was reading Julian Burnside’s latest book, The Watching Brief: Reflections on Human Rights, Law and Justice. Her attention was snagged by something the lawyer wrote: that even though he had been granted a visa to go to Nauru to act on behalf of refugees, Air Nauru staff had been instructed not to let him board the plane.

“I thought, ‘I could get there’,” she remembers.

Her decision, a few years later, to accept a contract as a general practitioner with International Health and Medical Services (IHMS) wasn’t without conflict. Chan’s father, a cardiologist who had run his clinic in the family home in North Melbourne, had drummed into her that she should first help people in her own backyard, and Chan and her sister had been raised to have a social conscience. They would accompany their mother on her Meals on Wheels rounds and were lectured that theirs was a life of good fortune. In Chan’s case, that social conscience knew no geographical bounds.

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In 2012, Chan left for Christmas Island, where she would undertake medical assessments of the boatloads of refugees who had been intercepted by the Australian navy, or whose boats had crashed upon the rocks. The clinical director demonstrated how to process the refugees in the most time-efficient way, but as Chan recalls, “I was very conscious of the fact that this was probably [the refugees] one opportunity to get some time and space.”

Chan soon found there had been good reason Burnside was refused access to refugees. Among the painfully familiar stories – of families being summarily separated, and spirits eroded by endless small cruelties – there were the more drastic episodes of desperation. “One night ... I was sitting on the balcony of the staff accommodation when I heard a man had sewed his lips together,” she says. “I couldn’t sleep, so I went back and we tried to coax him to release the knots. Because he’d sewn such tight mattress sutures – he was a theatre nurse himself – he only had a few hours before the lips would necrose. That night, I began typing a letter to IHMS and the immigration minister to voice my concerns.”

Still, when in 2014 Dr John-Paul Sanggaran put together a 92-page document of complaints about the Christmas Island detention centre, signed by 14 of his colleagues, Chan balked at adding her name. “I had been too scared to sign that one,” she admits. “We were all under the threat of getting prosecuted if we spoke out. Then I went to Nauru and thought, ‘You can’t do nothing, having seen what you’ve seen.’ ”

Facebook Twitter Pinterest Dr Ai-Lene Chan gives evidence at the national inquiry into children in immigration detention in Sydney in 2014. Photograph: Joel Carrett/AAP

The conditions on Nauru echoed those of Christmas Island, but with the added pressure of a local population largely hostile to the detention centre. Moreover, working for a bureaucracy increasingly felt like being a pawn in a game. “I had a strong sense that the better I did my job, the more it gave the government an avenue for hiding behind what they were actually doing to these people,” she says.

It was in 2015 that Chan bit the bullet and joined more than 40 medical and agency staff in signing an open letter (published in the Guardian) about conditions in offshore processing centres. She approached Burnside by email and received his assurance that he would back any doctor who spoke out, pro-bono. Another QC, Dennis Wheelahan, assisted Chan when she was called to the Human Rights Commission. There she described the unhygienic living quarters, the chronic staphylococcal infections, children who were self-harming, disruptions to the supply chains of vital medications, and the high infant-mortality rate.

“Both Julian and Dennis were critical for many of us who were initially too scared to sign the open letter,” she says. “That was a terrifying time in my life and having some form of legal backing gave me courage that I’m not sure I naturally had.”

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After leaving Nauru, Chan decided she couldn’t ethically work in a detention centre again. For 18 months she worked at a social-enterprise clinic in Brisbane. The World Wellness Group was formed in 2011 by GPs and mental-health workers after the Queensland government defunded the public service for community-based refugees. “They used GoFundMe to raise the rent, and some GPs work pro-bono, some at a reduced rate,” she says. “There’s a real sense of community. People can just spend time there. Local community groups bring food, and if someone’s homeless they’ll find a way to put them up.”

While Chan continues to be linked to World Wellness Group, for now she’s back on Christmas Island with her Papua New Guinean partner, this time working at the Indian Ocean Territories Health Service to care for the local community she had grown to love.

She’s already planning her next locum stint, in Somaliland. There, Dr Graham Forward leads Australian Doctors for Africa, the NGO redeveloping buildings into operating theatres and stocking them for orthopedic surgery. Chan and other GPs will train local medical students, as well as conduct ward rounds. Chan admires the project’s focus on increasing the sustainability of local doctors. “It’s something I believe strongly in doing, rather than flying in, working as a doctor and then leaving,” she says.

In a way, such projects also safeguard the sustainability of the individual GP. Chan has seen too many friends come back traumatised from war zones, unable to reintegrate into their social networks. “I’m very wary of that because I’m quite a sensitive person. There are no rules in war and once you’ve seen something you can’t unsee it. I’m much better suited to public health, health promotion or education,” she says.

She adds with a smile: “I also found after working for IHMS that I’m not a person who takes directive well.”