The Night-Side of Hospitals

Migrant doctors on the fringes of the medical system occupy a blurry zone between public and private space.

When one examines this fleeting and permanent reality carefully, one has the impression of exploring the night-side of societies, a night longer than their day, a dark sea from which successive institutions emerge, a maritime immensity on which socioeconomic and political structures appear as ephemeral islands.
— Michel de Certeau, The Practice of Everyday Life (1984)

Skilled workers have always moved around the globe, but in the 21st century we are seeing unprecedented mobility among doctors, nurses and other healthcare professionals. Despite immigration policies that often aim to facilitate this mobility, healthcare workers face unique regulatory and cultural barriers. Many occupy precarious positions on the fringes of the medical system in their new country: taking night shifts, for example, or working in undesirable locations or specialties. Others cannot find medical employment at all; they work as taxi drivers or cleaners while they study for licensing exams, learn a new language, or wait for jobs that never open. Cities around the world are filled with over-qualified migrants struggling to find a place in their new home.

In collaboration with photographer and psychologist Thomas Fuller, I undertook an ethnographic study of migrant doctors in Melbourne hospitals. Hospitals are logistically and ethically complex sites in which to conduct research and take photographs. Concerned about privacy, the hospital bureaucrats asked us not to photograph people, so Thomas took pictures of empty spaces at night. Through these photographs we witness the movements of the medical underground, the fringe-dwellers.

We found that these hospitals were not only places of employment for the “lucky ones”; they were also places where migrant doctors socialized and studied for exams. Because of the quasi-public nature of these institutions, unregistered doctors could gather in cafeterias, tutorial rooms and libraries. In some cases, staff-only areas were not actually restricted by access cards, and anyone could walk in. The migrant doctors made the most of the facilities, using the coffee machines and photocopiers, exhibiting a resourcefulness often found in the margins. Here, they negotiated their status in a new country and tried to hold on to a professional identity in an environment that had once belonged to them, moving between the public corridors, cafeterias and meeting rooms, and the private and more clinical spaces. The final image in this sequence shows a ward desk during the night shift, a space belonging to the so-called lucky ones.

Thomas Fuller and Anna Harris, “The Night-Side of Hospitals,” Places Journal, March 2014. Accessed 27 Jun 2022.

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