Our approach to the recruitment of workers from our Pacific Island neighbours has complex ethical connotations and is a recurrent demand from business and government pursuing a growth economy.
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In the case of healthcare workers, Australian governments, along with those of other wealthy countries, have used potent recruitment drives to fill increasing vacancies from the ravages of COVID.
At a recent meeting with Prime Minister Anthony Albanese, Prime Minister Jacinda Ardern strongly requested that Australia's nursing shortage should not involve recruiting nurses from New Zealand. Apparently it was OK for the two mates to recruit from other countries.
The ethical questions raised are easily buried by Australian governments in their mission to ease dire shortages in hospital and aged care health services which serve their communities across the nation.
However some of those attracted will come from inadequate health services in poor countries also scourged by COVID. We salve our consciences by reminding ourselves that they send money back home.
Furthermore this measure does nothing to address the long standing reprehensible conditions and pitiful pay suffered by healthcare workers in aged care which deter even those deeply committed to work in the caring profession.
Nowhere are our societal attitudes so evident as between healthcare workers scrambling to make a living cobbled together with shifts between aged care facilities, and congratulatory multimillion-dollar bonuses paid to captains of industry.
It is therefore with some relief that we can welcome the Pacific Australian Labour Mobility scheme which trains carers in their own country who then come to Australia to complete practical training and then deliver the "215 minutes of care in accordance with the aged care royal commission."
Mr Albanese has said the scheme is a stopgap which hopefully means he will address the underlying problems, for this advance does little to address the structural and remuneration needs of health care in a civilised society.
Nor does it address the ethical problem or our paternalistic attitude to our neighbours.
At the recent forum, Pacific Island leaders declared a "climate emergency that threatens the livelihoods, security and wellbeing of its people and ecosystems, backed by the latest science and the daily lived realities in Pacific communities."
It is fortunate that our new Prime Minister has the understanding and ability to meet these leaders with a reputation for consensus building.
This is vital because the past decade of take it or leave it diplomacy must be atoned for with recognition that many pleas to address climate change were cruelly dismissed at every Pacific Island Forum.
Even more regrettable, a past deputy prime minister said Pacific Islands would survive the crisis "because many of their workers come here to pick our fruit".
According to Pacific leaders, Scott Morrison suggested they should "take the money ... then shut up about climate change".
A Coalition senior minister joked with colleagues about "water lapping at your door."
Many have suggested such comments have a basis in racism. Such words would not be used to the flooded inhabitants of Lismore.
But there is an even more important issue to solve, one of international equity and justice because climate warming depresses economic growth in other nations.
At the Glasgow climate change meeting last year, the international community agreed to mobilise US$100 billion annually for developing countries to finance adaptation and to cover loss and damage.
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This was a tacit acknowledgement that rich countries had become rich from development conferred by fossil fuel usage without any reparations to poor countries which didn't participate and yet experience the brunt of climate change.
There was no progress on this proposal at the recent climate change meeting in Bonn.
Emissions from the US alone cause $2 trillion damage to the economies of other countries. Australia has had increasing emissions during the 40 years since climate change became understood and must also carry responsibility.
Not only that but we are blatantly opening new gas and coal mines with government subsidies.
The Pacific Islanders are aware of this malfeasance whilst welcoming Australia's new target on 2030 emissions.
Much remains to be done and with the words obligation and justice ringing in our ears, let us acknowledge the title of a recent article in The Conversation: "Climate change is white colonisation of the atmosphere. It's time to tackle this entrenched racism" for it has long been recognised that people of colour suffer disproportionate harms under climate change - and this is likely to worsen in the coming decades.
- Dr David Shearman, AM PhD FRACP, is emeritus professor of medicine at the University of Adelaide and co-founder of Doctors for the Environment Australia.