Critical Care: Nurses on the frontline of the AIDS crisis in Australia

by Geraldine Fela

HIV and AIDS devastated communities across Australia in the 1980s and 1990s. In the midst of this profound health crisis, nurses were caregivers and activists, both on and off the wards, and played a central role in shaping an innovative public health approach to a virus that was shrouded in fear and prejudice.

Nurses worked with communities to develop public health campaigns, advocated for their patients and – through their unions – opposed the efforts of doctors and surgeons to introduce traditional public health measures based on 'test and contain' measures.

Bringing together stories from across the country, historian Geraldine Fela documents the extraordinary care, compassion, and solidarity witnessed and experienced. Others shared painful memories of homophobia and prejudice, and some participated in unsettling and coercive aspects of Australia's response to the virus. Together, their stories paint a vivid and nuanced picture of HIV and AIDS nursing and shed light on an unexamined aspect of Australia's AIDS crisis.

Genres: Nonfiction, History

240 pages, Paperback

Published July 1, 2024

Reviews

[Ali · Rating 4 out of 5]

Based on extensive oral histories, this volume explores Australia's 1980s and 1990s world of hospital-based AIDS care. Fela is interested in the groundbreaking aspects of this movement, which was shaped by the strong demand by queer communities for involvement in all aspects of care and treatment. Fela is interested in how things changed through this process, and the role of individuals, AIDS Councils and unions in achieving that.
Fela brings the varied stories to life - from the significant number of queer nurses (more likely, Fela warns us, to participate in the project) to nurses who met their first gay man on the job. Most unforgettable is Aunty Gracelyn Smallwood, whose detirmination to make a difference, courage to speak truth to power and sheer hard work were probably decisive in avoiding high infection rates in Aboriginal communities.
This has been strongly recommended to me by many people, who noted the depth of emotion that Fela is able to tap into in writing these stories. I think the book's impact is also in that it recognises the kinds of achievements that are made steadily, whose significance may not be apparent until well after the fact.

[Renzo Tweedie · Rating 4 out of 5]

A brilliantly researched history of the HIV/AIDS crisis in Australia told from the perspective of the nurses who were often the caretakers, confidants and hand-holders of people dying from the disease.

Amongst the many nurses interviewed across the country, my mum features. It made me proud that, many years before she would have a gay son, she would nurse (mostly) men who often did not have acceptance or compassion from their own families. The memories she recounts made me cry.

Too often the AIDS crisis is told either from the perspective of cis gay men or doctors. This can be paternalistic and often lacks nuance. Here, Fela has triumphed in bringing into the conversation a group that fearlessly advocated for their patients; both individually and collectively as part of one of Australia’s strongest unions.

Finished in bed, on a Sunday night.

[Clive Hodges · Rating 4 out of 5]

Young men in the United States became concerned when unsightly purple lesions appeared on their bodies, they had groin pain and their lymph glands became inflamed. They also felt severely fatigued, had a fever and were losing weight. In 1982, this mysterious cluster of ailments was given a name: Acquired Immune Deficiency Syndrome (AIDS).

Later, it was realised AIDS was caused by a virus: Human Immunodeficiency Virus (HIV).

Geraldine Fela visited every Australian state and territory. She researched widely and interviewed nurses who courageously volunteered to care for HIV and AIDS patients.

Nurses’ compassion extended to families who were fearful of catching the virus, especially before it was realised how it was passed from one person to another. Some parents rejected their children, refusing to visit them in hospital.

The background of the epidemic given in the early pages of 'Critical Care' is informative and interesting. It is, however, the painful stories of the interviewees later in the book that remain in the memory days after the last page is turned.

Before pre-exposure prophylaxis and the advances in HIV treatment, death was inevitable. Nurses could only make patients comfortable and free from pain.

HIV/AIDS is a disease embroiled in the politics of blame, prejudice and sexual moralism. Some HIV positive gay patients who had returned to their hometowns to die, had not come out to their families. Nurses were often asked to pave the way for a full disclosure to be made to parents and siblings.

'Critical Care' is not all doom, gloom and funerals. Humour pops up now and again to lighten the mood. One hilarious anecdote involves a wax candle and a ceramic teaching aid.

[Ellen · Rating 4 out of 5]

A very interesting historical exploration centred on nurses. The use of oral history provides a compelling first person narrative while the critical analysis is helpful for exploring this history.