On The Couch with Ruiqi Fan

[00:00:00] Jennifer Farinella: Hello and welcome to an episode of On the Couch, where we collaborate with experts, practitioners, authors, advocates, and influencers to explore current social themes, sex positive topics, and share stories and insights that matter. This podcast was recorded on Aboriginal country. We acknowledge the traditional custodians of the lands that were never ceded on which we live, work and record upon.

We pay our respects to elders past and present and to those who may be visiting our website or listening to our podcasts today.

While listening, we encourage you to practice good self care. Check the show notes for content details and references.

Wherever you are, whatever you're doing, enjoy this episode of On The Couch.

[00:00:34] Maddy Stratten: Welcome to On the Couch with Ruiqi Fan, our clinical nurse specialist guest, which we're very excited to have join us.

 We really wanted to dive into the culturally and linguistically diverse, or as we will refer to it, the CALD communities experience and really let Ruiqi's story lead our chat.

 I'd like to welcome our guest, Ruiqi Fan welcome Ruiqi.

[00:00:58] Ruiqi Fan: Thank you, Maddy.

[00:01:00] Maddy Stratten: So good to have you joining us.

[00:01:03] Ruiqi Fan: Yeah, thank you for having me.

[00:01:05] Maddy Stratten: We are going to get into chatting about your international student's story. So, Ruiqi, can you start us off by sharing a little bit about your why, I guess, what has been your motivation to pursue a clinical career?

[00:01:19] Ruiqi Fan: Yeah, well, when I first decided to come to Australia and I was 18, so I just graduated from high school and I didn't really like the life that laying in front of me, um, in China. It's very predictable and it's very, for me, it's like, it's all set out for me, like my parents will, will find me a perfect husband that they satisfy and find me a perfect job that close to them and I'll be having kids and they will be taking care of the grandkids and it just all seems very boring and almost depressing for me.

So, and I didn't quite really like the part of the Chinese culture that um, that is a lack of variety or tolerance, um, to people who are different. So now I got this opportunities and so that I decided that I wanted to live in different countries and just to see what life could be. Um, so I start to applying for student visas through an agent in China and the agent said, that you have all those a career path is lying in front of you.

So there are lawyers, doctors, accountant, engineer, or nurse. But as an overseas student, you can't be a doctor or lawyer, because of so many rules and legalities. I think that's what the agent said. So my choice was accountant, engineer and nursing. And growing up, I really, like, I'm, I hate math. So the choices seems so very obvious to me that nursing.

[00:03:07] Maddy Stratten: I don't blame you, yeah.Yeah.

Out of those three, you probably chose the career path for you, right?

[00:03:14] Ruiqi Fan: Yeah. So, that's how I get to do, um started my nursing degrees in Australia. Um, how I end up at where I am was really accident. Um, I graduated from my uni and I was looking for a job and there's, um, Sydney Sexual Health Centre was, specifically looking for a clinician who can speak both Mandarin and English.

So that's how I started my sexual health career. When I first started working in Sydney Sexual Health Centre, I was really enjoying it. Um, and listening to people's different sex life. You know.

Interesting right?

Yeah, and the, the, my colleagues are very interesting bunch of people. So that's get me to stay till now, which is seven years later.

[00:04:09] Maddy Stratten: Right. And if I can ask, what did your family, what did your parents think when you graduated as a nurse and then got into the role at Sydney Sexual Health Centre?

[00:04:19] Ruiqi Fan: Yeah, they first was really scared for me. They told me this is just going to be a stepping stone job. They want me to, um, move on to, you know, cardiology, which is considered as more prestigious, um, place in Chinese culture.

And they want me to be really careful, wear double gloves and only stay in this job for like a year or two. And then move on.

[00:04:50] Maddy Stratten: What were they worried about mostly?

[00:04:53] Ruiqi Fan: Well, because the patients that I'm looking after day to day are people's, you know, people who have a chronic infections like HIV and chronic hepatitis B, chronic hep C.

And I talked to people's, um, you know, who are extremely marginalized sex workers and gay men and my family's stereotype about those peoples. I mean, as you can imagine, like a sex workers and gay men is not really considered as normal people per se by my families. And they just, my parents were really worried that I get influenced by them.

[00:05:34] Maddy Stratten: Or worried about infection too, probably, like with the double gloving.

[00:05:37] Ruiqi Fan: Yeah.

[00:05:38] Maddy Stratten: Yeah. Although not a similar experience for me having grown up here in Australia, but my mum did say to me, actually, after I started working in sexual health promotion, they're like, wow, the conversation of the dinner table has really changed for our family now that Maddy works in sexual health because you just become so, you know, you really normalize talking about sex and sexual health and STIs and condom use and, yeah, and it kind of then creates that really accepting culture within your family. So yeah.

[00:06:13] Ruiqi Fan: Yeah! Well, I wouldn't say that accepting her. I mean, it's good that your parents are quite accepting. I remember that i, my mum always made a comment about sex workers and I, quite disagree with that. And I said, well, it's just a job to me. Like, it's just like any other job. It's tough job to be in. Um, and I can remember my mum was strongly disapproval of that comment.

[00:06:41] Maddy Stratten: Yeah. And I wonder if that's, you know, a similar experience for a lot of international students kind of coming in and working in fields that are not cardiology and not kind of those, medical degrees that are gold star standard.

[00:06:56] Ruiqi Fan: Yeah, like the "proper medicine".

[00:06:59] Maddy Stratten: Yeah, I love that in the quotation marks. Then you've been there, for seven years. So you really kind of stuck it out and stayed because of the clients and the experience that you have there. So it must be a positive one.

[00:07:14] Ruiqi Fan: Yeah. Yeah. I'm really enjoying my client and the interactions with my colleague and with my patients.

[00:07:21] Maddy Stratten: Yeah. Such a great inception story. And I'm so glad that we could hear a little bit of that. Because I think it's really shows how you've ended up where you are and you know, doors opened and you just walked through those and, and ended up in a job that you're really passionate about. So it's really cool.

I'd like to take us back to your time as an international student, if that's okay, Ruiqi.

[00:07:46] Ruiqi Fan: Yeah.

[00:07:47] Maddy Stratten: We know that international students are this really unique priority population in that they're this cohort of such diverse backgrounds, ages, experiences. You know, no one international student can speak for all international students.

I've been working with international students and the co design of the International Student Health Hub website, and the stories that have been shared with me really have those themes around loneliness and missing home, but also this really strong sense of community that international students have built together. So what has been your sense of community and belonging in your experience as an international student?

[00:08:29] Ruiqi Fan: Well, when I was an international student and still now, I love to go to Um, suburb that has lots of Chinese food, like Eastwood and Hurstville and Chatswood.

Just being able to shopping and looking at the food and the familiarness that make me feel, um, like some sort of like comforting, like a reassurance of, of that missing home. And, um, and during Chinese New Years, and sometimes we would get together with a bunch of students and we would cook a traditional food from our hometown, and we're talking about, um, studies and, and it feels like, even though I don't have a family in Australia, but it feels like this is my family. Um, so that's my sense of community and working as a nurse. Like I can see, um, how patients are first to come to our clinic. Like everything's feels, so strange. They don't know where to begin. They have so many questions and so many worries like, I can understand all that because, um, I would imagine myself if I wasn't a nurse, like, how would I feel like if first time walk into a public sexual health clinic?

So, and it make me really wanted to help them being that link point of, um, of these populations.

[00:10:05] Maddy Stratten: Yeah, yeah, I can see that connection and, I mean, from the international students that I've spoken with in this co design process, there's this real desire to want to give back to other international students. I've learned this, I'm wanting to pay it forward to other international students who may be feeling kind of similar ways of, um, loneliness and, and kind of build that community and that family, which is really special, I think, to be able to have.

[00:10:32] Ruiqi Fan: Yeah.

[00:10:34] Maddy Stratten: And I know that, you know, I've said before, about international students being unique and having similar experiences, but so unique to the individual, but there does seem to be some common challenges and barriers for international students.

And if you're comfortable, are you able to share a little bit more about, um, your international student experience and how you overcame these challenges or, or maybe what strategies you've witnessed your peers utilize to overcome those challenges, you kind of already started talking about it in terms of, you know, family dinners and, and going to places that feel familiar with familiar food, but what are some other ways?

[00:11:15] Ruiqi Fan: I think the biggest challenge when I first came to Australia is the language, um, because if you don't speak English, like everything is in English and it's just really difficult. I remember my first alone trip was to Woolies in Parramatta, and I went there like I was like, I think I'm not wanting to buy anything, but I just wanted to shopping around and just to see how people's do their shoppings.

Like I remember I bought some chocolate and I bought a bottle of water and that cost about 10 Australian dollars and which in exchange that's like a 60 RMB, which is like, um, Chinese Yuan, which is a lot like.

[00:12:06] Maddy Stratten: It's not cheap.

[00:12:06] Ruiqi Fan: No, it's not. I mean, 60 RMB, you can buy a whole dinner for two people in China.

So I was like, And I went to the counter and they have like, um, the automatic register and the cashier register. And so I choose the cashier register because in China, there's no automatic register. So I went there and after I paid and the guy asking me, do you want a plastic bag? And he repeated it five times.

I just could not understand it. Um, because in China, we were taught in American accent. Like I remember the first time I asked for a bottle of water, and I asked, like, can I have a bottle of water? Water. Yeah. And that person gave me such a dirty look, and was like, you want a water? And I was like, yeah, water.

Maddy Stratten: It's my favorite. I think water, water and banana.

Ruiqi Fan: Yeah. It was very difficult for me to understand Australian accent. Um, and also Australian people like to short everything and if they can use a phrase, like they would use a phrase like, um, how do I give example? Like, um, you know, take up a lesson. And at first I was just like, I don't really understand it. Like, even though I understand every word, but I don't really understand what you're trying to say.

So I think English has been a very difficult challenge. My strategy was I, I actively trying to make a friends with Australian born people and just, um, even though the conversation is very limited, but I try to talk to them and try to encourage myself to talk as much as possible.

Um, and I, I remember buying newspapers, like, um, the Guardian and the Australian Telegraph, even though there's just Newspapers, I would not look at them right now. Um, they're all Murdoch propagandas.

[00:14:13] Maddy Stratten: But good to practice your English.

[00:14:15] Ruiqi Fan: Yeah. So, and that's how I get started. I think, um, that's how I get get better and better with English, but really, I didn't feel like my English was to a level that I can like, but like, it's every time everyone trying to talk to me, I got so nervous because I tried to respond to the question, but also I'm trying to translate in my head. So it's like, two step process.

Yeah. Um, it's not until like I think three years later that I feel a bit more comfortable and more relaxed to talking to people.

[00:14:54] Maddy Stratten: Mm-Hmm. Um, yeah, and I think it's a really, like the translating it in your head's really interesting for me because you're translating it from your home language, but then you're also translating it from American English to Australian English and slang.

And so it's kind of a, a two or three step process. So it's pretty impressive to me that that could even happen like instantly.

[00:15:19] Ruiqi Fan: Yeah. And my, my colleague right now, they, if they work with me for a couple of years, they would know that when I doing the CPR training, I wouldn't count in English.

I would just count in Chinese and I'll ask them, okay, you go, then that's their cue of they can do the breath, you know, you supposed to do the 28 presses and a two breath. But that's because, I mean, I can count in English, but then I have to think about the number first. And then, translate it into English and then say that out loud.

So it's like in CPR, like emergency situation. It's probably too much

[00:15:58] Maddy Stratten: CPR to get it right.

[00:16:00] Ruiqi Fan: Yeah.

[00:16:02] Maddy Stratten: Yeah. I think, um, I think it's really interesting and I want to talk about it again a little bit later when we're talking about kind of sexual health promotion campaigns and some things that we really need to consider when we're planning programs.

But I want to just take us back into international students and I guess some of the assumptions that we make about international students sexual and reproductive health knowledge. I know I've made some assumptions in my research when we've been talking with international students who study medicine and I guess the impact that cultural norms have made on their sexual reproductive health knowledge.

I remember a focus group discussion I had with some medical students about being clean and showering before and after sex as a way of preventing the transmission of sexually transmissible infections, but also unplanned pregnancy. Which we know not to be accurate. And we know that condoms are the best protection.

So, there's a lot of misconceptions and myths out there around safe sex, regardless of what you're studying. And it's, I guess, shows the impact of those cultural norms, on an international student. Have you found this impact of sexual and reproductive health knowledge, education and cultural norms on the CALD clients visiting their sexual health clinic that you're working in?

[00:17:22] Ruiqi Fan: Definitely. Vaginal douching is a very common practice among the sex workers or CALD population. Um, they think like you have, once you start having sex, then you're going to have to use some genital wash. Otherwise you're not clean. Or they think like you got to wash inside regularly otherwise you're at risk of contracting STIs or otherwise you're not healthy. Which is a very, um, very mistaken practice and a very, very not hygienic practice. Um, and also I noticed a lot of CALD population that come to our clinic, like they have this extreme anxiety that does not really match, um, the actual risk that they have towards STIs or HIV.

Um, I guess that's all because most, I think most of international students, they're coming from culture that is a quite conservative and sex with casual partners or sex as experimental practice is really stigmatized and, um, you know, or anal sex or sex to enjoy yourself is really, is really stigmatized.

So, um, you allow, you're only allowed to have sex with one person, um, ever, which is your, you know, your husband or your future partner. Um, so once they start having sex or, um, they just really concerned about their risk of contracting HIV um, or other STIs and they have very limited understanding about what test and what sort of infections at the most at risk off.

Like, um, I know from my experience with a lot of, um, uh, patients that who are born in China. So like they know gonorrhea, they know syphilis, they know HIV, but there's no, like, people don't get tested for chlamydia in China. So they don't, they never heard of this infection and they don't think that chlamydia is STI infection, which we know working in the field, chlamydia is most common STI infections among young peoples.

[00:19:48] Maddy Stratten: Yeah, that's really interesting. I wasn't aware that that wasn't tested for in China. And so I guess if it's not, you know, a normal part of your thinking, I'm going in for an STI test. Chlamydia. Oh, I don't need to worry about that. Yeah. Yeah. It's not going to, it's not going to bother me. Yeah. Yeah. And I guess, you know, I would imagine as a clinician, you have a toolbox of resources, um, or referrals that you have on hand for when you're having these conversations with your CALD, clients really around educating them and pointing them in the direction for accurate and trustworthy information.

Can you share with us what kind of services and resources you connect CALD clients with?

[00:20:34] Ruiqi Fan: Yeah, I think International Student Hub, the website, is really good resources. Um, it's very interactive and it uses simple language, and it's very colourful, it's engaging and provides the correct information. And also SHIL which is a Sexual Health Information Link. Is a very convenient to resources for someone who prefer to, um, talk to some people when they get concerned. Um, and they all are very experienced and nurses are sitting on that line answering the questions.

[00:21:06] Maddy Stratten: Yeah.

[00:21:07] Ruiqi Fan: And also I think GP is a valuable resources because they are often the first point of contact of many people when they have a symptoms or when they have a potential risk exposure. Um, and university clinic is most often like the first point of contact for a lot of international students because often they're free, um, and they're on site, they're easy, accessible.

So that's all the resources that international student can use.

[00:21:45] Maddy Stratten: Yeah, and you mentioned the International Student Health Hub, which, as you know, that's our project that I'm working on. So for our audience, I didn't pay Ruiqi to mention the International Student Health Hub.

[00:21:57] Ruiqi Fan: No.

[00:21:58] Maddy Stratten: So this is all real. But thank you for mentioning that because it's always really good to get that feedback. Um, the consultations we did with international students in developing the International Student Health Hub, really, I guess, confirmed this gap in knowledge around navigating the Australian healthcare system, um, as well as understanding overseas student health cover and topics like that, not just sexual and reproductive health topics.

Um, and I mean, I get it. It is confusing for me too navigating the Australian healthcare system. What was your experience with this as an international student?

[00:22:36] Ruiqi Fan: I think it was just a bit of lack of resources at first. So, I don't know what other countries are like. I can only speak from my own background. And so in China, if you're sick or if you need any sort of a testing done, you go to the emergency department in hospital. And there is a different, um, I guess, grade of the hospital based on the size and the expertise that is available. So there's Provincial, which is like a state based hospital.

There is city based hospital, which is a smaller size and probably doesn't perform some major surgeries like a heart transplant or lung transplant. Such a major surgeries is done in state hospitals. So, like, if you, for example, if you experience any symptoms, you just present to hospital, like emergency department, and you see someone, often you will get to see a doctor within half an hour, one hour, and you pay the doctor, like you pay at a counter, which is like the cashier for the whole hospital, like whatever you need, you pay at there.

Um, and so you can see if someone who's freshly from overseas if they have any symptoms or if they need STI testing done, they will go to the emergency department, which the ED department doesn't really work like that in Australia. And also, you don't pay at hospital because you have the Medicare card and, or you have private health insurance, they send a bill to you.

Um, you know, you sort it out your, with your insurance companies later on. So, um, you can see there's a gap there. And often I find when I refer patients to go to GP, they don't know what GP is, or they don't trust like they don't trust a GP because they think that's a smaller clinic. It's privately run. It's not regulated that sort of thing.

[00:24:45] Maddy Stratten: Yeah, lots of misconceptions there and my mind is thinking about, you know, this international student who has symptoms and is doing the right thing by wanting to go and get tested and then sitting in emergency for hours and hours to be told, go and see a GP, go to a sexual health clinic and I guess that would be really disheartening and there's the shame kind of connected to all of that as well, you know, if you've got those cultural norms and those belief systems around sex for marriage. So there's so many different layers, isn't there to that?

[00:25:19] Ruiqi Fan: Yeah. It's almost feel like there is like, because you don't belong to this country therefore you'd not entitled to access any Medicare service and another. Another huge issue is a cost so you pay very minimal, like 10 RMB or 40 RMB, which is about 10 Australian dollars or five Australian dollars to see for the consultation.

And it's not timed. So for as long as you need, and like, if you, um, finish your consult and if you still have later on you think about some question, you can always come back like cutting the line.

And also, um, with the testing fee. You don't pay that much. Um, the where as are here. Like, I mean, seeing a GP, if it's not bulk bill, if you don't have a Medicare card, it's very expensive and, and then you have to pay like 100 dollars to get yourself tested. So, which is another huge issue.

[00:26:21] Maddy Stratten: Yeah, a huge barrier. That's something that we're really trying to make sure that we've got that information up there on the International Student Health Hub, in particular, those frequently asked questions for Overseas Student Health Cover, because I think that's one way that we can kind of start to get the information out there about what's covered and what's not covered and, and what, what you can do in those situations, because I think it's super important.

But I'm interested to know how you manage the transition from international student navigating the Australian healthcare system to actually working within the Australian healthcare system as a clinician yourself.

I guess it's understanding those processes and systems, and maybe even using your international student experience to be able to, you know, support CALD clients.

[00:27:11] Ruiqi Fan: Yeah. So, um, my colleague, it definitely helped a lot. They were really accepting and they basically orientate me, um, to my job and they very curious about my culture background and all the food I eat, which, which also generates equal amount of curiosity about for me about their own culture.

So that's slightly transition me into a clinician working here. And, um, by come in contact with a lot of overseas students from different cultural backgrounds, I slowly, gradually noticed some common theme. So I learned that to not assuming that this is a common sense that everyone should know, I often provide, um, like a routine education is about genital hygiene to every overseas student, I tell them the infections that they should regularly get tested for.

And, um, I tell them what they can get from, uh, when they access, you know, public sexual health clinic and what sort of issues that they should take it to GP or any medical centers.

And, um, I often tell them the cost difference, Yeah. Um, So, that's basically just not assuming that they know how to figure out things and just to provide all the information's comprehensive information.

[00:28:49] Maddy Stratten: Yeah, yeah, no, I think that's super important. Um, and a question, I'm going to move on now because a question we often get asked as sexual health promotion [00:29:00] officers is what do we actually do on a regular work day?

It's a question we have asked guests On The Couch in the past. Because people love to get a glimpse behind that curtain and I think you've started sharing a little bit about that already in terms of the conversations you have with your clients. But I'm going to ask you the same question, take us behind the scenes, walk us through a typical day in the life of a sexual health nurse. And yeah, give us a little bit of a glimpse behind the curtain.

[00:29:31] Ruiqi Fan: Yeah. So, as a nurse working in Sydney Sexual Health Centre, we have lots of different roles based on the shift that we're on. So some are like triage and that's, um, what we call assessment nurses. So. It's often a very short consultation.

You can do front triage and you do face to face triage. You basically find out the people, what's their presentation, what's their issues that coming for the day. And, um, and then you delegate them to see a doctor or nurse or book appointment, uh, or refer to other service. Um, there is also treatment nurse on the shift, you just offer people who have confirmed results offer their treatment . The purpose of this is to get people who have infections to get them treated as soon as possible. Um, use the statewide nurse dispensing protocols, um, save a lot of time. And also, there is a nurse who are doing consultations.

So they are the ones who's seeing people's either with appointment or or without appointment and attend their needs for the day, sort out their symptoms to provide a treatment, um, or provide a referrals for afterwards.

[00:30:57] Maddy Stratten: Yeah, it sounds like a pretty, busy day in the life. So .

[00:31:01] Ruiqi Fan: It's very diverse.

[00:31:02] Maddy Stratten: Yeah, and I guess no day is the same as the day before, right?

[00:31:06] Ruiqi Fan: No.

[00:31:07] Maddy Stratten: I am interested in some of those services that are offered by Sydney Sexual Health Centre, but I guess more so about the work that you do to create that culturally inclusive service.

Can you talk a little bit about that?

[00:31:23] Ruiqi Fan: Yeah. Um, so Sydney Sexual Health Centre have language specific clinic. So that's, um, Sydney Sexual Health Centre partnership with ACON that we have a specifically a Mandarin speaking, um, gay man testing service at Surry Hills. So, um, the patients that they come in, they will speak to a Mandarin speaking peer to receive all the sexual health information that they are entitled to receive and they will then see a Mandarin speaking nurse to do their test and further answer their questions, if they still have any. Um, we also have Mandarin and Thai speaking sex workers clinic that run in Sydney Sexual Health Centre on, um, certain days that mainly run by, uh, a clinician who speak the language or we have interpreter booked for the day, and mainly to attend the needs for, um, those sex workers.

[00:32:25] Maddy Stratten: Yeah, yeah. And we've already, started talking about the importance of language and how that kind of helps to create that inclusive space. So let's talk about language a little bit more. It's something that we're working towards with the International Student Health Hub, uh, working with Multicultural HIV and Hepatitis Service to have translated, HIV and STI resources in language, which is really exciting and having those resources up on the website.

I would imagine in a clinical setting, it's super important to have interpreters and bilingual health professionals or health practitioners, to ensure that information around prevention, types of tests, treatment is understood. Especially when you mentioned before about those strongly held myths and preconceived ideas and misconceptions around sexual and reproductive health and kind of the client's anxiety not matching the symptoms or their diagnosis.

Can you share your thoughts and experiences of the benefits and the challenges of being a bilingual health practitioner?

[00:33:33] Ruiqi Fan: Um, the benefits as a bilingual practitioner is obviously the language is easy to communicate. And so, um, even though sometimes you do have interpreters, but things get misunderstood during translation. Um, and also it just always a feel nicer when you have this direct communication with someone who speaks your own language. Um, it's easier, it's less costly on the service. And also being from that culture when client talking about certain things like when they Um, you know like, you're asking them, Oh, do you have boyfriend?

Yeah, I have boyfriend, but I also had a sex and la la la and they have this anxiety. You, you sort of, you can understand it. This is all, I don't know how to say it, but like, it's, it cannot be communicated through language, but if you provide that assurance to them saying that it's okay to enjoy the sex or I'm not here to judge your relationship, um, I mean, only here to wanted to make sure that your stay STI free and stay healthy.

And also, um, understanding like I often tell client that um, this is a clinic, even though we're publicly funded, but we're not linked with immigration. So anything you tell us is confidential. It's not going to have any implications to your visa status, um, so that they feel more assured and more relaxed and more able to tell you more information.

[00:35:16] Maddy Stratten: Yeah. And it's something that international students have told us in the past, you know, are my parents going to find out what I went to the doctor for, what I went to the clinic for? So, um, yeah, I guess having that bilingual health practitioner and someone from the same cultural background as you, really kind of helps reassure you and process all of the emotions that are going around.

[00:35:38] Ruiqi Fan: Yeah.

[00:35:39] Maddy Stratten: I want to move on now to talking about some different parts of our roles. So, as you know, Caddyshack Project is a sexual health promotion program. So, naturally, I'm always interested in how our work transfers into the clinical settings and how the health promotion sector can really improve our programs and campaign design.

And, we kind of touched on it a little bit earlier in terms of language and, and having translated fact sheets and things like that. But, how do you see, sexual health promotion campaigns impact the CALD clients that you see?

[00:36:18] Ruiqi Fan: I think it's very important. Like, um, Asian gay men population, I think I, I seen a huge benefit for this population because the PrEP, campaign, like they know what PrEP is, because PrEP is not available in China. So when they come here, they see PrEP for this advertisement everywhere, and they heard their friends talking about it. So they, they know this. They heard about this. Um, so what I learned is that health promotional campaigns need to be the language that target the audience that you wanted to target so that it's easy for them to read and understand.

And also you need to specifically target the specific myth and misunderstanding in that culture, for example, like, um, would it be great to have some promotional campaigns for, you know, vagina douching, why you do that, and it's not really healthy, um, that sort of thing, or sitting toilet seat, public toilet seat, it won't give you STIs or, you know, genital herpes or genital warts.

So that like a promotional campaign specifically target the myth so that like not just a general oh you need to get tested for STI um that not touching the anxiety of those population, um, and also the health promotion campaigns need to work in partnership with a lot of other service providers.

So for example, university clinic, GP, um, or they're a student to private health insurance so that um, they know, okay, when you come to Australia, if you need STI testing, these are your ways that can find information or this is, uh, the places that you can go to get your free testing.

 So I think this is what I learned from the work that I do.

[00:38:25] Maddy Stratten: Yeah, and I guess, you know, when we're designing programs and campaigns, we really want to be super clear as well as culturally sensitive and recognize the importance of diversity and representation in the imagery that we're putting across and, and I think that, kind of also plays, plays a part in the effectiveness of that health promotion program or campaign. Something I sometimes find quite amusing, actually, but there's this assumption that health promotion is just about making pretty posters without much thought behind it.

And I love that we can have this discussion On The Couch, a clinician and a health promoter with this shared passion of increasing sexual health knowledge for marginalized communities. It's so refreshing to have this candid chat with you, Ruiqi. And there's so much that I think I'll be able to take back to my work with International Student Health Hub, as well as in Caddyshack Project around, I guess, cultural inclusive, but really kind of thinking about if we're, if we're developing something, where is, where is it going to go? Who is it going to be reaching?

[00:39:33] Ruiqi Fan: Yeah, I think the next challenge in sexual health is about like reduce the antibiotic resistance.

So a lot of researchers are around that. So, for example, at the moment, gonorrhea resistance has becoming, uh, increasingly a significant issues in sexual health, um, uh, field, and also because everyone now is on PrEP and you will notice that people tend to not to use condom that much because they think, um, you know, they can't contract HIV and other STIs are treatable, curable, therefore, um, they're not so scared, which I guess it's a very good message in that to destigmatize the HIV mm-Hmm. Um, but also, we'll also notice that, that, um, a lot of other STIs are on the rise. So, for example, syphilis.

[00:40:24] Maddy Stratten: Yeah, what was your, um, I guess, drive to want to get into that research space?

[00:40:32] Ruiqi Fan: I think research is very interesting and it's more about prevention. I can see more benefits on the patients rather than, you know, treatment. I'm not, like, treatment is good, but I think If we can prevent something before it happens, that's definitely save a lot of a cost on health care system and also save a lot of harm that consequences on the patients. So that's my passion that I like prevention. Um, and also, I like the idea that everything that we do in clinic are evidence-based, and there's data to behind that to provide a solid support. It's not just we think we're doing a good job, but this is actually proven to be effective. Yeah, so that's the two reasons that I like research.

[00:41:26] Maddy Stratten: Yeah, I am wanting to, start to wrap up our On The Couch chat with some final takeaway thoughts from you, Ruiqi about how we can better work with CALD communities in the sexual health space, and I guess how we can avoid falling into that judgment trap that you started talking about before. But I want to make sure I give time to you, Ruiqi, just to kind of wrap up the conversation and how can we better work with CALD community?

[00:41:51] Ruiqi Fan: I think it it requires a lot of compassion and patience. Um, I mean, I acknowledge such a population requires probably more effort than your average patients because you got to try to, you got to deliver a lot of health promotion, prevention strategies. You got to address a lot of issues, information. They certainly take a long consult to compare to other peoples who are regular testers. So it definitely requires a lot of compassion, understanding, and patience. And I find it's really rewarding because, um, people are from these populations, so because they haven't received such informations before, so they really appreciate all the efforts that you went through and they, they really listen to what you're saying.

[00:42:44] Maddy Stratten: Yeah, it's so worth it, isn't it? It's, yeah. It's worth the extra time to be able to have these conversations.

[00:42:52] Ruiqi Fan: So I, I really enjoyed it.

[00:42:54] Jennifer Farinella: Thanks for listening to On The Couch. We create this podcast because we are allies in actively challenging discrimination, microaggressions, and exclusionary behaviors. We want to create spaces where people feel safe to share their thoughts, knowing they will be heard and respected. Such an environment fosters collaboration, innovation, and contributes to a more inclusive society.

Connect with us on Instagram and Facebook where you can share On The Couch with your colleagues, friends, and family. On the couches made by Jennifer Farinella, Naomi Viret Maddy Stratten and Winnie Adamson.

Until next time, peace, love and protection.