At 14, Stuart Yiwarr McGrath made a radical decision that would change the course of his life.

Orphaned at 12, he had spent years bouncing around the homes of different relatives on the tiny island of Galiwin’ku (Elcho Island) on the northernmost tip of Australia, before he received a phone call from his aunty in Canberra asking if he wanted to live with her.

“I couldn’t really speak English,” he recalls. “I just said, ‘Yes, I will come’ and then hung up. I was on the plane the next day.”

The experience set him on a path that would see him become Australia’s first Yolŋu registered nurse – winning national accolades and starring on reality TV show The Amazing Race along the way.

McGrath grew up in Mata Mata in north-east Arnhem Land, a coastal community with six houses where the Yolŋu people lived off the land, eating mud mussels, mangrove worms, dugongs and stingrays. His mother and grandmother taught Yolŋu education at the local school. A white teacher was flown in once a week to teach in English, otherwise Yolŋu Matha was the dominant language – or, as McGrath puts it, “the language you dream in”.

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His father, a white man, died in a quad bike accident when McGrath was five. His mother became unwell in her 40s, experiencing weakness and persistent chest pain. After a long process trying to access healthcare, a specialist in Darwin identified her disease as something akin to lupus, whereby the body’s immune system attacks its own tissues and organs. She went straight into palliative care.

McGrath believes language barriers and a lack of cultural and health literacy “on both sides” contributed to the delayed diagnosis.

“I think it was just two worlds not actually understanding each other and colliding,” he says.

His mother’s experience is not unique. Australia’s race discrimination commissioner this week declared racism “a public health emergency” after a sweeping review of 100 studies showed the consequences of racism in the health system could be fatal.

McGrath in Arnhem Land. Photograph: UNSW/Becky Laurence

When McGrath arrived in Canberra, he could read and write in English, but was not confident to speak it. For a year, he used a whiteboard to communicate with his father’s non-Indigenous family – relaying messages about how his day was or whether he could go to the cinema that weekend.

His Canberra high school was “99% white kids”. McGrath remembers being introduced to another student who told him: “I don’t shake no black man’s hand.”

It was his first experience of racism.

“I didn’t know what that word meant because I came from a place where that didn’t exist,” he says. “It just made me feel like less of a human, you know?”

After two years in Canberra, McGrath returned to Arnhem Land and completed his schooling at a Darwin boarding school but found himself viewing his circumstances through a new lens.

McGrath was named 2021 NT Young Australian of the Year for his efforts to improve cultural safety in healthcare. Photograph: UNSW/Becky Laurence

“I realised that we weren’t the lucky Australians,” he says. “I started comparing things, like oh there’s overcrowding, there’s a shortage of food all the time – I’m always freaking hungry. Sometimes violence blows out here and there.”

He stresses that these were structural, not cultural problems: “This is not Yolŋu culture. These are symptoms of poverty.”

One of the most stark disparities that had become clear to McGrath was the health gap between black and white Australia. Yolŋu people experience the country’s highest number of avoidable deaths, mostly from chronic disease. Rates of diabetes and rheumatic heart disease are among the highest in the world.

McGrath had seen too many friends and family die young. His best friend killed himself aged 18. Funerals were a regular occurrence throughout his childhood and few people lived beyond their 50s.

We cannot close the gap in health outcomes without confronting the racism that underpins itGiridharan Sivaraman

“I realised the missing link is that none of us are in the health system,” McGrath says.

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He became an Aboriginal health practitioner, then enrolled to study at university – a “foreign concept” in his family. He completed his bachelor of nursing at Charles Darwin University over five years, juggling study and parenting as a single father of two daughters.

The 34-year-old returned to Ramingining on Yolŋu country last year to work as a registered nurse with the Miwatj Health Aboriginal Corporation.

Often, as he is placing an IV, his patients will tell him how proud they are. But while he loves the clinical work, McGrath believes it’s a Band-Aid solution to a much bigger problem.

McGrath works as a registered nurse with the Miwatj Health Aboriginal Corporation. Photograph: UNSW/Becky Laurence

Ultimately he wants to effect change at a higher level to address the root causes of health inequality, including a lack of cultural safety in healthcare settings.

It is something McGrath has experienced first-hand throughout his career: he was once mistaken for a renal patient while presenting at a health conference in Darwin, and says colleagues will sometimes pause during a medical assessment to ask, “So, where did you get your education from?”

It’s an experience many Indigenous health professionals and patients have gone through, according to a study published by the Australian Human Rights Commission on Tuesday. It found discrimination in healthcare – through neglect, stereotyping and substandard care – was a critical driver of poor health, chronic illness and premature death.

The race discrimination commissioner, Giridharan Sivaraman, says urgent reform is needed, including anti-racism training for health professionals, more interpreters, strengthened anti-discrimination laws and more input from diverse voices in public health policy.

“We cannot close the gap in health outcomes without confronting the racism that underpins it,” Sivaraman says.

McGrath spent two years as a teenager in Canberra before returning to the Northern Territory. Photograph: UNSW/Becky Laurence

McGrath was named 2021 NT Young Australian of the Year for his efforts to improve cultural safety, including through a study investigating why Indigenous patients leave hospital against medical advice (often due to a lack of interpreters, racism or a general sense of feeling uncomfortable “because they’re not recognised for who they are”).

McGrath says more First Nations health professionals are desperately needed to bridge the divide. He shared his story as part of the University of New South Wales’ Future You program, which aims to inspire more young people to pursue a career in science, technology, engineering or maths.

“I think I’d be naive to say if I can do it, any, anyone can do it,” he says. “I think we’ve got a long way to go. We’ll get there, but it’s time.”

His daughters are now 14 and 15. The youngest thinks she might like to be a nurse.