Unity in Regional Diversity for CMDFA – Dr Sneha Kirubakaran

Let’s move CMDFA activities around the whole country and celebrate our expansive diversity


From Luke’s Journal May 2023  |  Vol.28 No.2  |  Unity in Diversity 

Image Catarina Sousa, Pexels

Conversation with a friend in a regional town of Queensland who used to be very involved with CMDFA during our medical school days in South Australia:

Me: “So lovely to hear that you are in [Town-X]! Are you still involved with CMDFA?”

Regional friend: “There is no CMDFA in [Town-X].”

Conversation with a CMDFA member in a regional town of South Australia who has engaged with various events through Zoom:

Me: “Would you be interested in getting more involved with CMDFA? What do you know about the National Office and our national activities?”

Regional member: “Nothing. It is something that is over in Sydney and is quite irrelevant to me.”

Conversation with a CMDFA member who leads a regular gathering of Christian health professionals in a large but distant location:

Me: Would you and your team consider bringing your group under the banner of CMDFA? This will give your attendees access to our National Office and other resources that they may not currently be aware of.”

Regional leader: “Not really.

When I commenced as the National Chair of CMDFA in January 2022, I was struck by the fact that I was the first person in this role to live outside a capital city.

I had moved to Rockhampton in regional Queensland eight months prior, after living in Adelaide for two decades. The move allowed me to pursue an academic role in a rural clinical school, to continue my work as a rural GP locum, and to complete my PhD research related to ‘medically under-served areas’.

As I sought God for wisdom on what I should bring to my new role of CMDFA Chair, my regional positioning and ‘under-served’ emphasis seemed pointed – I had a unique lens with which to consider our Fellowship and its activities. It made sense that God might use these rural and regional perspectives in my new CMDFA responsibility. Uncle Mordecai’s question resonated eerily, “And who knows but that you have come to your [leadership] position for such a time as this?” (Esther 4:14, NIV).

The pandemic had already broken down barriers for gatherings and human relationships across widespread locations in both personal and professional spheres. Through the simplified and ubiquitous use of videoconferencing technology, we had already successfully engaged more regional, rural, remote, or otherwise physically disparate CMDFA members and non-members.

Despite this progress, my above conversations with rural friends and members reveal that our Fellowship still has scope to improve with engaging Christian doctors, dentists, and students across the whole of Australia. Truth is, it is an on-going challenge to be relevant and interesting to our members in capital cities, let alone engaging our more far-flung brothers and sisters. Furthermore, there are many active groups of Christian health professionals meeting all over the nation who don’t specifically align themselves with CMDFA.

“Furthermore, there are many active groups of Christian health professionals meeting all over the nation who don’t specifically align themselves with CMDFA.”

Historically, we have been quite an eastern-focused Fellowship, with most of our members, leaders, events, and activities centred around Sydney, Melbourne, and sometimes Brisbane. New South Wales and Victoria have the largest and most active state branches and student ministries.

Hey, what about Western Australia? They have been pretty active too! Oh yeah, them too … Unfortunately, almost every other area – including expansive Western Australia – tends to be a bit of an after-thought! Nonetheless, CMDFA has a history of being better with moving meetings around the country regularly. Remember those IMPACT conferences in Adelaide and Perth? They were great, weren’t they?!

Arguments in favour of frequently choosing eastern states for our national events and activities include those of critical mass and logistical simplicity. It is easier and more financially sensible to arrange things close to where we already have lots of leaders, resources, and potential attendees.

In fact, these arguments are not unique to CMDFA, but common to many other socio-political decisions regarding supplies and services. Yet, with His parable of leaving behind ninety-nine well-cared for sheep to look after an isolated loner, Jesus Himself encourages us not to think in terms of critical mass, but in terms of privileging the under-privileged (cf. Matthew 18:12 – 14; Luke 15:3 – 7).

With my ‘under-served’ lens on, counter-arguments also include better representation of the under-represented and more equitable access to all regions. After all we are a national fellowship, right?! Why should the burden of travel fall on the same shoulders every time? Even when our students are given generous subsidies to travel across the country, there is still the added cost to their time and energy to consider. The same goes for our graduates, leaders, and other members.

“At the risk of ruffling some feathers, I would like to introduce the term ‘geographical narcissism’! It describes a power imbalance that geography can exert between urban and rural locations.”

At the risk of ruffling some feathers, I would like to introduce the term ‘geographical narcissism’!1, 2 It describes a power imbalance that geography can exert between urban and rural locations. It is a well-known topic amongst rural clinicians and medical educators because of its adverse impact on the rural medical workforce and education.

Geographical narcissism is defined as “a subtle, often unconscious, devaluation of rural knowledge, conventions, and subjectivity, and a belief that urban reality is definitive.”1 This unconscious bias can foster unwitting colonial mindsets by people in some geo-political locations towards people in other regions.1, 2

It is “narcissistic to believe geography is a key determinant of quality”, caution Baker and Hess.2 Yet, even in Biblical times, “Can anything good come from Nazareth?” (John 1:46 NLT) may have been the prevailing attitude!

At the risk of ruffling even more feathers, I have often observed our Fellowship to be geographically narcissistic – if not through urban versus rural attitudes, then through east versus ‘the rest of Australia’ mindsets. I experienced this when I lived in South Australia and had to frequently travel eastwards, with negligible reciprocal movement by eastern-based brothers and sisters.

Image Leah Kelley, Pexels

A few years ago (pre-pandemic, no less!), when I suggested hosting the next national conference in Adelaide, the response I got from a Sydneysider was, “Oh, that is too far!”

Geographic narcissism tempts us to think of ourselves and our region of residence as the centre of the universe or axis mundi.1 This can, in turn, breed the attitude that it is ‘too far’ to travel elsewhere for a meeting, but not too far for others to travel in the opposite direction.2

“This can, in turn, breed the attitude that it is ‘too far’ to travel elsewhere for a meeting, but not too far for others to travel in the opposite direction.”

I can imagine that to some, Darwin (the site of our July 2023 national conference) could seem almost as remote as the moon! I know my words may be confronting and challenging, but I speak out … “for such a time as this!

Let me, thus, encourage all of us to reflect on our own subtle bias and geographical narcissism and “to acknowledge that one’s assumed center is not the navel of the world.” 1 Let us ‘consider the other as better than ourselves’ (cf. Philippians 2:3) and work to even the balance of historic privilege. Let us individually and collectively plan how we can ‘enlarge the place of our tent’ (cf. Isaiah 54:2) in our personal and professional services and ministries.

Let’s move CMDFA activities around the whole of our country and celebrate our expansive diversity. Let’s provide more opportunities for our regional and rural members (and non-members) to share in our Fellowship’s activities and resources and not expect the burden of travel to repeatedly fall on the same shoulders. And let’s encourage all our members to organise CMDFA gatherings wherever they are, rather than saying, “There is no CMDFA here”.

Dr Sneha Kirubakaran
Dr Sneha Kirubakaran is the current National Chair of CMDFA. She is an Associate Professor with the University of Queensland Rural Clinical School and the Head of the Regional Training Hub Central Queensland in Rockhampton. She locums as a Rural Generalist in small country hospitals around Central Queensland. Her PhD entitled Establishing New Medical Schools in Medically Under-served Areas was awarded in July 2022.


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  1. Fors M. Geographical narcissism in psychotherapy: Countermapping urban assumptions about power, space, and time. Psychoanalytic Psychology. 2018;35(4):446-53.
  2. Baker T, Hess K. Geographical narcissism: When city folk just assume they’re better. The Conversation [Internet]. 2019. Available from: https://theconversation.com/geographical-narcissism-when-city-folk-just-assume-theyre-better-127318.