As the New South Wales lockdowns dragged on, Mobinah Ahmad moved into her family’s 12-bedroom house in Bonnyrigg, in Sydney’s west. After spending Ramadan alone last year, the 32-year-old decided that living with her parents, sister and grandparents would support her wellbeing. Multigenerational connection and gathering is everything to her family.

“Growing up as an Australian, I love my independence, but my Indian–Pakistani Muslim heritage means I also have a community mindset,” she says. “When you live in a multigenerational household, as we do, space is important, particularly for social distancing. Living with family in a safe way is good for your mental health.”

Informal aged care is common among migrant communities. Ahmad’s family came together and talked about their responsibilities as a communal-living household.

“As we’re living with my grandparents, we had a family discussion about needing to be more vigilant and limit going out,” she continues.

Unable to go to the mosque, the family finds solace at home through prayer. “My dad loves the idea of the family coming together to pray five times a day – it is one of the ways we cope.”

Ahmad says it’s good to see the government investing in ethnic media, after failing to engage with it earlier in the pandemic. Her family runs the Australasian Muslim Times, which provides culturally specific messaging and is now focused on the pandemic. Having recently secured a vaccination appointment, Ahmad is the last in her family to receive the jab, and admits she has been lax.

“I rely on my sister for updates as there is a lot of panic and misinformation out there. There’s this idea that young people don’t get Covid, that it’s like a bad flu. But now we’ve heard about people our age dying, you realise it affects us, too.”

Mainstream news isn’t always accessible, particularly in hotspot local government areas such as Fairfield and Canterbury-Bankstown, where more than 80 per cent of the population speaks a language other than English. As the Australian-born population grows, it creates a generational rift when navigating the health system and lockdown restrictions.

Sarah Pham, who asked to use a pseudonym here, lives with her parents in Villawood, following a stint overseas. The Vietnamese community has been established in south-west Sydney since the 1980s. Despite her parents migrating to Australia 40 years ago, they mainly converse in Vietnamese.

“My mum stayed at home, so her English is not the best. Dad speaks broken English because he worked as a mechanic. Dad is fairly self-sufficient and does the shopping, but mum’s chronic pain has hindered her lifestyle significantly,” says Pham.

Pham has taken the lead among her five siblings in looking after her parents, assisting with household chores during lockdown. Socially, it has been challenging.

“We are a big, close family that meets up frequently,” the 30-year-old says. “Lockdown has been tough for my parents. Normally, the grandkids would be running around, creating havoc – they miss them. We are fortunate to have access to the internet to do video calls.”

Her parents find broadcast-level English difficult to understand and mostly access Covid-19 updates through online sources.

“For the Vietnamese community, there’s a few social media channels, mainly on YouTube, that provide Australian and global news in language,” Pham says. “Five to six years ago this didn’t exist, but it’s helped contextualise international issues, including Covid. Though I still have to keep my parents across local lockdown restrictions.”

Multilingual print correspondence distributed through local councils isn’t possible with the pace of changes, leaving knowledge gaps in certain residential pockets. Council Facebook pages and state-led social media campaigns provide information in Vietnamese, but it is inaccessible for those without internet access.

“Cabramatta used to be bustling,” Pham says. “Older Vietnamese men would gather, have coffee and play checkers. During lockdown, they continued to do this and received a police warning. They either didn’t get the memo, didn’t understand the announcement or disregarded it.”

Pham’s family is vaccinated. With the virality of the Delta strain, they were quick to book AstraZeneca shots.

“My dad initially wanted to wait it out, and Mum generally does what Dad decides. But when Delta came round, they changed their minds,” she says. “I am fortunate to be living with my parents through lockdown so I can check in on them. Not everyone can do that.”

In migrant cultures, established intergenerational ties mean that as the first generation gets older, the second generation takes care of them. In Fairfield, this has meant changing zoning restrictions to account for intergenerational family living, including building granny flats to house elderly family members.

“We had to change development applications to take into account a lot of families have their elderly relatives living with them,” says Thang Ngo, who was on the council at the time and influential in getting the changes through.

Due to distance restrictions, Ngo and his partner take primary care of his 70-year-old in-laws, who also live locally. Ngo’s mother-in-law has dementia and recently broke her leg. With casual social visits no longer possible, Ngo and his partner have been supporting his father-in-law with care to give him respite. His mother-in-law finds the Covid-19 test uncomfortable, so they have to coax her into it and remind both in-laws to wear masks.

“It’s really hard for the younger generation to take care of older people due to their apathy towards healthcare. She [his mother-in-law] doesn’t understand why we are in lockdown and can’t visit her. They don’t have a car, so we take them to drive-through clinics.”

Hospitals have also been sorely tested. An anonymous front-line worker at Liverpool Hospital says the situation in Covid-19 wards and the intensive care units are unrelenting.

“We’re burnt out. The numbers keep rising and there’s no end in sight. I’m anxious and struggling to sleep. Vaccination hubs keep popping up and we don’t have the capacity to staff them. People often say, ‘This is what you signed up for.’ There’s really not much sympathy for us.”

Sometimes entire households arrive at the hospital to be treated for Covid-19. Kids are being sent to separate hospitals from their parents due to bed availability. Visitation is prohibited to avoid further community transmission. Hospital staff have also moved out of home to avoid infecting their own families.

“Kids are catching it and passing it on to their parents and grandparents. It’s scary when families drop off their loved ones at emergency knowing it may be the last time they see them,” the front-line worker says.

Although there is distrust of the government and news outlets, migrant and refugee communities have confidence in medical advice. Liverpool Hospital has been encouraging patients’ family members to get vaccinated, offering language translators to make health advice more comprehensive.

“We often have people expressing that ‘My parents won’t listen to me. Can you call them and tell them to get vaccinated?’ Often once one family member gets vaccinated, it provides reassurance and the rest of the household follows shortly after.”

The Australian Afghan Hassanian Youth Association (AAHYA), a Regents Park-based organisation, has been offering support services to asylum seekers and migrants across generations – reaching parts of the community that traditional media doesn’t engage. Mursal Hasanyar, a 25-year-old employee, has been key to critical aid efforts during the pandemic, and now the Afghan crisis.

“It has been hard for the community to not sit together and help each other during this difficult time. AAHYA supports people of all ages, including the elderly, people that need income support and those on bridging, temporary and student visas,” Hasanyar says. “We book vaccination appointments and provide food relief, particularly for those that don’t understand English or have access to the internet.”

Language translation, familial connection, community-led support and advice from front-line health professionals are key to enhancing intergenerational public health literacy and access.

“The best way for all generations to be educated is using translation on social media and telephone interactions, especially when English is their second language,” Hasanyar says. “The community needs more direct and organised support, including food, income and employment. Due to the high case numbers, we have been educating people that by getting vaccinated you are helping the community to gather again.

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