(This story aired previously on Almanac, the Twin Cities PBS public affairs program, and was funded by the Otto Bremer Trust.)
Rural America is in need of doctors. That’s why family physician Ayaz Virji left a well-paid practice in Pennsylvania and moved his family halfway across the country to the small town of Dawson, Minn., population 1,500, in 2014.
“They needed a doctor,” Virji, 42, said. “I wanted to help fill the void.”
(See the Almanac video on Virji and his family below.)
The National Rural Health Association says the doctor to patient ratio in rural areas is about 40 to 100,000 people — compared to 53 doctors per 100,000 people in urban areas. When it comes to specialists, the number drops even lower, to 30 per 100,000 in rural areas, compared to 263 in major cities.
To fill the need, rural health providers are increasingly relying on foreign-born and often foreign-trained doctors. Minnesota projects it will have a 2,000-doctor shortfall by 2025 — the majority of those vacancies outside the Twin Cities metro area.
The Only Muslims in Town
Virji was born in Kenya but grew up in Florida and was educated in the U.S. He and his wife Musarrat, and their children Faisel, Imran and Maya, took up residence in a historic home near the main street of Dawson. The family, who are ethnically Indian, were the only Muslims in town, and possibly for miles. The family decided to take things in stride.
“I loved it. The people were so genuine, and so nice,” Virji recalled.
Musarrat Virji, 36, had a more difficult adjustment. The town’s residents are mostly from Norwegian, German or Swedish stock — not unusual for rural Minnesota. An observant Muslim, she had expected her hijab, or religious head covering, would attract a fair amount of stares. There weren’t any. The differences were under the surface.
“I’m just used to coming from a place where people are outspoken. Say it like it is,” the self-described East Coast “city girl” said.
“Maybe it’s the Midwest thing or ‘Minnesota Nice’ thing, where people don’t talk about their feelings and don’t let you know how they’re thinking,” she added.
A Star Recruit
Johnson Memorial Health Services had found its chief of staff and only full-time doctor. Chief Executive Officer Stacey Lee, who grew up in Dawson, said it was rare to find a physician with a medical degree from the likes of Georgetown University and with no ties to the area who would agree to come.
“Every once in a while we get lucky with a Dr. Virji, who feels he wants to practice rural-style medicine and not turnkey. He wants to make a big difference and give back to the community,” Lee said.
Virji’s warm personality and medical expertise won folks over. People liked the doctor; they didn’t see him as a Muslim. And nearly everyone in town was on his patient roster. He also specialized in bariatrics — the causes, prevention and treatment of obesity. And so far, he’s helped his patients collectively lose weight: 3,600 pounds in total.
But something changed after the 2016 presidential election. Donald Trump was elected, with the help of nearly half of the vote in Dawson. The surrounding Lac qui Parle County went red by nearly 60 percent. A centerpiece of President Trump’s campaign was cracking down on illegal immigration and fighting Muslim terrorists.
“I think Islam hates us,” Trump told Anderson Cooper during a campaign interview on CNN. “There’s something there, there’s a tremendous hatred there. We have to get to the bottom of it.”
Those comments and talk of putting Muslim-Americans on a type of registry angered Virji. He felt the president’s comments and sensationalized media reports were putting law-abiding, peaceful Muslims in a negative light. For Virji, the interpretation of the strong support for Trump in his community was clear.
“It felt as though if you could take the brown, Indian person and put him on a registry and export him, and keep the doctor, you’d have done it in a heartbeat,” he remembered. “I felt betrayed.”
Anti-Muslim Talk Grows
He wasn’t alone. Mandy France was serving as an intern pastor at Grace Lutheran Church in Dawson. She started noticing anti-Muslim and anti-Islam rhetoric creeping into conversations among parishioners and others in the community. She felt it went against her understanding of the Christian Gospel.
“If we’re saying we’re Christians and open and accepting but yet I’m hearing, ‘All Muslims should be on a registry… Islam is cancer,’ it was very conflicting for me and I wanted to do something about it,” she recalled recently.
France organized a talk at the local school titled “Love Thy Neighbor.” She asked Virji if he would talk about Islam and dispel myths about his faith. Virji had always been private about his faith and wasn’t out to convert anyone. But alarmed at the increased anti-Muslim hate rhetoric he had begun to see, he agreed.
A Contentious Meeting
The interfaith discussion faced challenges from the outset. France said people called school officials to protest that a Muslim was being allowed to make a public address there, citing separation of church and state principles. Earlier, she said a Christian funeral had taken place without complaint in that same space.
More than a third of the town attended the discussion. There was an outburst from some attendees. France said the backlash directed at the doctor was disturbing.
“There was a group of grown men who were screaming ‘Antichrist’ at him. And saying horrific things to him. One of them was a pastor,” she said.
The talk attracted media attention far and wide. A Washington Post article on Virji and his efforts to clarify Islam against a rising tide of anti-Muslim hate speech where he lived became part of the national discussion. France and Virji thought the talk would be the first and last. But the invitations started rolling in from nearby cities: Marshall, Montevideo and Aberdeen, South Dakota.
To his critics, Virji is direct. “I categorically condemn Isis and al-Qaida and anyone who murders any innocent person. They are not me and they are not 99.9 percent of Muslims here,” he has said.
Support and Hate Mail
The talks have mattered. One attendee went up to the microphone at Southwest Minnesota State University and said he recognized the toll it must take on Virji to so publicly talk about something so personal to him.
“I know this is draining work,” a man who identified himself only as “Brannon” said. “But you are making our community a better place and I want to thank you from the bottom of my heart,” he said before a smattering of applause from the audience.
It’s been 10 months since that first talk. Like clockwork, hate mail and angry letters in local newspapers follow each event. The Virjis still occasionally field an awkward question, like whether they’re American citizens. (They are.)
Staying the Course
But despite the national media attention and the public scrutiny, Virji and his family have vowed to go on in with their lives in Dawson.
Musarrat Virji has made friends through her aesthetic care business downtown. By now, the hospital nursing staff greet television crews and reporters with an almost routine air. Virji seamlessly weaves a sit-down news interview with cheerful chats with his patients during rounds. His children are active with sports and dance classes and have made friends at school. The family prays at home, in private.
Today, Musarrat Virji isn’t sure whether Dawson is their forever home. But it’s clear retreat is not in their vocabulary. “I think it’s important to stand up for what you believe in,” she said, illustrating a quiet strength. “And I think it’s important for people to see that diversity makes the world so colorful.”
Her husband agreed. He joked that his toughest critics might be his own kids.
“They think I talk too much,” he said, wrapping up the interview. “They’re like, ‘Dad we get the message. Leave us alone,’” Virji said, smiling. “I hope at some point when they’re older, there will be some point where they’ll come across a tough situation. And they’ll think [of this] and decide to do what’s right and not what’s easy because my dad did it,” he said, turning more serious.
“I would be the happiest dad in the world if that happens.”