A Mayo-based doctor has said "words cannot describe" the "anxiety, depression and safety concerns" migrant healthcare workers are experiencing in Ireland.
Dr Liqa Ur Rehman is the founder of the Irish Society of International Doctors and said the atmosphere of fear created by racially motivated abuse has led healthcare professionals to take steps to ensure their own safety.
He and other healthcare leaders say this is damaging Ireland's reputation among healthcare communities around the world and may hinder recruitment to Ireland in the future.
In many towns across Ireland, Dr Rehman says, migrant doctors have formed private WhatsApp groups to help ensure their own safety.
If individuals feel unsafe they share their location with the group and a response is co-ordinated among friends and colleagues.
Dr Edward Mathews of the Irish Nurses and Midwives Organisation (INMO) said healthcare workers are particularly vulnerable because of their working hours, often coming and going from work at "odd hours of the day and night".
He said people "worry about coming and going from hospital community care areas", causing some to modify their behaviour.
The trade union leader said he has heard from nurses and midwives who "group together when they're moving to and from shift".
"The general consensus in the community at the moment is that everybody is preparing to move somewhere else."
Dr Rehman said he has received calls from "many" doctors across the country who have been verbally abused, threatened and physically assaulted.
The Castlebar-based paediatrician says he has himself been chased and threatened while walking in a park, and has had stones thrown at his home.
As a result he and his family have stopped going out, an experience he says is common among migrant medical workers and is resulting in many of them considering leaving the country.
"There's a huge fear, and safety concerns, in the community," he said.
"The general consensus in the community at the moment is that everybody is preparing to move somewhere else."
While he said racism is "not something new", he feels "it has been newly empowered in the last few years".
In August, following a number of violent incidents, India's embassy in Dublin issued an advisory urging their citizens to avoid isolated areas at particular times and to take reasonable precautions for their personal security.
Days later, the INMO issued a statement saying racially motivated abuse of workers should not be tolerated.
Dr Mathews says since then they have "certainly seen a response, but we do think that more needs to be done in terms of a high visibility response for our members in communities and in their workplaces".
He said there is legislation in place but there needs to be "high visibility prosecutions in appropriate cases" so unacceptable behaviour is dealt with "definitively and in a public way".
Dr Rehman said incidents are reported to gardai, but many migrant healthcare workers have "lost trust" in the force.
The Department of Justice said: "The Government is determined to stamp out hate-motivated crime and protect vulnerable communities."
A spokesperson said An Garda Síochána "takes hate crime very seriously" and every instance reported to them "is professionally investigated and victims are supported during the criminal justice process".
They said hate crime laws have been strengthened through the introduction of the Criminal Justice Hate Offences Act 2024, and a new Migration and Integration Strategy for Ireland is being developed and due to launch next year.
43% of doctors obtained first qualification in another country
The health service relies heavily on migrant workers - according to the latest Government data, 43% of doctors obtained their first medical qualification in another country, with the largest cohort coming from Pakistan.
That figure rises to 52% among nurses, with the largest group having originally been educated in India.
This is a much higher rate than in other similar countries - in the UK 23% of nurses were educated abroad.
Dr Mathews said: "There is a clear understanding in the international community that there has been an uptick in the far-right and racist behaviour in Ireland.
"They have other destinations that are better paid, that have higher staffing levels, and that have better weather," but the provision of healthcare in Ireland "cannot survive without them".
Dr Suzanne Crowe from the Irish Medical Council said Ireland has long had a welcoming and friendly reputation, with medical workers settling here for that reason - a message she said has "gone back to" other countries.
But recently "something has changed" and in the past number of weeks she has received messages about doctors being verbally assaulted in supermarkets with their children, in car parks at hospitals, and outside train stations.
She said as medical professionals often move throughout their careers, they do not tend to "see geography as being a barrier, but they would see the type of society that they're moving to as a barrier".
If the current situation was to continue or increase, she warned: "We would start to see a fall off of the numbers of staff who want to come to Ireland.
"These attitudes are being whipped up by malign forces, many of whom are not even based in Ireland.
"That needs to be seen and that we're kinder, nicer people than that.
"We've got to, as a society, say this is not us as a people, we don't hold these attitudes."
