Like most developed countries, Australia has experienced an influx of people seeking asylum. However, the lot of these would-be refugees improves little if they are fortunate enough to reach Australian soil.
Asylum seekers who arrive without a valid visa are placed in remote detention centres, where they face spartan conditions until their claims are processed. This can take up to 4 years.
While conditions at the Woomera Centre, where temperatures reach up to 50° C, have improved, former detainees and staff say they remain grim. Detainees are identified by number, and personal possessions, including photos, are confiscated. The quality of the food is often questioned, and Muslim asylum seekers are not convinced it is halal (lawful food).
Education is available 2 to 3 hours per day, but only for children under age 12. Recreational facilities are limited, and the climate is too extreme to allow outside play. Mothers do not get routine support for breast-feeding or weaning, and women have to submit forms to get basic items such as disposable diapers or sanitary pads.
Nurses and GPs provide care under contract to Australian Correctional Services — the private company paid to run the centres — but they receive no special training. Consultations are by appointment, and guards may be present. When treatment is required outside the facility, detainees may be handcuffed or otherwise restrained, and accompanied by a guard. If escorts are unavailable, appointments may be cancelled.
The Australian Medical Association (AMA) asserts that detainees are often deprived of basic medical care and has supported the provision of temporary access to Australia's universal health care system. The Royal Australian and New Zealand College of Psychiatrists has also spoken out strongly, with Dr. Louise Newman telling The Lancet: “Medical practitioners face the dilemma of an intrinsic conflict between the desire to provide appropriate care, and the compromising of this by supporting a pathological system. This is similar to the issues that confronted doctors in Soviet Russia or Nazi Germany.”
Dr. Peter Sainsbury, president of the Public Health Association of Australia, says the detention facilities are an “absolute disgrace in terms of the conditions and standards that are applied.”
Even if their refugee claims are eventually accepted, asylum seekers can never obtain full citizenship rights. Instead, they are given temporary visas that must be renewed. Holders cannot return to Australia if they leave, and they are not allowed to bring their families. This causes great distress and insecurity and makes it extremely difficult for them to rebuild their lives or contribute to Australian society.
“The federal government's policy of mandatory detention violates all principles of public health and is contrary to its legal and humanitarian obligations to refugees,” says Sainsbury. “Refugees are by definition traumatized, due to their experience of repression and persecution, and many have chronic health problems. Overwhelmingly, health studies establish the need to place asylum seekers, particularly children, in supportive and rehabilitative social and cultural environments.”
Refugees have protested by setting fire to their accommodations and by hunger strikes. Some have sewed their lips together in an effort to draw attention to their plight.
Conditions in offshore detention centres are harder to ascertain. However, recent reports of chloroquine-resistant falciparum malaria on Manus Island in Papua New Guinea led Richard Larkins, president of the Royal Australasian College of Physicians (RACP), to comment: “Given the medical evidence about the prevalence of malaria … [there], the responsible course is to evacuate the detention centre.”
Articles documenting the adverse health consequences of this policy have been published in JAMA, the BMJ, the British Journal of Psychiatry, The Lancet and the Medical Journal of Australia. In the latter publication (Med J Aust 2001;175: 593-6), detainee Iraqi doctor Aamer Sultan, who was held indefinitely at the Villawood detention centre in Sydney, provided some insight into the reality facing asylum seekers (www.mja.com .au /public/issues/175 _12 _171201/sultan /sultan.html).
Hundreds of Australian doctors and health care workers have signed advertisements protesting conditions in the camps and the damage to detainees' long-term physical and mental health. The RACP, AMA and 12 other professional bodies have convened the Professional Alliance for the Health of Asylum Seekers and their Children. It has drafted a submission to the National Inquiry into Children in Immigration Detention.
Unfortunately, in a country where the most recent federal election was dominated by the asylum-seekers' issue, it will take many more protests before the situation of these unfortunate people improves substantially. — Dr. Julia Lowe, chair of Australia's Newcastle Institute of Public Health, is currently on attachment to the World Health Organization, Geneva.
Figure. Renowned Australian writer Thomas Keneally (centre) was one of many protesters attending a recent “silent vigil” outside the Department of Immigration in Sydney. They were protesting the government's harsh stance against asylum seekers. Photo by: Canapress