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What is an ethical response to the “torture” of immigration detention?

The ethical dilemmas that face health professionals involved in systems that support or profit from the mandatory detention of asylum seekers were explored recently by lawyer Brynn O’Brien in this must-read article for Australian Doctor.

She wrote:

“The  ‘detention industry’ – the private infrastructure that supports and implements the government’s policy of mandatory detention – is booming, and it’s time for all of us to start talking about how our actions, big and small, legitimise a system that we know causes serious harm to the health of so many….

By catching so many in the detention industry’s web, consecutive governments have made us all complicit in human rights abuse. Therein lies their central and insidious corruption. Near-universal complicity has – to an extent – both legitimised human rights abuse and immobilised us in responding to it. 

But the flipside of mass complicity of course, is that it also creates opportunities for widespread, decentralised and accessible acts of non-compliance.

By applying scrutiny to profit generated through human rights abuse we can start a conversation about our many, varied complicities in it. It is only when we understand how we are all implicated that we can begin to undo the system of mandatory detention that – as medical professionals and those who have experienced it have repeatedly told us – produces and reproduces irreparable harm.”

O’Brien’s urgings are worth revisiting in light of this article in Guardian Australia today where Dr Peter Young, the chief psychiatrist responsible for the care of asylum seekers in detention for the past three years, accuses the Immigration Department of deliberately inflicting harm on vulnerable people.

Young was until recently director of mental health services at International Health and Medical Services, the private contractor that provides medical care at Australia’s detention centres. He told Guardian Australia that the system is deliberately harsh, breaks people’s health, costs a fortune, compromises the ethics of doctors and is intended to place asylum seekers under “strong coercive pressure” to abandon plans to live in Australia.

He believes this process is akin to torture: “If we take the definition of torture to be the deliberate harming of people in order to coerce them into a desired outcome, I think it does fulfil that definition.”

Meanwhile, many thanks to freelance journalist and medical student Amy Coopes @coopesdetat) for tweet-reporting from a talk last night by Associate Professor Karen Zwi, a Conjoint Associate Professor at the University of NSW School of Women’s and Children’s Health.

Zwi was a member of the Australian Human Rights Commission team that visited children in immigration detention on Christmas Island earlier this year.

(The following text has been copied directly from Amy Coopes’s tweets, without editing and with her permission.)

Zwi says most refugee children have experienced violence, family separation and undergone dangerous journeys

Found most powerful to give children pieces of paper and asked them to draw their lives. Stories of fear where they came from

Detainee population 4,699, detention centres tend to be remote facilities to keep the press and access to services – lawyers etc – far away

There are 1,000 children in detention currently. Alternate Places of Detention – a nomenclature issue only. Conditions same to a kid

Every child we met you ask them their name they pull out their ID cards which has their boat number in much larger writing than their name

Dehumanising strategy used to take away people’s sense of autonomy. Very powerful, says Zwi

Zwi was part of the current inquiry into children in detention. Speaking about meeting people who saw them as their ‘window to the world’

27 babies under 1 yr, 144 1-5yrs, 101 6-12yrs. 42 unaccompanied. A typical message ‘here we are behind bars and crying’

Children in the centres can see kids from the outside community coming and going to school, free. They don’t understand why they are inside

Children held in recycled shipping containers. Stifling heat, little shade or communal gathering places. No privacy, very little space

Health conditions: skin infections, gastro, chest infections. Outbreaks common due to tropical climate and poor access to soap

Lot of parents spoke about children’s dental problems. Water not fluoridated, no toothbrushes or paste. Teeth rotting.

Profoundly deaf 18mo been in detention for 8 months, both parents also deaf. No signing interpreter, no hearing aids. Isolated

See children regressing, anxiety, lost appetites. Play on rough stony surfaces, few toys, no books in own languages (development issues)

Christmas Island an enviro disaster in addition to detention centre – either jungle or phosphate rubble. Baby can’t learn to crawl or walk

Children choose to only draw in black and brown, no colours. ‘Because black is angry, sad, scared’. Sleep disturbances v common

People woken twice a night for head counts. Issued with plastic cutlery and plate and cup – humiliating.

Queing and rationing for baby wipes, nappies, sanitary pads, constantly in the heat. Kids not allowed and desperate to go to school

Maths teacher who volunteered to teach kids told he wasn’t allowed. Plumbers among detainees not allowed to repair leaks

People worried about going mad with nothing to do, seeing people alongside them self-harming or very far gone. Desperate to be occupied

One father of two boys, aged 4 and 6, said he wanted to die but ‘who will look after my babies’

Children latch onto anyone who is leaving the detention centre and ask you to take them with them.

One child drew Tony Abbott shooting him, aged 7, with a gun. Only colour the red of blood

One woman’s children told her they wanted to go home with one of the detention centre wardens.

Another wrote on a complaints form ‘I have 4 girls, please someone take them, take care of them’

Children hear screams of self-harm, see the blood, the ambulances coming. Parents cannot shield their children from it.

Children cry themselves to sleep, play distressing games ‘i”m drowning, call Australia’, ‘you be the Serco guard’

‘I WISH I WERE DROWNING IN THE OCEAN BECAUSE TO DIE ONCE AND FOR ALL IT IS BETTER THAN EVERY DAY IS DYING’. A note from one girl

Zwi shocked by the level of family separation enforced by Dept of Immigration, would take mother of small children away for mths for medical

once male sons turn 18 they get taken away to the male adult compound, very distressing. can be transferred offshore

Legal guardian (minister of immigration) supposed to treat child like your child. Real concerns over whether this is feasible or reasonable

Children sent to pave the way to bring their families to safety – Somalia, Burma, Pakistan – and find themselves trapped in a cage

One child said when he grew up he wanted to be a journalist and interview Tony Abbott and put him on a boat

Using these current children to send a message to others not to come – from an ethical standpoint how can you do that? They are here now

Some people had already been processed by the UNHCR, determined as refugees, yet in detention in Australia.

Detainees say if they have ‘done a crime’ by coming to Australia they are happy to serve a sentence, but want a definite period of detention

‘At the moment we stand out as one of the cruelest countries on the globe in terms of asylum seekers coming to Australia by boat’

We are talking about less than 2pct of our annual migration, small numbers. Often v skilled people and v motivated

The information has been out there but Zwi says the press has not taken it up. Encourages people to educate themselves

Aust govt wants other countries to know that it’s awful if you come to Aust by boat. But most detainees have hope, have to hold onto sthing

Aust public for 15 years systematically indoctrinated with language about refugees – queue jumpers, terrorists. Press coverage meagre

If children are deprived of hearing aids in key developmental years spent in detention Zwi says they may never acquire speech

What happens to you in childhood is very well documented to affect you for the rest of your life – fear response becomes the way you are

That’s all from Dr Zwi’s talk from me. Profound thanks for the RTs and follows

***

Meanwhile, some advice from GP and Croakey columnist Dr Tim Senior on how health professionals (and others) might respond to the revelations in the Guardian Australia article.

 

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