Doctors condemn conditions in Australian refugee camp

By Mike Head

24 December 2013

A group of 15 doctors has exposed the sub-standard medical care they are forced to provide asylum seekers at Australia’s Christmas Island detention centre. Their 92-page “letter of concern,” given to their employer in November, was published by the Guardian Australia web site last week.

The detailed letter sheds further light on the inhuman conditions imposed on thousands of refugees in the country’s detention facilities, both within Australia and on remote islands in the Indian and Pacific oceans. It documents “numerous unsafe practices and gross departures from generally accepted medical standards which have posed significant risk to patients and caused considerable harm.”

Among the long list of shocking practices, the doctors revealed that, on arrival, asylum seekers are examined while exhausted, dehydrated and filthy, their clothing “soiled with urine and faeces” because there were no toilets on the refugee boats. The letter said patients were “begging for treatment,” queuing for up to three hours for medication, sometimes four times a day.

Antenatal care was unsafe, inadequate and did not comply with Australian standards, and there was a high risk of depression among children and no effective system for identifying children at risk. Basic medical stocks were low, drugs requested by doctors were not provided, and there were long delays in transferring patients to mainland hospitals, leading to “risks of life-threatening deterioration.”

The doctors said decisions by their employer, International Health and Medical Services (IHMS), were compromised by its relationship with the immigration department. “As a result, these decisions are not always in the best interest of the patient.” The report was written at the invitation of IHMS, which provides medical care to more than 2,000 asylum seekers detained on Christmas Island and the hundreds of men, women and children forcibly transported from there to camps on Nauru and Papua New Guinea’s Manus Island.

At busy times, initial health assessments were hurried through in as little as five minutes. As a result, a case of TB went undiagnosed for 44 days. “Potentially the entire camp has been exposed,” the letter said. The doctors concluded that the assessments “cannot and should not be relied upon.”

Life-threatening delays in medical transfers were accompanied by removals to Nauru, where the medical facilities were also primitive. Among the case studies in the report were:

* A baby needing heart surgery who waited two months to be flown to the mainland

* A child placed on the transfer list for more than two months who was flown instead to Nauru

* A man eventually sent to the mainland who returned to the island not having been treated

* A woman with a “very high-risk pregnancy”—thought to be twins by medical authorities in Indonesia and on Christmas Island—who was transferred to Nauru.

These conditions are not far different from those revealed last week on the Italian island of Lampedusa, where mobile-phone footage showed refugees being forced to strip naked, in mixed company, and being hosed down by staff. On both sides of the world, people fleeing repression and destitution are being treated as essentially sub-human in ways not seen since the horrors of fascism in the 1930s.

At his weekly media briefing last Friday, Immigration Minister Scott Morrison refused to comment on the doctors’ report, claiming his office had not received it, despite it being handed to his department nearly two weeks earlier. Blocking all questions, he said: “We are appropriately assessing the claims that have been made.”

In reality, this is far from the first exposure of the brutal conditions in Australia’s camps. Two reports released last month by the United Nations High Commissioner for Refugees (UNHCR) on Nauru and Manus revealed detainees living in tents under hot, cramped and rat-infested conditions. Children were lice-infested, some had skin infections and all suffered deteriorating mental health.

In July, under the previous Labor government, whistleblowers who worked inside the camps exposed a detention regime that drives refugees into insanity, self-harm and suicide.

Neither report altered official policy one iota. Following the lead of the Labor government—which expanded the Christmas Island camps and reopened those on Nauru and Manus—the Abbott government is deliberately using the punitive conditions in them, combined with indefinite incarceration, to stop refugees seeking asylum in Australia. The intent of its “Operation Sovereign Borders” regime, like the European Union’s “Fortress Europe” policy, is to block all refugees, including those fleeing Syria because of a civil war instigated by the Western powers.

Foreign Minister Julie Bishop, who visited Nauru last week as part of a three-day South Pacific tour, declared that conditions in the island’s detention facilities were better than in Australian mining workers’ camps. Aside from the fact that mining workers’ conditions are also poor, Bishop declared: “The standard of medical care and services I thought was very high.”

The bipartisan character of this policy was underscored by the response of Labor’s deputy opposition leader, Tanya Plibersek, who accompanied Bishop on the Pacific tour. She refused to condemn the conditions, for which Labor remains responsible, merely saying that Nauru was hot and dry, and not easy to live in, even for Nauruans.

Increasingly, this harsh regime is being intensified in flagrant violation of both international and domestic law. Last week, immigration minister Morrison deliberately evaded an imminent High Court challenge to one of his ministerial decrees by revoking a cap he imposed on the granting of protection visas. Morrison has now foreshadowed unspecified measures to achieve the government’s purpose of freezing out all refugees who arrive by boat.

Greens senator Sarah Hanson-Young, who spent four days on Nauru, deplored the conditions there, and also criticised Morrison’s visa cap manoeuvre to avoid legal scrutiny. While the Greens have postured as opponents of aspects of the anti-refugee policy, they have made clear their readiness to work closely with the Abbott government, just as they did with the former Labor government. Thoroughly integrated into the political establishment, the Greens support the underlying “border protection” framework of military, intelligence and police operations to bar access to all but a handful of the world’s desperate asylum seekers.