Doctors silenced over Australia's immigration centres

Abstract

A new law potentially threatens health workers with jail if they reveal too much about what really goes on inside Australia's immigration detention centres. Chris McCall reports. Nurse Marianne Evers lasted 3 weeks when she went to work in the Pacific island nation of Nauru. It sounded like a dream nursing job, but in revelations that subsequently made headlines, Evers described suicides, fights, beatings, and lack of proper toilet facilities at a centre holding would-be immigrants to Australia that Australia had kept out. She calls the place a “concentration camp”. It is not the image that Australia's Government wants, or likes tourists, investors, or voters to see. Under the new Australian Border Force Act passed this year, people like Evers will have to think a lot harder before they talk to the media, as it might mean a jail sentence. There has been plenty to discuss. For example, Evers told The Lancet that she was aware of four suicides in just 3 weeks on shifts she worked on back in 2013, in a centre holding around 600 asylum-seekers. “It is a common occurrence”, she said. Other whistleblowers have detailed rapes by Nauru men of foreign women, which Nauru police failed to investigate. Children are going without education and some may have had their growth stunted. Tamils from Sri Lanka have physically clashed with Afghan Hazaras, and those employed to guard them are poorly prepared. Reports from another offshore detention centre in Papua New Guinea's northern Manus Island are no better. But Australia also has onshore immigration detention centres, where it keeps people it cannot justify sending away even under its own draconian laws. Reports from those are also grim. Riots have broken out at some. An official inquiry has been held. Quietly, away from the cameras, sick detainees overseas have occasionally been moved to Australia for urgent medical care. However, the policies remain firmly intact, including turning back boats, refusing to allow those arriving by sea to settle in Australia, and mandatory detention of asylum-seekers. Refugee advocates argue that many of these things are at odds with Australia's obligations under the 1951 UN convention on refugees. Australia's justification for its policies? Stopping a dangerous illegal trade, which has led to hundreds of drownings and could be feeding millions of dollars into the pockets of people-smugglers and corrupt officials in other countries. By global standards, the numbers of asylum-seekers are small, in the thousands yearly, and many actually reach Australia by air, not by boat. Australia has also, over the years, taken in substantial numbers of refugees through official channels, particularly Sudanese refugees. Most of the migrants want to be recognised as refugees and want to settle in Australia. A substantial proportion of Australia's voters do not want them, enough possibly to swing an election. So Australia's Government is determined to keep them out and discourage others from trying. The left-wing opposition agrees. It wants to win the next election too. The new act allows jail terms of up to 2 years for unauthorised disclosures of information in relation to all immigration detention centres, by employees, contractors, and those who work for contractors. Australia's Government insists that public interest disclosures, defined in the Public Interest Disclosure Act, will not result in prosecution. Others are not so sure and suspect an attempt at a cover-up. Lawyers say that concerned health workers have come forward for legal advice since the act was passed, often unsure how to reconcile their ethical obligations with the law. In September, the UN Special Rapporteur on the Human Rights of Migrants, François Crépeau, called off a planned visit to Australia, citing the new law. He said health workers would be unable to communicate freely with him. Australia's Government, clearly irritated, said he was wrong. Stephen Parnis, vice-president of the Australian Medical Association, said Australian doctors and other health workers have long been concerned about the policy of detaining asylum-seekers. “You are an advocate for your patient. If you believe that the system is undermining the health of the patient, you have an obligation to speak out about that”, said Parnis. Australia's Department of Immigration and Border Protection told The Lancet that no one attempting to travel to Australia illegally by boat will ever be settled in Australia. The government's stance had made it easier for Australia to accept other refugees, it said, pointing out that Australia recently agreed to accept an additional 12 000 refugees from the conflicts in Syria and Iraq. International Health and Medical Services (IHMS), which provides health services to detainees both onshore and offshore under contract to the Australian Government, said its health care was consistent with Australian standards. Transfield Services, which runs the centres in Nauru and Manus Island, declined to comment. The Nauru and Papua New Guinea Governments did not respond to requests for comment.