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- Fred's Diary - 2004 June 24

[Ethics & truth in Howard govt policy - Andrew Wilkie, Dr Louise Newman, Dr John Kaye]

Ethics & truth in Howard govt policy - Andrew Wilkie, Dr Louise Newman, Dr John Kaye

7:30pm - Hornsby RSL Club.

- [MP3 Audio of Dr. Louise Newman's speech (12 Mbyte)]

Transcript of Dr. Louise Newman's speech:

Thank you very much, and thank you to the Greens for inviting me to this meeting tonight - it's been a great opportunity for me to meet many people who I've seen in various contexts. And I guess I'm speaking here to you as a reluctant politician, if you like, someone who has essentially come from a clinical and professional background and have found myself becoming progressively more interested in some of the issues we're discussing tonight - about the role of truth, ethics & morality in government policy, and how we all should respond when any government insititutes a policy that's actually harmful and damaging, both to the individuals that it affects directly and to us as a nation.

And I'm going to put it to you that current immigration policy - and obviously people here will be aware of many of the details of this policy - now this is fundamentally a bad and immoral policy. It's a policy that causes significant degrees of harm and suffering. It also has a tremendous impact on us as a nation. This is a policy that is currently diminishing us all, demeaning us all as a nation. It's current policy, but it's not a historical policy. The damage that I'll talk to you about has been done to individuals in the detention centres. It continues, and we have laws that allow that to be done at any time. The cause is policy that is fundamentally damaging. The degree of psychological distress and trauma, particularly to children, is very significant. And despite the HREOC [Australian Human Rights & Equal Opportunity Commission] inquiry recommending the release of the remaining 160 children from detention on June 10th, we of course have seen no action on that. It's policy that obviously denies our obligations in terms of international human rights, and our obligations as signatories to multiple U.N. conventions - the U.N. convention obviously on refugees, but also [the convention] on the rights of the child. But fundamentally, this is policy that is unnecessary. There is no need to have a system that operates on a punitive and penal model for the management of so few asylum seekers, those people who actually make it to our country.

It is fundamentally dishonest policy in terms of how it is sold to us by our government, and I think that raises the questions that we're talking about tonight. The government portrays this as a system that is necessary, harmless and is actually sending a very appropriate message to the rest of the world. I think I can put it to you that this is punitive treatment of the most vulnerable of asylum seekers who make it to our shore. This is detention of a class of people that is arbitrary, that is indefinite, that is over and above any processing that might be needed of people's health or welfare needs. This is detention that is punitive detention, not detention for the purposes of administration. It is detention that is indefinite. We have had children detained in our country for over 5 years. The length of time that children are spending in detention centres continues to increase. Currently it's over one-and-a-half years. This is not detention for brief periods of time as a last resort, as is stated by the U.N. convention. It is harmful detention - this is not benign. These children are exposed to extremes of rioting behaviour, stress in the adults around them. The series of drawings we're showing here [slides were shown during Louise Newman's talk] are children's, in this case from the Woomera detention centre at the height of the riots where children were exposed in an unprotected way to extreme breakdown of behaviour in the people around them, witnessed self-harm, and children that we've treated witnessed their own parents driven to the point of suicide, children have seen their own siblings self-harming, and of course some children have tried to die themselves. And yet our government argues that this is necessary and not harmful.

The message that this policy sends, that the policy of mandatory detention sends to the world, is not a [message] of deterrence - it's not even necessary for so-called deterrence - but it's certainly a message that many in our community are starting to question, and it's a message that we as a nation will accept harm to children and to vulnerable people as a form of collateral damage, if you like, in the name of so-called [?port] protections which is seen as some sort of greater good. It portrays us as a nation who are prepared to accept the state-sponsored abuse of children in a systematic and ongoing way. It portrays us fundamentally as a nation based on hypocrisy, where we have both major parties with wonderful documents talking about the need to protect children, to invest in the early [childhood] years, to support families - and yet somehow that applies to some of us and not others. It disintegrates and pulls apart a notion of human rights as something that's fundamental to all human beings, not just some that our elected representatives decide have more rights than others. The harm that this policy is doing [to the] nation is, I think, what brings many people together in this group and across the community. The debate we need to be having about this policy is essentially and ethical and moral debate. We need to think about what values we want as a community and, more importantly, what values we want in our political leaders and our policy makers. What does it say about us that we have leaders currently who are dissimulating and engaged in a very damaging war of language when we try and raise the concerns about this policy. The war of language, I think, is very important in this debate. We have our politicians deciding for us who constitutes a so-called "real" refugee, who has a real claim to seek asylum, who is legal as opposed to illegal. We have shifting sands and changing rules when it comes to what it takes to be classified as a true refugee. We now have protection offered to people that is temporary protection and we don't offer any form of permanency. We have a consistent distortion by the government about the reality of what's actually going on and continues to go on in the detention system and about the effects of immigration policy.

And speaking first hand about this, I have returned relatively unscathed I think from a meeting earlier this week with Amanda Vanstone and her advisers. As you can imagine it was quite an intimidating meeting to attend. We walked into Parliament House and on the stairs there was John Howard, swathed in Australian flags, talking about the need to be raising the flag on all occasions. But having survived that, I then met with Amanda Vanstone, to be told that we have no refugees in our detention centres. None at all. That the people in there are either over-stayers or illegals of various categories, that are all people who are being fooled by lawyers - and so apologies to any lawyers in the audience, Amanda Vanstone doesn't seem to like you despite here own background. So she blamed the length of time that people are spending in detention on the process of legal appeal, and raised some issues about whether we indeed should have such a liberal system in Australia in terms of our rights to appeal and our rights to engage in the legal process. She also told me that there was no real evidence that there was any mental damage done to people in detention at all, that she had personally come across cases where people feigned symptoms of mental illness in order to better help their cases. She also told me that the asylum seekers fundamentally put their children at risk and some even abused their own children by seeking asylum and putting their children on leaky boats. As if, as if it is not the most appropriate thing for any of us to do to try and protect ourselves and our children from persecution and harm and even death. And yet, she also wanted to tell me that Australia is a generous country, that we are increasing the number of people we're taking from some parts of the world, that we have some of the best functioning immigration policies in the world and that fundamentally deterrence as a policy will continue and that it is very effective.

So you can imagine that I came out of that meeting wondering how we can best proceed in this whole process. And maybe, I think, what we are doing at the moment - those of us who go into the camps, those of us who work with refugee groups and hear people's stories - is that in effect we are bearing witness to one of the greatest tragedies that our government has ever perpetrated upon them and upon us. And bearing witness, I think, has an important function. If we bear witness then we document what we're seeing. In time, I think if we remain optimistic, this government will be brought to account for what it has done. [Applause]

And the people that we're talking about, of course, are fleeing from those countries where there is no queue. As if waiting in a queue would be the most logical thing to do, anyway, if you're being persecuted or your children are being tortured or are under threat. So we have very vulnerable groups of people, those who flee from where there is no queue or process are going to be some of the most needy in the world. We all have a right, of course, to seek asylum and to protect our children, and this is an essentially a moral position, it's one of international human rights, but it's not one that is accepted by the Howard government.

Mandatory detention, of course, has been with us for some time and shamefully it is still a policy that accepted by both major parties and it is still a law that can be enacted at any time. It selectively discriminates against the most traumatised population, violates several U.N. conventions, and has affected significant numbers of minors up to and including the present day. If you look at the children in detention in particular, over 90% of these children have been found to be so-called "genuine" refugees after our government has finished the processing of them and produced tremendous amounts of harm and suffering. The average time in detention is currently 1 year and 8 months. The longest time in detention is over 5 years. But it's very difficult for me to be convinced that 5 years and 5 months in a detention centre is necessary for processing of someone's refugee claims. The whole generation of children that we're particularly interested in studying that have actually been born in detention environments. And many of these children are around about the age of 3 years at the moment have spent the majority of their lives in harsh, depriving and punitive environments with, as you can imagine, tremendous impact on their health and development. And since the HREOC inquiry began in 2001, 50% of those original children still remain there.

The sorts of disorders, unsurprisingly, that we've found in our studies looking at these children are very high rates of depression , anxiety and post traumatic stress disorder - things we're all familiar with . What is surprising is how severely affected these children are and how little the government has listened to this, and the lack of services that are provided to these people. Very young children are particularly badly affected and most children have experienced riots, witnessing the adults around them breaking down, becoming distressed and self-harming. So they've experienced in an unmediated way the sorts of experiences that none of us should ever be exposed to.

The youngest children currently in detention are those infants who were born there. Now these are children whose parents are clearly overwhelmed, stressed, not only by the situation they find themselves in but by the added demands of trying to be an effective and safe and nurturing parent in this environment. Most of the women who have given birth in detention environments have done so alone, unsupported - again as a result of government policies. Women are removed from the detention centres in the remote centres, taken to motel rooms in places like Port Augusta for the last 4 weeks of pregnancy. Many of those women are not allowed to have a support person with them, which would be very culturally appropriate for them for the delivery. Some of them have not even had an interpreter with them to help them through the medical processes involved.

So for clinicians involved and hearing these stories this raises huge ethical concerns for us about standards of care and about the way the system is actually governed. And in the detention centres doctors, clinicians, don't have much say. We raised the issue among the medical profession of - being very clear that - we refuse and will not be employees of any private provider of detention services. [Applause] We have consistently called for, and I raised again with Amanda Vanstone on Wednesday, was the need to have independent committees - as in non-ministerial appointees, but clinicians representative of the major medical colleges and other health groups - involved in the scrutiny and review of what's actually happening in terms of the provision of health services to asylum seekers. And yet again, only last week, the government wrote to the medical colleges asking us if we would like to make nominations for people to work for the new provider of detention, to better advise them about how to make detention centres better. The way to make detention centres better, and to provide the health needs of the people is to shut them down. [Applause]

But there is a certain recognition at government levels that there's an increasing body of evidence of harmful, cruel and inhumane treatment of children. The HREOC inquiry supported us in terms of our submission of the evidence, found that evidence to be robust and scientifically sound, that children are being treated in a way that is essentially damaging to their health and development. And yet somehow, as I think this cartoon illustrates very nicely, that is actually being turned into a positive by this government, who would see abuse of children as an important part in a political battle that they are waging.

The other points that I wanted to make briefly are about people on temporary protection visas, so-called, in the community and the issues - in terms of, particularly for families with young children, but for all people - in terms of recovery from trauma . After we actually release over 90% of these people into our communities, we still have very limited services, people have limited rights to resettlement and other services, some of course have very limited access to health and welfare services. We also have significant numbers of community-based asylum seekers who do not have access to Medicare, who we are involved in providing pro bono services for because there is no other alternative for those people. Those people cannot work and are dependent for their [?something] survival, usually on the non-government organisations, church & community groups.

We have in New South Wales , I think, a particularly difficult situation with the Carr government where they again have consistently refused to engage in a discussion with us and other groups about how best to provide for the health and welfare needs of people who are released from detention centres, arguing that this is a matter for the Commonwealth. And I received a letter from our health minister only about 4 weeks ago when I raised this issue with him about the need to have adequate services for the people on temporary protection visas that, quote, "the question of illegal aliens was to be dealt with by the Commonwealth government". So the language that's used here is very important. Not only is it coming from the Commonwealth, it's also coming, I believe, directly from the Premier.

And these are groups, of course, when we look at asylum seekers overall, who have significant health needs. Many of these people have suffered torture and trauma in their countries of origin, the difficulties and arduous nature of their journeys here, there are various medical issues that need to be attended to and the huge burden of psychological distress. We've been documenting excessive rates of suicide and self-harming behaviour across the detention system. The rates of suicide - completed suicide, death by suicide - is about 10 times that of the general community. That's putting the rate of death by suicide amongst these people up there with other groups of very vulnerable people such as Aboriginal people in custody. Self-harming behaviour is endemic in detention environment. It can affect very young people and it tends to be across groups of people. Very concerningly, we've seen suicide attempts in children as young as 9 nears of age. This is generally unheard of in the so-called "general" community. It's exceptionally rare and a sign of tremendous stress and distress obviously in that child. And amongst young people and adolescents, self-harming behaviour are a mixture of a need and a right to protest, but also feelings of despair, and then becomes very contagious in the hot-house environment, such a high-stress environment.

So to summarise that for you - and this will not surprise this audience and in fact it didn't surprise us, but they're still shameful findings - about 80% of people in the detention centres have a psychiatric illness at any one time. These places have become the biggest psychiatric hospitals short of, outside of, the prisons in our community. Physical distress and symptoms are common and people, again unsurprisingly, get worse the longer they spend in detention. That's been one of the strongest findings in all our research - that people become particularly disturbed as they become progressively more helpless and hopeless and don't see themselves as having any alternative or any hope of release. And maybe that's why the sewing up of mouths and sewing up of eyelids, although it horrifies us on one level, is such a powerful expression by a group that feel themselves essentially to be isolated, voiceless within a system and also unable to see any hope. So whilst that's very distressing for all of us, I think, [it's] particularly powerful.

And you might recall minister Ruddock, during the height of the self-harming behaviours that were going on in the Woomera riots putting the argument that of course people like us - whoever that might be, presumably he meant Anglo-Saxons, it's hard to tell - people like us wouldn't do these sort of things, that these sorts of behaviours were some sort of culture-bound syndrome and really again showed us that these people, who are very different from us, were not really the sort of people that we would want in our country.

So at those points in the history of this campaign, I think the medical profession and obviously the legal profession, have had a role to play in trying to talk, if not to the government but at least to the general community, to help them understand that people like us, I like to think, would do exactly what asylum seekers have done, that people just like us would protect ourselves and our children if we could, if we found ourselves in similar circumstances. We would take risks in order to protect our children and maybe give them a chance of survival. People like us, if we're treated in the way these people have been treated - if we're stressed to this extent - will react in exactly this way, and it's not surprising from a medical point of view that this is occurring.

The sense of isolation has only contributed to people's despair and the horror of their experience. Another argument I put to Amanda Vanstone - yet another of my arguments that wasn't really warmly received by the minister - was that it'd be much more appropriate to do all processing of asylum seeker claims in metropolitan areas, that I could see no justification for building bizarre fortresses in the desert for people who have never been demonstrated to pose any security risk to this country at all. She didn't accept that. [Applause]

I could give you lots of case examples. I think the trouble with talking about people's stories is that whilst they're very powerful they're also quite distressing for all of us to here. But there are numerous cases of people with stories that can only be described as horrendous, where it's very hard for me to understand why we as a community find it difficult to offer them safety and a safe haven. I'll give you one story, one that's on my mind because it's someone I sat with only last week, a woman who described to me the way in which she witnessed the sexual assault of her husband in a pack-rape situation, followed by the murder for political reasons of her father and two brothers, followed by dismemberment of infants in front of her, and she described these horrific experiences - experiences that for most of us are unimaginable and absolutely incomprehensible - in a calm and cut-off way. And this is a woman who we are threatening with deportation in one week. This is a woman who has recently been in a psychiatric hospital for 4 weeks with profound depression. She has two children here, born here, and currently are facing deportation and are under threat of being put into detention unless they voluntarily sign repatriation documents. This is the system as it operates. It is a system that can only operate if we as a community can enter into blanket and mass denial of the realities of traumatic experiences in people's lives. It is a system that can only operate if we have a media that allows us to develop an image of the asylum seeker as fundamentally alien, different from us and as a threat. And that system itself can only operate if we have a government that allows that distortion of the reality of these people's experiences, and is capable of manipulating that degree of trauma for political purposes and for self-interest. But that's the situation that we have.

We, when we visited the detention centres of course, along with many others, were shocked by what we saw in terms of the treatment on a day-to-day basis of children. Children called by numbers and not by name. On many of these drawings as you're seeing the children, when asked to write their names, wrote us their numbers. Children who had no access to education, who had no safety in terms of where they could play, who are living in these monotonous environments, chronically exposed to violence and at physical risk. exposed to distress and despair in their adults, children whose parents were profoundly depressed and who had essentially given up hope. And we repeatedly have notified all these children to their respective child protection authorities as being at risk of harm, by definition, by the fact that they're in these brutalising and punitive environments. Any yet we're faced with the impasse where child protection is not a Commonwealth responsibility, child protection is said to be a state responsibility and state government has no jurisdiction within the detention centres. So there are some children in our community with no rights to protection at all, and this is meant to be Australia, and this where both major political parties are running with child protection and the prevention of child abuse as significant child abuse as significant issues for this election. Now at the very least this is the greatest degree of hypocrisy that we've come across in politics, ... at the very least.

I'll just say in closing a couple of words about the Alliance of Health Professionals just for people's information in terms of what we're doing at the moment. This is a large grouping of all the major medical colleges, and you'll be aware that medical colleges are fairly conservative bodies on the whole and some have dragged reluctantly, or maybe less willingly than others, into this debate. But currently we have a united position of opposition to mandatory detention, and have repeatedly called, as with many others, for the removal of children along with their primary carers into the community . We believe that it is not possible within the current regime to provide for the health and welfare needs of asylum seekers. We've recognised the vulnerability of this group and do not see a penal and punitive model as in any way being appropriate for their treatment. And as I've said we've urged repeatedly for independent review by clinicians of what's actually going on. physicians. But there are serious issues for those of us who try and do something about this system. Those doctors and nurses and others who have worked in the detention centres - and many of those brave individuals have spoken out about their concerns, about the standards of care in there - have essentially found themselves in compromised clinical positions where decisions and recommendations that they make are repeatedly ignored, where bureaucrats, guards, DIMIA [Australian Department of Immigration and Multicultural and Indigenous Affairs] officials countermand medical decisions or take it upon themselves to make medical decisions or to ignore recommendations that people need certain treatments or certain reviews by specialists and so on. So there are very serious ethical issues for those who choose to become employees of detention providers and most of them would not be able to do that. It also raises the issue for what sort of treatment is possible for these people if it's the environment that is producing the tremendous despair and distress that they're experiencing. So if you are suffering from Post Traumatic Stress Disorder because of the environment that's so stressful, the solution is not to get treatment for Post Traumatic Stress Disorder or to take antidepressants and [?something] - that's not going to be a cure - the cure is to get out of the environment that you're in and to have a sense of hope and a sense of control in life and an understanding of the process that you find yourself in. [Applause].

So we certainly don't advocate the wholesale use of psychiatric treatment in this environment and in fact there are ongoing concerns about the behavioural management of people who are distressed and disturbed, particularly in [the] Baxter detention centre where there's prolonged and excessive use of isolation, punitive withdrawal on separation of children from parents as a form of punishment, and cases that we've raised with government about the uses of sedating psychiatric medication, again for the purposes of psychiatric control and behavioural control. This is not Russia, and yet here we are, many of us are aware of the abuses of psychiatry and medicine in places like the old Soviet Union and currently in the People's Republic of China. This is happening here, in our own country, and is well know to be occurring by the government.

So we, currently, will continue to do the research that we've been doing and to highlight that with government. We are facing ongoing attempts by the Commonwealth government to distort and minimize the impact of this sort of evidence. Internationally, in terms of the international situation, this work is highly regarded and is seen as very significant, and yet our own government really attempts to dismiss it, and attribute all the problems of asylum seekers to pre-migration trauma and currently to the length of time they're staying in detention, which of course is all the fault of lawyers. So much so that, at the end of my meeting with Amanda Vanstone yesterday - and I'll leave you with this - she paused and sort of glared at me, which I'm getting used to but it's a bit disconcerting, and she said that if I really was going to be a good clinician and if I cared about children, what I should really just say to these parents is "Why don't you just give up and go home, you're damaging your children if you stay here any longer and continue these legal appeals". So that's the line that's being pushed - it is really quite a remarkable and shameful line. So our recommendations, would be the same as many people's here, that the government must revoke policy of indefinite detention without trial as both international experience and research here conducted by us has shown it to be unnecessary for processing refugee status and because it produces psychological damage that is absolutely unacceptable on ethical and humanitarian grounds. [Applause]

See if that's not the way our leaders see it currently, and as you'll be aware there are many cases before the high court at the moment based around the legality or lawfulness of detention as we see it, even as it applies to children. For psychiatrists - and psychiatrists don't often get to speak out about these issues, I think it's very crucial that we do take a very clear ethical stand on a matter such as this - and from our point of view what we're witnessing and maybe what we're bearing witness to is the sort of harms to people that, for me, constitutes a form of mental or psychological abuse or torture. The damage that we're producing is likely to be long-lasting. The children that I'm seeing who have been in detention suffer when they're released from detention, they suffer not knowing what their future will be, they suffer because we don't have adequate services to help them recover from the trauma that we exposed them to. And there are clear guidelines for clinicians here, and for psychiatrists in paricular, where our own standards say that we shall not take part in any process of mental or physical torture even when authorities attempt to force their involvement in such acts, and that's why I won't work in a detention centre.

Thank you. [Applause]

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