Issue 3 / 3 February 2014

Silence in the face of evil is itself evil … Not to speak is to speak. Not to act is to act. Dietrich Bonhoeffer

LESS than 2 weeks before Christmas last year, the Abbott government notified medical members of the Immigration Health Advisory Group that the Group had been disbanded.

The Immigration Health Advisory Group (IHAG), with prominent health professionals among its members including a past AMA federal vice-president and past president of the Royal Australian and New Zealand College of Psychiatrists, gave independent, unbiased advice to the government of the day. Was that why it was disbanded?

The hypothesis that the government doesn’t want unbiased advice was reinforced by Prime Minister Tony Abbott’s subsequent labelling of the public’s desire for information on asylum seekers as “idle curiosity”, and Immigration Minister Scott Morrison’s decision to terminate weekly scheduled press briefings.

Recent research published in the MJA found substantial unmet health needs, a lack of transparency and high levels of psychiatric morbidity among asylum seekers in detention in Darwin. As bad as conditions are in Darwin, the conditions in Australia’s offshore facilities are reportedly worse.

Doctors working on Christmas Island have detailed medical practices that include unsafe antenatal care and no specialised child protection or psychiatry services. Doctors complain that necessary drugs are either not supplied or are supplied late, and unnecessary delays in transferring seriously ill patients to mainland hospitals is placing lives in avoidable jeopardy.

Detention practices on Manus Island are reportedly even worse.

Suicide is now reportedly the leading cause of death among detainees, as one would expect from a policy that leaves already traumatised people in indefinite detention, uncertain of their fate, some in conditions unfit for human habitation. If we were to deliberately design a system sufficiently cruel to promote suicide, this would be a good start.

The Australian Government is obliged, as a signatory to the UN Convention and protocol relating to the status of refugees, to provide the same standard of health care to detainees as is available to the general population. There can be little doubt Australia is in breach of that convention, as well as the Convention on the rights of the child.

The AMA’s position statement, which all doctors should be familiar with, incorporates the World Medical Association’s Declaration of Tokyo. It defines torture as “the deliberate, systematic or wanton infliction of physical or mental suffering by one or more persons acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason” (my emphasis).

It also declares that: “The physician shall not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty …”

Deliberately hidden from public scrutiny, the Australian Government is building a legacy to shame us for generations. It is a torturous system in which no doctor can ethically participate.

Doctors must stand above sectarian political interests when it comes to the wellbeing of our patients, for to act otherwise is to ally ourselves with those who share neither our ethics nor our concern for human lives.

Such abuse cannot be tolerated by us in any setting, for any reason. That’s why Doctors for Refugees was established, with a founding committee that includes a former AMA state president, Dr Richard Kidd, and state vice-president (myself) among its members.

As doctors we can fight with the angels or stand silent with the devil. As Bonhoeffer reminds us, it is the only choice we have.

 

Dr Michael Gliksman (@MGliksmanMDPhD) is a physician in private practice. He is an AMA federal councillor, and a member of the Australian Red Cross International Health Law Committee and Doctors for Refugees. The views expressed here are his own.

12 thoughts on “Michael Gliksman: Time to speak

  1. Julie Grint says:

    ” All that is necessary for the triumph of evil is that good men do nothing” Edmund Burke

    Too many so called Christians and Christan churches and their organisations do nothing and stand idly by and act as spectators as the Government pursues its agenda. I  for one have not heard the leaders of any of our churches publically criticize this Government or the last for its actions.

    I also find it rather sad and shameful that a man such as Tont Abbott who spent some time in a Roman Catholic  seminary does not have a better appreciation of moral and ethical behaviour. He has allowed base political advantage to drive Government policy thereby subjecting refugees to extremes of  psychological abuse.

    In years to come will we come to look back on our asylum seeker policy in the same way as we are now looking at the shameful practices of removing half caste Aboriginal children from their communities and creating the       ” stolen generations”.

    Some organizations find themselves compromised and silenced as they receive Government money to perform their work assisting asylum seekers and  fear that if they spoke out  their funding would be cut off. Here I am speaking of the Salvation army and the Red Cross who both perform a very useful role assisting refugees and asylum seekers once they are released into the community.

    All good men and women whether they are medical professionals, church leaders, psychologists, social workers, nurses or members  of the public  should make their voices heard to protest against this Government’s heartless and cruel policies.

     

    regards

     

  2. David Gordon says:

    Hi E Burke

    For a quick check on your comments about churches remaining silent you might want to view an ABC report:

    http://www.abc.net.au/radionational/programs/religionandethicsreport/churches-condemn-opposition-and-government-asylum-seeker-polici/4902704

  3. Janene Mannerheim says:

    I absolutely agree with you Michael. It is difficult to understand why Australians have become so intolerant. It is worth reading http://www.themoonbat on ‘Why do we hate asylum seekers?’. It throws some light on what is behind this governments ‘silence’. That in NO WAY excuses it. Nor does it excuse some comments by a few doctors that they don’t want their taxes to support refugees. Where should their taxes go? A four wheel drive in suburbia? Private schools?

    The important thing now is how do we as doctors (as a group) who do care about refugees get through to the Mr Abbott and Mr Morrison that we want transparency and decent nursing, medical & psychological care in the centres. Let alone a change in detention centres…. Where they are, what they are & who works there. Asylum seekers need access to legal representation and proper protection during interviews for assessment which is denied with the present ‘enhanced screening’.  And they need better treatment in terms of being able to work & seek medical care on arrival in Australia. And for families to be reunited.

    Silence from the government and exhorbitant costs for journalists to visit Nauru detention centre: from $200 to now about $8000,  reminds one of similar episodes in recent history in other countries with media blackouts and ordinary people kept from the truth and too scared to speak up. At least we still have freedom of speech and can still voice our opinion in Australia. Somehow we need to do it not as individuals but as a a group of Australian doctors as the government is not listening to the UN.

    We could all sign Lauren Smiths petition on change.org

     

     

  4. Dr D. M. Cunningham says:

    I think we should define what we are talking about.

    An asylum seeker is one who is seeking international protection but whose claim for refugee status has not yet been established.

    In contrast a refugee is someone who has been recognised under the1951 Convention and the 1967 Protocol and has come directly from a territory where their life or freedom has been threatened. This does not mean travelling through various countries to reach their objective.

    An economic refugee, or migrant, is someone who leaves a country voluntarily to seek a better life.

    We as a signature to the Refugee Convention, are obliged to accept established refugees and offer protection but this does not apply to asylum seekers and economic migrants, especially those who enter this country illegally. It is impossible to process people in an orderly manner if they arrive illegally en masse. We have no way of knowing if these illegals (Those who enter any country illegally), have any connection to a terrorist or drug cartel organisation. It is worth noting how few of the druglords or gang leaders have names like Smith, Jones or Fraser. 

    We also have to consider, do we want to be overwhelmed by another culture?

    Please undersand that I fully support the assimilation of our share of genuine refugees.

  5. Lachlan Evans says:

    While it is all well and good to reference humanity, morality, the UN Refugee Convetion etc., reality and rationality is severely lacking in the above piece. 

    A few simple questions; how many people are held in mandatory (and absolutely necessary) detention under current policies as compared to the previous government’s? Which policy lead to an influx of asylum seekers of such magnitude that physical and financial resources were overwhelmed leading to some of the poor conditions outlined above? How many poor souls drowned at sea in unseaworthy boats under previous policies? And which policy propped up a criminal trade that put these people in those unseaworthy boats? 

    I understand that it may be difficult to reconcile one’s values as a physician and as a human being with current immigration policies and it is only made harder by illogical and idealistic views such as those expressed in this article. Let me be clear, I completely support the right of the individual to seek asylum and the moral duty of a nation to help people in need. The most pragmatic, effective and in the end humane way to do so is to have an orderly, safe and efficient immigration process that will help the greatest amount of people. 

    This is what we as medical professionals should be advocating. 

  6. Mary Holland says:

    I am delighted to discover the doctors4refugees group and to know that there are more likened doctors out there. I would like to make a couple of responses to the dissenting comments. Firstly that while it is possible to have an orderly migration program, the reality of people fleeing war and persecution is chaos and disorder. Australia has bee n cushioned from that reality by distance and sea until recently. Secondly no matter how many countries asylum seekers have travelled through to attempt to reach a place where they can rebuild their lives there is no justification for trampling on their human rights, detaining them for indefinite periods, depriving them of work rights etc. I agree that history will judge us harshly as it has other countries and governments who have imprisoned and tortured minority groups. It is sad indeed to think that Australia is becoming a counry to be avoided as it strives to make itself harsher and more cruel to those seeking asylum.

  7. Michael Gliksman says:

    I’m saddened but hardly surprised at some of the comments my article generated. Recent history is replete with the involvement of doctors in State sanctioned torture, murder and genocide. Surprise is not an option.

    Article 1 of the UN Convention defines a refugee thus:

    “A person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it..” As uncomfortable as this may be for some in our profession, the vast majority of those previously interred were found to be genuine refugees. That will no longer be possible under the new regime and in the interim, the uncertainty and cruelty inherent in the new circumstances of their indefinite detention cannot be spun into compatibility with our ethical obligations as doctors.  Follow me on Twitter:  @MGliksmanMDPhD

  8. Bill Holley says:

    As one of a number of signatories in 2013 to a letter of concern to the contractor  responsible for  the assessment and health care of asylum seekers  arriving at Christmas Island where I was working I fully concur with Dr Gliksman’s observations.

    I also would point out to Iatros that the use of the term “illegal” to describe asylum seekers is incorrect. The use of the term by politicians who are fully aware of the legal status of asylum seekers is shameful. I quote from the Refugee Council’s website :

    “The UN Refugee Convention (to which Australia is a signatory) recognises that refugees have a right to enter a country for the purposes of seeking asylum, regardless of how they arrive or whether they hold valid travel or identity documents. The Convention stipulates that what would usually be considered as illegal actions (e.g. entering a country without a visa) should not be treated as illegal if a person is seeking asylum. This means that it is incorrect to refer to asylum seekers who arrive without authorisation as “illegal”, as they in fact have a right to enter Australia to seek asylum.

    In line with our obligations under the Convention, Australian law also permits unauthorised entry into Australia for the purposes of seeking asylum. Asylum seekers do not break any Australian laws simply by arriving on boats or without authorisation.” 

     

  9. David Cunningham says:

    It would appear from some of the comments that we should accept unlimited numbers of refugees no matter if they do arrive illegally (yes there is such a word) or not. We have seen how numbers of these increased exponentially when security was relaxed. I am aware that there are millions of genuine refugees, how many millions do you want us to take? Do you really want this country to be swamped with foreign cultures?

     Many of these want to impose their beliefs and cultures on us. Do you approve of sharia law, men marrying young girls etc. You may not like these facts and label them as racist but they are considerations that have to be faced. 

  10. Genevieve Freer says:

    The discussion appears to confuse three  issues:-

    whether asylum seekers arriving here should be treated according to the UN Convention-with which which I and the author and many agree

    and

    whether it is desired to have unlimited numbers of poor asylum seekers attempting to enter this country by boat  -with which I doubt anyone agrees.

    and

    how poor asylum seekers could  be discouraged from risking their lives on unseaworthy boats -perhaps by Red Cross , UN and other refugee centres being  established in or near  each of the countries from which asylum seekers come to this country. ( Rich criminals can fly here so are unlikely to be on a leaky  fishing boat.)

    On the subject of cost, why waste money paying contractors to breach human rights of asylum seekers?

    Perhaps this country should stop giving any  “aid” money to any of the  countries which abuse human rights including those who harvest organs from “dissident” students,  and redirect the aid directly to humane treatment of asylum seekers in this country, and other countries. .

    Iatros- do you think that this government should spend money recruiting overseas-trained doctors from countries which do not have enough  doctors, are they “economic refugees ” ?

  11. Henry Woo says:

    I agree with you “Ming the Merciless”. I already follow you on Twitter and so should everybody else.

  12. Tony Krins says:

    Shame, Australia, Shame.

    Who has used the wholesale crime,

    “Concentration Camps” before our time?

    Before one fifty years ’twas Spain.

    Then the Americans did the same.

    Again the British ‘gainst the Boers

    Were murderers on S. A. tours.

    And of course as we all know

    The Nazi caused the greatest woe.

    It’s been wrong of course each time.

    Against humanity the crime.

    But now we have it here once more!

    Just as evil as before!

    If it’s now a different name,

    Will it really be the same?

    “Detention Centre” ’tis this time

    But that is still a heinous crime.

    A crime ‘gainst all humanity.

    A crime for all the world to see.

    We can all pretend no more!

    Whether here or now off shore.

    Oh! Such cruelty we do inflict!

    But for us fools, it hasn’t clicked!

    You must not harm the human mind

    Outside the laws of humankind.

    You cannot say it’s for the best

    Or say subhumans are a pest.

    Torturing some can never be

    The way to stop the boats at sea.

    It’s torture still and thats a crime.

    It’s just as bad in our own time.

    Australians now the torturers are.

    The victims travel from afar.

    We inflict injustice grave

    On those who only kindness crave.

    They flee a world of dark despair.

    We lock them up and that’s not fair.

    Concentration Camps were there before,

    Created by the men of war.

    Now we inflict this heinous crime,

    But have ourselves no war this time.

    We can never innocence claim.

    These Torture Farms are in our name.

           Tony Krins 

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