Legislation that would help evacuate refugees held offshore is urgently needed to erase the dark history of suffering and punishment by the Coalition Government, writes Jane Salmon.
THE SCOPE of the offshore mental health crisis is not widely reported in the media because it is repetitive and self-harm cannot be promoted.
Take this report given to me from Nauru by “N.” just this morning following an enquiry about the welfare of two hunger strikers:
“‘A.’ hung himself three or four days ago. Cut down. Now held in RPC-1. Cannot be contacted.”
Great. Stories like A.'s cause moral injury to aware members of the Australian population. They are also a political liability — as Opposition Leader Peter Dutton's lousy popularity polling proves. He is lucky so many voters are still disconnected from the hard facts.
Like so many others, I am writing this highly personal account as a refugee advocate for over a decade. I am basing this application upon my direct encounters with hundreds of refugees affected by policies of indefinite offshore detention across the decade since July 2013. Most of my knowledge of conditions offshore has been obtained from first-person reports by around 80 refugees on Manus and Nauru.
I have read and circulated third-person reports about many others. I have probably met at least 160 offshore refugees while they have been recovering in Australia after medical evacuation.
The Migration Amendment (Evacuation to Safety) Bill 2023 was introduced due to the current, slow and painfully inadequate medical transfer process.
Most refugees who are currently offshore are physically sick or mentally unwell. A lot have untreated dental issues. All are distressed. Detention is, as is often said, a mental illness factory and seems devised by somewhat toxic minds.
I call upon the Labor Government to support the bill as a voter who has engaged with Labor politicians and Labor members on the issue of refugee treatment for over a decade.
Most Labor politicians are good people and work with the best of intentions. I have worked at SBS, a Labor initiative. My family has been the grateful beneficiaries of Labor programs from subsidised employment, defence housing and traineeships, to Medicare, public and tertiary education to the NDIS. I would prefer not to criticise a political party and government that has done so much for Australians.
Yet, I am continually ashamed of the ongoing cruelty administered by the Australian Government Immigration Department.
Not with my taxes. Not in my name. Please. Aussies are supposed to be the “good guys” in terms of respect for international human rights law.
I have been more aware of Australian refugee policy following the Tampa crisis. By 2010, I had become concerned by the Federal Labor Government's refugee policies. The resumption of indefinite offshore detention in 2013 under Labor and then the L-NP was deeply concerning.
As a student of international politics and strategic studies, I question the morality, drivers and overall sense of the (highly symbolic but shallow) Sovereign Borders policy.
The fetish of boat-stopping (ostensibly to prevent drowning) has not stemmed plane arrivals or penetration of our sovereignty by digital means. Regional processing could head off resort to unscheduled and dangerous maritime methods of arrival. This performatively brutal and catastrophic policy is unnecessary.
For me, direct contact (via social media messaging) with refugees held offshore commenced in October 2013 as it did for hundreds of other advocates. This cohort is bonded by repeated shared shocks and outrage, by all-night vigils and tracing Medevac emergency plane movements. We will never ever forget the turmoil we witnessed.
(Why do it? I was outraged by Australia's choice of lying Tony Abbott and the destructive social and economic policies that would inevitably follow. I was certainly trying to drown out my own issues, including family losses and realistic fear of Stage 4 cancer.)
Advocate contact over internet message carriers has tested and challenged the prevailing Australian L-NP Government characterisation of refugees who had resorted to arrival by boat as “terrorists and subversives” or people of “bad character”.
Once mobile phones were banned offshore, their reinstatement was a priority.
In the course of fact-finding, I suppose I got to chat with around at least 80 depressed detainees over the next few years. (Each name and conversation is retained and can be supplied upon request.)
The primary need seemed to be “suicide prevention”. It was difficult to turn away from people in acute crisis. (Handling this has been very uncomfortable for me.)
It was clear that the conditions were inhumane and squalid. It was clear that food was not nutritious. It was horrifically clear that unaccompanied minors were not well-protected or educated. It was clear that rapes by staff as well as islanders and other detainees were not prevented. It was clear that children needing a healthy environment, safety, education and resources were suffering. Sympathetic staff were sent home and services were cut. Birth sagas were hellish. Documentation is available. How can any of this be okay?
Some of the detainees on Manus became very effective advocates and media spokespeople. I joined many others in their work to help them obtain a voice and access to media.
One of those detainees I met in early 2014 turned out to be Behrouz Boochani. I eventually provided him with a good-quality phone and paid it off slowly. It's thrilling that he wrote an entire book on it. That book describes camp conditions well.
I have joined ASC, ASRC, Amnesty International, Bridge for Asylum Seekers, PJLU, RACS, RAR, ARAN, Labor For Refugees and several ecumenical groups. Small groups arranged several events with the City of Sydney.
Media restrictions on Nauru seemed anti-democratic and were of grave concern.
In 2015, the Abyan case on Nauru led me to join the nascent National Justice Project as a volunteer.
I publicised the campaign for two injunctions against the mobile phone bans. Then there was legislation to fight.
I then connected with Kids Off Nauru and volunteered for the Home to Bilo campaign.
Doctors, the Australian Medical Association (AMA) and Medical Students led the charge with Medevac issues.
Like many many others, I directly helped some detainees obtain phones, shoes, shirts, guitars, music industry contacts, production deals, celebrity support and banners designed by them. (I would frankly have preferred to save my money and effort for my own family, home ownership or a car but the overall need was too acute and pressing to ignore.)
Despite a very strong personal distaste for demonstration and my own limitations, it has seemed necessary to participate in dozens of refugee events in Sydney, Canberra, Melbourne and Adelaide across the past decade. (I really resent this whole experience.)
Stronger opposition to L-NP Home Affairs decisions and moral leadership by Labor would have rendered such persistent effort unnecessary. It is cowardice. It's time to redeem yourselves. This is the perfect opportunity. At the very least go down in history as more humane than the L-NP. (At this belated stage, a shown of overdue compassion will not inspire boat arrivals.)
Let's use Australia's relationship with Nauru and other Pacific Islands in a less destructive way. Deterrence is inherently negative. Positive aid projects would enhance Australia's reputation and status across the Pacific. Fill in a few airstrip potholes and counter Chinese investment and influence with more broadly useful infrastructure projects. Embody the governance, education and transparency standards you wish to inspire.
Raising voter awareness of the issues has proven challenging but Labor has hardly backed us volunteers in. Once again, it's time.
I am advised that this bill will compel the Government to offer transfer to Australia to all persons still subject to offshore processing still in PNG or Nauru within one month of the commencement of the bill.
It is also asserted that any refugee who wants to stay in PNG and Nauru can reject this offer for evacuation.
It is intended that refugees accepting this offer will be evacuated to Australia as soon as is practicable after their acceptance of the offer. They will receive appropriate medical/psychiatric assessment or treatment and automatically be placed into community detention. That is, they will not be held in immigration detention centres or Alternative Places of Detention (APODs).
I applaud this, having observed first-hand the trauma of prolonged APOD detention or indefinite Transit Centre conditions on many refugees.
I remain in contact with refugees held offshore since 2015. Our communication and concern do not end once they are out. Recovery is a gradual step-by-step process.
There are indeed cases where refugees living in the Australian community have begun to thrive. I can, just for example, mention Mostafa Azimitabar, Thanush Selvarasa, Farhad Bandesh and Maria Kahie (whose work, marriage and two children are testimony to the recovery that is possible.)
My only concern is that the refugees in Community Detention will still be under the dubious medical care of the International Health and Medical Services (IHMS), whose track record for timely and appropriate service delivery frankly stinks.
In my experience, IHMS follow-up of refugees medically evacuated onshore is also patchy and slow to the point of negligence. It is rare for a sickly refugee to get dental treatment other than extractions. They are often denied access to respiratory specialists or cardiologists or oncologists. Tropical parasites are rarely dealt with. Gut issues endure. Broken bones are not reset.
The more that is undertaken by the Government, the faster recovery can be. The release of refugees sometimes challenges the resources of advocates, the refugee sector and Australian charities affected by the rising cost of living. (We are broke and tired.)
Some of the fatalities relating to offshore medical mismanagement under IHMS are well-documented.
Hamid Khazaei's death from untreated septic shock on Manus was found by the Queensland coroner to have been preventable.
No one who saw the video of Omid Masoumali running unprotected, under-treated, screaming and burned around a less-than-sterile ward of RON Hospital in Nauru will ever forget it. (There were cats wandering through the place. None of the standard burns protocols was applied.) Nor will they have confidence that the medical systems in place were or ever will be adequate. Again, the inquest concluded that his death was preventable.
While some evacuation procedures and processes have changed, not enough have.
The bill was written to align with the ALP’s stated policy. It should therefore pass.
According to ASRC, this bill is focused on the evacuation of people from offshore to reside in Australia until they are provided with a durable third-country solution with a state party to the United Nations’ 1951 Convention Relating to the Status of Refugees or the 1967 Protocol relating to the Status of Refugees. (This bill does not address the resettlement pathways for people who sought asylum by sea.)
All persons accepting the Government’s offer will automatically be placed into “community detention”. Community detention is not closed detention (immigration detention centres or Alternative Places of Detention). People seeking asylum who live in community detention are given accommodation and a basic living allowance at 89 per cent of the Centrelink rate.
People in community detention do not have work rights or study rights, however, people have been able to transition from community detention onto bridging visas to work (if the minister grants same). Progression to Permanent Resident Visas thereafter would be the ideal.
This bill is important because the mistreatment of refugees in Australia offshore has been a national scandal.
Ordinary Australians would not accept the ordeals of isolation or standards of treatment experienced by stateless refugees in detention facilities offshore. Nor would they be willing to pay for ongoing cruelty, if fully aware of it.
As has been mentioned, after a decade of abuse, the remaining 150 people seeking asylum and refugees held offshore are in dismal psychological, physical and educational condition. Their economic lives have been stopped.
It is the responsibility of the Australian Government, not the PNG or Nauru governments, to support the well-being and rights of people seeking asylum from us. Playing shell games with the liable nations and corporate entities is not acceptable.
Again, a Nauru refugee who hung himself was cut down again this week. Hunger strikers are courting death as I write this.
Most of those still detained seem unable to function in offshore facilities, let alone a broader society, because of what they have endured.
This has not happened to a satisfactory level. The record of health care provided offshore by IHMS reveals gaping inadequacies to this day. Diseases and broken bones are ignored. Medical assessment tools like endoscopies and MRIs are not available. Ulcers and cancers go untreated.
Family separations, limited culture, inequity and low employment (plus cruelly low wages and inflated prices for essential groceries) – not to mention the arbitrarily cruel and random selection process for offshore – have created mental health issues that medication alone cannot fix. In fact, the iatrogenic side effects of over-prescription of psychiatric medications (such as liver damage) have compounded ill health. Freedom is the only drug needed.
I could dedicate a whole submission to what has been reported of Bomana prison in Port Moresby. “S.U.” was broken there. However, most of the information I have is second-hand or available elsewhere. Lynne Elworthy is one very reliable source.
Impoverished countries like Nauru and PNG have reduced resources and capacity to cater to the needs and values of people from diverse cultures. There are unaddressed equality, language and education gaps.
The healthy emotional development of young single males in particular has been stunted by the lack of access to diverse multicultural society and family modelling or guidance.
Institutionalisation produces incredible passivity.
Some dislocated people have spent more of their lives in camps and detention facilities than in their war-affected country of origin.
This loss of self-determination in detention in turn affects individuals' well-being and capacity to take steps towards meeting their own needs.
Taking up third-country options requires further skill and resilience. That resilience has been exhausted by the ten-year ordeal imposed on them offshore. Moreover, former refugees held offshore (like “S.U.” who went through Manus and Bomana) are now so damaged that they now live on the streets of America and are incapable of self-care. I will refrain from using names. We Australians did this to them. Us. The “good guys”.
That is, we have taken and incarcerated some brave, dynamic young people who had already worked and saved to escape crises. Their experiences of a decade of offshore detention or offshore restrictions have transformed many of those remaining into dependent, depressed, dysfunctional or timid patients. They've lost their “get up and go”.
This forced disintegration has been “bought” with funds supplied by trusting Australian taxpayers. It's not much of a national product. What a legacy. This bill is your opportunity to wash your hands of this L-NP legacy of grief.
We broke these asylum seekers and refugees. They were legal and their need was legitimate. We denied them their basic rights for a prolonged period. So now we are morally obliged to help rehabilitate them.
There seems to be discrimination by nationality, too. The concentration of particular ethnicities in the remainder group suggests that some less educated refugees from particular countries have been treated by Australian Immigration as less “worthy” of help onshore.
Detainees/hostages of certain ethnicities (like Bangladeshis or Nepalis) seem to have floundered offshore for longer. The political strife and violence they fled are as real as that experienced by recognised groups such as Rohingyans, Hazaras or Iranians, for example. Australian Government discrimination towards them borders on economic apartheid.
APODs are mostly harmful. They are isolating, grey, airless and exercise opportunities are limited. My friend, the very gentle “T.”, was cut down after hanging himself in a Melbourne APOD — the Preston Mantra Hotel in May 2019. My understanding is that he was in ICU for three days. He was then transferred to Melbourne Immigration Transit Accommodation (MITA) where proximity to 501s, drugs and dawn deportations by all-black, armoured Task Force squads are common. Great. Hardly what any good doctor would have ordered.
Some people transferred to community detention onshore recover some health and social well-being quite quickly.
Most refugees transferred from offshore that I have known are keen to establish social connections, basic resources like banking, take up some online learning or follow their interests, sort out work and build hobbies as soon as this is permitted. Once on Bridging Visas, some Medevacced refugees have shown an impressive appetite for hard work in frontline jobs through COVID and beyond.
In my experience, groups of very functional refugees released earlier may share bedrooms in small apartments or houses to save money, but they keep their homes immaculate. Their impact on the demand for housing is minimal.
Such drive, flexibility and versatility see Medevacced refugees rapidly become contributors. By contrast, ordinary Aussies rarely see sharing rooms or paying tax as a privilege. Many rich “golden ticket” immigrants own multiple empty multimillion-dollar properties.
Refugees on Bridging Visas take rental leases and get car loans as soon as they are able. Released detainees may be denied family reunions, but continue to show care for their families and to build new relationships.
I also know of refugees who have become business owners and employers.
The improvement in the mental and physical health of people recently transferred from offshore to onshore is often rapid. Altogether, I have met over a hundred people who were offshore. I cannot adequately describe my delight or their joy and relief at becoming part of the onshore workforce.
I fully support this bill.
The bill offers a humane solution and also complies with Labor's policy undertakings for Medevac as necessary.
I have the permission of four people currently on Nauru to publicly discuss their cases in detail. Each of these people is suffering mentally. Several are driven to acts of self-harm to highlight their plight.
Each of the 20 Nauru refugees I have spoken with since November has unaddressed medical problems. Few have sufficient confidence in the outcomes of medical treatment in Taiwan where there is yet another language barrier.
I am personally affected by the traumas observed. I would be relieved to be freed from the moral obligation to campaign for each refugee who approaches me.
Corrupt and brutal or negligent dealings offshore cast a shadow over Australia's future.
I am also aware that when we institutionalise abuse it drifts onshore. Many of the for-profit contractors engaged offshore also have responsibility for “care” of (and therefore power over) vulnerable groups onshore. Their track records offshore inspire great concern for the future of human rights in Australia. Prison, housing and aged care health contractors are a case in point.
I guess the tradition of fighting for the nation's future is ingrained. Four Salmon great uncles fought and died for Australia. Wilfred Salmon died in the sky defending London. My grandfather, Walter Salmon, lost his arm at Ypres. Bishop Edwin Davidson, my maternal grandfather, was gassed in France and died prematurely.
Relatives and my father have fought and suffered for Australia since. My father, Brigadier John Salmon CBE, lived with shrapnel embedded near his spine for almost 61 years. It was caught on his second of five overseas military tours. Having been exposed to intergenerational war trauma and notions of personal sacrifice for the greater good, I find that I am also (reluctantly) engaged in a battle for a better nation. Maybe we're just lemmings.
Restricting folk who came to Australia for help to a corruptly-run rocky island like Nauru for ten years is redolent of the colonial French prison islands described in Papillon.
As refugee organisations have stated, the sooner refugees are free from harmful policies like offshore detention, the sooner they can start the journey to recover and thrive as part of a safe community. There are still around 150 refugees being held against their will in PNG and Nauru who urgently need to have their freedom restored.
It cannot be over-emphasised that the mental and physical health of people held offshore is critical after ten years of struggle and resistance against the harm and cruelty of the Australian Government.
People held offshore have internationally agreed rights that are being denied. They have expressed their need for release. I have read plea after plea for help from Nauru. Every damn plea sounds exactly the same. I am happy to provide graphic photographs, video, screenshots and reports of these cases. I never want to see another machete wound to a head or torso.
The ALP National Platform states:
‘Labor will ensure asylum seekers who arrive by irregular means will not be punished for their mode of arrival.’
(How does that even fit in with the perpetuation of Sovereign Borders?)
The Platform states that Labor will:
Improve the medical transfer process, establish an Independent Health Advice Panel to provide medical advice and maintain ministerial discretion in all decision making.
...effort must be made to remove asylum seekers from immigration detention centres through community detention or the granting of bridging visas with work rights. People seeking asylum will have means-tested access to funded migration assistance, and to appropriate social services, including income, crisis housing healthcare, mental health, community, education and English as a Second Language support during the assessment of the claim for protection.
The ALP also supported the Medevac Bill and has not retracted its stance on this.
Further ALP politicians have also stated that they want no one to be held offshore. Stephen Jones, Assistant Treasurer and Minister for Financial Services, said on 6 Feb 2023 on Q&A:
“Our objective is to get it to zero [people held offshore] over the course of this year.”
Great. Let's do it. Now. Please.
Let's differentiate Labor from the L-NP in the eyes of the international human rights community. Let's stride past the nastiness of recent immigration abuses.
This is the natural next step.
Jane Salmon is a refugee advocate. You can follow her on Twitter @jsalmonupstream.
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