The Challenges of Speaking Up

I have an early memory. A memory that does me no credit. I’m a kid, maybe 5 or so. I’m in a playground and there’s a slightly older kid who really wants to use the slippery dip. There’s a younger kid in the way. And when he hatches a plan to run the kid away a bit, then push him over so his parents will come to scoop him up, I can see what’s happening and I don’t speak up. It all unfolds and I’m silent.

I don’t even quite know why I’m silent. I can’t quite put my finger on why I don’t speak up to stop the squeeze in my chest somewhere. It’s a memory that’s been reconstructed that replays from time to time. It replays whenever I am reminded of how difficult it is to make some sound.

Giving Voice

I’d like to think that as a doctor I’d speak up now if something was happening in front of me. I’d like to think I’d start making noises like the doctors in this story, covering details of a 92 page letter written by doctors working with a health contractor in the offshore detention centre. Or Dr Caroline de Costa, detailing concerns about obstetric and perinatal care in detention centres here and offshore. I would like to think I’d take steps to address the erosive ulcer at the heart of refugee policy – the denial of humanity endorsed by the civic machinery of successive governments.

In recommencing then continuing offshore detention, federal governments have wasted no opportunity to demonise a voiceless group to suit political ends. It has steadily reached new peaks of absurdity under the current regime, fronted by a minister who seems a little too delighted at being given real navy ships to play with, rather than those usually reserved for bath time.

To ‘take the sugar off the table’ we have to impose ever harsher conditions. Media are not allowed in, but have the opportunity to hear the Foreign Minister refer to conditions as better than mining camps (presumably the sort of mining camps where you can’t leave, have extremely limited access to basic amenities and can’t work). Governments do all of this because they know that once the public truly identifies with asylum seekers as human beings, the game will be over.

The Kids

Nowhere is the horrifying institution of these policies more distressing than when considering the plight of children. If you need an international reference, then perusal of the UNHCR – Refugee Children: Guidelines on Protection and Care has it all. The Convention on the Rights of the Child clearly states that “Every child has the right to the “highest attainable standard of health” amongst other goals that aren’t actually that lofty.

The simple goals stated such as nutrition, opportunities for appropriate stimulation, adequate clean water and hygiene are all too high for the camp conditions to consistently maintain. Transfers out to address issues like defective pacemakers seem too difficult. Children are being held in centres where frustration boils over to violence and abuse. As in so many situations, children bear the scars of the folly of  adults. But this time, it is a government acting in our names inflicting those scars.

Futility in Action

To top it off, it’s hard to see how this approach will succeed in influencing refugee arrival patterns in the long term. For all the hyperbole attached to the numbers of arrivals by governments, placed in context they are a drop in a global current. The numbers from Syria alone are staggering.

Australia has agreed to take 500 of these people.

Australia has agreed to take 500 of these people.

The future is likely to see vastly increased numbers, not decreasing numbers. That growth will surely swamp any deterrents advertised by politicians. If the goal is truly to stop drownings at sea, then it’s time to genuinely engage with regional solutions rather than dazzle the populace with shiny generals’ stars.

See No Evil, Hear No Evil, Speak of Nothing

What is abundantly clear is that there can be no hope that the current political class will alter course through a sudden revelation on the road to whichever illusory Damascus they set out for. That letter from the doctors was received in government circles on December 6. On December 13, the Independent Health Advisory Group providing support on asylum seeker and detention health matters was advised they were no longer required. Less engagement advertised as ‘streamlining’.

A bipartisan touring party visited, with the Foreign Minister lauding conditions, as noted above. Of course, the fact they hadn’t inspected the facilities for the actual asylum seekers was only confirmed after further reporting.

Another farcical briefing from the relevant minister on Friday, replete with the usual refusal to engage with the actual matters at hand ensued. The standard patter, dense with references to investigations and processes seemingly designed to distance himself from a responsibility to act were all that was allowed.

The Doctors’ Response

So we are left with the efforts of the medical professionals on the ground. They have concerns as to whether they are threatening their own medical registration by being part of the system. Thankfully they have not forgotten their duty to the patients in front of them, and are advocating for change from within.

It cannot be easy to be faced with a situation where your care is limited by the structures above. They are seeing the grim effects of an inhumane system seeking to crush the few to send some sort of message to the many. Even with their advocacy, the experience will undoubtedly haunt the rest of their careers and scar them as well. That they are seeking to stay and produce change is something we should all be grateful for.

In Our Name

This treatment of asylum seekers is being conducted in the name of the people of Australia. The most extraordinary element of that original story is the following quote towards the end:

“According to the doctors the same IHMS manager told them in September: ‘There will one day be a royal commission into what is taking place on Christmas Island. He suggested we document well.'”

There is another royal commission proceeding in Australia at the moment. It is exploring the devastation across many lives and generations after institutional child abuse. At the time it may have been that the problem was hidden behind the curtain dropped by trusted bodies.

Those delivering health care, including the company contracted to do so, are telling us that child abuse is happening now, in institutions overseen by the federal government. The Northern Territory branch of the Australian Medical Association says the same. We cannot claim ignorance.

The Minister for Immigration and Border Protection, Scott Morrison, is the guardian for all unaccompanied minors in detention. If you were in the position of being guardian to those children, I’d venture that you would see only one appropriate response – get the children out.

Politicians on both sides are pursuing a policy that seems destined to fail in its aim, and asking us to accept a high price on their way. The doctors involved seem to be trying to find their voice. Now I just have to figure out how to lend mine and convince others to do the same.

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6 thoughts on “The Challenges of Speaking Up

  1. I read that people are tired of politics and politicians. But I think we’ve been slack in our duties as citizens of this nation. “She’ll be right mate” has been the attitude for long enough, but we can’t keep hoping that problems will magically go away. I don’t think things are right now, and they certainly won’t BE right if we keep ignoring what’s going on around us.
    We need to listen to what frontline people – doctors, scientists, teachers, qualified experts in whatever field, and the locals – are telling us, rather than politicians influenced by votes and money, who fact-check using wikipedia.
    If enough people – voters – demand a change to policy, the government will dance to our tune and backflip on anything. We saw it with the Gonski funding! Now we, as a nation, need to be that engaged about other matters. See asylum seekers as people and families just like us. See that the world needs proactive cooperation, not promised dependant on others targets being achieved. Because even if we think we can turn a blind eye, even if we think it doesn’t affect us – it does.
    It can take enormous courage to speak up, but it’s not hard to lend your voice to support someone who has. Don’t let that brave person stand alone if you think they’re right. Be brave and stand by them. Tweet, Like, Share, petition, email, blog, phone your MP.
    Only WE can save the world – together.

    • Impressive bit of passion there. I certainly agree that you can’t just lay all blame at the feet of politicians – there’s at least a 2 way street there (and a few intersections and roundabouts).

  2. Pingback: Protecting Kids | The Flying PhD

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