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Commission Website: National Inquiry into Children in Immigration Detention

This statement was provided by Bernice Pfitzner to the National Inquiry

into Children in Immigration Detention


I, Dr Bernice Pfitzner,

of [address removed], Medical Practitioner, do solemnly and sincerely

declare as follows:


1. I make this

statement for the purposes of the Human Rights and Equal Opportunity

Commission's Inquiry into Children in Immigration Detention.

2. I was employed

from October 2000 to June 2001 by Australasian Correctional Management

(ACM) at the Woomera Immigration Reception and Processing Centre (WIRPC)

as a Medical Officer.

3. I am currently

employed as Senior Medical Officer with the SA Drug and Alcohol Council.

I hold an MBBS (Adel) and an MD on child development. Previous work

includes work with children in child development and as a GP.

4. I was the

only full-time doctor employed at the WIRPC. I received assistance

from the doctor from the Woomera hospital who came in for 3 hours

per day and was on call on alternative weekends.

5. I understand

that there are now 2 full-time doctors at the WIRPC. I regard this

as a more appropriate level of staffing to provide adequate medical



at the WIRPC

6. The environment

at the WIRPC was highly stressed and this acted as a significant detrimental

factor on the wellbeing of fathers and mothers and therefore children.

7. The main cause

of this stress was visas processing. The length of time taken was

inordinately long and information given to applicants was almost non-existent.

People were therefore suspended in limbo.

8. The observable

effects of this, was, in medical terms, depression, anxiety and more

severely psychosis. I would expect the same result for any human beings

in the same situation.

9. There were

1,500 detainees at the WIRPC when I was working there. Depression

was almost universal amongst detainees.

10. I observed

3 or 4 cases of psychosis amongst adult detainees and severe personality

disorders in about 10 adult detainees. I observed the deterioration

of these people from normalcy to their more severe abnormal state.

They had not initially presented as depressed or abnormal.

11. Deterioration

amongst detainees was clear, and it is my view that if this was not

initiated by the conditions at WIRPC then it was precipitated by it.

Treatment of


12. While in

my opinion the main factor impacting upon the mental health of all

detainees was insecurity and their unknown visa status, the attitude

of the correctional officers was also damaging. Many of the officers

did not seem to be aware of appropriate cultural reactions. I observed

amongst the detainees from the Middle East a particular sensitivity

to "saving face" and preserving their dignity. This was

impacted upon significantly by the treatment of officers who had come

from criminal detention background and treated detainees accordingly.

This resulted in detainees being treated as criminals and ordered

around. This had obvious effects on the self-esteem of detainees.

13. I also regarded

the treatment of "trouble-makers" as inappropriate. They

were isolated and subjected to constant checks and this increased

stress and its symptoms and signs. I raised this with management but

told it was not a hospital and told that this treatment was appropriate

in a correctional environment.

14. To my mind

there were not that many detainees who had a significant mental disorder

when they arrived at the WIRPC. I therefore concluded that the mental

disorders that manifested themselves amongst detainees (from one end

of the spectrum to the other) must have been brought on by harsh environment

and treatment. I am of the view that had they been treated more appropriately

there would not have been as many mental problems and they could have

been alleviated through things such as proper cultural training.

15. While initially

it might have been hard to provide this sort of training with large

increase in arrivals, it appeared that no training was put in place

once these problems were obvious.

Provision of

Health Services

16. In terms

of physical health, I was of the view that children received appropriate

levels of care at the WIRPC when I was working there. I did not think

that medical care was denied on the basis of cost. In my opinion it

was always available when it was pressed for.

17. I was fully

occupied with the immediate illnesses and diseases of detainees, and

therefore was limited in my ability to provide any preventative health


18. In my opinion

there was adequate screening in terms of physical health, but the

screening of mental health was not adequate. Having said this, it

is hard to screen for mental health as there are cultural issues and

our tools that can be used for screening may not be appropriate. I

tried to screen when people presented with a symptoms indicating that

they had a mental health issue that needed to be addressed.

19. I did try

to initiate mental health screening for children as I was particularly

concerned about their wellbeing. I tried to get SA Department of Child

and Youth Health to conduct this and they agreed in principle. However,

in the end it did not go ahead as I understood there to be a dispute

between them and the Commonwealth about who would pay. The aim was

to identify children who needed care and provide a "baseline"

for children when they were released from detention. I gave up pursuing

this after numerous (10) attempts.

20. I was not

able to get an appropriate programme in place for immunisation. Again

this was because of a dispute between SA Department of Child and Youth

Health and the Commonwealth about who would pay for this. Nurses at

the WIRPC lacked the training or confidence to perform immunisation

so I therefore tried to immunise children myself. I was critical of

the failure to properly immunise children as it was important not

only in the immediate individual case but also for when the child

was released in to the community.

21. I saw about

10-12 children with physical disabilities. When they were identified

we investigated their health needs and where appropriate they were

sent to paediatricians in Port Augusta. We had to work harder to get

appropriate people to look at them because of the isolation of WIRPC

and this also made medical follow-up more difficult.

Self-Harm and

Child Abuse

22. I did not

witness, nor was I aware of, any child self-harm while I was working

at the WIRPC. I presume that the learning of self-harm had not percolated

to the children from parents at this stage.

23. There was

an allegation of child abuse that had happened before my time at the

WIRPC. I understand that the incident was investigated. Nobody was

brought to me in relation to child abuse and I was of the view that

adequate and appropriate procedures were in place to deal with any

allegations of child abuse after the first allegation of child abuse

to which I have referred. From my previous experience I was fully

aware of the reporting that should take place and I was satisfied

that the policy was appropriate in relation to mandatory reporting

whilst I was there.

24. I had no

involvement with the Hight Risk Assessment Team (HRAT). I did ask

to be involved and thought that it was appropriate that a doctor be

involved. I tried to go to two meeting but they were postponed on

each occasion. In principle I regarded the HRAT as a good idea a good

idea, however my main criticism was that it did not meet regularly



I make this solemn

declaration by virtue of the Statutory Declarations Act 1959 as amended

and subject to the penalties provided by that Act for the making of

false statements in statutory declarations, conscientiously believing

the statements contained in this declaration to be true in every particular.

This statement was signed on 16 July 2002.


Updated 10 October 2002.