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.
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.
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.
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.
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.