Submission to National Inquiry
into Children in Immigration Detention from
Refugee Health Network and Refugee Claimants Support Centre
Over 40% of community
based asylum seekers, their children and families undergo yet another
form of 'immigration detention' that our nation has designed. This submission
particularly concerns itself with the conditions under which children
of asylum seekers are severely marginalised in the community under conditions
of severe poverty and deprivation of services and basic human rights,
many for several years. We, as professionals working in the field, largely
unpaid due to the current legislation, are deeply concerned with the effects
of this policy, especially since major changes to the Migration Act in
1996-1997. These changes are having very negative and far reaching impacts
on the development of children caught up in these severely punitive policies
Our submission touches
on the human rights implications of these policies. We explore the current
divisive way of interpreting human rights used by DIMIA. The negative
impact this has on both the asylum seeker's children and on children in
our own communities (article 2, Convention on the Rights of the
Child, CRC) is that they see human rights as privileges, rather
than basic rights for us all to enjoy and partake in. The ethical implications
of the way human rights are easily denied even to severely marginalized
asylum seeker children in our community, the denial of basic human rights
is impacting on many professionals in the health field. Many health professionals
are turning to their professional organisations for guidance as they seek
to care for the children of many severely impoverished asylum seekers
in our communities who are denied access to the health service.
adults and children are often uncared for (articles 19&34 CRC),
conditions often resemble 'third world' settings when it comes to lack
of access to effective diagnostic services, or the ability for even children
to get the medicines that they need for basic health care (article
24 CRC). The development of these children is severely negatively
affected by our current policies: lack of access to education (articles
28&29 CRC), welfare, immunisation and other screening and
developmental health services or even Torture & Trauma counselling
for asylum seeker's children or their families (article 39 CRC).
These policies severely affect the right to a family life for many of
these children as they see their human rights and that of their parents
denied, they often become severely depressed and disempowered (articles
If this becomes the
new model that is adopted as we try to release asylum seeker's children
and their families or unaccompanied minors into the community more rapidly,
rather than locking them behind 'razor wire' in remote locations, we will
have gained very little. It is the plight of these community based asylum
seekers, their children and their families that we as professionals wish
to express in this submission. This is not a humanitarian solution to
an International need for protection of asylum seekers, refugees their
children and families (article 27 CRC). This is yet another
punitive, disempowering and severely marginalising measure that negatively
impacts on the developmental needs of many children who need our protection
and understanding (article 22 CRC).
SUPPORT CENTRE BRISBANE:
GABY HEUFT - CO-ORDINATOR
MANDY McNULTY - CHAIR OF CTEE.
ASYLUM SEEKERS: YET ANOTHER MODEL OF DETENTION, BY SEVERE MARGINALISATION
AND DENIAL OF BASIC HUMAN RIGHTS FOR SEVERAL YEARS AS A MESSAGE OF DETERRENCE
TO OTHERS WHO MAY DARE TO SEEK ASYLUM.
This group comprises
around 8,000-10,000 human beings in Australia per year. Over 40% will
rapidly fall into the category of severe poverty and marginalisation whilst
they wait 2-4 years (sometimes longer) for the outcome of their claim
for refugee status. Over 40% of this subgroup will have no work rights,
no medicare rights, no rights to public housing, no welfare rights, no
interpreter services (except where directly related to their refugee claims),
no rights to English language classes, no rights to Torture and Trauma
counselling, no rights to education for their children (even at primary
school level). In fact this subpopulation is so severely marginalized
that they in effect "live apart" whilst living within our own
communities, they are often like "ghost people" on our streets.
Children in this group are severely affected in many ways. This is, in
effect, a severe form of "Community Based Detention".
The neglect of many basic human rights can go on for years.
Un Convention on
The Rights of the Child:
children should be entitled to basic rights without discrimination"
(UDHR, ICESCR, CROC) 
in Ireland of children of community based asylum seekers even with much
more generous welfare, health, schooling, housing and other provisions
raise concerns about their system and the way it marginalizes this group
of children. This report was published under the title "Beyond the
Pale". One wonders what a similarly funded report
into the system created by our own Migration Act would have to say about
the Australian situation for children of Community Based Asylum Seekers?
We have a system that openly denies most human rights to children of community
based asylum seekers because their parents are attempting to seek asylum
in this country. Most of these people have fled from some of the most
barbarous political regimes on this planet, suffered a high rate of torture
and trauma themselves and are desperately seeking asylum and our protection
from persecution. A right to which one would have thought they were entitled,
as we are a signatory nation to the United Nations Convention on Refugees.
Many of the community
based Asylum Seekers flee here from some of the most horrendous regimes,
escaping from severe persecution, torture, rape and other forms of state
studies undertaken in Australia more than 20% of asylum seekers reported
experiencing previous torture, more than 33% reported imprisonment for
political reasons, and a similar number report the murder of family
or friends" 
This group of asylum
seekers have eventually managed to obtain Tourist, Student and occasionally
Work Visas to come to Australia. They often obtain these from within neighbouring
countries where it may be temporarily safer. They, their families and
friends scrape together whatever finances they can to help them escape
to safety and try to find 'refuge'. Most hope that after a break away
things may become safe for them back in their own countries. Some flee
here with their immediate families, some without any family, as they fear
that if they all left together it would raise the suspicions of the authorities.
When they find that things are still not safe for them at home they apply
for asylum and ask for our protection. Many wait, quite naturally, for
3,6 or 12 months until their initial visa has almost expired before they
make up their minds about whether it is safe to return. Over the last
few years there have been many changes to the Australian Migration Act
and to the way it is applied, which makes things a lot harder for this
group of asylum seekers:
- The '45 day
Rule': this means that anyone applying for asylum after 45 days
from entry into Australia (no matter how long their 'entry visa' was)
may be allowed to stay on a 'bridging visa' whilst their claims are
heard. However, they will have no 'work rights', nor 'welfare entitlements',
no 'medicare rights', no 'rights for their children to attend school'
(not even Primary school), no access to Torture & Trauma counselling,
no English language class entitlements, no access to public housing,
- The number of
rejections at 'primary stage' have increased dramatically, as has the
number of rejections at Refugee Review Tribunal (RRT) stage. Appointments
to the RRT are now tightly controlled by the minister and his department
and are short term. There is no attempt to follow people up when they
are finally deported to check for the possibility of 'refoulement' even
though there have been quite a few cases that have come to prominence
over the last few years.
- The Federal Court
can only consider cases on technical grounds not review the merits of
the case and Appeals to both the Federal and High Courts are becoming
increasingly costly and more and more difficult. In fact now there are
moves to disallow any judicial review or transparency to the system.
Of Community Based
Asylum Seekers over 40% will fall into this category (severe denial of
basic human rights) immediately or at some stage early on in their 2-4
year assessment wait (sometimes it can be 7 or more years). This group
is severely marginalized, impoverished and disempowered for several years
by the current legislation. Children in this group are severely disadvantaged
and re-traumatised. The costs of caring for this group of asylum seekers
is shifted on to State Governments, Local Councils and the Community Sectors.
 Luckily, so far, the Community Sector, often helped
by Local councils, Parish Church networks, Ecumenical Social Justice Groups
and many concerned citizens, have helped fund 'Asylum Seeker Centres'
in major capital cities to try to advocate on behalf of this severely
disadvantaged subpopulation. However this sector does not have the resources
to fully deal with the demands and service provision required, especially
as the right to work and the right to access any welfare make this group
totally dependent on charity. Most services are ad hoc and as such are
erratic, affecting everything: accommodation, nutrition, healthcare etc,
and place many adults and children in severe poverty. Insecurity of place,
person and the most basic 'Human Rights' that we take for granted are
denied to this group of Community Based Asylum Seekers and their children.
When provided for they are totally dependent on charity, goodwill and
capacity for the Community Sector to find ways of paying for them, and
as such provision of basic needs are seen as privileges not rights. 
Impacts on children of Community Based Asylum Seekers are severe and affect
them and their development over the 2-4 years waiting period. For those
that are allowed to stay as refugees our community must then bear the
added burden of trying to make up for their added traumatisation during
the determination process. This is a trauma that may well have been avoided
and may have long term consequences. There are currently few studies done
on the impact of this legislative impoverishment, marginalisation and
disempowerment and is a vital area that should be urgently researched
so that we can know what impact our 'deterrence based' legislation has
on the future of these children and adults. Similar situations are causing
great concern in the child health field here and overseas, even when welfare
access is allowed. So, if we can extrapolate from these studies to look
at the plight of the children of Community Based Asylum Seekers in Australia
they must form a severely at risk group in our population already. When
we also deny basic human rights to 40-50% of these children we may well
find our impacts are very serious indeed:
of suffering experienced by children with mental health needs and their
families has created a health crisis in this country [USA]. Growing numbers
of children are suffering needlessly because their emotional, behavioural,
and developmental needs are not being met by those very institutions which
were explicitly created to take care of them. It is time that we as a
Nation took seriously the task of preventing mental health problems and
treating mental illnesses in youth."
(Report of the Surgeon General's Conference on Children's Mental
impose a heavy burden on children, families and communities and often
persist into adulthood. The cost to society in human and economic terms
is great. There is broad agreement that we need to detect these problems
early, provide effective treatment and attempt prevention."
editorial MJA 2001 
(Professor, Department of Psychological Medicine, University of Sydney,
Director, Child and Adolescent Mental Health Services Northern Sydney
For those children
and adults we deport, having compounded their original trauma, we then
pass on a legacy of problems that may well have long term detrimental
effects and may well lead to permanent developmental problems for the
children. As we do no random audits we do not even know if we are sending
these children and adults back to safe environments or back to face further
persecution and trauma.
Some of the impacts
our current Migration Legislation is having on the children of Community
Based Asylum Seekers are detailed under separate headings below. There
is urgent need for detailed and well funded research to be carried out
focusing on the needs of these children and an evaluation made on how
we as a society are responding to these needs and protecting their basic
'human rights' under all the UN Conventions we, as a nation, are signatories
Many children of
Community Based Asylum Seekers have no Medicare access (their parents
are not allowed to work and receive no welfare etc.), they are totally
dependent on doctors, nurses, counsellors etc. to provide 'pro bono' service.
Any medications must be paid for on a totally private basis and they are
dependent on the goodwill of General Practitioners to supply sample medication,
or for community groups to collect money to pay very high rates for medications
from Pharmacists at private rates (10-20 times higher than the subsidised
rates, and totally open to the profit motives of individual Pharmacists).
This is an ad hoc system and medications are often out of date or erratically
supplied. Referral for diagnostic services such as X-ray or Pathology
is almost non existent and hence in effect diagnostic facility useage
resembles that in many 'third world' settings.
If emergency care
is sought at hospitals Medicare cards are often demanded, staff become
abusive and eventually bills are sent out in an attempt to recoup costs
as if these people were wealthy overseas tourists. Debt collectors are
often used by hospitals and many asylum seekers are made to feel like
criminals and fear that these bills will be used against them when their
asylum claims are assessed.
of asylum seekers may often exhibit symptoms of anxiety, nightmares,
withdrawal, or hyperactivity .Support for these children needs
to be multifaceted aiming to provide as normal a life as possible, importing
a sense of security, promoting education and self esteem. It is also
important to support parents as they may be facing difficulties themselves.
The most therapeutic event for a refugee child can be to become part
of the local school community and learn and to make friends."
Dr's Burnett & Peel, Medical Foundation for the care of Victims
of Torture, London, U.K.
Dental care, immunisation
and other health screening services are not generally available or totally
dependent on 'pro bono' work or charity and donations from a local parish
or community group. The Federal government's 'Asylum Seekers Assistance
Scheme' is poorly funded, ad hoc and almost useless in its lack of availability.
Children of Community
Based Asylum Seekers are also often exposed to severe and untreated mental
illness in their parents. This is a severely traumatised subpopulation
and long, harsh and severely impoverishing and disempowering refugee application
processes increase the burden of mental trauma leading to high rates of
severe Post Traumatic Stress Disorder, anxiety and depression. 
At hospitals children who can speak any English (if they have been able
to attend school, given their parents cannot access English classes) may
well have to translate for their parents. Sometimes they have to detail
the torture & trauma histories of their parents for health practitioners
and others, repeatedly explain suicidal feelings in their parents and
much more. These are highly traumatising events for adults to relate,
let alone for children, especially when it concerns those who are supposed
to be one's major protectors in life (case study in Appendix 1.).
There is no entitlement
for schooling, in spite of the many mixed messages that DIMIA tries to
give about not denying any children access to education. Fees asked seem
to range from $4,000 -$10,000 per year for even State primary schools.
Any exemptions must be applied for individually to the relevant State
Ministers and is totally dependent on their goodwill, or that of their
bureaucrats, who look at the application and is somewhat ad hoc, rather
than being seen as a 'human right'. More often Church based schools approach
their governing bodies and take in some of the children of Community Based
Asylum Seekers, who are linked to a persistent community worker advocate,
on a charitable basis. Transport, uniforms, text and exercise books are
obviously a major added expense as well. Bullying and racial discrimination
at school in these days of 'government vilification' of asylum seekers
and refugees is yet another traumatic hurdle to be overcome by many of
Housing is erratic,
totally dependent on charity and often short term. Rooms in houses for
a family, garages, space in backrooms of factories without showers and
sometimes even toilets and all sorts of temporary arrangements are common.
The recurrent changes add to the translocation stresses suffered by families
fleeing their homes and country. It is unknown what long term implications
this has for a child's development and needs urgent research once more.
Once more this is
totally dependent on charity. Vouchers begged for, the goodwill of a baker
to supply left overs, almost rotting vegetables etc. Not even pregnant
women, babies or young children are quarantined from the excessive impoverishment
of our nation's current 'asylum deterrence' measures.
There are no free
bus passes etc., accommodation could be anywhere, bus tickets must be
begged for. With parents without work rights or welfare rights the isolation
of children in these families is extreme.
There are no entitlements
to interpreters except for the basic need for the initial stages of their
refugee claims. If children are able to attend school and learn some English
they are often used as interpreters even in complex medical consultations
involving family members
There are no entitlements,
classes are totally charity dependent, and transport costs create problems
even if classes are organised by volunteers.
State sponsored vilification
(in labels such as 'illegals', 'queue jumpers', 'criminals' etc.), severe
impoverishment (no work rights or welfare access etc.), having to beg
for everything or depend on others to advocate on one's behalf and having
no real basic rights are a legislative violation of human rights of asylum
seekers that this nation has created. Added to all this is the fact that
most of these people have fled their countries and left behind their friends,
immediate or extended families and all their usual support networks. The
vulnerability to abuse and exploitation of this group who live here for
several years without 'basic rights', impoverished, disempowered and demoralised
is enormous. Parents are often so depressed and traumatised that they
may not be able to even give the normal emotional support and security
necessary for a child to grow and develop into a healthy adult.
These services are
no exception either. They too are dependent on the vagueries of charity
and the goodwill of a few health practitioners and midwives who may advocate
for help. There is no protection of pregnant women , babies and young
children from the violation of their human rights.
(Convention on the Elimination of all forms of Discrimination Against
Women - CEDAW):
Parties shall ensure to women appropriate services in connection with
pregnancy, confinement and the post-natal period, granting free services
where necessary, as well as adequate nutrition during pregnancy and
the only rights and entitlements many asylum seekers have are those
guaranteed under the Transport Act. Where in the case of an accident
with a public vehicle they may be covered irrespective of residency
Ms. Dunbar, Refugee Council of Australia (quoted on the home web
page of the Hotham Mission Asylum Seekers Centre Melbourne, Victoria)
Children of the Community
Based Asylum seekers with no work, welfare, medicare, education, language
or housing rights are severely marginalized, impoverished and further
traumatised by a different form of Detention. It is "Community
Based Detention". The trauma suffered is as real as that suffered
in isolation behind 'razor wire'. The isolation is almost as extreme and
the insecurity felt can even be more frightening at times. It can be said
that "one lives in the community, but apart". The denial of
basic human rights to these children is hidden and their rights are totally
dependent on the charity of many individuals and community groups who
feel strongly about social justice issues. The severe discriminatory practices
outlined above are justified on two grounds by DIMIA and the Immigration
1. That they are
'other' than us, and non citizens.
2. That these are
necessary deterrence measures to stem the flow of more 'others' that may
follow, if we allowed them their basic rights.
practices have severe health implications and may well last long into
the future where a child's development is concerned. These children are
in our midst, and treating them in this manner creates in the mind of
many in our society and in our schools a concept that it is alright to
deny some children their basic human rights. It undermines our own society's
beliefs in social justice and 'fairplay'.
against ethnic, religious and racial minorities, as well as on account
of gender, political opinion or immigration status, compromises or threatens
the health and well-being and, all too often, the very lives of millions.
Discriminatory practices threaten physical and mental health and deny
people access to care altogether, deny people appropriate therapies,
or relegate them to inferior care. In extreme forms of discrimination,
as exemplified by apartheid, ethnic cleansing and genocide, the devaluation
of human beings as 'other' has had devastating consequences." Introduction
on the Homepage of the Physicians for Human Rights USA. 
should be careful not to discriminate against asylum seekers who seek
to register with their practice and should ensure that administrators
are aware of procedures for registering asylum seekers. The BMA has
issued guidance for doctors on access to healthcare for asylum seekers
in the UK which confirms that there is no requirement to demand the
immigration status of an individual who is seeking to register at primary
supports training for all doctors who regularly treat asylum seekers,
some of whom will be victims of torture, in order that they are able
to address their particular healthcare needs. The BMA calls on national
governments to develop training programmes with the help of specialist
bodies such as the London-based Medical Foundation for the care of victims
of Torture. National governments should ensure that there are sufficient
support services for doctors who treat asylum seekers, including specialist
rehabilitative and interpreting services." Recommendations 58
& 59 from the BMA Handbook on Human Rights for The Medical Profession
Under our current
Migration Act as regards to many categories of asylum seekers all human
rights become divisible, even for children. The legislation no longer
supports the concept of basic non divisible human rights as we allow human
beings on certain visa categories to be denied these rights. Even children
who may live in our midst in abject poverty for several, very important,
years in their development are denied basic human rights depending on
the visa categories of their parents. This raises very serious ethical
implications for doctors and healthworkers who are supposedly condoned
in the practice of discriminating on the basis of immigration status to
deny basic heathcare to those in need.
is a right of all individuals. Everyone should have access to health care
regardless of financial, political, geographical, racial, or religious
considerations. The nurse should seek to ensure such impartial treatment."
of Nurses Role in Safeguarding Human Rights, International Council of
1. Full rights to
all asylum seekers, their children and their families to live productive
lives in our communities until their cases for refugee status are fully
heard. These would include: work permission, welfare provision on a means
tested basis, health rights, education rights for their children at Primary
& High School level, English language classes, Torture & Trauma
Counselling, use of interpreters for all medical and asylum claim purposes.
(see BMA, UK web page for a good example of the ethical policy we are
2. That the use of
Dental & wrist X-rays as a non-therapeutic tool by DIMIA be stopped
until the techniques can be properly, scientifically verified. These techniques,
according to many medical and dental experts have no validity beyond their
therapeutic use in staging various surgical procedures in patients who
are still likely to grow. (see Appendix 2 )
3. Active measures
be taken in all schools to decrease discrimination against all asylum
seeker and refugee children. Human Rights Education be a core subject
in all Australian Schools and that it cover asylum seeker and refugee
issues. (see Appendix 3 )
4. Development of
a National Asylum seeker and Refugee Health Policy. That this policy be
developed in consultation with all the State, Territory and Commonwealth
Departments of Health and in consultation with the various professional
Medical Colleges and Nursing organisations, Dental Associations, Pharmacists
Associations as well as with all health workers working with asylum seekers
and refugees already. (refer to MOH Refugee Health Care documents in NZ
launched in November 2001  and various articles
referred to in the BMA UK document listed above). That the ability of
DIMIA to determine health policy (based on the discriminatory practice
of visa category entitlements, even for a highly vulnerable group such
as asylum seekers) be removed and that human rights principles of non
divisibility be taken into account when determining future health policy
for all asylum seekers, their families and their children, as set out
in many of the Human Rights instruments alluded to previously, that Australia
is a signatory nation to, and also as re-iterated in the WHO constitution
of 1948, Alma Ata Declaration of 1978, Ottawa Charter of 1986 and the
various WHO Health & Human rights statements made in 1998 by its Director-General,
Dr. Gro Harlem Brundtland.
5. That all health
policies in this country, especially as relates to all marginalised groups
(indigenous, homeless, chronically mentally ill, asylum seekers &
refugees etc.) adhere to Human Rights instruments that we are a signatory
nation to. That the non divisibility of Human Rights becomes a core principle
on which all future health policy in this country is based, especially
when it relates to the health of marginalised sub-groups.
6. Full health screening,
immunisation and especially paediatric developmental health services are
made available to all asylum seeker & refugee families, as they are
especially at risk.
7. That appropriately
trained infrastructure support in the way of community health services,
community mental health services, interpreters and others support GP's
as primary health care providers for asylum seekers, refugees, their children
8. Networks of doctors,
nurses, dentists, pharmacists and other health workers be encouraged to
form both locally and nationally to learn about asylum seeker and refugee
health. (see Appendices 4 & 5 )
are recognised in the pivotal role that they play; that they are well
trained and totally independent of any interference by DIMIA & its
policies and be made available to all doctors, nurses and health workers
dealing with asylum seekers, refugees, children and their families. That
the use of children as interpreters be actively discouraged.
10. Hospital staff
be encouraged to attend 'in service' training on the use of interpreters,
on Torture & Trauma and other health issues relating to asylum seekers,
refugees and their children.
11. That all the
professional Medical Colleges, Nursing organisations, dental Associations
and allied health organisations be encouraged to develop ethical standards
and guidelines, based on the 'Human Rights' instruments for any of their
members to refer to when dealing with asylum seekers, refugees and their
children and families.
12. That all asylum
seekers, refugees, their children & families be able to help protect
the rights of children who are involved in the process of seeking protection
and are fully able to meet their developmental needs whilst they are in
this country. That the rights as expounded in the 'Convention on the Rights
of the Child' are regarded as paramount and that any unaccompanied minors
be assigned appropriate protective guardians. That our responsibility
as a nation be explained to all our citizens as the joint carers and protective
guardians of the children of the future, no matter what status we may
assign to their visa category.
Some few of many
Case Studies collected by the Refugee Claimants Support Centre (RCSC -
In regards to children's emotional, mental and physical health (for
names and contacts please contact Ms. Gaby Heuft, co-ordinator RCSC and
Ms. Mandy McNulty migration agent and counsellor with the South Brisbane
Immigrant and Community Legal Service)
The six year old son of a family of refugee claimants was referred for
a hearing test with an audiologist by concerned school teachers, who had
become increasingly concerned over the boys problematic behaviour in class,
his learning difficulties and general inattentiveness. According to the
parents their boy had for some time been of 'poor health', had had many
falls and little accidents, and was not developing well.
The test found
that the boy had considerable hearing loss in both ears and was required
to wear hearing aids. Two hearing aids were fitted by the audiologist,
and the family was presented with the bill (around $400). The family had
been living on a bridging visa without work permission and without Medicare
card for almost two years. They had been surviving on charity, homeless
and hungry at times, without access to ASAS. This was not known to the
school before they arranged the appointment for the hearing test, and
the staff at the hearing centre had automatically assumed that the family
would have a Medicare card '" .'as every other school kid has".
After the RCSC
wrote a letter to explain the financial situation and inability of the
family to pay, the audiologist decided to not take the child's hearing
aids away from him. Instead they changed their procedures. In future children
without initial presentation of a Medicare card will not get seen.
Note: workers and
teachers wonder whether this child suffered unnecessarily. Had there been
a Medicare card available, a doctor might have picked up, treated and
possibly prevented the medical condition responsible for the hearing loss.
The little boy is encouraged by the family to do without hearing aids
when he is at home, so the expensive batteries last longer ..Both
children of this family do not have access to regular checks, immunization,
or treatment of childhood diseases. If they receive a prescription, lets
say for antibiotics to treat a middle ear infection, the parents cannot
afford the cost. Without a Healthcare card PBS medication is not accessible
to them, and full commercial price must be paid, which is anywhere from
10-20 times the PBS price and depends on the whims of the individual Pharmacist.
A six year old boy from an asylum seekers family of five, who have been
waiting for a final decision on their application for protection for over
four years now, is given a small bicycle as a gift from a community group.
He and his brother are full of joy over the generous gift, and immediately
take the bicycle to the backyard to practice.
The boy falls
and injures his shoulder and forearm in the process. He has to be taken
to the hospital, and after a stay over night is released with a collar
& cuff sling and an arm set in plaster. The bill for treatment and
hospitalization is several hundred dollars. As the family has no work
permission, no Medicare card and survives on charity the hospital's
debt-collector visits and after some imposing behaviour leaves empty handed
(but not without threatening that there will be a 'legal ending and possible
court proceedings' over their non-payment).
of the parents, and the tears and sleepless nights of the mother over
what this debt may mean for their case decision by the Minister, leaves
the little boy with feelings of guilt and great worry over their future.
He tries his best to " never get sick".
Note: Hospitals do
not directly refuse emergency treatment of refugee claimants without Medicare
card, but many general practitioners do. Hospitals do, however, pursue
the costs of their treatment. Debt collectors automatically follow normal
procedure if there is no intervention by the hospitals, and their threats
of legal action leave families deeply traumatized. Community workers advocated
in this case to get the fees waived, eventually they were waived after
much unnecessary and traumatizing heartache for the child and the family.
After living on a bridging visa for three years the father of a twelve
year old girl suffered acute anxiety attacks, paranoia and severe depression
over the trauma of being faced with deportation to his country where he
was sure he would face further persecution and even torture. Also his
experiences with the asylum seeking process here in Australia (not being
believed, threatened with deportation and what he saw as definite 'refoulement',
losing work permission & health & welfare rights) had taken a
tremendous toll on his earlier extraordinary abilities of survival. As
he was also suicidal he was admitted at the insistence of community workers
as an involuntary patient to the Mental Health Ward in a major local hospital.
were not readily available and his daughter was required to help the staff
communicate with the father upon admission and again on several other
occasions. An experience that was deeply disturbing to the child. There
was also the suggestion she help translate a letter written by the father
to the doctors, which seemed to contain his plans to die should he be
sent back. Upon release from hospital the father locked himself and his
family into their accommodation, and would not allow the child to go to
school, to play, to meet other children or talk to anyone. Instead she
had to help him ring and talk to community members, politicians, lawyers
and the media in a bid to secure safety. The girl had to find 'the right
words' to translate all his words into English, translate Department of
Immigration documents and legal jargon for the family (only she spoke
English after three years here as the parents were barred from English
classes as asylum seekers and a church school had agreed to take the daughter
in). She was forced to bear witness to the father's (and mother's) fear,
her father's desperate and disturbed threats to kill his family and himself
(although he loved his daughter dearly and longed for a safer place for
her to grow up in), 'breakdowns', outbursts of anger and self-harm in
his desperation to secure a visa to 'hope & safety' for the whole
family. Upon the release after the involuntary admission of the father
into the mental ward of a public hospital, the family received a bill
of $ 7500. The father was still extremely unwell and the family had to
further witness his severely mentally disturbed and agitated state. The
RCSC had to intervene rapidly before a debt collector could cause even
more stress and trauma to an already very traumatized family.
who knew the child well considered her strong and calm in the face of
the chaos around her. Nevertheless, she complained of nightmares, sleeplessness,
lack of appetite, deep sadness and constant worry that her father might
get killed and she would have to take care of her mother. She felt so
Note: The loss of
work permission and Medicare card rights, as well as the lack of access
to translator services deeply affected this family. Enforced uselessness,
begging on a weekly basis and being knocked back by charity organizations,
as well as the inability to access medical help when needed were in part
responsible for the breakdowns of the father ..which in turn impacted
on the child.
A mother and her three children have been seeking asylum in Australia
alone, as their father never 'made it to the airport' to escape with them.
They live in the community, waiting for many months to hear from him so
he can join them in safety (with dwindling hope that this will ever happen).
and teenage son have gone through great trauma as well as torture at the
hands of religious persecutors. As asylum seekers they have no access
to trauma counseling, and no interpreter service to help them communicate
their pain and needs. The two young siblings are very much affected, but
there is not much help for the family. While there is shelter and food
through compassionate community carers ..there is not much
else that will stop the tears and wailing of the mother, someone who will
tell them that life will get better, that they are safe. It is unsure
whether they will get a protection visa. The children don't leave their
mother's side if they can help it, they are very protective. The older
son feels he is responsible for the family's survival now, but work is
difficult to come by for a young man who has just finished school in his
country, has limited English and no skills. In his country he would have
to be the bread winner, without the father around. In Australia he is
unable to fulfill his 'duties as a son'.
and ten year old children had been prevented from going to school for
almost a year by government policy before the RCSC was able to receive
a ministerial exemption for them. Their future is insecure.
Children of refugee
claimants have no formal 'right to access primary school education'. The
government is charging up to $ 4000 per term in 'Foreign Student' school
fees for any bridging visa holder, irrespective of means to pay. A sum
too forbidding to be affordable, for anymore than the wealthiest of tourists.
Many children are kept at home indefinitely, or for extended periods of
time. It is mostly small Catholic colleges who end up admitting children
and ask their parent body to absorb the cost. The Minister for Education
could be approached to grant an individual exemption on economic grounds,
this is often ad hoc and sometimes is expected each term a
possibility full of barriers for asylum seekers on many levels.
A young divorced mother fled here with her two year old son. They were
living for several months in a storage shed in the back of an industrial
property when they first came to our attention. No running water, no toilet
and no kitchen facilities. As money ran out there was no food for some
time either. Finding work has proven almost impossible without English
language and without access to childcare. The two stay mostly in their
accommodation as there is not enough money for transport, and no possibility
to attend even volunteer run English classes at RCSC with her young child.
boy has had several minor accidents. On the last occasion he fell and
knocked his mouth at the edge of his bed, pushing his front teeth partly
back into his gums, and chipping other teeth. A helpful community member
tried to find a dentist to help the child as there was bleeding and pain,
but was pressured into agreeing to pay the bill first before a dentist
was prepared to treat the child. The cost of antibiotics and painkillers
diminished the mother's already 'donated funds' for food and transport
even further and finally costs were born from donations from the community
of concerned volunteers. The mother herself has gynecological problems
but without money, lack of access to interpreters and for several months
without Medicare she was unable to seek attention early. She feels faint
and unwell a lot, depressed and very anxious over her recent negative
case decision by DIMIA (most cases are rejected at the primary stage now
and clog up the RRT mechanism). She is physically and emotionally not
able to cope very well with her active little son. As ASAS money has now
been cut, she is totally dependent on charity and forced to visit several
charities per week to ask for food and help with money.
ASAS (Asylum seekers
Assistance Scheme) is funded by the Department of Immigration and administered
by the Red Cross. It is available to assist families with children who
are also holders of work permission while they wait for the first decision
by DIMIA, and only if they have waited longer than 6 months for the decision
to be made. As soon as a negative decision has been handed down the money
stops. In our experience, over ninety percent of initial DIMIA decisions
are decided against the application by the refugee claimant. Families
and single parents who loose this support are often struggling with maintaining
a roof over their heads, and food in their children's stomach. We know
of families living on rice or donated stale bread for weeks; we know of
families 'camping' in other people's homes and moving on when this becomes
inconvenient; we are aware of children not receiving enough food or sleep,
medical assistance, education and care because parents are just not managing.
USE OF DENTAL
& WRIST X-RAYS BY DIMIA:
There is anecdotal
evidence in Australia of this practice being used to deny the validity
of claims made by asylum seekers, especially unaccompanied minors and
in an effort to have other claims heard under separate & individual
adult guidelines rather than as a family grouping. If the Human Rights
& Equal Opportunity Commission can help to collate data on this practice,
we can add it to data collected from the USA, Canada & UK where this
practice has been called into question. The data is totally unreliable
for this purpose, unethical for use in for non- therapeutic purposes for
any practitioner , and a grave misuse of unscientific and completely invalidated
evidence being presented to obtain a negative refugee outcome. The data
is not standardised for difference in ethnicity, nutritional status and
many other factors and is only useful for therapeutic purposes when trying
to stage definitive surgical interventions on boney growth areas.
We present below
documents supplied to us from Physicians for Human Rights USA who originally
alerted us to the use by the USA of these tests for negative refugee outcomes.
They had attended meetings at which Australian DIMIA representatives had
been present in the USA.
New York Dentists
Can Settle Fate of Migrants
By Alan Elsner, National
NEW YORK (Reuters)
- Robert Trager may be the most powerful dentist in America -- and the
Working for the Immigration
and Naturalization Service, Dr. Trager has subjected over 1,000 young
people to dental and wrist X-rays to determine their age -- tests that
critics say are highly inaccurate and scientifically unfounded.
Based on his determination
of whether they are 18 or older, his youthful subjects, many of whom say
they are fleeing persecution and torture, may be summarily deported, placed
in juvenile detention or sent to adult jail, where they may languish for
months or years.
Trager, who has clinics
at New York's John F. Kennedy and La Guardia airports where he treats
airport employees, says he is a link in the chain protecting the United
States against terrorism, especially after the Sept. 11, 2001, attacks.
"I've seen alleged
terrorists, people who come in with forged passports from places like
Pakistan and Afghanistan. I've also seen drug dealers," he said in
But human rights
activists regard Trager's work with horror, even leaving aside uncomfortable
parallels to judging the age of horses by checking their teeth. They also
note that nearly all those examined by Trager are declared to be adults.
that someone without an appropriate scientific basis, is playing God with
children's lives. It's probably unconstitutional and it's definitely wrong,"
said Rhonda Brownstein of the Southern Poverty Law Center.
Trager X-rays his
subjects' teeth to measure the eruption of the third molars or wisdom
teeth, which usually break through toward the end of adolescence. He also
X-rays their wrists to measure the fusion of their radius and ulna bones.
He says these two tests allow him to determine with 98 percent accuracy
whether a person has passed their 18th birthday or not. The 98 percent
figure is his own.
"The ones who
complain, not one has been able to overturn my exam," said Trager,
who is now evaluating X-rays for the Canadian government and was recently
approached for information by the Australian Embassy.
His verdicts can
be critical. Under U.S. law, adults who arrive without proper documentation
are subject to immediate deportation unless an immigration officer determines
their story is credible enough to warrant an asylum hearing.
must be admitted to the country and can be released into the custody of
relatives. If they are found to be victims of persecution, abuse or neglect,
they can stay.
If they have no family,
they are sent to juvenile detention centers. However, if Trager decides
they are adult, even though they claim to be children, they are sent to
Many medical experts
say Trager's methods are fatally flawed and the age of 18 has no biological
"I find it breathtaking
that someone could be so wrong about the biologic concept, draw conclusions
from this serious misinterpretation that have a profound impact on the
life and welfare of another human being and do it with the official or
quasi-official sanction of the government," said Nalton Ferraro,
a dental surgeon at Children's Hospital in Boston who is also on the faculty
of Harvard University.
can have a very mature dentition with fully formed wisdom teeth. Conversely,
an 18-year-old can have wisdom teeth that on radiograph are less mature
in development and more typical of the wisdom tooth you might see in a
15 or 16 year old," he said in an e-mail message to Reuters.
VARIATION IS THE
deviation around the 'norm' is also extremely common with the bone age.
For example, a 16-year-old boy may have a fully developed skeleton; the
bone age would then be reported as 19 years," Ferraro said.
New York University
radiology professor Herb Frommer said there are wide variations in the
eruption of molars. Neill Serman, head of oral radiation at Columbia University,
said wisdom teeth could well erupt by age 16, especially in girls.
it is common knowledge that when teeth are extracted in young children,
the teeth behind the extracted teeth erupt much earlier in life,"
Peter Capatano, a
clinical associate professor of pediatrics at New York University Medical
School, said using two unreliable tests did not reassure him.
"Using two inaccurate
measures does not produce accuracy," he said. "You have to follow
the subject over time."
The State Department
stopped using bone testing to establish age in 1998 because of wide ethnic
and individual variations in development that could be exacerbated by
poor diet and disease.
The U.S. Immigration
and Naturalization Service holds around 5,000 unaccompanied minors in
custody at any given time, because they arrived in the country without
ONE OF SEVERAL TOOLS
INS spokeswoman Karen
Kraushaar said the dental examination was one of several tools employed
to determine a juvenile's age. Others include family records, school records
and the testimony of people who know the asylum seeker. But when none
of these is available, the dental and wrist examinations are treated as
"If we cannot
establish a person's identity, which includes their age, we cannot be
sure who they really are. It is our job to do that and we take it pretty
seriously," Kraushaar said.
But lawyers representing
minors know of several cases in which dental and bone examinations have
trumped legal identity documents. Anwen Hughes of Lawyers for Human Rights
said she knew of two juveniles who were sent to adult jails and released
several months later after the INS determined their birth certificates
Brownstein is currently
representing Huai Chun Zheng, a Chinese boy incarcerated in an adult jail
in Georgia on the basis of a dental examination, even though she has produced
an authenticated and notarized English translation of his household register,
the Chinese equivalent of a birth certificate, which establishes his age
Trager is unperturbed.
"Have I made a mistake in the thousand or so I've done? It's possible,
but I feel pretty comfortable about the way things are done," he
Reuters 2001. All rights reserved.
Harsh Fate Can Await
Young Refugees in U.S.
By Alan Elsner
ELIZABETH, N.J. (Reuters)
- Mohamed Boukrage, a 16-year-old orphan from Algeria, arrived in the
United States on Oct. 23, 2000, to seek asylum. Since then, he has been
in prison, barely able to see the sun or the sky. Immigration authorities,
who did not believe he was 16, subjected him to a dental examination and
X-rayed his wrist to determine his age.
On the basis of these
tests, which many doctors say cannot be used to precisely pinpoint the
age of an adolescent, they declared Boukrage was 18 or older, and brought
him to an adult prison just south of New York where he has been since.
``They said they
were taking me to a hotel and then they brought me right here,' Boukrage
said through an interpreter. 'They handcuffed me and treated me like
a criminal. I feel I'm being punished for no reason.'
But worse may lie
ahead for Boukrage. Since he has no papers, he cannot be deported back
to Algeria and no other country will have him. Unless his claim for asylum
is accepted in the United States, and so far it has been denied, he could
stay in prison indefinitely, conceivably for life.
The U.S. Immigration
and Naturalization Service holds around 5,000 unaccompanied minors in
custody at any given time. These are children who have arrived in the
United States without proper documents. Some have experienced torture
or the traumas of war. Most are sent to juvenile detention centers while
their claims for asylum are considered.
``The average custody
is 40 days but refugee children are often held for months or years. Less
than half have lawyers and they can sit in jail for months with no support,'
said Wendy Young of the Women's Commission for Refugee Women and Children.
this is a country of civil rights and human rights. They have no idea
how we treat these foreign children,' she said.
NO SCHOOL CLASSES
in juvenile facilities can be harsh and abuses have been alleged at several,
inmates do have access to educational services including English classes.
For youths like Boukrage held in adult prisons, there are no such services.
He gets one hour a day of exercise in a covered area where he can just
glimpse the outside through a high window, and one hour in a library where
there are no books in his language. The rest of the time, he is in a large
dormitory with 38 men and no privacy, not even the opportunity to close
a door or curtain when using the toilet or shower.
``I don't have much
hope. There are people who have been here for four years,' Boukrage said.
``I came here dreaming of getting an education, of perhaps becoming an
architect. Now, I take it one day at a time and just pray to get out.'
When he was 10, Boukrage's
parents and sister were killed by a bomb in Algeria. He spent a year living
with an aunt but she threw him out so he stowed away on a boat and made
his way to France and from there to Italy. He spent four years doing odd
jobs and living in abandoned buildings before hiding away on a ship he
thought was bound for Canada but which docked in the United States.
To be granted asylum
in the United States, a person has to demonstrate they would be in danger
if they were sent back to their homeland. When Boukrage's case came up
last April, an immigration judge ruled his story was credible but lacked
sufficient detail. His lawyer, Erin Corcoran, wonders how much detail
a youth can be expected to remember of events that happened when he was
``This boy has been
terribly traumatized by his incarceration,' said Dr. Allen Keller, who
runs the Bellevue, New York, University program for torture survivors
and has examined Boukrage. ``He came to this country seeking safety and
instead he's being treated like a criminal. The experience has left him
with feelings of fear, sadness, uncertainty, loneliness and isolation.
It's tragic,' said Keller, a primary care doctor and member of Physicians
for Human Rights.
Three times in the
past year, Boukrage has been put in solitary confinement for 30-day stretches
he found terrifying. The first time he had nightmares and wet his bed.
The second time he refused food for religious reasons.
DENTIST HAS KEY ROLE
Perhaps the most
controversial aspect of Boukrage's fate is the role of dental and bone
examination in determining his age. The INS employs a dentist with an
office at New York airports to examine hundreds of youthful asylum seekers
each year. INS spokeswoman Karen Kraushaar said the dental examination
was one of several tools employed to determine a juvenile's age. Others
included family records, school records and the testimony of people who
know the asylum seeker. But when none of these is available, as in Boukrage's
case, the dental and wrist examinations are treated as conclusive.
``We use these methods
to assist us in determining age. If we cannot establish a person's identity,
which includes their age, we cannot be sure who they really are. It is
our job to do that and we take it pretty seriously,' Kraushaar said.
The dental test looks at the eruption of molars and development of wisdom
teeth. The X-ray measures the fusion of bones in the wrist. But numerous
medical authorities say these tests are inexact. The State Department
and Department of Health and Human Services have stopped using them.
According to Professor
Herbert Frommer, chairman of Radiology at New York University's David
B. Kriser Dental Center, the eruption of wisdom teeth can happen at any
time between the ages of 17 to 21 and can be further delayed by many factors,
including past illness. ``It is my opinion that it is impossible to make
an exact judgement based on radiographs of whether an individual is above
or below the age of 18,' he said.
Dr. Nalton Ferraro
of Children's Hospital in Boston, who often uses tests of skeletal maturity
to decide the timing of operations, has written that chronological age,
dental age and skeletal age are not necessarily the same in a given individual.
In fact, deviation is common -- a fact he says is well known to both pediatricians
is trying to have his file transferred to a family court, in which case
he could be released. The agency has refused.
AMNESTY QLD SCHOOLS
Described below are
major activities that have had a tremendously positive effect on the self
esteem and have helped decrease feelings of powerlessness and hopelessness
of some of the children in Brisbane who have been in Immigration Detention,
asylum seeker children and other refugee children.
Report from Barbara
Ashby - AI Qld Schools Network
Queensland Schools Network facilitates about 2000 students across Qld
in over 140 school groups to learn about human rights.
As the International
campaign for AI this year is focussed on refugees and refugees have been
so much part of Australian media for the last year it is not surprising
that Australian students have been keenly interested in refugee issues.
AI Qld was keen to
help AI students meet refugee students to listen to their stories and
to mix with them in a friendly way. The student conferences, both large
and small have proved to be ideal ways of doing this. These are
Courage To Care
Conference Nov 2001
This was held on
a Sunday in Brisbane and attracted many students from within Brisbane
and as far as Toowoomba. There were speakers from YRAN (The QPASTT Young
Refugees Advocacy Network) who spoke to the students and took part in
workshops with them. This resulted in friendships between the refugee
students and AI students and further social contacts. The awareness of
the human rights issues for refugees is in AI literature, but the opportunity
to meet students like themselves is very important for both parties. As
well as this speakers and workshops explored human rights and Indigenous
issues and Multifaith issues, looking at Islam and Christianity.
Rights Conference April 2002
This was a weekend
conference at which students again met some YRAN students - including
one unaccompanied minor from Afghanistan. They listened to a speaker from
the Immigration Legal Service in Brisbane and ultimately showed their
support for children of asylum seekers in a press release from the final
workshop (see next page). Students came from as far afield as Cairns and
Mini Human Rights
stimulate smaller interschool meetings held by Amnesty School Groups.
One such was Mt St Michael's invitation to Milpera Refugee and Migrant
High School to come for lunch. Another was the invitation from St Ursula's
in Toowoomba to the Tiger 11 Afghan Soccer Team and Marist Ashgrove is
The potential of
these small conferences is in greater human rights awareness on refugee
issues and relationship building between refugee students and others.
Courage To Care
September 5th 2002
Is the next student
human rights conference planned. AI Qld knows that students welcome the
chance to find out for themselves about current human rights issues and
can do so in a friendly atmosphere.
for immediate release 22nd April 2002
"Out of Sight,
but not out of mind!"
declare they ashamed that children in Australia are locked up having committed
Last weekend school
students from as far apart as Cairns and Alstonville in Northern NSW attended
the annual Amnesty International Human Rights Conference. The youthful
delegates listened to speakers and discussed topics in human rights as
diverse as sexuality, Indigenous youth and women and refugees.
The students involved
in the conference were deeply distressed by the plight of Asylum Seeker
children in Australia. When hearing from refugees and asylum seekers and
people who work with refugees and asylum seekers in the community the
students learned that in Australia innocent men, women and children are
detained indefinitely without a system of review. They are denied the
same access to education, health care and socialisation expected by other
young people in this country.
The student delegates
took the initiative to draft a declaration on this issue which states
that "We are ashamed that our government does not protect all
children in Australia. Asylum seekers children and families should not
be locked up when they have committed no crime."
As one student from
Cairns asks this poignant question of the Federal Government: "Frightened,
alone, confused, trapped inside a metal cage whilst waiting for answers,
desperate for freedom. Is this the kind of life you
would want for
The students were
also given the opportunity to write down their thoughts to form part of
a submission to the Human Rights and Equal Opportunities Commission Inquiry
into Children in Immigration Detention which particularly called for opinions
from children and young people.
Some of the written
submissions and comments made were:
- No-one should
be punished for fleeing persecution. We want people to open their minds
and face the reality of what we are doing, to feel compassion and take
- There are viable
alternatives, parents and children could wait in the community for refugee
decisions and health and security checks. "
- Australia is
such a lucky country, why not share it?"
There are over 140
secondary schools in the Qld AI Network with students involved in learning
about International Human Rights, lobbying internationally on specific
cases, fund raising and meeting each other at large and small conferences.
For further information
contact Amnesty International Qld Schools Network - Co-ordinators Barbara
Ashby 07 33682885 and David George 07 33535029 or email email@example.com
. Interviews with student delegates can be arranged.
Health Network (BRHN)
This is a voluntary
and totally independent advocacy group of doctors, nurses, dentists, pharmacists,
allied health workers and community development workers that meet monthly
in Brisbane to work out strategies to improve the health of asylum seekers,
refugees, their children and families. The policy document for this group
is reprinted on the next page followed by the letter of appeal sent out
by the group to recruit more volunteers. Appendix 5 describes a few of
the current advocacy, educational and pro bono service activities of the
BRHN members. This group has well over 70 members and is growing rapidly.
Meetings are held monthly at the Refugee Claimants Support Centre (RCSC)
at 12 Bonython Street Windsor, Brisbane.
Dr. Rohan Vora 33682885,
or email: firstname.lastname@example.org
Ms. Margot Salom via RCSC (Monday mornings): 33579013
Ms. Gaby Heuft RCSC Co-ordinator: (Monday & Tuesday) 33579013
We are an independent,
voluntary, member driven and action based organisation focusing on the
broad health care needs (physical, mental, spiritual & social) of
those individuals and their families who have entered Australia as asylum
seekers or refugees and who reside in this region of Australia.
We are a loosely
affiliated network of health professionals and community development workers
who are committed to the principles of non divisible human rights and
social justice for all.
We are committed
to working in close partnership with asylum seekers, refugees and their
families, asylum seeker and refugee advocacy groups and all other organisations
and persons who share a similar vision of justice and equity.
We envision an Australian
society, especially the region in which we live, where all asylum seekers,
refugees, former refugees and their families can enjoy all of the human
rights enshrined in the 'Universal Declaration of Human Rights', other
international covenants that make up the 'International Bill of Rights',
and the subsequent human rights articles Australia is a signatory to.
We envision an Australian
society, especially the region in which we live, where all asylum seekers,
refugees, former refugees and their families can enjoy the benefits of
health policies that enshrine their human rights in line with the various
WHO policy documents on health and human rights: the WHO Constitution,
1948, the Alma Ata Declaration, 1978; the Ottawa charter 1986; the Jakarta
declaration 1997; the WHO statement on Health & Human Rights 1998.
- To research and
document the broad health needs (as outlined in the WHO documents listed
above) of asylum seekers, refugees and their families residing in SE
Qld., especially focusing on unmet health needs.
- To advocate on
behalf of all asylum seekers, refugees and their families for equitable
and optimal health access.
- To educate all
people in our region about the unmet health &human rights needs
of asylum seekers & refugees, and empower them to act to help protect
- To work in partnership
with asylum seekers, refugees, their families and other groups locally,
nationally and internationally working with them to help develop health
policies that meet the human rights and health needs of asylum seekers,
refugees and their families in this region.
- To lobby all
medical, nursing and allied health professional representative bodies
and their training institutions to develop "ethical standards"
to provide services that meet the human rights and health needs of asylum
seekers, refugees and their families.
- We view research
and intersectoral collaboration as opportunities for social transformation,
not only of the researchers and their institutions, but the whole community,
through which research can become an instrument of social change and
- We act in an impartial
and independent manner according to consensus and discussion within
- We believe in
the indivisibility and universality of all human rights and share the
view expressed in the WHO Constitution that:
- The enjoyment
of the highest attainable standard of health is one of the fundamental
rights of every human being without distinction of race, religion, political
belief, economic or social condition.
- We maintain our
independence and ability to make impartial decisions about what advocacy
work and service provision we undertake, based solely on the identified
health and human rights needs of all asylum seekers, refugees and their
- Funds or material
goods collected in our work will be used for meeting any emergency medical
needs of asylum seekers & refugees and their families in this region
of Australia or distributed to our major affiliated organisations the
'Refugee Claimants Support Centre' & 'The Romero Centre',
or as otherwise decided by the BRHN committee, for this purpose.
Some activities to
1. Setting up
an advocacy forum locally that meets regularly in Brisbane to discuss
health related issues affecting all asylum seekers, refugees, their
children and their families. Members of BRHN advocate on behalf of all
these groups for improved health service access and equity. Members
of BRHN meet regularly with asylum seekers and refugees to determine
their health needs, and try to develop programmes in partnership with
these groups and help empower them and allow them to make some of their
own decisions again about their lives. BRHN works in close partnership
with the Refugee Claimants Support Centre (a charity based asylum seeker
support service) and the Romero Centre (another volunteer led service
for TPV holders) in Brisbane. This allows members to have a good knowledge
of the barriers to health care for asylum seekers, refugees their children
and families here in Brisbane, and hence work out effective strategies
to bring about change where needed.
nursing outreach service: Volunteer nurses have banded together
with a retired medical socialworker to form an active group and provide
an outreach community nursing service to asylum seekers their families
and children. Nurses and other supervised volunteers are assigned particular
families to work with. Around a family's place of residence support
networks are set up that try to include doctors, dentists, pharmacists,
parish support groups, local butchers, greengrocers, bakers, schools
for any children etc. Health needs are slowly being documented and data
is being collected under this programme, eventhough it is totally volunteer
run, due to current government policy.
3. BRHN Networking
to set up "Refugee Clinic": Collaboration of BRHN with
many other organisations such as RCSC, Romero Centre, QPASTT, Divisions
of General Practice in Brisbane, Qld. State Health, asylum seekers and
refugees has resulted in the setting up of a clinic for Refugees and
their children and families in Brisbane. It is planned that this will
be an outreach service to work with other GP's in the community, community
health services as well as networking with specialised services to get
the best health outcome for any refugees, asylum seekers, their children
and families in Brisbane who are currently not able to access services
for many reasons. Doctors, nurses, counsellors, dentists and allied
health workers have agreed to work on a pro bono basis where necessary
to establish this service. State health Qld has provided a small amount
of seeding funding for a part-time co-ordinator, the rest is happening
on the basis of tremendous concern and enthusiasm in the health sector
4. Major hospital
collaboration to decrease health barriers: BRHN members have been
working with senior staff at one of our major Brisbane Teaching hospitals
to get better access and equity outcomes for asylum seekers, refugees,
their children and families. The other two teaching hospitals have now
also expressed an interest in a similar programme. Inservice training
has been organised for all staff: doctors and nurses in the A&E
Department over a series of weeks. This, once again, was done on a voluntary
basis by BRHN members. It was very successful from the feedback we are
getting from consumer groups and those working with the asylum seekers,
refugees, their children and families.
Activities: BRHN is working on many levels with many other groups
to get the message out about the barriers to health care for asylum
seekers, refugees and their children and families.
The following groups are being contacted on a regular basis: Amnesty
International Australia (BRHN members are part of the national refugee
team structure), RACP new Asylum Seeker interest group has formed
and BRHN has joined and is working closely with this group. Other
Refugee Health Networks are forming on a more formal basis in Melbourne
and Sydney and from scratch in Darwin, we work closely with all these
groups and try to give any new ones support and link them in with
the other groups nationally. BRHN has been successfully lobbying the
AMA over the past 18 months as well as the RACGP and both have produced
media releases and position statements on the ethical and human rights
implications of current asylum seeker and refugee policy and its impact
on health of asylum seekers, refigees, their children and families.
- Local networking
activities: BRHN networks with the local Divisions of General Practice,
RACGP Qld., AMAQ, Amnesty Qld Refugee networks, QPASTT, RCSC, Romero
Centre, all three major teaching hospitals, medical and health science
student groups, Dental Association members, pharmacists and allied
health worker groups
Networking: BRHN has started to network with Amnesty Medical under
the International Secretariat of Amnesty and Physicians for Human
Rights USA on a regular basis. Currently work is in progress on the
issue of the use of dental and wrist x-rays internationally by many
countries to try to exclude people from the various phases of the
refugee determination process, we are exchanging information about
conditions in each of our countries for asylum seekers, refugees,
their children and families on a regular basis.
These are just some
of the activities of BRHN and its very enthusiastic members in the last
Convention on the Rights of the Child, UDHR Article 25, ICESCR Article
B, Veale A, O'Connor D, Beyond the Pale: Asylum-Seeking Children and Social
Exclusion in Ireland, Dublin, July 2001 www.irishrefugeecouncil.ie
D, Steel Z, Watters C, Policies of Deterrence and the Mental Health of
Asylum Seekers. JAMA. 2000;284:604-615
G, report for Qld. Government from Dept. Multicultural Affairs Qld., titled:
"Australia's response to on-shore refugee claimants, and its impact
on Qld. with particular reference to those claimants allowed to live in
the community pending determination of their claim." November, 2001.
G, Report as above.
Rey J, Editorial, The mental health of young Australians, MJA 2001; 174:380-381
D, Sinnerbrink I, et al, Anxiety, depression and PTSD in asylum seekers:
associations with pre-migration trauma and post-migration stressors. Br
J Psychiatry. 1997;170:351-357.
The Medical Profession And Human Rights, Handbook For A Changing Agenda,
Published Zed Books Ltd., 2001.
Health Care: A Handbook for Health Professionals, launched by Minister
of Health on 15th November 2001: http://www.moh.govt.nz/moh.nsf/49ba80c00757b8804c256673001d47d0/2891ec942c310db2cc256b6e00116de7?OpenDocument
Updated 9 January 2003.