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Commission Website: National Inquiry into Children in Immigration Detention

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Submission to National Inquiry

into Children in Immigration Detention from

the Brisbane

Refugee Health Network and Refugee Claimants Support Centre


Introduction

Background

Health

Schooling

Shelter

Food/nutrition

Transport

Interpreters

Language

Social

Support

Maternity

Recommendations

Appendix

1

Appendix

2

Appendix

3

Appendix

4

Appendix

5


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

of deterrence.

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.

Severely depressed

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

5,9,18 CRC).

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).


ACKNOWLEDGEMENTS

REFUGEE CLAIMANTS

SUPPORT CENTRE BRISBANE:

GABY HEUFT - CO-ORDINATOR

MANDY McNULTY - CHAIR OF CTEE.

BRISBANE REFUGEE

HEALTH NETWORK:

NURSES OUTREACH

PROJECT:

MARGOT SALOM

KAREN EAGLESON

KAREN BRANDT

CATHERINE STOLL

REBECCA SOMERSMITH

DOCTORS GROUP:

ROHAN VORA


COMMUNITY BASED

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.

INTRODUCTION:

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:

… "all

children should be entitled to basic rights without discrimination"

(UDHR, ICESCR, CROC) [1]

Research studies

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".[2] 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.

BACKGROUND

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

condoned violence.

"In several

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" [3]

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,

    etc.

  • 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.

[4] 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. [5]

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:

"The burden

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."

USA Surgeon

General 2000

(Report of the Surgeon General's Conference on Children's Mental

Health 2000)

"Mental disorders

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."

Joseph Rey,

editorial MJA 2001 [6]

(Professor, Department of Psychological Medicine, University of Sydney,

Director, Child and Adolescent Mental Health Services Northern Sydney

Health, NSW).

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

to.

1. HEALTH

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.

"children

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. [7]

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.).

2. SCHOOLING

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

these children.

3. SHELTER

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.

4. FOOD/NUTRITION

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.

5. TRANSPORT

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.

6. INTERPRETERS

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

7. LANGUAGE CLASSES

There are no entitlements,

classes are totally charity dependent, and transport costs create problems

even if classes are organised by volunteers.

8. SOCIAL SUPPORT

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.

9. MATERNITY,

ANTENATAL & POSTNATAL SERVICES

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.

ARTICLE 12

(Convention on the Elimination of all forms of Discrimination Against

Women - CEDAW):

… "States

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

lactation."

"In general

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

status."

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

Minister:

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.

These legislative

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'.

"Discrimination

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. [8]

"Doctors

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

healthcare level."

"The BMA

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

2001 [9]

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.

"Health care

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."

Statement

of Nurses Role in Safeguarding Human Rights, International Council of

Nurses, 1983

RECOMMENDATIONS:

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

recommending: http://www.bma.org.uk/ap.nsf/Content/Access+to+health+care+for+asylum+seekers+2001#Introduction

)

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 [10] 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

& families.

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 )

9. Interpreters,

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.

APPENDIX

1:

Some few of many

Case Studies collected by the Refugee Claimants Support Centre (RCSC -

Brisbane)

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)

1.

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.

2.

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).

The anxiety

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.

3.

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.

Translators

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.

Community workers

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

hopeless.

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.

4.

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).

Both mother

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'.

The fourteen

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.

5.

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.

The little

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.

APPENDIX

2:

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

Correspondent

NEW YORK (Reuters)

- Robert Trager may be the most powerful dentist in America -- and the

most controversial.

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

an interview.

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.

'PLAYING GOD'

"It's scary

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.

Minors, however,

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

adult jail.

Many medical experts

say Trager's methods are fatally flawed and the age of 18 has no biological

significance.

"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.

"A 15-year-old

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

NORM

"Variation and

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.

"Additionally,

it is common knowledge that when teeth are extracted in young children,

the teeth behind the extracted teeth erupt much earlier in life,"

he said.

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

proper documents.

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

conclusive.

"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

were accurate.

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

as 17.

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

said.

© Copyright

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.

``Americans believe

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

Although conditions

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

10.

``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

and dentists.

Boukrage's lawyer

is trying to have his file transferred to a family court, in which case

he could be released. The agency has refused.

APPENDIX

3

AMNESTY QLD SCHOOLS

NETWORK

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

Amnesty International

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.

Students Human

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

Alstonville NSW.

Mini Human Rights

Conferences

These activities

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

following suit.

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.

Press release

for immediate release 22nd April 2002

"Out of Sight,

but not out of mind!"

Queensland children

declare they ashamed that children in Australia are locked up having committed

no crime

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

your child?"

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

    action."

  • 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 qldaia@amnesty.org.au

. Interviews with student delegates can be arranged.

APPENDIX

4:

Brisbane Refugee

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.

Contact Persons:

Dr. Rohan Vora 33682885,

or email: rohanvora@bigpond.com

Ms. Margot Salom via RCSC (Monday mornings): 33579013

Ms. Gaby Heuft RCSC Co-ordinator: (Monday & Tuesday) 33579013

BRISBANE REFUGEE

HEALTH NETWORK

POLICY CHARTER:

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.

VISION:

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.

GOALS:

  • 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

    these rights.

  • 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.

VALUES:

  • 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

    understanding.

  • We act in an impartial

    and independent manner according to consensus and discussion within

    our membership.

  • 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

    families.

FINANCIAL MATTERS:

  • 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.

APPENDIX

5:

Brisbane Refugee

Health Network

Some activities to

date:

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.

2. Community

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

community.

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.

5. Networking

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.

  • Nationally:

    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

    (http://www.racp.edu.au/hpu/policy/asylumseekers/alliance.htm)

    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

  • International

    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

18 months.


1. UN

Convention on the Rights of the Child, UDHR Article 25, ICESCR Article

12

2. Fanning

B, Veale A, O'Connor D, Beyond the Pale: Asylum-Seeking Children and Social

Exclusion in Ireland, Dublin, July 2001 www.irishrefugeecouncil.ie

3. Silove

D, Steel Z, Watters C, Policies of Deterrence and the Mental Health of

Asylum Seekers. JAMA. 2000;284:604-615

4. Cifali

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.

5. Cefali

G, Report as above.

6.

Rey J, Editorial, The mental health of young Australians, MJA 2001; 174:380-381

7. Silove

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.

8. www.phrusa.org/students

9. BMA,

The Medical Profession And Human Rights, Handbook For A Changing Agenda,

Published Zed Books Ltd., 2001.

10. Refugee

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

Last

Updated 9 January 2003.