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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 usage 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 counselling, 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 centres. 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 centres 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.