Looking after asylum seekers – who is crossing the line?

In the ‘Blogging on Demand’ series you get to choose the topic. If you have a great idea you want the world to know about, send an email, contact me via social media or leave a comment below. Dr Kellie West suggested the topic of this post. She tweeted: “Love to see you tackle the social justice responsibility of doctors [and], health care worker’s responsibility to refugees and asylum seekers.”

I arrived in Australia by plane. My introduction in Australian medicine took place in an empty emergency department and lasted for one hour. The compulsory 4WD course took about eight hours. Afterwards I was flown to a remote hospital, and the next day I found myself on the ward treating patients.

Some people refer to me as an IMG (international medical graduate), others call me an OTD (overseas trained doctor), but according to the government I’m a skilled migrant.

Skilled migrants

I’m grateful to have been given the opportunity to live and work in Australia. I feel welcome here and I see Australia as an example of a tolerant, multicultural immigration country. In the past ten years I have treated thousands of people, mostly in rural areas where many Australian doctors don’t go.

Australia shares in the benefits of global trade, including skilled migration. Annually about 130,000 skilled migrants enter the country. Australia has not paid for my expensive education, which is fair enough. The skilled migrant program is designed to address specific skill shortages and enhance the skill level of the Australian labour force.

Asylum seekers, on the other hand, are a different kettle of fish.

Who’s afraid of boat people?

In nearly forty years, about 70,000 asylum seekers have arrived by boat; an average of 1,750 per year. Compare this to the 130,000 skilled migrants arriving every year, and I can’t help but wonder how a political party can win an election over such a relative minor issue.

It appears strangers in boats change something in the usually tolerant ozzies. Journalist Christos Tsiolkas writes:

We’ll lock up asylum seekers in offshore detention centres, we’ll stand idly by as they slowly go crazy or harm themselves, we’ll refuse journalists the right to speak to them or to name them, we’ll redefine our borders to not let them in, we’ll farm them off to our impoverished, under-developed neighbours rather than construct a humane and efficient system to process their claims for asylum.

Tsiolkas feels that Australians are not convinced about the benefits of globalisation.

Yet, healthcare in rural areas is predominantly delivered by overseas trained doctors like me. Yet, a quarter of the Australian population has been born overseas. Yet, the Australian economy depends on international trade, and millions of Australians travel to Asia, Africa, and other destinations for leisure and business purposes.

Many people have preconceived ideas about asylum seekers. The risk is that prejudice leads to acceptance of a questionable approach to asylum seekers.

Asylum seekers
Image: The annual number of new skilled migrants in Australia is about 130,000. In nearly 40 years, about 70,000 asylum seekers have arrived by boat; an average of 1,750 per year. Note: 40 percent of asylum seekers arrive by boat. Sources: Refugee Council of Australia and Department of Immigration and Border Protection.

Common myths 

Are they economic migrants instead of refugees? Depending on the source you read, between 70-92 percent of arrivals is ‘genuine’, meaning they are not coming for economic reasons but because they are being persecuted.

Are boat people queue jumping? The queue refers to resettlement: The assisted movement of refugees who are unable to return home to safe third countries. Unfortunately these queues do not exist (it’s more like a lottery) and resettlement is only available for the ‘lucky’ one percent of the world’s refugees.

Somehow we have forgotten that seeking asylum is a correct and legal procedure; asylum seekers are not ‘illegal’ and cannot not be penalised for arriving without travel documents.

Australia’s responsibilities

Australia is one of 147 signatory countries to the UN Refugees Convention, which means we are obliged to protect refugees. But is Australia taking its responsibilities? Paul Power, CEO of the refugee council of Australia says:

“The view from Indonesia is of a very wealthy, largely unpopulated country pushing unwanted people back to a much poorer, overpopulated neighbour.

The question is: How sustainable is Australia’s solution? The boats have stopped, but global humanitarian crises haven’t. Power: “I can’t see the international pressures which result in refugee movements and desperation migration decreasing in years to come.”

Australia has been heavily criticised by the UN and other countries for its treatment of asylum seekers and refugees. Power recommends a major review of Australia’s treatment of asylum seekers. We must make sure, he says, that they have the following:

  1. Access to refugee status determination, with access to information, interpretation, funded legal advice and review
  2. Freedom from detention, using existing detention alternatives in all but the most exceptional of circumstances and develop detention alternatives in Nauru and PNG
  3. Giving all asylum seekers the right to work – even if work is hard to find, not robbing them of the hope associated with looking for work
  4. Ensuring all asylum seekers have access to basic services, including adequate shelter, physical and mental health care and education
  5. Access to durable solutions – providing prompt decisions and outcomes and living conditions which are sustainable for recognised refugees
  6. The option to explore alternative entry options for people at risk.

First-rate healthcare

The deaths of asylum-seekers Reza Berati and Hamid Kehazaei were preventable according to many. The Australian Medical Association feels strongly that asylum seekers and refugees should have access to proper healthcare. The AMA’s 2013 pre-election position statement:

  • The AMA wants humanity restored to an otherwise inhumane approach to asylum seekers
  • The next Government must establish a truly independent medical panel to oversee, and report regularly on, the health services that are available to asylum seekers in immigration detention facilities, both onshore and offshore
  • The Panel would inspect the available health services, and detainee access to them, and report quarterly to the Parliament, the Prime Minister, and relevant Ministers.

As far as I can see, these recommendations have not been implemented.

In fact, a recently leaked draft consultant report obtained by the ABC revealed that the government feels that medical staff contracted to take care of asylum seekers were advocating too strongly for refugees.

Don’t cross the line

The AMA’s code of conduct dictates that doctors should refrain from denying treatment to patients because of a judgement based on discrimination.

It also stipulates that, regardless of society’s attitudes, doctors do not support ‘cruel, inhumane, or degrading procedures, whatever the offence of which the victim of such procedures is suspected, accused or convicted.’ This is in line with the Declaration of Geneva and doctors have to uphold this – no matter what the government says or does.

Immediate past president of the AMA Dr Steve Hambleton once said at the National Press Club:

“Let’s stay out of where they are from and why they’re here and all the other stuff. Once we are in control or once we take responsibility for people, we should be providing them with first-rate health care.

Thanks to Dr Kellie West for the topic suggestion.

One thought on “Looking after asylum seekers – who is crossing the line?

  • Surely the ultimate responsibility for asylum seekers, lies with the country of origin? Uncontrolled immigration becomes a real dilemma and you end up with a problem seen in the U.K – fragmentation and social incohesion within communities and unsustainable pressures on public services.


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