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Harming the health of refugees for the sake of stopping boats

Like many other Australians, I am alarmed by the hardening policy positions on asylum seekers of both major political parties. And today, the Royal Australian College of Physicians (RACP), of which I am…

Both major political parties are so intent on ‘stopping the boats’ that they have lost sight of their obligations to protect people. ROSSBACH/KREPP/AAP IMAGE

Like many other Australians, I am alarmed by the hardening policy positions on asylum seekers of both major political parties. And today, the Royal Australian College of Physicians (RACP), of which I am president-elect, has released a public statement about what these policies mean for their health.

Many Australians are concerned about the conditions asylum seekers face while their fate is decided and the impact this will have on their physical and mental health.

Such concerns have been heightened following recent policy announcements by both major parties that aim to put people in detention and resettle them in places where their health will be at risk.

Politicians say they are committed to “stopping the boats” and solving the “asylum seeker issue”. The resulting hard-line approaches to immigration policy may get and retain votes in some sections of the community and contribute to an election win, but at what cost?

While the new measures will ostensibly stop people from drowning on their way to Australia, what about our international obligations to protect the human rights of individuals, in particular their right to health?

The physical and environmental conditions in off-shore detention facilities and regional processing centres will compromise the right to health that people seeking refuge in Australia have.

Asylum seeker accommodation on Manus Island, Papua New Guinea. Department of Immigration and Citizenship/AAP

We will see the physical health and mental well-being of thousands of vulnerable people, including children, damaged. Are we all happy to have this sit collectively on the Australian conscience?

The RACP is calling on the next government to adhere to its international obligations and show respect for health as a basic human right, especially for this vulnerable group.

Dangers on the ground

Asylum seekers detained in off-shore detention facilities and regional processing centres located on Manus Island and Nauru are exposed to multiple environmental and infrastructure deficiencies that put their health at risk.

Papua New Guinea has endemic malaria, with over 100 cases for every 1,000 people and 430 deaths in confirmed cases every year.

Clearly, this presents a significant risk to the health of the people we’re sending over there. Especially because standard environmental avoidance measures, such as repellent sprays, treated mosquito nets and staying inside after dusk, are difficult in temporary accommodation settings.

And there are no options for malaria prevention in very young infants who, along with pregnant women, are at highest risk for malarial disease.

The immunisation schedules in Papua New Guinea and Nauru don’t include key illnesses such as mumps, varicella (chicken pox), human papilloma virus or pneumococcal vaccines as recommended by the Australian Immunisation Schedule.

And large numbers of people living in close proximity presents a real risk for transmission of vaccine preventable diseases.

Close living conditions will also amplify the risk of tuberculosis infection; multi-drug resistant tuberculosis is a serious concern in Papua New Guinea.

People sent to both Papua New Guinea and Nauru are also at risk of dengue fever, typhoid fever, hepatitis A and other water-borne infections.

There are major challenges to delivering adequate health services, mental-health care, child-health screening, and providing medical accountability and access to clean drinking water (particularly on Nauru) for the people we place there.

Steps in the right direction

There are also complex issues around equity and different standards of health care and services for refugees compared to citizens of Papua New Guinea and Nauru, particularly children.

File footage of the federal government’s offshore detention centre in Nauru. Department of Immigration and Citizenship/AAP

Indeed, children and adolescents seeking asylum are particularly vulnerable to the effects of detention.

The detention of children is contrary to Australia’s obligation to uphold the rights of the child. To ensure Australia adheres to these obligations, the RACP statement is calling for the incoming government to take the following steps:

  • increase the capacity for placing children or adolescents and their families in community residence, and make this the standard model of care for all children. Under no circumstances should children be separated from their families;

  • no children are to be held in regional processing centres on Manus Island and Nauru;

  • immediately transfer children seeking asylum and their families to a community setting;

  • establish an independent mechanism for the oversight and management of health-care services available in off-shore detention facilities and regional processing centres; and

  • undertake immediate and sustained efforts to improve the efficacy and speed of the assessment process for all detainees to eliminate prolonged detention.

Most of the discussion and debate around asylum seekers during this election campaign has been about the rights of asylum seekers to permanently settle in Australia. Let’s not forget about their basic human rights, particularly their right to health.

The government’s approach to processing asylum seekers is an immigration decision but ensuring their health is an issue of rights. The two positions are not, and must not be, mutually exclusive.

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10 Comments sorted by

  1. Wade Macdonald


    Governments here don't always have hospital beds available for their own citizens let alone every other Tom, Dick and Harry that attempts to arrive here by boat or plane.

    The women's and children's hospital here in S.A. requires equipment badly as patients are having to travel interstate/overseas for treatment..

    If the Aussie dollars we give PNG or Indonesia don't go to aiding these people then bring that up with those countries, put your hand in your own pockets or go and work there yourselves.

    1. R. Ambrose Raven


      In reply to Wade Macdonald

      Ah! A victim-blamer!

      Despite six years of stagnation and massively increasing public debt, there is still minimal challenge to be pre-GFC economic and political orthodoxy. Julia Gillard, Kevin Rudd, Wayne Swan and Lindsay Tanner insist that market-based reforms will continue, deregulation is still alive and the post-1983 reform age will be renewed, not buried.

      Supporting Big Money are the Hard Right's denialists and fellow travellers, now organising to transfer the blame for the Great Recession…

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    2. Stephen H

      In a contemplative fashion...

      In reply to Wade Macdonald

      Wade, the article is about refugees. You know, people fleeing for their lives? And we're spending more money trying to keep them away than would cost to welcome them humanely - a lot more! It costs crazy amounts to lock people up, and even more to lock them up somewhere where the general public doesn't have to think of them as real people.

      Of course, Australia's had terrible trouble with refugees in the past. Look at all those people who came from Europe after WWII. Look at the Vietnamese…

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    3. Wade Macdonald


      In reply to R. Ambrose Raven

      Your a rambling mess buddy. Clearly you have no idea of the millions of dollars we already send to overseas officials to take care of these people. Why don't you go and ask the foreign officials what they are doing with this cash once you learn to think before you type?

    4. Wade Macdonald


      In reply to Stephen H

      Racist? Ha, if you have nothing left pull the racist card.

      If you can't be rational you may as well be a walking charity case as well.

    5. Mike Brisco

      Scientist at Flinders University of South Australia

      In reply to Wade Macdonald

      Are you, Wade, seriously suggesting, we should refuse people life-saving treatment, because they don't have a piece of paper, that says "Citizen?".

      That debate was over long ago. The public system, care is allocated based on need.

      Australia is not the kind of place, that refuses sick people life-saving treament - just because they lack documents. r at least, I hope it isn't.

    6. Wade Macdonald


      In reply to Mike Brisco

      Of course not. How many hospitals in other countries did they ignore before wanting this medical treatment however?

  2. Russell Hamilton


    Thanks for this piece Nicholas. People need reminding again and again.

  3. Rosemary Stanton

    Nutritionist & Visiting Fellow at UNSW Australia

    Nicholas - thank you for reminding us of our obligations. We live in a wealthy country and we can afford to look after people properly. These people will then add to our nation, just as previous migrants have done after leaving war-torn areas.

  4. R. Ambrose Raven


    Brutalising refugees is obviously much the most popular option – the entertainment is seen as well worth the cost.

    Yet there appears to be quite a lot that could be done to develop small-scale industries both within the concentration camps (thus making them forced labour camps) and for the locals (who themselves have low incomes but face increasing resource stresses). Since the Robben (sorry, Manus) Island refugees won't be coming to Australia, we can be less afraid of training and educating…

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