A medical emergency as doctors call for urgent Nauru action

This medical emergency requires an immediate response as doctors call for urgent Nauru action

Dr Neela Janakiramanan and Dr Sara Townend have been working on a grassroots campaign calling to urgently evacuate critically ill children and families from Nauru. Within weeks they have collected the signatures of more than 5500 doctors in Australia including more than 250 organisations. The petition will be delivered to Parliament House today. Dr Janakiramanan shares why. 

You can see the open letter to the Prime Minister here

During the recent school holidays, I took two of my children to the historic site at Port Arthur. It was a glorious Tasmanian day, streaming with sunshine and the first flowers of spring. My children skipped across the large lawn, in the shadow of one of Australia’s most brutal prisons.

The butterflies flitted around us as we stood and looked at the remnants of the narrow cells which once held people transported to the other side of the world. As I tried to describe the enormity of a lifetime sentence far from family and friends to my children, my telephone beeped with messages from my friend and colleague in Sydney, Dr Sara Townend, with whom I was working on a grassroots campaign to call on our government to urgently evacuate critically ill children and families from Nauru. Almost 200 years later, the walls of Port Arthur have crumbled, but it seems that little has changed.

History buffs will know that Port Arthur, and indeed the whole Australian penal experiment, marked a change in approaches to punishment spearheaded by Jeremy Bentham and others in the early 1800s. Hard corporal punishment, such as whippings, gave way to deliberate psychological manipulation, in the form of rewards of food and tobacco for good behaviour, and the so-called “Silent System” of isolation, hooding and enforced silence which was supposed to allow prisoners time to reflect on the actions that had led to their incarceration and punishment. 200 years ago, it could perhaps be argued that the severe mental health issues that arose from these psychological methods were unintended consequences, but these same arguments seem rather disingenuous now.

There is a health crisis affecting those held in indefinite offshore detention. This is not an accident. This is the result of a system of punishment once deliberately designed around psychological impact. This is not an anomaly; this is, sadly, part of who we are.

Last month, Australian Medical Association (AMA) President, Tony Bartone condemned the growing health crisis affecting refugees and asylum seekers in Nauru, and his call for change was swiftly dismissed by Prime Minister Scott Morrison.

Doctors are the custodians of healthcare in this country. In a matter of weeks, over 5500 individual doctors, along with over a dozen medical Colleges and societies representing every major medical specialty, have joined together to call on the government to end this policy of indefinite detention, which in and of itself causes harm, especially to vulnerable children. This degree of unity is unprecedented.

As doctors, we cannot accept a medical system that provides suboptimal care. We cannot tolerate a medical system where medical recommendations require order of a Federal Court for implementation, or one without the clinical review and oversight of our peak medical bodies. And when our peak bodies point to a growing health crisis, our collective expertise on matters of health should not be so readily rejected.

This call for change could not have come at a more important time, as the health of those refugees and asylum seekers in Nauru and on Manus Island continues to deteriorate.

The eviction of Médecins sans Frontieres from Nauru, and the heart-breaking reports of their doctors in the media last week clearly spells out how dire the situation is. The United Nations High Commission for Refugees reported last week that more refugees and asylum seekers were evacuated for urgent medical care in the month of September, than in the previous two years combined. This is a medical emergency. It requires an emergency response.

I am proud to say that, this morning, Sara delivered our letter calling for the evacuation of the children and families from Nauru to the office of the Prime Minister. This letter has been signed by over 5500 thousand doctors, ranging from eminent professors, appointees to the Order of Australia, and several Australians of the Year, to ordinary hardworking doctors and medical students from all over the country.

They have signed following a short grassroots campaign which had no institutional support, and no aim other than to circulate the letter and make doctors aware of its existence.

They have signed because this is important to them. Some have fled persecution themselves and now provide quality healthcare to the Australian community, or have refugees in their family history. Others work or have worked with refugees and asylum seekers both in the community or in detention and regional processing facilities.

Most are ordinary doctors who are committed to an equitable healthcare system, regardless of any individual characteristic of the patient needing care. These are doctors who wish to prevent poor health and death, regardless of whether it happens on land or at sea. These are doctors who believe that our politicians must create a better policy. These are doctors who have individual and collective expertise, and demand that our voice be heard.

It is time to move away from a system of punishment that delivered catastrophic health outcomes almost 200 years ago. And more immediately, it is time to allow Australians doctors to genuinely take care of these families by evacuating them from Nauru.

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