Transcript of Hearing - Adelaide
Monday, 1 July 2002
Please note: This is an edited transcript
DR SEV OZDOWSKI, Human Rights Commissioner
MRS ROBIN SULLIVAN, Queensland Children's Commissioner
PROFESSOR TRANG
THOMAS, Professor of Psychology,
Royal Melbourne Institute of Technology
MS VANESSA LESNIE, Secretary to the Inquiry
HILTON HOTEL
(MEETING ROOM B)
DR OZDOWSKI: I would like to formally open this public hearing which is one of a series of hearings conducted around Australia. My name is Sev Ozdowski and I'm the Human Rights Commissioner. I have two colleagues sitting with me, Mrs Robin Sullivan who is Queensland Children's Commissioner, who is assisting with the Inquiry and Dr Trang Thomas who is Professor of Psychology at the Royal Melbourne Institute of Technology who is the second Assistant Commissioner. I also have Ms Vanessa Lesnie, sitting to my left and she is Secretary to the Inquiry and she will also ask some of the questions. Before the Inquiry begins, I have made a number of rulings relating to confidentiality and privacy because the Commission believes the respect of privacy of individuals and particularly the issue of the protection of children is of utmost importance.
So consequently I issued a number of directions and the ethic of these orders is that the identity of asylum seekers is not to be disclosed around the hearing, that the identity of any other person who requests anonymity is not to be disclosed and that identity of any third parties is not to be disclosed. This includes the current and former employees of Detention Centres. The issue is that these people should not be named because they would have not an opportunity to defend themselves against allegations that could be made. I don't see media here - or do we have any media here? Yes, we have got some media here, so I would like in this case to ask media that where a witness requests to not to be identified by name or photograph, please respect this, and also when filming, please respect the wishes of people who may not wish to be included in the background shots.
Now I would like to invite Professor Nicholas Proctor to give evidence. Perhaps I will mention that the role of the Commissioner is to test the evidence which was provided in submissions and to obtain other information which would be helpful to the Inquiry. We are inquiring into the acts and practices of Commonwealth Government with regard to children in detention and we are trying to establish whether Australia is meeting its international obligations especially with regard to the Convention on the Rights of the Child. So I would like to ask you to take an oath or affirmation and I will ask secretary to the Inquiry to administer it.
DR NICHOLAS PROCTER, sworn [8.38am] Associate Professor of Mental Health, University of SA
DR OZDOWSKI: Thank you. Could I perhaps - one more comment, considering what I said about privacy and confidentiality, you may wish if you have some names you would like to notify to do it in confidence to the secretary of the Inquiry and also if you would like to provide later some additional material in writing, you are most welcome. If you have a problem with understanding some question or wish to seek clarification, please do so. At the moment, let us go maybe, to your submission and my understanding is that you have conducted study of the mental health of refugees released from detention. Could I ask you to make an opening statement and let me know what the main findings of the study were?
DR PROCTER: Yes. Thank you very much. I undertook a project which was funded under the Australian Trans-Cultural Mental Health Network. The project lasted for 14 months. The Australian Trans-Cultural Mental Health Network is part of the National Mental Health Strategy. My project involved the creation of a model of interactive learning between mainstream mental health services so that people who work in those services, psychiatrists, social workers, psychologists, psychiatric nurses and three culturally and distinctively diverse groups, one of which was a group of Iranian and Afghani men who had been released from either Port Hedland or Woomera Detention Centre.
I undertook the study using ethnographic techniques which is a qualitative form of inquiry involving in-depth interviews, participant observation and my task was to learn as much as possible from these men about their experience of sadness, broadly defined which brought me to the interface of their struggles, if you like, in the post-detention period of their life and involved very lengthy periods of field work in their homes and where their study was based which was at the Migrant Health Service. I think the main point to make is that these people talked very much about their experience being a dehumanising one and I've broken that down into the number of sort of areas which I can speak to and the dehumanising experience begins in the detention camp and never really ends. It continues throughout the everyday life of people and it is something that people keep thinking about every minute of every single day. Almost all of the information that was given to me was never given to me directly. In other words, there was also the use of an interpreter so it was never - it was in the Farsi or Dari speaking language through an accredited interpreter at level 3.
DR OZDOWSKI: Could you say how many men were involved with your study?
DR PROCTER: Yes, a group around 14 who were core men and then up to around 50 who came and went.
DR OZDOWSKI: Could we perhaps come now to the outcomes of your studies? Could you say something about the impact of detention on the mental health of these people?
DR PROCTER: What I can say is that the key issue is trust and a feeling of worthlessness that was manifesting a range of behaviours and attitudes and let me explain what I mean - feeling down, feeling sad, feeling as if they are second class citizens, feeling as if nobody believes their story, feeling as if they are not wanted here and feeling as if they can't be trusted. Many felt that they were disillusioned by the treatment that they had received in detention and the sort of treatment that they were talking about was this, sort of mocking of them as being here as terrorists, or their humanness was not trusted, their worthwhile sense of who they were was not trusted and many of them felt that it would take a long time for them to develop the sort of trust that they needed to in order to get on with every day life and one of the major issues, I think for many of them, is that the processes that take place post-detention, in a sense reinforce the processes that took place during detention. In other words, there was a range of, your know, letters and information and regulations that they needed to follow in the post detention period which made it more - increasingly difficult for them to move on and move forward and have any sense of worthwhile purpose. They were
DR OZDOWSKI: Yes. Did you discover that the length of detention plays any role in their feelings?
DR PROCTER: People talked about what the group determined as time torture. This notion of not knowing the outcome of their detention and this process of wanting to - needing to, having to tell their story over and over and over again and will they be believed. I don't have any more material on the length of detention, only to say that it was a sense of: what will happen next? This feeling of being in limbo and with that a lack of structure and purpose. It is very difficult to plan so in the post detention period people have difficulty planning, making plans because they don't know the outcome of the three year visa.
DR OZDOWSKI: This Inquiry is focusing on children. Were any of these men fathers with children here, or they were single men?
DR PROCTER: Okay. Some were fathers, and as I mentioned to your staff in the invitation that I received to come and speak to you today, I never spoke with children. It is important for me to make that perfectly clear, but what I did offer your staff was insight into adult life which may complement some of the other Inquiry questions that you have. Some people had children and one of the features of that experience was the role reversal. For the older child who had picked up English rather quickly or had some English, there was a pressure coming down on that child to undertake, I guess, an interpreting role. So they would pick up the phone or they would take information in and relay that back to their parents. There were issues in relation to the way funding is allocated, such as security funding is allocated and for some parents it was difficult for them not to be in control of those funds or moneys so that the whole role alteration and erosion of role, more to the point.
I think there were thirdly, issues in relation to the dreams and aspirations that parents had for their children and their wanting to do whatever they could in supporting and encouraging and nurturing the development, social and intellectual development of the child and their feeling of letting down the child and betraying the child and that inevitably broke down relationships with - between the child and the parent and their were periods of frustration. It was reported to me during my work period that what goes on inside the house is quite different to what goes on outside the house and there was one example put to me of yelling and physical threats being made to spouses that was, in a sense, these periods of intense emotional distress and exhaustion and frustration and those sorts of reports were picked up by the authorities who were involved so that was one isolated incident that I came across.
DR OZDOWSKI: So it was happening inside the house?
DR PROCTER: That is correct. Yes.
DR OZDOWSKI: Yes. So what would be your professional view, how family can function? What impact on family as an institution would that detention and especially long term detention?
DR PROCTER: I think the - the opinion that I have is more to do - the link between detention, medium to long term detention and post detention, I don't have strong links to make, but what I can say to you is that the breakdown of family structure and the recasting of a new family structure in an ambiguous time bound context where people don't know, can't plan, want to plan, need structure, want to have intimacy with others within themselves and in their family and want to be able to trust others, is made incredibly difficult and the processes of detention create, I believe, a worsening situation.
There is no opportunity to develop trust. There is no opportunity to be able to move forward and to develop the sort of confidence that is needed because of all of these external variables that seem to be ever present. As a family structure what I have noticed is that people are struggling to keep it together. Their struggle is manifest not only within the interface they have agencies that they need to interface with, but their struggle is also within themselves and whilst - and I can comment a little bit about the workers who are involved in the care of those people or social service providers of those people, but I think it is very hard to plan and it is very hard to plan on the long term.
DR OZDOWSKI: Before I will ask my Assistant Commissioners to ask their questions, I would like to explore with you, one more issue, and it is the issue of self harm in detentions. Did you hear any reports of self harm during your studies?
DR PROCTER: No.
DR OZDOWSKI: No. Okay, so
PROF THOMAS: Yes, but first of all, can I just establish your background. Are your sociology, psychology or
DR PROCTER: No. I'm an Associate Professor of Nursing
PROF THOMAS: Yes, nursing.
DR PROCTER: Mental Health at University of South Australia.
PROF THOMAS: Okay. Your background was in nursing then?
DR PROCTER: And sociology.
PROF THOMAS: Okay, thank you. So obviously we can use the same language. Now, in your model that you are trying to build and in your study, in your methodology, were you able to differentiate between the impact of the detention centre and the impact of the past trauma that the people experienced before they came to Australia?
DR PROCTER: We didn't go searching for the differentiation between previous torture and trauma histories and the impact of detention because it wasn't part of what we were looking for. What we were really looking for was post detention experiences and in the process of post detention experiences we came across detention experiences and some previous histories but they weren't the primary focus of my study. The study - the primary focus of the study was to be able to learn as much as possible from people in the present day about their experiences, the metaphors and the language of their experience of sadness and depression and to take that material, within the languages of the project, to take that material across to mainstream mental health workers to give them an opportunity for more informed and compassionate awareness of those issues and at the same time, take material from mainstream mental health workers about their view, the Western ontology of depression, and put that back into community languages, working with community people, trying to build closer bridges between mainstream ontology, if you like, and the metaphors for cultural experience and cultural ways of knowing of these particular people and in that process we naturally when you - and any qualitative inquiries, you would know, you come across other information and that news became the Human Rights Equal Opportunity Commission people became aware of that and invited me here today to speak.
PROF THOMAS: So in your study did you find any cultural impact on the people - reaction, a coping experience to the experiences? Did you see any difference between the Iraqi, the Iranian, the Afghanistan?
DR PROCTER: I didn't speak with Iraqi. I spoke to Afghani and Arabian. I think what
PROF THOMAS: Or the gender difference?
DR PROCTER: Yes, I only spoke to men
PROF THOMAS: Men, right.
DR PROCTER: okay, and what came through was certainly a feeling of - well, certainly a very strong feeling of wanting to withdraw, shame, embarrassment, stigma in relation to their experience. For example, there are 78 Middle Eastern men living around the Murray Bridge region at the moment and what they are talking about and what they have been talking about is a feeling within that region that a lot of people think they are homosexual. They greet each other in the street, they kiss each other. There are five or six men living in the one house. There is no woman living in that particular house and they wear clothing which resembles western styled feminine dress. You might say that on the one hand that is a, you know, that is a one isolated kind of description of people living in a semi-rural location in South Australia.
What for many of these people seems to come through is the cross currents between being detained, seeking asylum, being detained and being treated in a dehumanising, or what they feel is a second class way, and the notion of dehumanisation stayed on this project for around 4 months. We met with the men often in group situations or in individual situations and many of them couldn't just move off that notion of dehumanisation and people talked about it in terms of black and white South Africa where they felt that they were always different. Other refugees who were legitimate would have experiences or would have access to social services that they did not have access to and I think that for, certainly the work that I was trying to achieve, was to try and bring around a sense of trust and what mechanisms would be useful to try and do that. That in a sense is a synopsis of some of this and I guess, if you have got any other questions I can respond to them.
PROF THOMAS: In your study, did you come up with any recommendation for some special kind of intervention for them - you know, for the people? Did you look at the treatment aspect at all?
DR PROCTER: Yes. The recommendations were less, well certainly less of an emphasis on psycho pharmacological interventions for depression, more language based therapies, a recommendation for partnership models or greater community participation in mental health services, engagement with interpreters, it should be the same interpreter each time, particularly with children, recommendations for children with families to have as much integration in social life as possible, recommendations for structure and importance of structure and creating structure, whether to create employment or voluntary work. Now all of those recommendations have been made and have been sent back to the Commonwealth and there are others and having said that, there are still problems within those recommendations too which - they are not as straightforward as I've just put in this time limited interview but there are a number of issues and problems within those recommendations.
Certainly there needs to be a greater alignment between the sorts of services that are being made available to TPVs that would normally be made available to refugees and certainly Family Assistance payments is one of those. One very useful anecdote, just to give a sense of this, is for many of these people they felt as they did in detention, that they were under surveillance and 2 weeks ago someone came to Centrelink with a letter, this letter had been given to this man and it was saying that he could have intensive assistance but as soon as he hit the front desk it became aware that he was a TPV and he was not eligible and it takes many, many hours of work to explain to this man that he is not eligible for intensive assistance, because of the disappointment and rejection.
I think that that is something, at the very beginning of my submission, this sense of every minute of every day there is a difference. It has its own depth and its own dimension and it comes up unexpectedly and it comes up at times when there are all these other variables, such as the feelings of people not wanting them here, feelings that they are under surveillance and clearly, a feeling of not knowing what will be the outcome of their visa application.
MRS SULLIVAN: Did the people involved in your study comment on the use of medication, in terms of their treatment?
DR PROCTER: I'd have to go back over raw data. Nothing stands out. I could come back to you on that.
MRS SULLIVAN: Thanks. The second thing is, are there any elements of your recommendations that could be implemented in a detention context as distinct from an outside detention context?
DR PROCTER: Yes, and I'd be very happy to draft up some specific recommendations if you wish, after this interview, but I think certainly letting people know more about what is going on and why there are delays, why there are administrative processes, I think certainly that would be of tremendous value and letting people know that in the language most familiar to them on each and every occasion.
MRS SULLIVAN: In your submission you talk about the retelling of their stories over and over again and the impact of that, and I think at one point you talk about the equivalence of discrepancies with the use of the term "lies". Would you like to expand on that a bit?
DR PROCTER: Yes. I think the document that you are referring to is a public lecture that I gave as part of the Hawke Institute's: Weaving the Social Fabric public lecture series. Very briefly, in the early part of this work and understandably very few people were willing to speak to me and it took several weeks to be able to better understand that but by the same token people kept coming and wanting to meet with me and there was one moment during the work where a particular gentleman said, you know: what do you really think of us? Do you really believe us? What that unravelled was a whole series of stories about having to tell and retell their story over and over again, and what came through for me was, the questions people are asked about their life history or their circumstances, are asked with particular thoughts in mind on the behalf of the person asking the question, as being central to that person who is asking the question, when in actual fact they are not central to the person who is telling the story.
It coinciding with some work that was published just a few months ago in the British Medical Journal where a group of Kosovar refugees who were seeking asylum in Europe were asked similar questions and of the 27 Kosovars who were interviewed in a B & J paper found none of them had identical stories and it made perfect sense to me for two reasons why people felt that way. One is that they were being asked questions in an environment and a context that was not trusting and not facilitative of trust and disclosure. It also meant that people had difficulty talking about things not knowing how the information would be used and how do you guarantee that. There's a whole range of questions around that. It also brought home for me that these questions and the life histories of people that I've certainly be talking to, tells something about the inner life of people and the inner life of people is something that people want to protect at all costs.
So I took the view that, in order to better understand the inner life of people it is going to take some time and I think that the context in which you would do that is best done outside of a detention setting where the context is not one that is facilitative of the elements that I speak of, the elements of trust, the elements of understanding what is going on and certainly the elements of having some predicability in where their people are going and how the information will be used.
MS LESNIE: There is obviously a bureaucratic need to establish the facts in circumstances of individual cases, have you got any recommendations, other than your comments earlier about how that process could satisfy that need as well?
DR PROCTER: I am not against detention per se. I think it is the conditions which, clearly, are causing concern. I think that the way in which you could broker better community participation and better trust between people who are in detention, across the lifespan of all ages, is through a series of community liaison workers or community development workers, probably similar to what you might see with people who are needing to be detained in the community for other reasons. The nature of the work that would be done would constantly involve the use of two languages and would involve interface with authorities but could be done in a way that was more culturally appropriate, more informed and certainly more compassionate and I would be recommending that people explore that and cost it at the same time and look at the benefits, both social, emotional, mental health as well as financial.
The other part of my recommendation would be to have, at the outset, people approach that with a framework of acceptance of these people. Acceptance of them as people and their stories as people rather than come at them from a framework that they are somehow sinister or foreboding beings who are here from a foreign land to, to you, to be investigated.
MS LESNIE: Finally, having given that description, could you hypothesise about whether there are any aspects you would add on for children and young people? Is that universal comment or do you consider there are some additional features that you would want to accommodate the needs of children and young people?
DR PROCTER: I think I would emphasise for children and young people the importance of a safe and predictable environment and I think that is important for all people but particularly for children and also I would emphasise the use of peer support mechanisms for children. I can come back to you - go back to my data and extract more fully. If you wish, I am happy to do that.
MS LESNIE: That would be helpful. It is just really trying to tease out whether it is of universal significance or whether there are some special dimensions.
DR OZDOWSKI: Professor Procter, thank you very much for your submission and for the evidence you gave. If you would like to provide us with specific recommendations as you said, then you are most welcome. Thank you for your attentions.
Now, I would like to ask Ms Karyn Fromene, I hope I am pronouncing the name properly, to come forward. As I mentioned before the role of the hearing is to test evidence we received so thank you for coming in. I understand you have been hear before so you listened to the ruling regard privacy so I don't need to repeat them. I would like to ask you to take an oath or affirmation now.
MS KARYN FROMENE, affirmed [9.07am] Coordinator, New Arrivals Clinic, City of Port Adelaide Enfield
DR OZDOWSKI: Thank you very much. Now, I would like to ask you to give your name, address, qualification and capacity in which you are appearing, for the record.
MS FROMENE: My name is Karyn Fromene. I live at [address removed]. I am a community health nurse and I work for the Port Adelaide Enfield Council and I am here as a local government immunisation provider.
DR OZDOWSKI: Again, thank you very much for your submission, it was very useful. Could we start, maybe with examination of immunisation services which are provided in Woomera. Could you perhaps describe briefly the extent of immunisation services which are provided on Woomera.
MS FROMENE: To the best of my knowledge, at the moment children have been given full immunisation services. This was not always the case. I believe originally they were only offered oral polio vaccine and measles mumps and rubella. That has changed since, I believe last year.
DR OZDOWSKI: When last year, would you know?
MS FROMENE: Towards the end of last year. They were then offered all vaccines that were offered to children on the Australian immunisation schedule.
DR OZDOWSKI: So by now you are satisfied that all immunisation which is provided is very comparable with immunisation provided to general public in Australia?
MS FROMENE: I believe that the immunisation - vaccines are offered to these people, they are available to them but they don't always have the access to them. I can speak from our experiences of what happened with us. I actually conduct an immunisation clinic in the Enfield area, a public immunisation clinic and middle of last year we had families attending our clinic, large families, families of up to eight people in some cases, requesting immunisation services. Child and Youth Health, who I work fairly closely with, have been going out to help these families in the home but obviously of the 60 to 80 families in the area, which could be up to 300 to 400 people, and people were coming to us because obviously they felt they needed the services.
When they arrived at our clinic we were not set up for refugees or people that have a different language and it is quite - it was quite evident they needed much better services than what we were able to offer. So what we did was we actually approached Child and Youth Health and asked them if they would like to, in collaboration with us and the Department of Human Services, offer a clinic for these people to attend that we could offer them culturally appropriate information and make them feel more comfortable and that way, hopefully, improve access to the vaccines.
DR OZDOWSKI: How many people did you immunise, people who are on TPVs?
MS FROMENE: Our first clinic we had about 20 people turn up, 20 to 25 people, sorry, I can't remember exactly how many. It was quite confusing. The first time they all turned up. Records, at first they didn't have all their records. We were not really sure what they had had and what they hadn't had. With immunisation, if a person does not attend with records then you have to assume they haven't been immunised and you have to commence again.
Eventually we were able to ascertain that most people have initially been to Migrant Health in the city and have been commenced on catch-up - this is children I am talking about - have been commenced on a catch-up schedule of vaccines. The problem with that access to transport can be a big problem for families. If you have eight people in one family trying to get to the city on a bus, it can be quite cost prohibitive in some ways so a lot of these people had commenced vaccination services but hadn't continued on because obviously it was far too hard for them.
Basically, the first clinic we had around about 20 - I think 22 people. We found there was a problem with the families. They didn't like to take their children out of school, there was another barrier for them. They are very keen to have their children learn English and even for an hour - we had to change to our times around, make it more appropriate for them to attend because they really didn't like to take their children out of school.
DR OZDOWSKI: Ms Fromene, going back to the numbers, you said initially 20 to 22?
MS FROMENE: Yes.
PROF THOMAS: Were there any
MS FROMENE: We fluctuate from - sometimes we only have half a dozen people turn up and then the last clinic we had we had 17, I think, and we are actually getting new parents turning up as well which obviously means word of mouth is reaching these people. Brand new babies, only 6 weeks old. We are quite hopeful that will continue and it will be an adjunct to the Child and Youth Health program.
PROF THOMAS: You mentioned you had some problems with having records of previous immunisation, would you go a bit further?
MS FROMENE: Well, mainly, I think, families were unaware that we required the records when they arrive so in some instances they did have records at home but didn't bring them and it was very difficult to ascertain what they had had. Other times the parents had no records but the children did. We felt it was really important that the parents also were immunised as well, that is why we commenced them on a program as well.
There were some people from Port Hedland and they appeared not to have too many vaccinations at all. I think they only really had polio and that was all that we could see that they had been given. It was very difficult because Child and Youth Health document what vaccinations in their records and the families with the hand-held records they had, didn't always mesh together so it was always a bit difficult to ascertain what was required.
DR OZDOWSKI: Did you try to get in touch with Port Hedland or Woomera or any other detention centre to establish what records are available?
MS FROMENE: No. At that stage I believe South Australian Immunisation Coordination Unit has actually got a data base they are trying to establish from people from Woomera. It is not by name, it is by boat number so it is very difficult. Unfortunately, a lot of the names are similar and it is very difficult to work who is who and who has had what so what we have done is we have - if they have no records, we commence from the beginning.
DR OZDOWSKI: So the detention centre is providing you with boat numbers and not with the names?
MS FROMENE: This is the immunisation unit. They actually have records of people in their unit but as far as my understanding is, it is boat numbers - they go by boat numbers not names.
DR OZDOWSKI: Not the names. Do people, in your experience, use boat numbers after they are released from detention?
MS FROMENE: No. No, they have all used their names.
DR OZDOWSKI: So how do you match boat numbers with the names?
MS FROMENE: We don't. We just commence - if they haven't got records we just offer them from the beginning.
DR OZDOWSKI: Did you see any records which were issued in the detention centre about immunisation?
MS FROMENE: Yes, yes, there was a couple and it had Woomera written - now whether - I am not actually sure whether they were from Woomera that they came or whether they were established that they were given by - the previous provider had written Woomera across the card so I am not really sure. I would imagine it would be the previous provider, it might be Migrant Health, that would have ascertained they would have had a certain amount of vaccinations in Woomera and would have written Woomera across - the same went for Port Hedland as well. We didn't - it just had Port Hedland written on the card, it didn't actually have what they had actually been given.
DR OZDOWSKI: Are you aware of any communication between your clinic and the detention centre or maybe between state authorities and detention centre about immunisation records?
MS FROMENE: I have faxed off a list of people that we have immunised, their dates of birth and their name, to the South Australian immunisation record to let them know what we have given them but I haven't received any - I haven't spoken to them about how they mesh in with their records, as of yet.
DR OZDOWSKI: Did you have any formal
MS FROMENE: No.
DR OZDOWSKI: communication with the detention centres?
MS FROMENE: No.
DR OZDOWSKI: No. What about state authorities? Are you aware that they had any form of communication with the detention centre about records?
MS FROMENE: I believe they do. The nurses from the South Australian Immunisation Unit go up to Woomera, I believe, and offer the polio and measles - were offering polio and measles, mumps and then later on diphtheria, whooping cough etcetera so I believe they were actually going up there and making sure people were vaccinated.
DR OZDOWSKI: Before I ask my Assistant Commissioner to ask you questions, could you perhaps focus on children who are coming to your clinic. How did they behave, very much like any other children who are coming to your clinic or are there any differences?
MS FROMENE: I would have to say they are very quiet children. They don't cry when I give them their injections. They are very well-behaved. They are very - I wouldn't say withdrawn but very quiet. They do as their parents tell them and they are very polite so I wouldn't say they are totally withdrawn as such but they are much quieter than normal children that have vaccinations for the same age.
DR OZDOWSKI: How is their English?
MS FROMENE: English is - mainly the children that attend school have a very - a small command of the English language. We do have interpreters there so they interpret for them. Some of the children can speak English but it is not very much. The ones that go to high school seem to be better able to speak English.
DR OZDOWSKI: Thank you. Mrs Sullivan.
MRS SULLIVAN: In your judgment should children or adults from the backgrounds these people come from, require any additional vaccinations other than the regime that is given to the Australian children?
MS FROMENE: I wouldn't say additional, I believe they should have what everyone else has here, especially the polio and measles. Measles - I believe they come from a high area which is endemic to polio and measles. They probably have had some form of vaccination as children or babies in their own country but many of the families cannot remember what they have had, they don't know, so I believe they should have what we have.
DR OZDOWSKI: Those that turn up at your clinic obviously believe in immunisation. Are you aware of any adults who for some reason, maybe cultural reason, were resistant to immunisation?
MS FROMENE: Not that I am aware of, no. The families - the parents are very, as you say, very aware that immunisation is important and as far as I know, I don't know of any families that are not coming for that reason.
DR OZDOWSKI: Is there anything else you would like to add to your testimony?
MS FROMENE: Basically, I would just like to say, I guess, I would like to see more public providers offering this service for their community, if they knew there was a community that needed service like this in their community. I am very lucky to have a very good employer that supports us in this. I really just think it would be terrific if we could continue and if we could have some - if we could have resources to help us offer culturally appropriate translated material for people so that they know what is offered to them. I am sure at Migrant Health they are able to get this information but it is not always easily accessed. We don't always have the information. It is very hard when we send to the Department of Aged Care, for instance, for translated material. We usually have to wait a long time for it. If we are offering this service, it would be nice to be able to have the information to give to the families.
MS LESNIE: I wanted to just quickly go back to the records. Could I just clarify, when people - do you ever see people who have been in detention centres that have medical - do they have medical records in their hands that have a list of vaccinations?
MS FROMENE: Some of them do, some of them don't.
MS LESNIE: The ones that don't, have you asked them why they don't have records?
MS FROMENE: We have had - we ask them do they have their cards and I don't normally push the issue if they don't.
MS LESNIE: Sorry, what is a "card"?
MS FROMENE: We actually have a record - it is an immunisation record that is given to people when they are vaccinated. It should be given to everybody that is vaccinated. So if they have been vaccinated anywhere, then they should be given a record.
MS LESNIE: So people who are vaccinated inside the detention centres are vaccinated by the South Australian Government?
MS FROMENE: Yes.
MS LESNIE: Whoever does that, gives them a card. So if they don't have the card, is it ever noted on their sort of medical portfolios?
MS FROMENE: I couldn't tell you that.
MS LESNIE: You don't know?
MS FROMENE: We don't actually have access to their medical records as such but they do have - they carry a little envelope with all their bits and pieces in it and we basically just - we just ask them have you got a record we can have a look at and if they don't, then we have to assume they have not been vaccinated. Some of them are quite adamant that they have been vaccinated and they are up to date but without being able to - going on parent parental recall is not always - does not always work and they might think they have done it and they haven't so it is best to just commence the course again and make sure they are covered.
MS LESNIE: The second question I have is how do people know to come to your clinic?
MS FROMENE: Child and Youth Health, when they do their home visits, they have actually been promoting our clinic saying - the nurse that does the home visits at Enfield goes out and does an initial assessment of all the families and then lets them know that we are there, what dates we are there and they actually ring them on the day - they get the interpreter to remind them to come in and make sure they attend if they have said they are going to attend.
MS LESNIE: Do you know how - why do Child and Youth Health go and visit these families? What is the system?
MS FROMENE: Well, as far as I know, because of the accessibility, the language barriers. Child and Youth
MS LESNIE: How do they know that they are there?
MS FROMENE: They are referred from Migrant Health, I believe.
MS LESNIE: So they would have to have gone to Migrant Health first?
MS FROMENE: First. Yes, if they have never been there, then they would never know.
DR OZDOWSKI: I ask you two more questions. Firstly, could you name the vaccinations of every child that expected to have in Australia now?
MS FROMENE: Yes, from age - what age
DR OZDOWSKI: Yes.
MS FROMENE: From birth they are given hepatitis B vaccination and then at 2, 4, and 6 months they are given diphtheria, tetanus, whooping cough and hepatitis B, haemophilias influenza B, which is the HIB, and an oral polio. At 12 months of age they are given a measles, mumps and rubella and another HIB. At 18 months they get a diphtheria, tetanus, whooping cough on its own and at 4 years of age they get a diphtheria, tetanus, measles, mumps and rubella and a polio vaccine.
DR OZDOWSKI: At the moment all these vaccinations are given to people released from detentions centres that did not have it?
MS FROMENE: They are made available now, yes.
DR OZDOWSKI: What was the difference before the end of last year? Which of the vaccinations were not given the end of 2001?
MS FROMENE: As far as I know, diphtheria, tetanus and whooping cough and HIB. I know they were given measles, mumps and rubella and a polio but as far as I know the other two were not offered at that stage but the South Australian Immunisation Coordination Unit was very supportive and if we have families attend our clinic, our public clinic, at that stage we were asking what do we give these people because we weren't sure. Most of them were TPV clients so we were told to vaccinate them with what we would normally catch them up with.
DR OZDOWSKI: Vaccinations are free for all these people?
MS FROMENE: Yes, they are.
DR OZDOWSKI: They do not pay anything?
MS FROMENE: No. They are free for everybody in the community.
MS LESNIE: Do you know how often - is it Child and Youth Health, goes into the detention centre to do the vaccinations?
MS FROMENE: The South Australian Immunisation Unit was going. I don't know if they are still attending. Child and Youth Health, as far as I know, were attending as well. I don't know how often. I don't really have access to that information. We also offer - for the adults, that haven't been vaccinated against tetanus, measles, mumps and rubella, our area offers free tetanus so we do offer that to the parents as well which is not normally free. That is a local thing that we offer all our residents.
DR OZDOWSKI: That is, I think, all from us. Thank you very much for putting forward your submission and coming in to appear at this hearing. Ms Fromene, thank you.
Now, could we ask please Ms Tina Dolgopol, if she is here? No. In this case, I am ordering 5 minutes break.
SHORT BREAK [9.26am]
RESUMED [9.37am]
DR OZDOWSKI: All right, thank you. I would like to welcome Ms Tina Dolgopol and I would like to mention that we are here to test the evidence provided so thank you for the evidence provided so far and I would like to ask you to take an oath or affirmation now.
MS DOLGOPOL: The affirmation.
MS TINA DOLGOPOL, affirmed [9.37am] Action for Children South Australia
DR OZDOWSKI: Thank you. Could I ask you now to give your name, address, qualifications and the capacity in which you are appearing for the record?
MS DOLGOPOL: My full name is Ustinia Dolgopol. My address is [address removed]. My qualifications are senior lecturer in law with a JD from the State University of New York at Buffalo. I'm appearing today before the Commission as Chair of Action for Children, a community-based children's rights organisation here in South Australia.
DR OZDOWSKI: Thank you very much. I would like to remind for those who came later that the Commission believes that it is important to respect the privacy of individuals and to protect children in particular. So when giving the evidence please remember that the identity of asylum seekers is not to be disclosed and also the identity of said parties including former or current employees of detention centres should not be disclosed. If you feel that the Commission should know some details regarding the identity of people, please talk to the Secretary of the Inquiry, Ms Vanessa Lesnie, who is here and leave her with the details after exhibiting.
Could I ask you first to start with an opening statement and in particular indicate the experience you have with people from detention centres? I understand you were making visits to Woomera and I also understand that you interviewed former detainees and when you are making this opening statement if you also could focus on your contact with children from detention.
MS DOLGOPOL: Thank you very much. During January this year I had an opportunity to visit the Woomera Detention Centre and interview approximately 16 families. In addition I interviewed two families on temporary protection visas in Adelaide at a subsequent date. Our submission is divided into several parts and I would like to touch on each of them in my opening statement. From the point of view of the families that we interviewed, clearly one of the matters and most pressing concerns is the developmental delays that are being experienced by their children.
These families are very much aware that the lack of leisure and recreational activities have affected the mental state of their children, and also affect their child's creativity. They also uniformly expressed concern at the lack of education, appropriate education available to their children. I realise that since my visit some things have changed and that there are the trips now to St Michael's that were not taking place at the time I visited Woomera but certainly there still remain concerns from the families I've spoken to who are on temporary protection visas about the quality of education for adolescent children.
One of the main issues and one of the overriding senses I had from those interviews was that the detainees or asylum seekers do not feel that either the government or the Australian population actually understands what they experienced in their countries of origin and as an organisation we think this is a crucial issue, that it is not really part of the public domain in Australia. The extent of the persecution that they have suffered in their countries of origin, nor the extent to which the rule of law is undermined and the things that we take for granted in terms of an impartial judiciary are not present in any of the countries and although obviously steps are being taken at the moment to return Afghanistan to a democracy, it would be hard to say that there is a functioning independent judiciary in Afghanistan at this moment in time.
If one can stop and think about the effect that that has on a culture and a society where you have no belief in your ability to attain any sense of justice from a court system and the ongoing levels of persecution that these families experienced, whether it was for their political views or their status as a religious minority, and one has to remember that in terms of the children, they become aware in many of these societies at a very early age of the persecution that their parents are experiencing. If they are members of a religious minority they become aware at a very early age of the persecution that they are experiencing and I think that we need to do far more to assist the Australian population to actually understand that background so that they can put in context some of the behaviours that they see.
It is not out of the ordinary for someone who has experienced years of persecution to react when they are in a detention facility with nothing to do all day and where they feel they are again being persecuted. I think you have to look at a history in order to understand present behaviour. I also think that there are levels of racial and religious intolerance that are reappearing in the Australian community and that the government is not doing enough to depoliticise the situation. It is not doing enough to educate people about that level of persecution so that they gain at least some sense of the humanity of the detainees including obviously the children.
DR OZDOWSKI: Yes, and could I maybe stop you for a moment? Could we go back and establish how often did you go to Woomera?
MS DOLGOPOL: Just the once.
DR OZDOWSKI: Just once? How many people did you meet?
MS DOLGOPOL: About 30.
DR OZDOWSKI: Thirty. Were you meeting them individually, as your clients, or you were meeting them in group meetings?
MS DOLGOPOL: No, I met individually with families and in some cases where there were families with children I interviewed some of the older adolescents. I did not try and interview the younger children, although at times some of them were present in the room. Each of the families was told that I was there specifically for the purpose of the Inquiry that the Commission was undertaking and that I was not there to represent them as their lawyer.
DR OZDOWSKI: I see. So you went there. When it was, it was
MS DOLGOPOL: In January this year.
DR OZDOWSKI: In January. So you went after our Inquiry was announced and you went especially to prepare the submission.
MS DOLGOPOL: Yes.
DR OZDOWSKI: Did you have a chance to visit Woomera facilities or you met only in the reception area?
MS DOLGOPOL: We met in the interview rooms that are in the centre of the compound.
DR OZDOWSKI: So you didn't visit the facility?
MS DOLGOPOL: No, I did not.
DR OZDOWSKI: You didn't go to the places they live and so on?
MS DOLGOPOL: No.
DR OZDOWSKI: Okay and now could we also establish your contacts with people who are on TPVs now in Adelaide. How many of them do you know?
MS DOLGOPOL: Two families.
DR OZDOWSKI: Two families. Thank you very much. Please continue.
MS DOLGOPOL: I would like to move on to the part of our submission that deals with the Memorandum of Understanding between the Government of South Australia and the Minister for Immigration. It is of serious concern to our organisation that no independent authority has oversight of child protection issues, particularly when it is the guards or the very conditions at Woomera that lead to the emotional or physical abuse of children. In our society we have set up child protection legislation not only in terms of what parents may do to their children but in terms of what institutions may do to a child and in this particular case no legislation existing in Australia can reach the child protection concerns that come out of the very conditions that exist in Woomera Detention Centre.
When you have that number of children who are suicidal or self harming and the Commission may note from our submission that the interpreter and I spent 45 minutes with a 16-year-old woman who was suicidal on the day that we spoke to her. We spent 45 minutes trying to calm her down and deal with the guards in order to have her situation focused in on and dealt with by the ACM Management. That to us was a clear case of child protection and yet there's nothing anyone can do and as I understand it from media reports this morning, the State Government of South Australia will be making some comments on that as well about their inability to focus in on it.
But it does seem to us that at a minimum the Minister cannot carry out his functions as the guardian of unaccompanied minors as well as being the jailer of those unaccompanied minors and that something needs to be done to create an independent authority so that the Australian people can be comfortable that child protection matters are being taken account of. We have in our submission made very specific recommendations about the creation of an independent authority.
I would also like to note that there have been a number of issues raised with respect to gender, the issue of gender, that almost nothing has been done at Woomera to educate the ACM guards on women's rights. Both women and adolescent girls experience levels of harassment from other detainees from cultures that may be somewhat different than their own. Some minority group members are harassed by men from majority groups in the countries that they have fled. This resembles the persecution they were already receiving from that majority group. ACM has done very little to address this issue, despite constant complaints from families and some of the adolescent girls about this matter. There is
MS LESNIE: Sorry, you said they have done very little. Do you know what they have done to address this issue?
MS DOLGOPOL: I didn't want to say they have done nothing because I can't be sure of that. We did not go back and speak directly with the ACM Management. My impression is that some of the people we spoke to have raised this matter with the guards but didn't feel that they were getting anywhere.
MS LESNIE: So what sort of things would you want them to be doing to prevent that risk for young girls?
MS DOLGOPOL: Well, as we pointed out in our submission, the United Nations High Commissioner for Refugees has specifically called on all parties to the Refugee Convention to appoint gender advisers for each and every refugee detention facility or each and every refugee facility around the world. That in fact is being done in a number of countries around the world, both in the developed world and in the developing world, yet we have not done anything along these lines. The whole purpose of a gender adviser is to talk to women about the issues that they are experiencing and to then carry on some negotiations with management of the centre whether that management be a government management as it is in some countries or as here, a private security firm.
But you need someone who will take up these issues and who is in a position to carry out ongoing negotiations. One of the issues that keeps arising is the absolute sense of powerlessness that the asylum seekers feel and their comments to us, because we specifically asked them whether there were complaint mechanisms at Woomera, were that there were not specific complaint mechanisms. Those people who did complain, never got feedback on their complaints, were never told what had happened to them and they had no understanding of any changes that had been made as a result of their complaints.
So you need someone there who is in a position of power who can be a mediator between the asylum seekers and the management. Also although there are no complaints about the behaviour of the guards, it is clear that some of the treatment that the women detainees are receiving, they find humiliating and I'm not sure that the guards actually understand that.
MS LESNIE: Could you give examples?
MS DOLGOPOL: Comments made about their always wanting to go to the infirmary, comments, difficulties in obtaining milk for their children when they need it and then comments made to them about being too demanding, issues around obtaining nappies, issues around their own medical complaints being dealt with and there is a sense in which there is a tension that exists there because of course people who have nothing much else to do during the day because those facilities are not being provided to them will focus in on their physical condition. You then create a cycle where they will in fact say something because of course it is one of the things they end up focusing in on and the guards then see them as too demanding or too insistent and you then have an interchange where there's a complete lack of understanding and I think that this is a major issue, both in gender terms and in cultural terms.
DR OZDOWSKI: Could I perhaps change the tack of questioning and I would like to - we will come later yet again to gender issues, time permitting, but I would like to go to your legal expertise and in a submission which we received from the Department of Immigration there was an assertion that under Australian law immigration detainees have the capacity to take proceedings before a court to determine the legality of the detention. Is it a correct reflection of Australian law? How do you see it?
MS DOLGOPOL: I don't actually agree with that assertion. The only alternative which a lot of detainees would not be aware of because of course there isn't a complete right to legal advice in the sense that we would understand that in the general population and in fact the Australian Government has admitted before the Human Rights Committee that the only way in fact you could test the legality of the detention is through a writ of habeas corpus. Now, there are not that many writs filed in Australia to carry through on that but in terms of the actual legislation, the privative clause that prevents any effective review by the Federal Court would prevent an effective review of detention and I think the government has been a bit disingenuous and is found to be disingenuous by the Human Rights Committee of the United Nations.
DR OZDOWSKI: Did you hear of even one writ of habeas corpus relating to detainees?
MS DOLGOPOL: Yes, there has been one.
DR OZDOWSKI: There has been one?
MS DOLGOPOL: Yes.
DR OZDOWSKI: Any more?
MS DOLGOPOL: As far as I'm aware, certainly what I'm aware of in South Australia is that there has been one writ of habeas corpus which at a trial level was successful but is up on appeal by the Minister.
DR OZDOWSKI: Thank you.
MS DOLGOPOL: I would like to add to that that that writ did not in fact test the conditions of detention. What it tested was that you had a detainee who wanted to go back to a third country that they had initially escaped to. So even in that writ it was not the lawfulness of the detention itself but rather the unwillingness of the government to allow this person to leave to yet a third country that they claimed they could get access to.
DR OZDOWSKI: The second issue you mentioned before is the issue of child protection legislation and my question is really to you about the state legislation and about its effectiveness in that area. As I understand there is quite good state legislation in the area of child protection and I understand that if a child living in South Australia is mistreated or isn't sent to school and so on, there are enough measures in the legislation to ensure that the best interest of the child is well looked after. The question to you is does this legislation apply to children in detention centres?
MS DOLGOPOL: I think the answer is both yes and no and in our submission we actually quoted a part of the memorandum of understanding and perhaps it would be easier if I read that into the record. "The Department of Human Services has a legal responsibility to investigate child protection concerns for children in immigration detention in South Australia. However any interventions undertaken to secure the care and protection of detainees must be actioned by DIMIA. DIMIA will consider carefully DHS recommendations to ensure that the best interests of the child are protected."
I think that language is pretty clear that at the end of the day it is DIMIA that is the arbitrator of whether or not any action should be taken and whether in fact any abuse has occurred and that to us is what causes the problem. The legislation ultimately has a very limited effect.
DR OZDOWSKI: DIMIA reports the issues of sexual abuse of children on a regular basis for state authorities investigation as I understand. Are there any other circumstances where DIMIA or ACM or anybody working in detention centres calls upon state authorities to look into the welfare of children?
MS DOLGOPOL: There have been a couple of suggestions of physical abuse of children. The problem is I'm not sure that the asylum seekers themselves have any real knowledge of child protection laws. When you ask people what they've been told about Australian law they say: basically nothing. Very little is done to educate them so it is not surprising that the reports are being made by ACM more than by the detainees themselves because the detainees don't even know that they have a right to make those allegations.
In our conversations with some of the families concerns were expressed about the behaviour of some of the other detainees towards children in the compound, of unnecessary discipline and forceful discipline which might amount to forms of physical abuse of a child and there were also issues raised about the emotional abuse of children both by other detainees and by ACM guards.
DR OZDOWSKI: What kind of a model should be adopted, legislative model, to ensure much better protection of children in detention?
MS DOLGOPOL: Either the Commission or the Ombudsman needs to be given some power in this area or, as we have recommended, an independent authority but there has to be a Commonwealth-level authority that will have the ability to investigate abuses in any detention centre around Australia because the inherent problem in this is section 109 of the Constitution and any place where there's a conflict between State law and Commonwealth law, the Commonwealth law will prevail. So unless you have a Commonwealth law in this area you will always be stymied by that part of the constitution. So it seems to me something needs to be done at the Commonwealth level.
DR OZDOWSKI: Yes, thank you very much. Now, I will ask my Assistant Commissioners to put questions to you.
MRS SULLIVAN: I was just interested in pursuing this independent authority a little further. If we could imagine a scenario that at some point in the future the children were to attend state schools in South Australia and a teacher reported that a child had disclosed to them, how would you play out that scenario in terms of an independent Commonwealth authority?
MS DOLGOPOL: It depends on if the - are you talking about a child who is still nominally in detention but who may be living in the community and then
MRS SULLIVAN: Or on day release to a school.
MS DOLGOPOL: If the child was still in detention then it has to be the Commonwealth authority that would investigate the child abuse or authorise the State authorities to investigate on their behalf but it still needs to be independent from the Minister because ultimately the Minister is in a position where his responsibility to control or as he sees it to control Australia's waters will always conflict with the child's protection needs. It would be very difficult for anyone in that position to make a truly neutral and unbiased decision and that is why we need to be confident that the decision maker in that area is neutral.
MRS SULLIVAN: It is also quite well known that the definitions of child abuse and neglect vary from state to state.
MS DOLGOPOL: Yes.
MRS SULLIVAN: How do you overcome that problem with an independent commonwealth body?
MS DOLGOPOL: They do vary from state to state but there is some overlap and I think it is more important that we look at perhaps best practice. It might be possible to find one piece of State legislation that seems to be more specific and use that as a model. We have enough lawyers and talented people around Australia that I would have no difficulty in believing that they could draft legislation that would be appropriate to the situation. I wouldn't be concerned about the ability to draft the legislation. It is really the interaction between that authority and the Minister and who will have the final say that becomes crucial and I think that would be the difficulty in the political discussion.
MRS SULLIVAN: Did you get any sense in your interviews of how much intra-familial abuse could be occurring, if any?
MS DOLGOPOL: No. It was brought to our attention that there were a couple of instances, including among the families that we interviewed, of suggestions but no proof as yet. There were more concerns expressed about physical issues than sexual issues in the families that we interviewed but I did not specifically question family members about this because those sorts of interviews would have taken time and required a counsel to be present. I did not feel it appropriate to actually push the families to try and discover whether there are instances. I think many of us have come away and certainly I personally came away with a concern not at what parents were doing to their children in a sense of purposely doing, and I don't fault the parents, but real concern about the fact the children are witnessing the deterioration of the mental health of their parents, of what that must do to them as children to watch that phenomenon taking place.
I kept thinking to myself, of trying to picture what it would be like as a child to watch a parent who is that depressed who constantly found it difficult to cope with life and who could state quite clearly and was very much aware that they were finding it difficult to cope with their parenting responsibilities. Again I think we need to remind ourselves that it is the situation and the conditions of detention that lead to that and the lack of proper training of staff, as I said, in terms of persecution people faced. But I think that this is a serious concern that children have to watch the mental deterioration of their parents.
MRS SULLIVAN: Finally you mentioned you interviewed some adolescents. Given that adolescence is a period maybe of, I don't know, hormones if nothing else, would you like to comment on the main trends you perceived in those interviews and how those adolescents may have been having different experiences than their counterparts outside detention centres? And I'm thinking particularly in terms of the mental issues you have raised but also perhaps some education and vocational issues.
MS DOLGOPOL: For some of the adolescents we interviewed who came from Iran and Iraq there was a very strong level of homesickness. They remember the quality of life that they had in terms of relationships with family, extended family, with their school, with their friends. They remember the things that they did as normal every day children. And so several of the children talked about missing that aspect of their life and of course then were quite aware of what they had had and what they did not now have.
All of them expressed concern about their future, about the lack of education and what that would do to their future prospects in life. These are children who want to work hard, who want to make a better life. There was also a sense from some of the male adolescents of a resentment developing which, you know, to give them credit they were very much aware of. There was a lot of self insight but certainly resentment developing towards the Australian Government about their treatment and the fact that they had been made to suffer like this and they couldn't understand it.
They could not understand why having fled persecution they were being made to suffer yet again by a government that they thought was democratic and of course because they've had so little interaction with the Australian population they don't actually know what any of us think about the situation. They don't know about the divergency of views in the Australian population and during those interviews it is not appropriate to try and discuss those matters with them. So I'm just recounting, you know, the sense of frustration and resentment that they are feeling and of course that level of pent-up frustration cannot be good for anyone.
One of the unaccompanied adolescent females was very concerned because she comes from a particular group where women are modest. She accepts her cultural background and is a firm believer in women being very modest. Men show an enormous amount of disrespect towards women when they are not accompanied by an older male relative and she was finding this situation incredibly difficult. She had no effective way of dealing with it and I think that that situation and the fact that nothing was being done despite the fact that this situation had been brought to the attention of ACM's management several times by the Woomera Legal Outpost and by other visitors to Woomera, nothing had been done and I'm sure that the constancy of trying to deal with this situation led to her being suicidal.
MRS SULLIVAN: Were they taking advantage of the English lessons, for example?
MS DOLGOPOL: The levels of depression in the adolescents is such that even they can't always take advantage of the situation. Some of them had gone to school and I think one of the issues that is raised in Action for Children's submission and I know has been raised in other submissions, is that the lack of resources into education means that there's no difference made between those students who may in fact have been studying English in their countries of origin and there's a wide range in the families that have come to Australia.
Some have come from middle class backgrounds who are either at school or privately they were taking English language classes so they already had some level of proficiency. Other students had had no formal education at all in their countries of origin and yet everyone has been lumped together and so it became very difficult. If you are being taught an alphabet that you already know and you actually had some basic command of the English language, to be sitting in a room where someone is trying to teach you the ABCs all over again becomes quite frustrating. So certainly a couple of the adolescents said that they had stopped going to school because they felt they weren't learning anything.
DR OZDOWSKI: Professor Thomas?
PROF THOMAS: Considering the cultures these people came from, patriarchal, male-dominated, how do you think the gender advisers will be able to operate?
MS DOLGOPOL: One of the things that the High Commissioner for Refugees has talked about quite extensively is that even in societies that are very patriarchal there are often structures in place for women to have their voice heard. They may not be obvious to us as an outsider but inside their culture you know whether it is through family members, whether it is through other networks of women, but women do manage to in fact find a voice in many societies where we wouldn't necessarily assume that. Becoming refugees mean those structures have all broken down so that you don't have that way of making your voice heard. That is one of the things that a gender adviser is supposed to be doing, is looking at the cultural background of the women and thinking through how they can in fact give them a voice in a way that would be culturally appropriate.
PROF THOMAS: What do you think is the long-term impact of the detention centre experience is on the girls, the women, when they come out of the detention centre?
MS DOLGOPOL: Absolutely. I mean, the women that I interviewed felt that they had come to a point where they could not effectively carry out their parenting responsibilities and given that a lot of them saw this as one of their major roles in life it was quite a depressing thought and obviously fed into their levels of depression. It was awful for them to think through that they were not being the sort of parents that they wanted to be to their children. I think for some of the adolescents there are issues about how they learn to be adolescents both within the context of their own culture but they are very much aware that they have come to Australia and that Australia will be different. They are not being given an opportunity to learn how you deal with being an adolescent from a particular culture but living in this society that is different from your own.
I think the High Commissioner for Refugees has pointed out on a number of occasions that wherever you look around the world, sometimes people from developed countries who are in a refugee camp bring prejudices with them about the situation of women and girl children and don't actually try and learn. I think it would be that sort of situation that is happening now where we make assumptions that because these are girl children from particular cultural backgrounds that they don't have goals to be educated, that they don't want a career, when in fact in their own society they might be able to get access to those things and many of them do. I think we need to be careful not to put our own prejudices on the people that are at Woomera.
DR OZDOWSKI: Just a last question, coming to this legislative conflict. We have got state legislation dealing with child protection; we don't have federal legislation here.
MS DOLGOPOL: That is right.
DR OZDOWSKI: Where is the conflict?
MS DOLGOPOL: The conflict is in the Migration Act. Ultimately the Minister is the guardian under the Migration Act of unaccompanied minors and has the right to detain unauthorised arrivals. As I read into the record, that provision, the whole Memorandum of Understanding is based on the theory that the Commonwealth has the power and ultimately
DR OZDOWSKI: So if I understand you correctly, what you are saying, it is a mandatory system of detention and the federal legislation overrides the state legislation dealing with child protection.
MS DOLGOPOL: That is the way everything has been structured. Obviously it has not been tested in Court and you are right but we don't have two pieces of legislation that claim to be dealing with the exact same issue but everyone has been operating on the assumption that the Migration Act and the Minister's powers under the Migration Act override any authority of the state.
DR OZDOWSKI: Thank you. Thank you very much for your submission. Thank you also to your organisation, Action for Children, and thank you for coming and giving the evidence.
MS DOLGOPOL: Thank you.
DR OZDOWSKI: Now I would like to ask Dr Ros Powrie to come forward. Thank you very much for coming to give the evidence and also thanks for the submission which was certainly very interesting. I would like to ask you to take an oath or affirmation to start the proceedings.
DR ROS POWRIE, affirmed [10.09am] Australian Association for Infant Mental Health
DR OZDOWSKI: Thank you. Now, could I ask you to give your name, address, qualification and capacity in which you are appearing for the record of proceedings?
DR POWRIE: My name is Dr Rosalind Powrie. I reside at [address removed]. I'm a child and adolescent psychiatrist and a perinatal psychiatrist in the public health system in South Australia and I have also been a visiting psychiatrist to the Survivors for Torture and Trauma Rehabilitation Service up until August last year. I'm here in a capacity as representative for the Australian Association of Infant Mental Health and authored submission on behalf of that association into the Inquiry into Children in Immigration Detention.
DR OZDOWSKI: Thank you. Could you perhaps mention a bit more about whether you have got any direct experience of going to detention centres or of people who are released from detention centres, in particular children?
DR POWRIE: I visited Woomera Detention Centre on one occasion on March 7 this year. That was in relation to an invitation from the Australian Correctional Management Services to Adult Mental Health Services looking at what kind of pathways of referral could be made in relation to detainees and also I went with an interest in looking at how the detention centre supported, or didn't, the mental health needs of children.
DR OZDOWSKI: So you went, one could say, as a consultant to ACM?
DR POWRIE: I probably went along more as an interested party because the invitation was directed to the Adult Mental Health Services but I did in the course of that visit gain some understanding about the difficulties that children and families face in detention and also the difficulties that the ACM staff have in identifying problems of children.
DR OZDOWSKI: Were you paid for your services to ACM?
DR POWRIE: No. No, I was not.
DR OZDOWSKI: So you just were invited just to
DR POWRIE: I went of my own - yes.
DR OZDOWSKI: Thank you. Now, could I ask you to make an opening statement.
DR POWRIE: The Australian Association of Infant Mental Health, first of all it is important to put in context our interests. We aim to improve the professional and public recognition that infancy is a critical period in psycho-social development for infants and family and to provide a focus for multi-disciplinary interaction and cooperation for those who are involved and interested in working with infants and care givers. So our specific focus in making this submission was to make comments on the psychological and social well-being and development of infants and young children in families in immigration detention; to make recommendations about specific services required for young children and pregnant women in detention and on release in the community; to look at culture and its influence on the psycho social well being of infants and parents; to make comments on the impact of detention on the well-being of young children and recommendations thereof.
DR OZDOWSKI: Thank you. Your submission is saying that the first few years are really crucial for the development of the child. Are you saying that the changes to development - if it wasn't conducted in a proper way there will be some irreversible changes in child psychology?
DR POWRIE: That is correct. We know now from the last 10 years of research into brain development and research into the development of children's social and emotional life that the first years are absolutely critical to the subsequent adjustment in childhood and adulthood and what can happen in the first 3 years can certainly be irreversible and long lasting. We see this in cases of severe child neglect and emotional abuse where actual changes in the brain structure occur and they are irreversible.
DR OZDOWSKI: And it applies to all children or some of them would be more resilient and would be reacting differently to their environment?
DR POWRIE: Yes. One of the influences on the impact of trauma, neglect or abuse on children is their own genetic potential and of course genetics play some part in the resilience of children, so does their constitution and temperament and so do factors related to their attachment relationships and the ability of care-givers to help repair the impact of trauma and to help enrich their development such that they may overcome adverse circumstances.
DR OZDOWSKI: Does the detention involvement impact on development of children after 3 years?
DR POWRIE: We believe as an Association it certainly does. When you look at the world literature on the impact of emotionally depriving environments, which detention clearly is and I can speak about that further, we can see that that does have an impact on the development both intellectually, emotionally and socially of children's lives.
DR OZDOWSKI: There are some mental health services provided in detention. Are you aware of any services which specifically focus on children - mental health services in detention centres?
DR POWRIE: As I understand it, the Australian detention standards do state that there are services available for children, health services and psychological services. However, these are largely ineffectual in relation to the length of time that psychologists are available. They are on 6-week contracts mostly in ACM and there is little continuity of care for families or children who have mental health problems and certainly in visiting Woomera and other services there is extremely poor access to what our larger community or larger body of children in the community have to specialised mental health services, certainly no perinatal services and very poor access to child and adolescent mental health services.
DR OZDOWSKI: Thank you. I now will ask Professor Thomas to continue asking questions.
PROF THOMAS: Could you comment on the effect of the mental health of the parents on these little children?
DR POWRIE: Yes. We know that the mental health of parents certainly impacts on the development of children's attachment relationships. Infants are extremely sensitive to their environment and in fact require their primary care-giver to provide them with an environment that will help their emotions develop. So parents who are emotionally unavailable because of their mental health problems, we know that there are very high rates of mental health problems in asylum seekers in detention and in the community. Up to 40 per cent, for instance, in one study in Sydney were assessed as having post traumatic stress disorder. We know that those kind of problems can severely impact on the development of attachment relationships and sensitive care giving.
PROF THOMAS: So what kind of major changes would you like to see happen? I mean practical implementable strategies?
DR POWRIE: Well, the first would be that particularly for infants and young children their period in detention is kept to a minimum and they are also for women particularly who are at risk of mental health problems, antenatally and postnatally and certainly women in immigration detention would be in this category, that they have direct access to the kind of services that would provide help for them. But overridingly it seems that detention has a pathogenic effect on parenting. The institutional experience of parents, as has already been mentioned here, very much undermines their ability to care for their children. They cannot provide for children's emotional needs while they are in a situation of deprivation themselves. So that kind of problem is passed on to children and
DR OZDOWSKI: Could last for life? The impact of it could be lifelong?
DR POWRIE: Potentially it could. Children's brains develop at - there are critical periods for the development of certain abilities in children and critical periods certainly those could be impacted upon, such that they can have lifelong effects.
PROF THOMAS: There is one mention in your submission about the practice of ACM to transfer pregnant women at 36 weeks to the hospital. On the surface it is - is it a good thing or in your submission it could be a very traumatic experience. Can you explain why this practice should be stopped or should not?
DR POWRIE: Well, this is a practice that seemed to be best practice in obstetric care in rural and remote areas, so it just does not apply to women in immigration detention. Unfortunately the problems of language and understanding about obstetric care are seen to be very lacking in terms of the antenatal care for women in detention centres and I think the recommendation is that women consent - are fully aware of their options in terms of giving birth and fully consent to those options so that they are not traumatised further by separations from their families, of which they know no reason for.
PROF THOMAS: You emphasise that the first 3 years is crucial and therefore do you think that age has a factor, children - of the children under the age of, say, 5 or 6, 10, 11 and so on? I'm just looking at the developmental stages of the children. Do you think that children in the first 3 years are more vulnerable than the 5-year-old or 6-year-old or the impact is different for different age groups?
DR POWRIE: Well, certainly both of those statements are probably true. I think in terms of children's brain development though, the early years - the impact of environmental stress is even more critical in the first 3 years of life because children of that age require a most consistent and nurturing environment to support healthy development. The impact of an adverse social situation or an adverse environment will be different for an older child who has previously had a good enough experience of attachment or nurturing. So it will impact differently at different stages of development but certainly during the first 3 years when the infant's brain reaches 90 per cent of its adult capacity then those years are a very vulnerable time for the young child.
PROF THOMAS: So are you saying this, that the children who have had a good first 3 years, say, before they arrive here and they arrive here at the age of 5 or 7, the impact will not be so serious?
DR POWRIE: It is not that it will be so serious, it may be quite different and it will impact differently on their developmental task that they experience at that particular time. For instance, a 5-year-old child who previously has adequate development and adequate parenting but perhaps arrives in a detention centre without then adequate schooling or whose parents then become depressed, demoralised, where the environment does not support the further development of that child's needs, then you will see a different set of behaviours or emotional reaction but you probably won't get the extent of difficulties that you would for a younger child placed in similar circumstances.
PROF THOMAS: Yes. The Minister claimed that he has offered to move mothers and little children out but they refuse to leave because the father would have to stay behind. So how would you recommend an implementable strategy?
DR POWRIE: The removal - the separation of families is not a healthy development or not a healthy solution to the child's needs and we would recommend that families are kept together and not separated with the father in detention and the mother and children in, say, community housing. Some detainees, some may choose to do that but in fact it is not a healthy or necessarily a protective solution to those children's problems.
DR OZDOWSKI: Could I ask you, there is a picture of this dilemma in terms of policy because the Minister is saying that he is showing the best interests of the child by keeping the whole family in detention rather than allowing separation and letting children out or letting mother and children out. How do you see
DR POWRIE: Well, from a child developmental point of view there is no dilemma. A child's development is best supported within a healthy family context where parents are free to care for their child in their culture and supported in a way in which they see fit as parents.
DR OZDOWSKI: So what you are saying is that the best interests of the child cannot be served in the detention context.
DR POWRIE: No, and they cannot be served either by a forced separation of parents because, of course, that creates a whole new set of difficulties for the child being separated from the other parent and for the parents in being unable to support each other and parent together as a family unit.
PROF THOMAS: They report some of the parents say: take my children, take them away from here. Then what do you think about the fostering, that maybe the children are - if the parents agree, what do you think about the impact of that strategy?
DR POWRIE: I can understand parents wanting - well, I can understand parents doing that. Parents will in extremes will put their children's survival above their own and that is how I would interpret that situation, that is one of trying to ensure their children's survival. Ultimately in the long term that is not going to serve children well, being separated from their parents and in an adopting or fostering situation for the long term. For the short term it may be appropriate in some circumstances but certainly not in the long term, it is likely to have very damaging effects for the child.
MRS SULLIVAN: Can I just ask you to comment on the impact of higher stress levels on infants and young children. I guess I'm making an assumption that there are in fact heightened levels of stress in the situation we are just describing.
DR POWRIE: Yes. Well, there's certainly a lot of literature around to show that even in utero infants - well, foetuses exposed to high levels of anxiety in their mothers will have an increased risk of adverse outcomes perinatally. Those children are more likely to have low birth weight and more complications in the perinatal period. Some of the advances in neuro-biology show that circulating stress hormones have a toxic effect on the development of the brain and Bruce Perry's work has shown that children who are exposed to those highly stressful environments, particularly where there's maltreatment or community violence or community trauma, have poor outcomes in terms of their intellectual development and their social development.
MRS SULLIVAN: Given that list that you have just provided, have you any recommendations about how the stress levels within detention centres could be reduced, given that you visited there fairly recently?
DR POWRIE: It is hard to see, given the environment of detention and what detention is set up to do, how stress levels could be reduced. It is a quasi prison environment and so the problem really is one of changing that context for children rather than trying to, I suppose, restructure detention. I think it would be very difficult to offset the stress by changing what goes on in detention but if that were to happen I think there are lots of things within the environment of the detention centres, what I have seen anyway, that could be changed. It is a physically harsh environment with very poor opportunities for infants and children to play freely so enriching that environment may be one way of offsetting the stress, providing proper early child development enrichment tools, having proper facilities for enriching children's development, having facilities for parents to play with their children and having the freedom to do so, for parents to be having regular and adequate access to therapeutic services which will help decrease their stress levels may be of some help. I think that is probably tinkering around the edges and not getting to the fundamental issue and that is of the kind of environmental deprivation that is part of the detention structure.
MRS SULLIVAN: Could I explore one other aspect of your submission and it relates to attachment. What is the impact, in your view, of detention on attachment and have you any advice to us again about possible improvements within the detention context?
DR POWRIE: Well, as I outlined in my report, in the submission, the detention environment is one basically of dehumanisation and as has been pointed out previously children witness that dehumanisation of their parents and themselves every day. That inevitably erodes the attachment relationship, whether it was secure or insecure, with their parents, it erodes that even further. Parents aren't able to actually care for their children and - in a way that is part of normal parental responsibility. They are not allowed to feed their children in a way that is customary for their family. They cannot provide them with clothing, they cannot even dispense medicines or have ready access to things, nappies and so on without first having a gate-keeping process. All of those parenting functions mean that the ability for parents to care and protect for the children is very much compromised. So clearly that will have adverse effects on the attachment relationship with their children and children experience that, can experience that as a parent depriving them of emotional nurturing. So the attachment relationships are very much undermined by both the problems of parenting in detention but also doubly undermined by the high rates of mental health problems that parents experience as well.
MRS SULLIVAN: In your visit do you see any signs of re-attachment to others, in other words, an attachment of children to adults or individuals other than their natural parents?
DR POWRIE: I didn't witness that directly but certainly there are a number of case vignettes cited by other psychiatrists, particularly Dr Sarah Mares, where children, especially young toddlers would wander off and attach themselves to the ACM staff for instance, over and above their parents, they seem to sort of wander aimlessly around with no attachment really to any particular adult. I saw children probably a 6 or 7 year old little boy wandering around when I was there with a group of men who had dug mock graves and it was - I don't know what that child was doing but no one seemed to be caring for that child. He was wandering aimlessly around the compound.
DR OZDOWSKI: Just two things which were not covered by your submission, when we speak to parents and children quite often we are told that there is no special food prepared for children. Quite often children complain that their food, which is prepared for adults, is inadequate. Is it of relevance to child development that there are some special meals provided or it is more or less a question of taste only?
DR POWRIE: Well, children have many varied patterns of eating. One of the things we recognise in the mainstream community is that the children need to be offered a variety of tasty and nutritional foods, particularly for younger children who don't have the kind of adult appetite that we do. They are often best served by allowing to graze on food during the day, have healthy snacks in between meals so that their nutritional requirements are met and that is just a fact of good childcare and what we know about children's eating patterns, that they don't necessarily eat at set meal times, three meals a day, as might be offered in an institutional setting. They eat when they feel hungry and that depends a lot on the individual child and their level of activity.
DR OZDOWSKI: The second issue is the issue of self-harming. We have seen children as young as 9 years old committing self-harm. Could you explain how this could happen and what I'm also interested in is whether parents play - could play some role in encouraging children to self-harm?
DR POWRIE: In the detention
DR OZDOWSKI: In the detention centres, yes.
DR POWRIE: Certainly children are very susceptible to the influence of adult behaviour around them and in a very confined community such as immigration detention, children are witnessing and are unable to be protected it seems from witnessing the despairing and often self mutilating acts of other adults. When children are unable to be offered an alternative behavioural strategy or modelling for dealing with despairing feelings, hopelessness, anger, then often they will model on the kind of adult behaviour they see in a copycat kind of way. SO that is one of the possible mechanisms why children may, as young as 9 may self-mutilate. As to parents, I don't think any parents would wittingly would want their children to hurt themselves, but I think in the kind of despair and helplessness that some of these parents feel they actually cannot connect with their children's needs. They cannot - they are so overwhelmed and pre-occupied with their own situation that they cannot think about the needs of their children and that is a very serious and worrying situation for young children in immigration detention.
DR OZDOWSKI: In your professional experience, how frequent is self-mutilation in broader Australian community among children?
DR POWRIE: Self-mutilating behaviours are very uncommon in pre-adolescent children. They become more common in the teenage years and often related to stressful circumstances, depressive illnesses, in some sub-cultures of youth self-mutilation becomes a form of acting on one's despair and existential despair, in particular, but in younger children it is extremely uncommon. What you are more likely to see in young children who are miserable and unhappy is just neglect of themselves, behavioural and emotional disturbance, anxiety and probably risk taking behaviours, an unawareness of their own safety in keeping themselves safe.
DR OZDOWSKI: Are you aware of any statistics kept on State or Federal level which relate to children's self-harm?
DR POWRIE: There are certainly many studies looking at suicidal behaviour in adolescents, in particular. There are many studies in Australia, I cannot tell you the direct references at the moment, but certainly there is a large literature body of research on self-harming behaviours in children and adolescents.
DR OZDOWSKI: Any other questions, yes?
MS LESNIE: I just have one question to take us back to where we started which was in your submission that the impact of detention on the 3 and under age would be quite grave. As we know, a large number of the people who arrive unauthorised end up in the Australian community, can you describe to us the sorts of problems that, we as a community, will have to deal with as a result of the impact that detention has had on these infants?
DR POWRIE: Well, the cost I guess will be potentially quite great in terms of the services that might need to be engaged with these families to help children with their educational difficulties because children who have been subject to trauma and abuse in early childhood often end up having quite severe learning difficulties so extra resources are needed there in terms of helping their education. These children are more likely to have behavioural difficulties, problems with their impulse control, some of these children will be seen to have attention deficit disorder which is probably a simple way of looking at their problem but does not understand the complex pathological pathways that result in that kind of behaviour. These children will have difficulties in socialising with other children, again, that will affect their schooling, it will also affect their relationship with their parents. Their parents also because of the adverse affects on their attachment will probably have difficulties in parenting those children so they themselves will need extra support in helping to care for their off-spring. There may be a whole host of problems which will result in more intensive therapeutic support needed for these children and families. For boys the problem may be particularly difficult in that we know that boys, male children subject to early trauma and attachment problems are more likely to develop acting out behaviours, disturbances of conduct and down the track even delinquency and that is one of the pathways that can lead to criminal behaviour.
DR OZDOWSKI: Okay, thank you very much, Dr Powrie. Thank you to you and to the Australian Association for Infant Men