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03 Feb 2014

By Dr Michael Gliksman*


“Silence in the face of evil is itself evil. Not to speak is to speak. Not to act is to act.”

Dietrich Bonhoeffer

In Australia there exists a shameful conjunction between injustice and ill-health involving foreseeable, avoidable and possibly irreparable harm to the innocent.

I speak of the indefinite detention of asylum seekers – children too – charged with nothing, guilty of nothing, in Australia’s Gulag Archipelago stretching from Christmas Island, through our remote deserts and on to tropical islands to our north.

Some children have been there from birth, born in Australia but denied their birthright of citizenship, knowing no crib but one bounded by razor wire. Some are unaccompanied minors, some are orphans. All are denied the benefit of child protection legislation we take for granted.

Doctors as a group are reluctant to enter the political fray, but there is a long established exception to this reluctance: when the health and wellbeing of people are threatened by any policy espoused by any government, of any political flavour.

At the AMA Federal Conference in 2005 an Urgency Motion proposed by myself, seconded by Dr Michael Noel, was passed unaltered. It included the following:

  • recognise that the indefinite detention of children is child abuse; and
  • release immediately all children detained in immigration detention facilities.

Within days of its passage, the Howard Government announced the release all children in detention, a policy since undone by successive Labor and Liberal Governments. Worse was to come.

Late last year, the Abbott Government disbanded the Immigration Health Advisory Group (IHAG), established by the Howard Government in 2006. Populated by prominent medical and other health professionals, IHAG gave independent, unbiased advice to the Government of the day.

Coming hard on the heels of a highly critical Amnesty International report into conditions at the Manus Island detention facility, it begs the question: what have they to hide? I think we know.

Research recently published in the Medical Journal of Australia found substantial unmet health needs and high levels of psychiatric morbidity among asylum seekers in detention in Darwin. The lack of transparent independent scrutiny of detainees’ health care was of major concern.

The conditions in Australia's offshore facilities, where there is now no independent medical oversight, are even worse, including restrictions on essential female hygiene products and access to water in tropical environments!

In an accompanying MJA editorial, Australian Human Rights Commission President Gillian Triggs wrote: “ is often the detention environment itself that causes mental illness.....Accordingly, it is the removal of people from closed detention that will have the most powerful effect in mitigating mental illness.”

Suicide is the leading cause of death among detainees, as one would expect from a policy that leaves people in indefinite detention, unaware of their ultimate fate, some in conditions unfit for human habitation. If we were to design a system sufficiently cruel to promote suicide, this would be it.

Is it by design? Or is it simply the willful indifference, the turning of the blind eye to which Bonhoeffer referred?

The Australian Government is obliged, as a signatory to the UN Convention Relating to the Status of Refugees, to provide the same standard of health care to detainees as is available to the general population. There can be little doubt Australia is in breach of that Convention.

Out of sight and largely out of mind, Australia is gratuitously harming people almost all of whom, recent history shows, are entitled to refugee status under our international treaty obligations. In our name, Australia's Government is building a legacy to shame us for generations.

Currently more than 1100 children are in indefinite locked detention, their future uncertain, their health and development blighted by the ongoing abuse that is integral to that detention. We should consider our response in the light of Bonhoeffer's declaration, for we too will be held accountable by history for silent acquiescence.

We know the damage done and, equally, we know the remedy. We would not remain silent in the face of such abuse in any other setting. In fact, Australian law would not allow us to.

Our profession needs to send a strong, unequivocal message, one that is true to its tradition.

That is why Doctors For Refugees was brought into existence, with a founding committee that counts a prior State President (Richard Kidd) and a prior State Vice-President (myself) among its members.

We can fight with the angels or stand silent with the devil. As Bonhoeffer reminded us, it is the only choice we have.


* Dr Michael Gliksman (aka Ming the Merciless @MGliksmanMDPhD) is a physician in private practice in Sydney. He is an AMA Federal Councillor, and a member of the Australian Red Cross International Health Law Committee. The views expressed here are his own. Join Doctors For Refugees at .


Published: 03 Feb 2014