Detention turns refugees into patients. Don’t jail doctors for saying so | Ranjana Srivastava

By Ranjana Srivastava

My parents recently gave me some advice: don’t get arrested, it would be a waste of a career. Their concern was fuelled by the Australian government’s new law to imprison doctors for up to two years for unauthorised disclosure of information relating to detention centres.The delicious irony of two migrant parents warning their migrant daughter to not write about the plight of other migrants was not lost on me.


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The new law is chilling news not only for the handful of brave doctors who risk the government’s ire by travelling to detention centres, but, in my opinion, all the other doctors who will never set foot inside these hellish places but who nonetheless object to what is reported from inside.

Earlier this year, Dr David Issacs, a Sydney-based paediatrician, revealed the lack of sanitary pads for women detainees held on Nauru. His claims were decried but his words rang true to me. I had experienced something similar (albeit in different circumstances) 10 years ago, when I was a Commonwealth volunteer doctor in the tsunami-ravaged Maldives.

A neighbouring island had been pulverised by the giant waves, leading to a mass evacuation of residents to the tiny island that I was posted to. Altogether there must have been nearly a thousand people living in cramped conditions on an island that barely had services for its own people.

The world’s generosity in the aftermath of the tsunami was tremendous and aid poured in. Much of it was well-intentioned but quite useless such as stale bread from the Middle East, an expensive desalination plant and sophisticated, intravenous anaesthetics from Europe.
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Amid the usual stories of grief, trauma, diarrhoea and depression, I began hearing a strange account. Girls and women were being denied sanitary napkins unless they were proven to be “genuine refugees” – that is, belonging to the evacuated island.

I told the first few women that this was simply a ridiculous misunderstanding. After all, if you needed sanitary pads and there was no place to buy them and your home had been flooded, how could someone deny you access to an essential hygiene supply? But the stories kept coming and I was forced to turn to the island administrator who already considered me a hindrance to his authority. It was an excruciating dialogue to have.

“What can I do, Miss? Government orders.” he sighed, following my gaze to the sacks of sanitary napkins in his control. I resisted asking him a very personal question as to what he might do if his own little girl were in that position someday. I toyed with the idea of stealing some pads but didn’t want to risk censure. So I told the women I couldn’t help. They nodded understandingly.

A patient told me he didn’t mind what happened in Nauru as long as “his” Medicare worked.

Luckily, an international monitoring delegation arrived on the island that week, led by the then-president Maumoon Abdul Gayoom’s daughter, Dunya Gayoom, a graduate of the London School of Economics. The team hardly spoke to the islanders. I wondered how the delegation could reach any decision about the adequacy of aid by only speaking to those in charge.

I waited for my chance and just as she was about to leave, I virtually pounced on Dunya Gayoom, whom I recall as concerned and engaged.

“Have you any idea that half the women are being denied sanitary napkins?” I whispered. Her eyes widened.

“What?” she replied.

“Government orders, I am told. I hope you see how awful and denigrating this is.”

She was whisked away, I was glared at, but later that same day, every woman was lining up for her personal supply of sanitary napkins. It was a major triumph. As it turned out, the administrator had made policy on the run simply because he could.

I repeatedly noted that under conditions of stress, those in power made rules with impunity. At one time, guns were trained on bottled water that was strictly rationed. I was afraid to go out in the dark because I wasn’t game to be mistaken for a miscreant.

Which brings me back to the point about doctors who speak up about injustice from places closed to scrutiny. They are not rabble-rousers but almost always people who are deeply troubled by egregious breaches of human rights and who grapple with the ethics of keeping quiet.

For any doctor, highly educated and qualified, there are infinitely better ways to attract attention than by being the voice of detainees, mistrusted and demeaned by a significant proportion of the population.

In one of the more heated exchanges I’ve had this year a patient told me he didn’t mind what happened in Nauru as long as “his” Medicare worked. I told him bluntly that his worldview was very narrow. “It’s a free country,” he said. “We are allowed to disagree.”
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Yes, as a democracy we are allowed to disagree. That same democracy should never gag the rights of doctors who speak out against perceived injustices against current patients. Or, for that matter, the refugees who are on their way to becoming patients.

The government counters that there are appropriate mechanisms for reporting misconduct and maladministration. Even if they were ideally efficient, transparent and responsive, which no one claims, I would think that the reasoned voice of an experienced doctor would make for a robust link in the mechanism. Especially when that voice soon becomes a chorus.

Let doctors speak in the defence of vulnerable citizens and their basic rights like they always have – if there is nothing to hide, then they will soon stop.

And let the parents of doctors sleep in peace, knowing that the next call from their child won’t be from a prison cell for having fulfilled what is nothing more than their fundamental duty of care to patients.

Source: Detention turns refugees into patients. Don’t jail doctors for saying so | Ranjana Srivastava | Comment is free | The Guardian

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