Introduction by Croakey: Despite working in psychiatry for 20 years, Dr Emma Adams wasn’t prepared for what she saw when she first went as a volunteer observer to a detention centre for asylum seekers in Darwin, where mothers and children were trapped in utter despair.
She made up her mind to take action at a personal level and to bear witness as a professional.
“This is how we can change hearts and minds,” Adams told this week’s Royal Australian and New Zealand College of Psychiatrists (RANZCP) annual meeting in Cairns.
That visit to Darwin led to Adams, an Aboriginal woman, and her husband welcoming two young Afghan boys into their family and to the publication late last year of Unbreakable Threads: The true story of an Australian mother, a refugee boy and the real meaning of family.
Australia’s widely condemned policies on asylum seekers have not dominated the federal election campaign as they looked set to do in March when Prime Minister Scott Morrison re-opened – at a cost of $185 million – the Christmas Island detention centre in response to medevac legislation, which he opposed, that makes it easier for sick refugees on Manus Island and Nauru to seek medical transfers.
But there is little doubt they will play a role in how people vote, with the ABC’s Vote Compass survey showing that views on whether boats carrying asylum seekers should be turned back have “barely shifted since it was a top-order issue in the 2013 election”.
Labor is in lock step with the Coalition on boat turnbacks and refusing entry ever for those on Nauru and Manus, but its broader policies deviate from Coalition policy in significant ways, says Melbourne University academic Dr Claire Loughnan in this useful analysis.
That includes Labor’s promise to abolish Temporary Protection Visas (TPVs), addressing the state of limbo and extensive hardship for refugees and asylum seekers living in community, often without means of support, housing and services – among important moves “towards fulfilling the spirit and aims of the Refugee Convention”, Loughnan says.
Australian medical and health groups, including the RANZCP, have spoken out against mandatory detention of asylum seekers and warned about the human rights and mental health toll of Australia’s policies.
Adams’ presentation to the congress, which is published as a #LongRead below as part of our coverage of #RANZCP2019, graphically describes that toll and reminds us of the need to step up advocacy and action as Australia heads to the polls tomorrow.
Emma Adams writes:
Despite all that has happened in the last 230 years, Aboriginal people remain generous and openhearted. Make no mistake, this is and always will be Aboriginal land. Sovereignty has never been ceded. I would like us all to acknowledge this, thinking deeply about reconciliation and respect. And in this spirit, consider those who have sought safety on our shores.
Five years ago, I went as a volunteer observer to check on the wellbeing of mums and bubs in Darwin’s immigration detention centres. I expected this trip to be confronting. Mothers and children kept behind bars always is.
But even as a psychiatrist with 20 years experience, nothing prepared me for what I saw.
The atmosphere in the supposedly family-friendly version of these detention centres was suffocating. All had high wire fences, one called Wickham even had a double 10 metre high electrified fence and prison-style airlock gates. I witnessed people called by their boat numbers rather than their names. Every mother I saw was suffering and all the children I saw were distressed. All of them.
I saw mothers sitting unresponsive to their own children, lost in their own misery. One woman told me about their escape across the Indian Ocean, seemingly oblivious to her little girl weeping beside her, ‘it would have been better if we were eaten by sharks’ she said.
I saw a child aged a little over a year sitting in a sandpit, all alone. In no culture is it normal for babies to be left by themselves like that. This baby’s face was blank and his dark eyes stared into space as he repeatedly flicked the handle of a brightly coloured plastic bucket.
The child in front of me was not playing. He was helpless; he couldn’t run away or fight this abandonment, and since there was no one around to help soothe his distress he had become frozen.
Crossing the line on humanity
Here, in Australia, was a profoundly abnormal situation.
These were families in prison. They had broken no laws by fleeing to the first country that was a signatory to the UN refugee convention and now they were being treated worse than convicted criminals.
In the real Australian world outside, I’d be recommending these depressed women and their babies be removed from this dangerous situation and offered intensive psychological treatment. Here, that would not happen.
This isn’t politics. There is a line regarding humane and inhumane treatment of people. And this line had well and truly been crossed.
I was anguished from what I had seen. And angry. And felt so powerless.
What could I do as just one doctor, when all the other medical bodies including our own college, were being ignored?
By chance perhaps, I met a 16 year old boy called Abdul. He was an unaccompanied child, sent to Australia to escape persecution and threats against his life. He was Hazara, an ethnic and religious minority in Afghanistan who have been targeted by the Taliban and now ISIS with bombings, kidnappings and murders.
I remember that Abdul had worn a clean white t-shirt that almost glowed…he stood straight…and perhaps a little defiant (for sure, a lot defiant), when so many other people there were broken.
After a while he asked me ‘am I going to die soon?’…… He thought he would because his heart would suddenly beat uncontrollably and his whole body would shake when he remembered the bomb explosion in Kabul he had nearly died in.
The one thing about Abdul’s stance was that he held onto his right elbow with his left hand. This was because he had a chronically dislocating shoulder. Abdul was concerned that his mum, still living in Afghanistan, would worry if she found out he needed surgery.
That’s why he was in Darwin and hadn’t been shipped out to Nauru like most of his friends. At the time I thought to myself, ‘oh bub, they’re not going to tell your mum you’re having surgery, they don’t care about her… Or you’
I knew by the way Abdul spoke about his family that he was a much-loved child. I thought about the agonising decision his mother made to send her boy to safety. If I was in her place, I would want someone to look out for my children. But Abdul, like the others in detention, now faced a hopeless fate and wasted years in limbo.
Wouldn’t any teenager be better off staying with a family rather than locked behind a wire fence?
The government ignored my proposition of having Abdul move in with us. The then Immigration Minister, Scott Morrison was not going to let any of the children out of detention unless his infamous ‘fast track’ and temporary protection visas bill were passed.
Unless Morrison had his bill passed, he made it very clear, the children would stay locked up… they were being held to ransom.
Unless I could do something, I knew that the next stop for Abdul would be the detention centre in Nauru, an ominous, secretive place, and from where, some very horrible stories were beginning to leak out.
In 2014, we found out that Abdul had a brother Ahad who arrived earlier as an unaccompanied minor, before the offshore detention system was set up. When I invited Ahad to visit us for the school holidays, I didn’t know he was so young, and when he responded to my invitation, ‘I would love to be near a family again’, my heart melted. We found out that he wasn’t doing too well either and having this quiet, sweet boy with us, solidified our resolve.
From the outset my husband Rob and I thought deeply about how having two refugee brothers living with us would affect our family. As mums and dads, we only ever get one chance with our kids’ childhoods – there’s no rewind button.
Rob and I had our fair share of ‘tut-tut’s from others about not trusting Muslim people or ‘illegals’. Of course we expected difficulties but more importantly, we saw having Abdul and Ahad as enriching all of us. We wanted our children to see that ethics are not just a mouthing of intentions but doing – and that often the doing is hard.
Where is the outcry
I wish I could tell you now how difficult 2014 was for Abdul (who spent a total of 501 days in detention), and also tell you of the beautiful family moments we have shared together since (they’re in the book). Magically, what we needed and what has grown is love; the courageous, unbreakable love of family.
There isn’t a fairy tale ending, I’m sorry, and life for Abdul is still not easy. I wish I could say to him, ‘you’re safe now, and you can make dreams for your future like my other boys.’ But we both know this isn’t true. His stay in Australia is precarious under the temporary visa system, and Abdul could still be sent back to Afghanistan where his life remains at risk.
I started writing this book as an insurance policy for Abdul, thinking that the more people who knew our story, the safer Abdul will be. But not just Abdul…..
Of course not just Abdul. With all of this focus on the predicament of those refugees offshore, it is very important to remember the refugees and asylum seekers who are in Australia and doing it tough.
I want to talk about Australia’s offshore situation too. Our government hides asylum seekers and refugees offshore in a veil of secrecy. They paint the picture of these people fleeing persecution as threats, as ‘illegals’ to help them win their electoral seats out of fear. And in this created fear, the most cruel decisions have been made.
I’m so angry when I hear that a 12 year old girl, who had been on Nauru since she was 7, had tried to set herself on fire in her depression and hopelessness. And she’s not the only one. What if this little girl was one of our kids? Why is she seen as not deserving of decency or kindness? Where is the outcry?
These are the things that I’ve seen time and time again in the notes from International Health and Medical Services (IHMS), the private provider of health services to the Nauru detention centre, that have been given to me.
Referring to people their boat numbers or as a ‘detainee’ in their clinical notes when a name is allowed is a denial of a shared humanity. Significant illness is mis-labelled as ‘behavioural’, meaning that people are punished rather than treated.
A person’s punctuality, cooperativeness, compliance, politeness and calmness is focused on rather than the biological, psychological and social aspects to their presentation. And for the sake of proving that a conversation took place, for no clinical reason, a patient’s personal and political views are recorded on file, placing them at risk, both for immigration and especially their safety in Nauru.
Reviewing these reports for the High Court has been harrowing and after each, though I give my opinion in a clinical, dispassionate way, I cry at the suffering that does not have to be.
Using our voices
I’m tired. I don’t want to fight anymore. All I can do now is push my book.
I want to change the narrative, and after so many stories of cruelty, I want to give our story of hope and strength and the message that it’s okay to be kind.
What has writing this book done? Well at first, I was worried, because there is a lot of racist violence out there. I closed my private practice (for a number of reasons) but a major one was the exposure and isolation increasing risk for me. My name was on the door and anyone could walk in.
The feedback I’ve had has been uplifting. People tell me that they read it in one night, because it was easy to read and they couldn’t put it down. People have said to me that I’ve changed their thinking about asylum seekers and refugees…through their hearts.
That’s the power of stories. I strongly believe that Australians want to be kind…it’s just that politicians have cynically manufactured the fear that has overruled the rational and the empathic parts of us as a nation.
Regardless, what I want to say is, that we can have powerful voices as individuals, even when the government and the media are ignoring our peak bodies. There is a field known as arts-activism. As psychiatrists, we are skilled at listening and remembering stories. And this is how we can change hearts and minds.
Dr Emma Adams is a psychiatrist specialising in the wellbeing of mothers and babies. An Aboriginal woman, she was born in Sydney and grew up in the country town of Armidale in New South Wales. She studied medicine at the University of Queensland and a few years later met her husband Rob when romance blossomed between trauma calls in the emergency department of the Canberra Hospital. They have three teenage sons and live in Canberra.
You can also read this article from the Medical Journal of Australia written in 2014 by Adams and Professor Caroline de Costa.