MEDICUS MARCH 2016

P R E S I D E N T ’ S D E S K

Careful compassion needed for dealing with asylum seeker issue

Dr Michael Gannon AMA (WA) President I t would be extremely hard for any Australian to not be aware of the contentious issues around asylum seekers. For more than a decade, it has, at times, dominated the political debate and probably played a major role in the outcome of at least one federal election. More recently, the Federal AMA made its voice heard on the issue, convening a symposium in Sydney. The Federal President Professor Brian Owler has been widely commended on his speech at the event. However, many of our members here in Western Australia were unhappy with the Federal AMA event, as well as our position on the subject, which culminated in a number of resignations. Human compassion is not something that belongs to one side of politics or another. There might be disagreement amongst members of the profession as to the degree of failure of the Rudd/ Gillard Government’s policy of a more relaxed attitude to maritime arrivals. The proposal to send asylum seekers to Malaysia and the

Solution’ of sending desperate human beings to Manus Island in Papua New Guinea and Nauru are all well known. The Commonwealth Government is spending millions of dollars dealing with this problem. The decision by our colleagues at Lady Cilento Children’s Hospital in Brisbane to not discharge baby Asha back to Nauru was controversial. I understand and applaud the compassion of my medical colleagues. Equally they might be seen to be ‘setting the bar’ extremely high when they refuse to discharge patients into ‘unsafe’ environments. It is a sad but unfortunate reality that every day of the week vulnerable Australians are discharged into less than ideal settings in the community, in step-down facilities and residential aged care facilities. It can be dangerous to assert that a new mother might struggle to care for her babe in arms, sometimes less than 30 hours after delivery. The intergenerational failure of our ability to look after patients with mental illness is further testament to this. These issues are not simple. The misery of the Syrian refugee crisis and the hundreds of thousands of people now living in often appalling conditions in continental Europe must trouble even the hardest heart. The fact that only 26 of the 12,000 refugees who Australia promised to accept from Syria have arrived, is testament to the huge complexity of organising security checks, quarantine, housing, social services and schooling. The AMA’s policy in this area is very carefully crafted and worded. We have been criticised for straying outside

the health issues. Professor Owler’s comments talk clearly about the issues of returning children to detention, the inherent health risks of this, and the ethical duty not to discharge children into unsafe settings. The secrecy provisions in the Border Force Act place doctors in unenviable positions. It is however, very hard to separate our policy and the content of the Symposium from being seen to be critical of the government’s immigration policy. Surely we cannot support measures, which might in any way incentivise desperate human beings to put themselves and their children on leaky boats. There were 1,700 children in detention on mainland Australia and Christmas Island when the Coalition took office. It peaked at well over 2,000. Now there are 67. Further, when organisations such as the AMA speak out against government policy, they need to recognise the risk to other aspects of their agenda. We need to consider the deleterious effect it may have on our relationship with government. If we criticise government policy, we are also obliged to provide workable alternative solutions. According to UNHCR, there are 50 million refugees, asylum seekers and internally displaced people worldwide. It is not remotely feasible to assist even 1 per cent of these people. It is our job to participate in international agencies to, wherever possible, minimise the impacts of drought, pestilence, disease and war. Recently I welcomed representatives of Ishar, the multicultural women’s health

decision to house them in old Air Force bases in remote areas of the country’s north, in locked-down detention facilities in our capital cities, or the ‘Pacific

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