But as rising numbers of refugees flee to countries neighbouring Ukraine, it needs to be remembered that for anyone fleeing war or persecution to Australia, their means of travel makes a profound difference to how they are treated.
Under Australian policy, enforced by Operation Sovereign Borders, so-called unauthorised arrivals by boat have been subjected to offshore detention on the remote Pacific Islands of Nauru and the now dismantled Manus Island detention centre in Papua New Guinea while their refugee status is processed.
Regardless of their refugee status, these arrivals are automatically ruled to be ineligible for settlement in Australia.
The experiences of the people kept in offshore immigration detention, sometimes for many years, have been investigated only sparsely. This is in large part due to a lack of ready access to those living in immigration detention.
We know that prolonged detention has a detrimental toll on the physical and mental health of refugees and asylum seekers. For example, rates of self-harm among asylum seekers in Australian-sponsored offshore and onshore immigration detention are much higher than for those living in the community.
A conceptual framework that may help us understand what is happening to these people is that of ‘moral injury’.
This concept refers to the experience of having your deeply held beliefs of what is right transgressed, resulting in lasting negative impact.
Moral injury has been most studied in the context of the experience of soldiers in conflict zones, but little is known about moral injury among refugees, especially among those held for extended periods in detention.
To better understand the extent to which refugees and asylum seekers experience moral injury, we set out to hear the perspectives of those who had been through immigration detention on Nauru. We conducted interviews with 13 individuals who had been temporarily allowed into Australia following medical transfer from Nauru.
Only if an asylum seeker or refugee on Nauru needs medical treatment in Australia can they be evacuated to Australia. During treatment, they live in detention centres, community detention or in the community on a final departure visa, which must be renewed every six months.
After treatment, government policy is to return individuals offshore.
Our team, which included colleagues at the Cabrini Asylum Seeker and Refugee Health Hub, conducted in-depth interviews with 13 people who had initially arrived in Australia by boat.
1) The risk at home and the expectation of getting protection as their main reasons to flee to Australia.
2) The experience of deprivation, a lack of agency, violence and dehumanisation after arrival, for which they held Australian authorities responsible.
3) The feeling of being irreparably damaged as a result.
They shared a multitude of examples of arbitrary rules and enforcements that led to inadequate access to food, facilities to contact family, medication, clothing and sanitation.
As one participant told us:
“We had only two minutes to take shower. I had an exception because the doctor had written that I can take more time. So, they gave me two minutes more. One day it was very hot, and I was sweating. And my clothes were wet. So, I went to take a shower, and it was empty, vacant. And despite that, I was told ‘Look, you’ve got only two minutes to take a shower.’ And I said, ‘Look, I’ve got a permission, I’ve got a card that I can have extra.’ He said, ‘There’s no difference between you and others!’
I said, ‘Look, I have no other way to do it. Please let me to climb the step, take off my clothes and then you time it.’ And he said, ‘No, when you step in, the time starts.’ When I went there, I had soap on my face and my body, and I wanted to wash it off. They disconnected the water. I was so depressed. So I went out of the shower, without any clothes. And when the officer saw me like that, said ‘Go, go, go, go back, go back!’ And then I said, ‘Look, I’ve got another two minutes.’ He said, ‘No, no, no. I give you 30 seconds only. Just go and wash!’
I only washed my face because of the soap affecting my eyes. And when I came out it wasn’t in my control what I was doing. I was so agitated and I pushed the officer. And I said ‘Why did you do that?’”
A sense of having lost dignity came through strongly.
For example, interviewees mentioned feeling treated as if they had a contagious disease. Multiple participants made an explicit comparison with animals:
“We feel as an animal. It’s not what they do to humans. That time, I felt they were looking at me as an animal. But when they transferred me to Australia, I thought, no, I thought wrong because the people have a very nice behaviour with pets. When I went to the shop for the first time, I saw lots of food for dogs or cats. They have got toilets, they have got doctors. They have everything they need. So, we are smaller than that for the people who work in the detention camp or government.”
Feeling dehumanised also included feeling used for political purposes to ‘stop the boats’, without regard for the impact on the people involved.
As a result, our participants felt hopeless.
They felt they had lost important years of their lives in detention, not only in terms of time, but also their health. They described that they and their friends were in such despair that self-harm and suicide attempts were common during and after detention.
One participant conveyed the main interview themes in one sentence: “In my country, they torture your body but in Australia they kill your mind.”
These chilling accounts shouldn’t be shared in vain. So, what can be done?
Indefinite immigration detention needs to be abolished and replaced with safe, humane, ethical and reasonably quick procedures that facilitate people’s agency (the opposite of the traumatic experiences they have already endured) and opportunities for healing.
This comes with ensuring processes are transparent and providing adequate training of the workforce involved.
Refugee and asylum seekers also need to be provided with access to comprehensive and long-term mental health support, including those on temporary visas.
Moreover, our interviewees and others subjected to offshore regional processing need to be provided immediately with an acceptable safe and secure resettlement pathway. And those refugees and asylum seekers currently locked up in hotels in Australia, like at Melbourne’s Park Hotel, need to be released into the community.
We as citizens can all help in achieving changes like these.
We can vote, call and write to government representatives; we can donate to advocacy and support groups; we can keep talking about the plight of refugees and asylum seeker and keep up the momentum for change; and we need to express our support directly to those already affected so they know they aren’t forgotten.
All in all, we – as a country – need to be facilitating the arrival of people fleeing conflict zones around the world. We need public health policies and actions that foster inclusion instead of ‘othering’ refugees and asylum seekers.
With thanks to our colleagues and co-authors Dr Debbie Hocking, Research Fellow and Clinical Psychologist at the Cabrini Asylum Seeker and Refugee Health Hub, and Dr Naser Morina head of research and co-head of the Outpatient Unit for Victims of Torture and War, University Hospital Zurich.
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