“When You Silence Doctors And Nurses You’re Getting Into Dangerous Territory”

Nurse Alanna Maycock travelled to Nauru last year where she witnessed the trauma and despair facing asylum seekers. Photo: marie claire

“I am a specialist nurse and I co-run a refugee clinic at a children’s hospital in Sydney. Last December, International Health and Medical Services (IHMS) asked me and my colleague, Professor David Isaacs, if we would go to Nauru. They wanted us to assess the patients over five days then write recommendations about how IHMS could improve the health care services.

“Nauru can be beautiful. It takes just 20 minutes to drive around it. The locals live around the tropical outskirts of the island, but the detention centre is where the decimated phosphate mines are. There, it can reach 50°C.

“We took charter flights from Sydney to Brisbane to Nauru, chaperoned by IHMS workers all the way. When we got there we were met by another group of IHMS workers and they took us to our accommodation, which was where the 2013 riots took place. That building had been burned down, so they built makeshift metal Portakabins for the service provider workers to stay in. You’d need a pass every time you went in or out. Then you were in there again behind these gates. It was a surreal, oppressive experience.

“One of the things we stipulated was that we wanted to see the living conditions of the asylum seekers. We wanted to see where the asylum seekers ate, to see the sanitation. We felt this was important because it had implications on the health of the children. The asylum seekers’ camp is about 4km away from the medical centre, which in itself is a huge problem. These people can’t actively just walk up the road and go to a doctor if they need to. They have to put in a slip to apply to see the doctor. That then has to be approved. Then, the Save the Children workers will give them a slip to say whether or not it’s been accepted and when the appointment is. So, if your child is sick on a Monday morning, you can’t just go and see the doctor.

“The first part of the camp that you come to is the family wing. They walked us through very quickly; we weren’t allowed to spend any time talking to families. There’s barbed wire and fences everywhere. There are security guards all over the place and they take your mobile phones, any cameras … you’re not allowed [to take] any piece of technology into the camp. We looked around the tents and they were covered in green mould. They are thin, flimsy tents that are all joined. Mould can give children, in particular, really bad respiratory problems. I will say that children under five have air-conditioning in their tents, but none of the other tents do.

“The great thing about Professor Isaacs and I going was that we had such different perspectives on what we saw. He is a professor; a doctor. His view was quite medical, whereas I was looking at the psychosocial issues. One of the things that women always look for is the toilet – it’s just a natural thing! So I noticed when we came out of the family wing that there was a desk about seven to 10 metres away from the Portakabins with the showers and toilets, and there were male guards sitting on top of and behind the desk. There were no doors on the showers, just a flimsy curtain. So that’s where the mothers have to wash their babies, holding the curtain and trying to keep themselves covered from anybody seeing.

“We said to the security guards and the IHMS staff at that point, ‘Look at the showers. Look how close they are to this desk – and there are no doors.’ And they turned around and said, ‘God yeah, yeah.’ It was like they hadn’t even thought about it. Men and women look at things differently, don’t they? And it was all men that we were with.

“Depending on where the families slept, these toilets were between 30 and 120 metres away and women had to walk up a long path with male guards to reach the toilets in the middle of the night. When we provided consultations for the children, the mothers would tell us they were too frightened to go to the toilet at night and were wetting the bed. They were having to put the same mattress out in the sunshine to dry, so God only knows what it would smell like night after night with both the children and the mothers bed-wetting. Several times I asked the person on duty for sanitary towels and I was just blanked. I was told, ‘Yeah, yeah, they’re over there.’ I’d say, ‘Where?’ And they would walk off. I was never shown them. It became clear that they didn’t have regular access.

“At the end of each day we went out to a restaurant with the IHMS staff. We felt conflicted, partly because we felt guilty that we were having this nice meal, and partly because some of the staff were really nice and we were very fond of them. We would ask them, ‘How can you carry on working in this environment?’ Their argument was, ‘Well if we don’t do it, someone else will.’

“There are many reasons why doctors and nurses go and work in these places. One European doctor we met there had previously worked for Médecins Sans Frontières, an amazing organisation. She’d seen this advertisement to work on this island of Nauru and I think she went thinking it was going to be an aid experience, not realising the horror and the politics until she was there.

“We’d get back from the restaurant and we’d sign in to our accommodation area. It was very difficult to contact home. Internet access is terrible, phone lines are awful. I managed to speak to my kids for about five minutes, maximum, then the phone would go dead. It was very hard for us to have contact with the outside world.

“Through our consultations at the medical centre, Professor Isaacs diagnosed a baby with typhoid. We were in the consultation room with the baby and the mother, and the dad was waiting down the end of the corridor, so I went to get him. I said, ‘You can come with me now. We’ll go and see your baby, he’s OK.’ The female security guard pushed the dad full flight in the back and he went flying. The dad just looked absolutely hopeless. He just took the abuse and looked at me with these dead, sad eyes. He can’t fight back because that will impede on his asylum application.

“I told the IHMS director what had happened and he said, ‘You can fill in a formal complaint form.’ But where is this form going to go? He’ll give it to the Australian government. Where’s the chain of command?

Professor Isaacs diagnosed another baby with tuberculosis. In fact, the baby had already had it for three to six months and we found out this was causing a lot of problems down in the camp because the other parents were frightened that their children were all being exposed. It wasn’t that kind of TB that he had, but this was the general feeling.

“There was talk of a riot kicking off down there, not because they’re bad people, but because nobody tells them any information, day in, day out. All they’ve got to think about are their health issues or their problems. They’re not going to work, they’re not socialising, and they’re not doing the normal things you do day after day. It sends someone crazy. So there was a constant feeling of unrest and unpredictability.

“Professor Isaacs and I assured every family we saw that we were going to do something to help them, that when we got back we were going to try and help their cases and say to Australia that what is going on there is wrong. We had lots of interpreters coming up to us saying, ‘Everybody’s talking about you in the camp, saying you’re here to help us.’ Actually, the first family that we saw had presented to us with hostility, as if to say, ‘Oh, here’s another doctor that doesn’t really give a shit about us.’ But Professor Isaacs and I cried in front of them, which is not very professional because you’re supposed to be strong in front of your patients. It was humility. It was just us showing them that we are listening to them and we’re not like everybody else.

“People felt hopeful, that somebody was going to do something for them. I had a seven-year-old girl say to me, ‘Can you film me, please, and put my face and my name on Facebook and on the internet and tell everybody what’s happening to me.’ For a seven-year-old to even know to do that … They’d say, ‘Please, when are you next coming back?’ I said to them that we would try and come back, but obviously we will never be allowed back now.

“Some asylum seekers have been released onto five-year temporary protection visas. So they can be released into the Nauruan community for five years and then they will have their application processed again. Under international refugee law, if you’ve had your asylum application looked at and it’s deemed to be legitimate, you’re given refugee status in the first country that you fled to. So under international law, the refugees who reached Christmas Island are supposed to be processed in Australia, not in Nauru.

“The big problem is that there’s quite a lot of animosity between the Nauru islanders and the asylum seekers. A report came out recently that a woman was raped, found in the street with hardly any clothes on. So there have been known attacks against asylum seekers. There have been known attacks on staff members as well.

“When Professor Isaacs and I got back to Australia, we sought legal advice and were told that we are within our rights to speak out about inequity. As doctors and nurses, we have mandatory reporting obligations. Eighty per cent of surveyed paediatricians have said that they think mandatory detention is tantamount to child abuse. We felt that children were being inadvertently tortured there, so that is a form of child abuse. So we felt that we had a duty of care and mandatory reporting obligations to speak out on behalf of our patients.

“That was before the government introduced the Australian Border Force Act 2015. It states that as of July 1, 2015, anybody who has been to the Nauru or Manus Island camps – be they charity workers, service workers or UN representatives – cannot speak about what they’ve witnessed to anyone. It’s punishable by up to two years imprisonment.

“The Labor Party went hand-in-hand with the Liberals over this act, and it was released on the same day as the budget, so it got hardly any media attention. We were just astounded. I was worried that IHMS was going to sue us, but this is a different level of fear. I’ve been advised that my phone might be tapped, and our computers monitored.

“We were subpoenaed and we went to the Senate and gave them our information. We got hammered with questions and ran out of time. It was that whole political spiel of asking us a question, but when we tried to answer, the politicians would ask us another question without listening. Then all of a sudden they said we’d run out of time.

“The day after I got back, my partner’s parents flew in from the UK and I had to go straight into holiday mode. I was literally having nightmares because I had vicarious trauma. The nightmare I kept having was that my kids were in the detention centre and I couldn’t get them out.

“I have two little boys, five and six years old. Last week my partner said to them, ‘Mummy’s on the radio.’ So they listened and they heard me say ‘Nauru’.

‘Ollie said, ‘Peru? Like Paddington Bear?’

“It slammed home the sort of innocent things kids should be thinking about. But the refugee children I met on Nauru understood acutely the trauma and despair around them.

“When I’m at work my work takes over, but it’s when I go home to the kids, I think ‘Oh my God, what am I doing? Are they going to end up without a mum?’ And then I try and think about it intelligently and logically and think, ‘Really, do the Australian public want nurses in their already overrun jails? With drug traffickers and armed robbers … is that the category that I’m in?’

“Luckily my partner, Neil, is really supportive, but he’s worried about me. And he’s worried about the kids having no mum. He’s never told me not to do it, ever, but he gets the fear. I’ve been getting a lot of phone calls and attention from the press recently and that hits it home to him – particularly an article in The Guardian that had me and Professor Isaacs in the same context as Edward Snowden. This media stuff is tricky, because I don’t want to lose sight of what it’s really about. It’s not about me, it’s about the people imprisoned on Nauru.

“I find doing presentations about my experience really difficult. I did one the other day and started sobbing; it was so embarrassing. Particularly our TB boy. After we’d left Nauru, he was transferred to Villawood with his family for treatment and we’ve been seeing him once a month in the clinic here. But the treatment has been coming to an end, so we think they’re going to transfer him back to Nauru. When the guards brought him into hospital, we were all crying, me, his mum and dad, because then we had to send him off to Villawood again. The guard said, ‘Oh, they’re all just drug addicts anyway.’

“I hear that attitude at the school gates. A few mums will say, ‘Oh, I don’t want to know about that.’ I do understand that some people are politically passive, but are we really going to teach our children that it’s not OK to stand up for what you think is right because your government might put you in prison? When you silence doctors and nurses you’re getting into dangerous territory.

“When people can’t access basic health care and have their basic human needs met, there’s something really wrong. This could be switched off in an instant. The Australian government could shut Nauru down tonight, plane them all over to Australia and they could all be processed in the community – but it won’t happen because it’s not a vote winner. This is all about becoming re-elected. It’s got nothing to do with protecting the Australian community, because terrorists do not come on rickety boats.”

Note: This interview was conducted before the introduction of the Border Force Act on July 1, 2015.

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