What is it like to be a doctor in immigration detention centres?

Abstract

I am often asked questions about my work as a general practitioner in the Christmas Island and Nauru immigration detention centres. Are the conditions as bad as they say? Is the health care adequate? Are they genuine refugees? What are the people like? I often don’t know what to say, and wonder whether my answers are ever sufficient. Words often seem inadequate to describe what I saw, or the ways in which my experience continues to impact upon me. Are the conditions bad? Absolutely. Imagine tents at a grungy music festival, but without the festivity and enclosed by wire. Imagine a world that has a 500m radius and is characterized by bleakness and oppressive humidity. And then imagine living there, for months on end, with no purpose or direction, unable to leave and not being told if you ever will. Is the health care adequate? Definitely not. But arguably this is impossible to provide in such remote and underdeveloped centres, where the primary purpose is not health but segregation and isolation. Are they genuine refugees? I have no idea because I never asked, and as a doctor who sat beside Ahmed, or Leila, or Antony I didn’t really need to know. So what are “they” like? And what is it like to be their doctor? As a practitioner working in a detention centre you see many shocking departures from the ordinary – men with their lips sewn closed with thread from a blanket, women drinking from bottles of shampoo, children with weeping sores and no shoes, people hurting themselves to express their pain. In each case you try and do what you can to treat both the physical consequences of living in harsh environments and the mental anguish caused by losing hope.