In February 2020, as a Covid-19 outbreak had led to lockdown in Wuhan and was sparking alarm around the globe, a small audience gathered in a Dunedin Methodist church for an evening of conversation between Behrouz Boochani and Professor Alison Phipps. Behrouz Boochani is a Kurdish refugee, journalist and film maker who recently achieved both fame and literary acclaim from within the walls of Manus Island Detention Centre for his novel No Friend but the Mountains. Professor Alison Phipps is the UNESCO Chair in Refugee Integration through Languages and the Arts at the University of Glasgow. She was in Dunedin as the 2019 De Carle Distinguished lecturer at the University of Otago. Present also were Neil Vallely (Centre for Global Migrations, University of Otago), Ali Mostolizadeh, (Translator and PhD candidate in Sociology and Legal Studies, University of Waterloo) and respected Dunedin poets Emma Neale and Rhian Gallagher.
It’s not often a discussion about human rights abuses and serious political regression ends with a celebration of poetry and music, but given the guests, this was a natural outcome.
The evening’s conversation embraced issues of race, colonialism and the purpose of language. Medicine, in particular psychiatry, wove its way through the narrative, not as an altruistic, heroic vehicle for healing, but as a spectre of oppression and control.
Although only a small proportion of displaced people from around the globe seek refuge in Australia, recent decades have seen increasingly punitive policies implemented by the Australian government in the name of ‘humane deterrence’. Healthcare to Australian refugee detention centres is provided mainly by private contractors such as Global Solutions Limited and Australian Corrections Management. Conditions of their provision of service fall outside of the usual systems of monitoring and support seen in every other healthcare setting in Australia.
Indefinite detention is itself a form of re-traumatisation. Detainees suffer isolation, prolonged limbo and uncertainty, and often brutal and degrading treatment. For health workers who are legally obligated to serve the very systems that thwart the patient’s access to protection inside Australian borders, a conflict of interest may arise that puts at risk their primary duty of care. In such contexts, psychiatry, with its longstanding involvement in involuntary treatment and hospitalisation, may be especially vulnerable to both mis-use and misinterpretation.
No surprise then, to hear Boochani describe the presence of healthcare workers as exacerbating, rather than relieving, anxiety among detainees. Detainees may, for example, be encouraged to confide in psychologists who are suspected of reporting to officials. Boochani told of Manus guards forcibly removing a man’s ‘broken guitar’, on the premise that the ‘prisoner’ may use the strings to hang himself. Professor Phipps expanded on this, speaking of how the removal of music can be used by officials to strip away identity and sever connections with homeland and past. She later played the mbira, or African thumb piano, a musical instrument once outlawed in Zimbabwe by white colonials.
It’s a sad irony when policies that generate an urgent need for health intervention simultaneously sabotage effective provision of that care. It’s also ironic that health-workers opting to work in difficult environments such as offshore detention centres are likely to be well-intended, humanitarian-minded individuals. Among the less obvious victims of any distorted system are its own employees.
While some Australian psychiatrists have ‘borne witness’ and expressed sustained concern about the negative mental health effects of indefinite detention and lobbied government for change, senior psychiatrists and the Australian Medical Council have also cautioned against working in detention centres. There have been warnings that the risk of collusion with government may outweigh potential benefits to refugees. Unfortunately, the withdrawing of medical care is also problematic. When policies enable inhumane treatment of others, there are ramifications that extend well beyond detention centre boundaries to affect us all, directly or indirectly.
In a detention centre such as Manus there is inherently a power imbalance between visitors (including humanitarian and health workers) and refugees. Contributing to this, as Boochani pointed out, is a tendency for refugees to be viewed as either ‘demons’ (by those who wish to keep them ‘out’) or ‘angels’ (by those who wish to assist them), when refugees – like everyone else – are neither.
Professor Phipps recalled attending the Dungavel Immigration Removal Centre in Ireland, in her role as a linguist. Faced with Kurdish refugees who spoke only Farsi, “colonial languages of greed and trade” were useless. She realised the “best thing” she could do “was to learn words of the languages spoken by the people” around her – and this from a position of humility rather than one of superiority and power.
Rhian Gallagher’s poem, Gate, aptly read on the night, recalls Seacliff, Dunedin’s historic psychiatric asylum, and the suffering, displacement and deprivation experienced within its imprisoning boundaries. Emma Neale read Warning, a poem highlighting the suffering of displaced children. Her words, ‘This era contains events we must find appalling’, were equally apt.
The evening conveyed an overall sense that the systems of authority and power within which we struggle to operate, and the languages generated by such systems, fail when fundamental human kindness is subsumed by other agendas.
With respect to the refugee crisis, Behrouz Boochani and Professor Phipps highlighted an evolving need to revive the concepts of healing, helping and communicating. In the field of psychiatry, this is reflected in recent focus on how a compassionate ‘ethics of care’, might be translated into the political sphere. Recently, our own prime minister, Jacinda Adern has implemented just such a politics, at a time when economic considerations have required balancing with wider issues of safety and survival.
And if the speakers in the small Dunedin church in February are anything to go by, the ongoing translation of an ‘ethics of care’ is likely to manifest, at least in part, on the powerful wings of music and poetry.
(Below is my own response, a poem whose initial version was inspired the evening I attended a Skype interview at the Dunedin Public Library with Behrouz Boochani in early 2019, when he was still imprisoned on Manus Island.)
Even the Moon
They had a vacuity of time on their hands
in the place of exile behind an iron fence,
where people shouted at them
that not belonging
was a crime.
But displacement has a way of
new arrivals and
those who arrived before,
scatter like ants over smouldering ground,
only to retreat before an encroaching pandemic.
Lately, I imagine that even the moon turns her face
in search of a less fraught universe.
Sophia Wilson is an Australian/New Zealand writer with a background in arts, medicine and psychiatry. Her recent poetry/prose can be found in StylusLit, Ars Medica, Corpus, Not Very Quiet, Hektoen International, Intima, Poems in the Waiting Room, NZ Poetry Shelf, The Otago Daily Times and elsewhere
The full conversation between Behrouz and Alison can be heard at https://www.oar.org.nz/event/boochani_phipps/
Sources and additional relevant links:
1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690255/ The mental health of asylum seekers in Australia and the role of psychiatrists, D. Silove and S. Mares, BJPSych Int, August 2018; 15(3): 65-68
2: Psychiatric Ethics and a Politics of Compassion; The Case of Detrained Asylum Seekers in Australia, D. Zion, L. Briskman, B. Loff, Bioethical Inquiry (2012) 9:67-75
3: Ethical Challenges for Doctors Working in Immigration Detention, J.Sanggaran, G.Ferguson, B.Haire, Medical Journal of Australia 210 (7), Oct 2014
4: Seeking Asylum-Trauma, Mental Health, and Human Rights: An Australian Perspective, Louise Newman, Journal of Trauma and Dissociation, Volume 14, 2013-Issue 2: Individual and Societal Oppression.
5: Challenges to Providing Mental Health Care in Immigration Detention, Global Detention Working Project, Working Paper No. 19, Stephen Brooker, Steve Albert, Peter Young, Zachary Steel, Dec 2016