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Women’s health across cultures

Mother and her baby (Getty images).

Social and economic disadvantage are important contributors to poor maternal and perinatal outcomes in high-income countries such as Australia. For example Australian research shows women from refugee
backgrounds have higher rates of stillbirth, fetal death in utero and perinatal mortality compared with Australian born women. However, the recent publication of findings from a retrospective (looking back) population based cohort study of all individual (as opposed to multiple) births at 24 or more weeks gestational age from 2000–2011 in Victoria, Australia, found that the mother’s country of birth was also an important factor in having a baby who was stillborn.

The place of birth of pregnant women has important implications for risk of stillbirth in high-income countries, as research in the UK, Netherlands, Sweden, Singapore and Australia has shown. Yet, only the American Congress of Obstetricians and Gynecologists (ACOG) clinical guidelines recognise ‘black women’ as being at increased risk of stillbirth. Other clinical guidelines are silent on maternal region of birth  including the Royal College of Obstetricians and Gynaecologists, the National Institute of Clinical Excellence, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. A significant omission considering migration remains a feature in those countries. The authors found that women who were born in South Asian or Africa have a significantly higher rate of stillbirth. However, women who were born in South East/East Asian had lower rates of stillbirth. This equates to women born in South Asia having an almost two and a half times greater chance of having a late pregnancy stillbirth than a woman who was born in Australia accessing the same public maternity services. The authors recommend that all clinical guidelines should recognize the importance of maternal region of birth (as an independent) risk factor for stillbirth.

This is only one example where ethnicity, faith, culture and place of birth matter, not just in terms of attitudes and expectations about pregnancy, labour and birth but in the context of risk factors for adverse maternal and perinatal outcomes. Recently, I was part of a webinar panel hosted by the Jean Hailes centre, a women’s health organisation, which focused on: culture and its impact on health; culturally safe practice; communication and health literacy and strategies to enhance practice. Along with Monique Hameed (Multicultural Centre for Women’s Health) and Natalija Nesvadba (Multicultural Services, Mercy Health, Victoria). The free ninety minute webinar for which participants are eligible for
RACGP – 3 Category 2 QI&CPD points can be accessed here. It’s structured with three presentations and then two case studies. Further resources below.

Further reading

Useful multilingual resources from the Health Translations Directory

The Health Translations Directory managed by the Centre for Culture, Ethnicity and Health, comprises a searchable database with over 14,000 translated online health resources in over 100 languages:

Pregnancy and post-natal care resources 
Women’s Health resources

Refs

  • Davies-Tuck, M. L., Davey, M.-A., & Wallace, E. M. (2017). Maternal region of birth and stillbirth in Victoria, Australia 2000-2011: A retrospective cohort study of Victorian perinatal data. PloS One, 12(6), e0178727.
  • Yelland, J., Riggs, E., Szwarc, J., Casey, S., Dawson, W., Vanpraag, D., … Brown, S. (2015). Bridging the Gap: using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities. Implementation Science: IS, 10, 62.
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Providing Culturally Safe Maternal and Child Healthcare

Cite as: DeSouza, R. (2016, June 1st). Keynote address-Providing Culturally Safe Maternal and Child Healthcare, Multicultural Health Research to Practice Forum: Early Interventions in Maternal and Child Health, Program, Organised by the Multicultural Health Service, South Eastern Sydney, Local Health District, Australia. Retrieved fromhttp://ruthdesouza.dreamhosters.com/2016/06/11/cultural-safety-in-maternity/

 

Image from the film, the Namesake

Image from the film, the Namesake

A paragraph haunts me in The Namesake, Jhumpa Lahiri’s fictional account of the Indian immigrant experience. Ashoke and Ashima Ganguli migrate from Calcutta to Cambridge, Massachusetts after their arranged wedding. While pregnant, Ashima reflects:

Nothing feels normal. it’s not so much the pain which she knows she will survive. It’s the consequence: motherhood in a foreign land. For it was one thing to be pregnant to suffer the queasy mornings in bed, the sleepless nights, the dull throbbing in her back, the countless visits to the bathroom. Throughout the experience, in spite of her growing discomfort, she’s been astonished by her body’s ability to make life, exactly as her and grandmother and all her great grandmothers had done. That it was happening so far from home, unmonitored and unobserved by those she loved, had made it more miraculous still. But she is terrified to raise a child in a country where she is related to no one, where she knows so little, where life seems so tentative and spare. The Namesake, Jhumpa Lahiri

Ashima’s account beautifully captures the universality of the physical, embodied changes of maternity, the swelling, the nausea and other changes. But what Lahiri poignantly conveys is the singular emotional and cultural upheaval of these changes, the losses they give rise to. The absence of loving, knowledgeable, nurturing witnesses, the absence of a soft place to fall.

Arrival of baby girl in Prato, Tuscany. Credit DeSouza (2006).

Arrival of baby girl in Prato, Tuscany. Credit DeSouza (2006).

In 1994 I worked on a post-natal ward where I was struck by the limits of universality and how treating everybody the same was problematic. For example, ostensibly beneficial practices like the routine administration of an icepack for soothing the perineum postnatally, or the imperative to mobilise quickly or to “room in” have potentially damaging effects on women whose knowledge frameworks differed from the dominant Pakeha culture of healthcare. These practices combined with a system designed for an imagined white middle class user, where professionals had knowledge deficits and monocultural and assimilatory attitudes, led to unsafe practices such as using family members and children as interpreters (my horror when a boy child was asked to ask his mother about the amount of lochia on her pad). The sanctity of birth, requiring the special, nurturing treatment of new mothers and a welcome from a community was superseded by the factory culture of maximum efficiency. Not all mothers were created equal, not young mothers, not older mothers, not single mothers, not substance using mothers, not indigenous mothers, not culturally different mothers. The sense that I was a cog in a big machine that was inattentive to the needs of “other” mothers led me to critique the effectiveness of cultural safety in the curriculum. How was it possible that a powerful indigenous pedagogical tool for addressing health inequity was not evident in clinical practice?

Photo of me as a staff nurse back in the day.

Photo of me as a staff nurse back in the day.

Leaving the post-natal ward, I took up a role helping to develop a new maternal mental health service in Auckland. There too I began to question the limitations of our model of care which privileged talking therapies rather than providing practical help and support. I was also staggered at the time at the raced and classed profile of our clients who were predominantly white middle class career women. Interestingly, the longer I was involved in the service the greater the number of ethnic women accessed the service. For my Master’s thesis, I interviewed Goan women about their maternity experiences in New Zealand, where the importance of social support and rituals in the perinatal period was noted by participants.

As much as it was important to register and legitimate cultural difference, I was also aware of the importance of not falling into the cultural awareness chasm. As Gregory Philips notes in his stunning PhD, it was assumed that through teaching about other cultures, needs would be better understood as “complex, equal and valid” (Philips, 2015). However, it didn’t challenge privilege, class and power. As Joan Scott points out:

There is nothing wrong, on the face of it, with teaching individuals about how to behave decently in relation to others and about how to empathize with each other’s pain. The problem is that difficult analyses of how history and social standing, privilege, and subordination are involved in personal behavior entirely drop out (Scott, 1992, p.9).

The problem with culturalism is that the notion of “learning about” groups of people with a common ethnicity assumes that groups of people are homogenous, unchanging and can be known. Their cultural differences are then viewed as the problem, juxtaposed against an implicit dominant white middle class cultural norm. This became evident in my PhD analysis of interviews with Korean mothers who’d birthed in New Zealand. In Australia and the US, cultural competence has superseded cultural awareness as a mechanism for correcting the limitations of universalism, by drawing attention to organisational and systemic mechanisms that can be measured but as a strategy for individual and interpersonal action, several authors draw attention to competence as being part of the “problem”:

The concept of multicultural competence is flawed… I question the notion that one could become “competent” at the culture of another. I would instead propose a model in which maintaining an awareness of one’s lack of competence is the goal rather than the establishment of competence. With “lack of competence” as the focus, a different view of practicing across cultures emerges. The client is the “expert” and the clinician is in a position of seeking knowledge and trying to understand what life is like for the client. There is no thought of competence—instead one thinks of gaining understanding (always partial) of a phenomenon that is evolving and changing (Dean, 2001, p.624).

In Wellness for all: the possibilities of cultural safety and cultural competence in New Zealand, I advocated for a combination of cultural competence and cultural safety. Cultural safety was developed by Indigenous nurses in Aotearoa New Zealand as a mechanism for considering and equalizing power relationships between client and practitioner. It is an ethical framework for practice derived from postcolonial and critical theory. Cultural safety proposes that practitioners reflect on how their status as culture bearers impacts on care, with care being deemed culturally safe by the consumer or recipient of care. In my PhD I wrote about the inadequacy of the liberal foundations of nursing and midwifery discourses for meeting the health needs of diverse maternal groups. My thesis advocated for the extension of the theory and practice of cultural safety to critique nursing’s Anglo-European knowledge base in order to extend the discipline’s intellectual and political mandate with the aim of providing effective support to diverse groups of mothers. In Australia, cultural responsiveness, cultural security and cultural respect are also used, you can read more about this on my post on Minding the Gap.

So let’s look at culturally safe maternity care. My experience as a clinician and researcher reveal a gap between how birth is viewed. In contemporary settler nations like New Zealand, midwifery discourses position birth as natural and the maternal subject as physically capable of caring for her baby from the moment it is born, requiring minimal intervention and protection. The maternal body is represented as strong and capable for taking on the tasks of motherhood. In contrast, many cultures view birth as a process that makes the body vulnerable, requiring careful surveillance and monitoring and a period of rest and nurturing before the new mother can take on new or additional responsibilities. The maternal body is seen as a body at risk (Mahjouri, 2008), and vulnerable requiring special care through rituals and support. Therefore, practices based on a dominant discourse of birth as a normal physiological event and neoliberal discourses of productive subjectivity create a gap between what migrant  women expect in the care they expect from maternal services. These practices also constitute modes of governing which are intended to be empowering and normalizing, but are experienced  as disempowering because they don’t take into account other views of birth. Consequently there is no recognition on the part of maternity services that for a short time, there is a temporary role change, where the new mother transitions into a caregiver by being cared for. This social transition where the mother is mothered is sanctioned in order to safeguard the new mother, a demonstration to value and protect both future capacity for mothering and long term well being, in contrast with dominant discourses of responsibilisation and intensive motherhood. Thus, instead of a few days of celebration or a baby shower, extended post-partum practices are enacted which can include the following (Note that these will vary depending on in group differences, urbanisation, working mothers, migration):

  • Organised support- where family members (eg mother, mother-in-law, and other female relatives) care for the new mother and infant. Other women may also be involved eg birth attendants.
  • Rest period and restricted practices- where women have a prescribed rest periods of between 21 days and five weeks, sometimes called “Doing the month”. Activities including sexual activity, physical and intellectual work are reduced.
  • Diet- Special foods are prepared that promote healing/restore health or have a rebalancing function for example because the postpartum period is seen as a time when the body is cold, hot food (protein rich) chicken soup, ginger and seaweed, milk, ghee, nuts, jaggery might be consumed. Special soups and tonics with a cleansing or activating function are consumed eg to help the body expel lochia, to increase breastmilk. These foods might be consumed at different stages of the perinatal period and some food might be prohibited while breastfeeding.
  • Hygiene and warmth- particular practices might be adhered to including purification/bathing practices eg warm baths, immersion. Others might include not washing hair.
  • Infant care and breastfeeding- Diverse beliefs about colostrum, other members of family may take more responsibility while mother recovers and has a temporarily peripheral role. Breastfeeding instigation and duration may differ.
  • Other practices include: binding, infant massage, maternal massage, care of the placenta.

If women are confronted with an unfamiliar health system with little support and understanding, they can experience stress, insecurity, loneliness, isolation, powerlessness, hopelessness. This combined with communication gaps and isolation, poor information provision, different norms, feeling misunderstood and feeling stigmatized. What could be a special time is perceived as a lack of care. Fortunately in Australia there are some excellent resources, for example this research based chapter on Cultural dimensions of pregnancy, birth and post-natal care produced by Victoria Team, Katie Vasey and Lenore Manderson, proposes useful questions for perinatal assessment which I have summarised below:

  • Are you comfortable with both male and female health care providers?
  • Are there any cultural practices that we need to be aware of in caring for you during your pregnancy, giving birth and postnatal period? – For example, requirements with the placenta, female circumcision or infant feeding method.
  • In your culture, do fathers usually attend births? Does your partner want to attend the birth of his child? If not, is there another close family member you would like to be present? Would you like us to speak to them about your care?
  • Are there any foods that are appropriate or inappropriate for you according to your religion or customs during pregnancy, birth and the postpartum period?
  • Are there any beliefs or customs prohibiting physical activity during pregnancy, birth and the postpartum period? Do you plan to observe these? – For example, a confinement period.
  • What is the culturally acceptable way for you to express pain during childbirth? – For example, screaming or trying to keep silent.
  • Are there any precautions with infant care?
  • How many visitors do you expect while you are in the hospital?
  • Do you have anyone in your family or community who can help you in practical ways when you get home?

Negotiating between cultural practices, values and norms, religious beliefs and views, beliefs about perinatal care is a starting point. It is also important to consider language proficiency, health literacy, quality of written materials, and level of acculturation. For further information on health literacy see the Centre for Culture, Ethnicity & Health (CEH) resources including: What is health literacy?, Social determinants of health and health literacy.  Using professional interpreters improves communication, clinical outcomes, patient satisfaction and quality of care, and reduces medical testing, errors, costs and risk of hospitalisation. Lack of appropriate interpreter service use is associated with adverse health outcomes. Centre for Culture,Ethnicity & Health (CEH) has excellent resources in this regard: Interpreters: an introduction, Assessing the need for an interpreter, Booking and briefing an interpreter, Communicating via an interpreter, Debriefing with an interpreter, Developing a comprehensive language services response, Language services guide Managing bilingual staff, Planning for translation, Recruiting bilingual staff.

Assessment should also consider:

  • Genetics and pregnancy: women’s age, parity, planning and acceptance of pregnancy, pregnancy related health behaviour and perceived health during pregnancy. 
  • Migration: women’s knowledge of/familiarity with the prenatal care services/system, experiences and expectations with prenatal care use in their country of origin, pregnancy status on arrival in the new industrialized western country.
  • Culture: women’s cultural practices, values and norms, acculturation, religious beliefs and views, language proficiency, beliefs about pregnancy and prenatal care.
  • Position in the host country: women’s education level, women’s pregnancy-related knowledge, household arrangement, financial resources and income.
  • Social network: size and degree of contact with social network, information and support from social network.
  • Accessibility: transport, opening hours, booking appointments, direct and indirect discrimination by the prenatal care providers.
  • Expertise: prenatal care tailored to patients’ needs and preferences.
  • Treatment and communication: communication from prenatal care providers to women, personal treatment of women by prenatal care providers, availability of health promotion/information material, use of alternative means of communication.
  • Professionally defined need: referral by general practitioners and other healthcare providers to prenatal care providers

A review by Small, Roth et al., (2014) found that what immigrant and non-immigrant women want from maternity care is similar: safe, high quality, attentive and individualised care, with adequate information and support. Generally immigrant women were less positive about care than non-immigrant women, in part due to communication issues, lack of familiarity with care systems, perceptions of discriminatory care which was not kind or respectful. The challenge for health systems is to address the barriers immigrant women face by improving communication, increasing women’s understanding of care provision and reducing discrimination. Clinical skills including—introspection, self-awareness, respectful questioning, attentive listening, curiosity, interest, and caring.

Also:

  • Facilitating trust, control
  • Delivering quality, safe care, communicating, being caring, providing choices
  • Facilitating access to interpreters and choice of gender of care provider,
  • Considering cultural practices, preferences and needs/different expectations for care
  • Engendering positive interactions, being empathetic, kind, caring and supportive.
  • Taking concerns seriously
  • Preserving dignity and privacy
  • Seeing a person both as an individual, a family member and a community member
  • Developing composure managing verbal and non-verbal expressions of disgust and surprise
  • Paradoxical combination of two ideas— being “informed” and “not knowing” simultaneously.

In that sense, our knowledge is always partial and we are always operating from a position of incompletion or lack of competence. Our goal is not so much to achieve competence but to participate in the ongoing processes of seeking understanding and building relationships. This understanding needs to be directed toward ourselves and not just our clients. As we question ourselves we gradually wear away our own resistance and bias. It is not that we need to agree with our clients’ practices and beliefs; we need to understand them and under-stand the contexts and history in which they develop (Dean, 2001, p.628).

Conclusion

In this presentation I have invited you to examine your own values and beliefs about the perinatal period and how they might impact on the care you might provide. I have asked you to consider both the similarities and differences between how women from culturally diverse communities experience maternity and those from the dominant culture. Together, we have scrutinised a range of strategies for enhancing trust, engagement and perinatal outcomes for all women. Drawing on my own clinical practice and research, I have asked you to consider an alternative conceptualisation of the maternal body when caring for some women, that is the maternal body as vulnerable, which requires a period of rest and nurturing. This framing requires a temporary role change for the new mother to transition into being a caregiver, by being cared for, so that her future capacity for mothering and long term well being are enhanced. I have asked you to reflect on how supposedly empowering practices can be experienced as disempowering because they don’t take into account this view of birth. In the context of differing conceptualisations of birth and the maternal body I have drawn special attention to: negotiating between health beliefs; having cultural humility; considering ways in which your own knowledge is always partial; and recommended a range of resources that can be utilised to ensure positive outcomes for women and their families. As health services in Australia grapple with changing societal demographics including cultural diversity, changing consumer demands and expectations; resource constraints; the limitations in traditional health care delivery; greater emphasis on transparency, accountability, evidence- based practice (EBP) and clinical governance (Davidson et al., 2006), questions of how to provide effective universal health care can be enhanced by considering how differing views can be incorporated as they hold potential benefits for all.

Selected references

  • Boerleider, A. W., Wiegers, T. A., Manniën, J., Francke, A. L., & Devillé, W. L. (2013). Factors affecting the use of prenatal care by non-western women in industrialized western countries: A systematic review. BMC Pregnancy and Childbirth, 13(1), 8.
  • Dennis, C. L., Fung, K., Grigoriadis, S., Robinson, G. E., Romans, S., & Ross, L. (2007). Traditional postpartum practices and rituals: A qualitative systematic review. Women’s Health (London, England), 3(4), 487-502. doi:10.2217/17455057.3.4.487.
  • Mander, S., & Miller, Y. D. (2016). Perceived safety, quality and cultural competency of maternity care for culturally and linguistically diverse women in queensland. Journal of Racial and Ethnic Health Disparities, 3(1), 83-98. doi:10.1007/s40615-015-0118.
  • Small, R., Roth, C., Raval, M., Shafiei, T., Korfker, D., Heaman, M. Gagnon, A. (2014). Immigrant and non-immigrant women’s experiences of maternity care: A systematic and comparative review of studies in five countries. BMC Pregnancy and Childbirth, 14(1).

Additional web resources

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All I want for Christmas is… On International Day of Solidarity with Migrants 2015

December 18th marks the anniversary of the signing of the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families by the United Nations in 1990. Lobbying from Filipino and other Asian migrant organisations in 1997, led to December18th being promoted as an International Day of Solidarity with Migrants. The day recognises the contributions of migrants to both the economies of their receiving and home countries, and promotes respect for their human rights. However, as of 2015, the Convention has only been signed by a quarter of UN member states.

2015 has seen the unprecedented displacement of people globally with tragic consequences. UNHCR’s annual Global Trends report shows a massive increase in the number of people forced to flee their homes. 59.5 million people were forcibly displaced at the end of 2014 compared to 51.2 million a year earlier and 37.5 million a decade ago.

Politicians and media have a pivotal role in agenda setting and shaping public opinion around migrants, refugees and asylum seekers. A 100-page report, Moving Stories, released for International Migrants Day reviews media coverage of migration across the European Union and 14 countries across the world. The report acknowledges the vulnerability of refugees and migrants and the propensity for them to be politically scapegoated for society’s ills and has five key recommendations, briefly (p.8):

  1. Ethical context: that the following five core principles of journalism are adhered to:
    accuracy, independence, impartiality, humanity and accountability;
  2. Newsroom practice: have diversity in the newsroom, journalists with specialist knowledge, provide detailed information on the background of migrants and refugees and the consequences of migration;
  3. Engage with communities: Refugee groups, activists and NGOs can be briefed
    on how best to communicate with journalists;
  4. Challenge hate speech.
  5. Demand access to information: When access to information is restricted, media and civil society groups should press the national and international governments to be more transparent.

Much remains to be done, but it is heartening to see Canadian Prime Minister Justin Trudeau’s response to the arrival of thousands of Syrian refugees: 

You are home…Welcome home…

Tonight they step off the plane as refugees, but they walk out of this terminal as permanent residents of Canada. With social insurance numbers. With health cards and with an opportunity to become full Canadians

Trudeau’s response sharply contrasts with that of the United States, where many politicians have responded to Islamophobic constituencies with restrictions or bans on receiving refugees. The welcome from Indigenous Canadians to newly arrived refugees has also been generous and inclusive, considering that refugees and migrants are implicated in the ongoing colonial practices of the state. These practices can maintain Indigenous disadvantage while economic, social and political advantage accrue to settlers. It is encouraging that Trudeau’s welcome coincided with an acknowledgement of the multiple harms Canada has imposed on Indigenous people since colonisation. 

Alarmingly, the center-right Danish government’s bill currently before the Danish Parliament on asylum policy, allows for immigration authorities to seize jewellery and other valuables from refugees in order to recoup costs. The capacity to remove personal valuables from people seeking sanctuary is expected to be effective from February 2016 and has a chilling precedent in Europe, as Dylan Matthews notes in Vox:

Denmark was occupied by Nazi Germany for five years, from 1940 to 1945, during which time Germany confiscated assets from Jewish Danes, just as it did to Jews across Europe. Danish Jews saw less seized than most nations under Nazi occupation; the Danish government successfully prevented most confiscations until 1943, and Danes who survived the concentration camps generally returned to find their homes as they had left them, as their neighbors prevented Nazis from looting them too thoroughly. But Nazi confiscations still loom large in European historical memory more generally.

The UN, the Parliamentary Assembly of the Council of Europe (PACE) and the International Organization for Migration (IOM) have advocated for the development of regional and longer term responses. Statements echoed by Ban Ki-moon which proposed better cooperation and responsibility sharing between countries and the upholding of the human rights of migrants regardless of their status (Australia take note). He proposes that we:

must expand safe channels for regular migration, including for family reunification, labour mobility at all skill levels, greater resettlement opportunities, and education opportunities for children and adults.

On International Migrants Day, let us commit to coherent, comprehensive and human-rights-based responses guided by international law and standards and a shared resolve to leave no one behind.

What does this all mean for Australia and New Zealand? I’ve written elsewhere about the contradiction between the consumptive celebrations of multiculturalism and the increasing brutality and punitiveness of policies in both countries; the concerns of Australia’s key professional nursing and midwifery bodies about the secrecy provisions in the Australian Border Force Act 2015 and the ways in which New Zealand is emulating a punitive and dehumanising Australian asylum seeker policy.

It is appropriate then in this season of goodwill and peace to write an updated Christmas wish list, but with a migration focus. As a child growing up in Nairobi, one of my pleasures around Christmas time was drawing up such a list. I was so captivated with this activity that I used to drag our Hindu landlord’s children into it. This was kind of unfair as I don’t think they received any of the gifts on their list. For those who aren’t in the know, a wish list is a list of goods or services that are wanted and then distributed to family and friends, so that they know what to purchase for the would-be recipient. The idea of a list is somewhat manipulative as it is designed around the desires of the recipient rather than the financial and emotional capacity of the giver. Now that I’ve grown up a little, I’ve eschewed the consumptive, labour exploitative, commercial and land-filling aspects of Christmas in favour of spending time with family, as George Monbiot notes in his essay The Gift of Death:

They seem amusing on the first day of Christmas, daft on the second, embarrassing on the third. By the twelfth they’re in landfill. For thirty seconds of dubious entertainment, or a hedonic stimulus that lasts no longer than a nicotine hit, we commission the use of materials whose impacts will ramify for generations.

So, this list focuses on International Day of Solidarity with Migrants. All I want for Christmas is that ‘we’:

  1. End the Australian Government policy of turning back people seeking asylum by boat ie “unauthorised maritime arrivals”. 
  2. Stop punishing the courageous and legitimate right to seek asylum with the uniquely cruel policy of mandatory indefinite detention and offshore processing. Mandatory detention must end. It is highly distressing and has long-term consequences.
  3. Remove children and adolescents from mandatory detention. Children, make up half of all asylum seekers in the industrialized world. Australia, The United States, the United Kingdom, Germany and Italy directly contradict The Convention on the Rights of the Child (UNCRC).
  4. Engage in regional co-operation to effectively and efficiently process refugee claims and provide safe interim places. Ensure solutions that uphold people’s human rights and dignity, see this piece about the Calais “Jungle”.
  5. End the use of asylum-seeker, refugee and migrant bodies for political gain.
  6. Demand more ethical reporting by having news media: appoint specialist migration reporters; improve training of journalists on migration issues and problems of hate-speech; create better links with migrant and refugee groups; and employ journalists from ethnic minority communities, see Moving Stories.
  7. Follow the money. Is our money enabling corporate complicity in detention? Support divestment campaigns, see X Border Operational matters. Support pledges that challenge the outsourcing of misery for example No Business in Abuse (NBIA) who have partnered with GetUp.
  8. Support the many actions by Indigenous peoples to welcome refugees. Indigenous demands for sovereignty and migrant inclusion are both characterised as threats to social cohesion in settler-colonial societies.
  9. Challenge further racial injustice through social and economic exclusion and violence that often face people from migrantnd refugee backgrounds.
  10. Ask ourselves these questions:‘What are my borders?’ ‘Who do I/my community exile?’ ’How and where does my body act as a border?’ and ‘What kind of borders exist in my spaces?’ The questions are from a wonderful piece by Farzana Khan.
Seppo Leinonen, a cartoonist and illustrator from Finland

Seppo Leinonen, a cartoonist and illustrator from Finland

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Politics and policies reflect values: Border Force Act 2015 and the Immigration Amendment Bill (NZ)

World Refugee Day in June acknowledges the courage, resilience and contributions of refugees. On this day, I acknowledge those caught in geopolitical situations that aren’t of their own making. I acknowledge those who risk life and limb for a better life. I acknowledge those who create new lives despite horror, profound loss and hardship. I acknowledge those who fight for a better world. I mourn for the loss of life, the loss of potential, the loss of innocence, the loss of family, the loss of dignity, hope, freedom. I burn fiercely with rage for those who dehumanise, destroy, lay waste to, ignore, collude and contribute to the reason people flee. For all those who have survived, I salute your courageous hearts and spirits, your resilience in the face of unspeakable atrocity. 

The many celebrations, performances, speeches representing individual and community acts of welcome in both New Zealand and Australia, disguise the increasing brutality and punitiveness of policies in both countries. Policy refers to “a course or principle of action adopted or proposed by a government, party, business or individual” (Australian Concise Oxford Dictionary). Policy not only references content, it points to the kinds of values and beliefs held in a society. Consider the passing of the second reading of the Immigration Amendment Bill by the New Zealand Parliament which will allow the imprisonment of asylum seekers arriving boat, following in Australia’s footsteps of penalising maritime arrivals. Consider the persecution of refugees who arrive by sea, the removal to offshore facilities of babies and children, the payment of “people smugglers” to “turn back the boats” in Australia. For health professionals the secrecy provisions in Section 42 of the Australian Border Force Act 2015 threaten jail for up to two years for professionals who disclose information about the conditions in immigration Detention Centres. These policies are often cited as grounds for moral superiority by New Zealand, but Australia has a larger refugee quota per capita than New Zealand does, which is more often being seen as “a heartless country and a bad global citizen” (see Dr Bryce Edwards excellent summation).

So what “we” are to do with these contradictory aspects of celebration and deterrence that are present in World Refugee Day? RISE: Refugees, Survivors and Ex-Detainees is the first and only refugee and asylum seeker welfare and advocacy organisation in Australia, entirely governed by refugees, asylum seekers, and ex-detainees. RISE have made a powerful statement for World Refugee Week:

The world has forcibly displaced over 57 million people, the highest number since World War II. Most of the displaced refugees are hosted by non-signatory refugee countries, yet most people who celebrate Refugee week are signatories of the refugee convention. There has been no coordinated effort to create more places for resettlement nor other long-term humanitarian solutions for refugees other than lucrative “border security” that feeds the military industrial and detention industrial complex at the expense of our lives. Presently, most refugee signatory countries are trying to block borders and decrease refugee intake, so what is left for us to celebrate here? The death and torture of refugees? Thus far, we have not witnessed safe passage for asylum seekers and refugees across borders.

Questioning the performance aspects of the many activities organised for this week and especially today, they state:

Basically we are remembered once a year as entertainers, visible once a year but voiceless and too incompetent to provide solutions to address our own community’s needs for the rest of the year.

UNHCR’s new annual Global Trends report shows a massive increase in the number of people forced to flee their homes. 59.5 million people were forcibly displaced at the end of 2014 compared to 51.2 million a year earlier and 37.5 million a decade ago. Over half the world’s refugees are children. How can those of us who are disturbed by the scale of displacement and trauma influence governments to influence policy? Murdoch Stevens’ work is a great example. He set up Doing Our Bit in New Zealand and has spearheaded a campaign since 2013 supported by the New Zealand Greens, World Vision, Amnesty International and the New Zealand Race Relations Commissioner Susan DeVoy asking for the New Zealand Refugee Quota to be doubled (you can sign a petition at Action Station). On Wednesday 17th June a private members bill was launched by Denise Roche of the Green Party to increase the refugee quota from 750 to 1000 places.

Tracey Barnett a journalist has responded to the backlash from calls to increase the quota in New Zealand by developing a series of one minute videos to counter misconceptions about refugees : Can New Zealand Get a Refugee Boat Arrival?, Define a refugee, an asylum seeker and an economic migrant?, Are boat arrivals really jumping the UN queue? :

As families risk their lives at sea rather than die in the war that has engulfed them, New Zealand has quietly just shrugged. It’s not our crisis. It’s so far away. We’re missing the boat entirely. We are every bit a part of the problem. New Zealand has very quietly closed the door to refugees from long-term neglect.

In Australia, The Royal Australasian College of Physicians (RACP) released a new Refugee and Asylum Seeker Health Policy and Position Statement which outlines the deleterious health impacts of detention and sets out the RACP’s Policy relating to Refugee and Asylum Seeker health. The Position Statement outlines four key aspects influencing health for people seeking asylum in Australia and New Zealand: an end to immigration detention, good access to health services in the community, rigorous health assessments, and promotion of long-term health in the community. There is also a video. The Australian College of Midwives, The Australian College of Mental Health Nurses and The Australian College of Nurses, Australia’s key professional nursing and midwifery bodies have expressed serious concern about the secrecy provisions in the Australian Border Force Act 2015, arguing that the threat of imprisonment for nurses or midwives that disclose any protected information acquired while working in immigration detention centres, places them at odds with obligations under the Australian Codes of Professional Conduct and Codes of Ethics:

This law actively prohibits nurses and midwives from fulfilling their duty under their respective Code of Professional Conduct and Code of Ethics which set the minimum standards for practice a nurse or midwife is expected to uphold. Under their respective Codes of Professional Conduct both nurses and midwives are required, where they have made a report of unlawful or otherwise unacceptable conduct to their employers and that report fails to produce an appropriate response from the employers, to take the matter to an appropriate external authority. However, restrictions imposed by the Australian Border Force Act prohibit nurses and midwives from doing so.

 

The nursing and midwifery bodies endorsing this statement are of the strong view that the Australian Border Force Act 2015 requires urgent amendments. These amendments must ensure that all health professionals and all contractors can advocate freely for best practice health care and against conditions or practices that are harmful to detainees’ health or that otherwise violate their human rights.
As organisations representing Australia’s nurses and midwives, we consider it inconceivable that the Government should seek to place us at odds with our obligations under the Australian Health Practitioner Regulation Agency when delivering health care to people in immigration detention. The Australian Border Force Act requires immediate amendment so nurses and midwives working in immigration detention centres can comply with their professional requirements.”

These examples highlight how activists, professionals and citizens can advocate and influence policy and politics. We can influence politics meaning discussions of how resources are allocated and we can influence policy meaning the distribution of resources. Furthermore, we can engage in politics in the context of how conflict is expressed in the public sphere with regard to values (Mason, Leavitt, Chaffee, 2014). Teanau Tuiono (Ngāpuhi, Ngāi Takoto, Atiu) advocates for Māori values of manaakitanga and whanaungatanga and a respect of Indigenous Peoples guide the criteria of who can stay. It would do us all well to remember which values are embedded in the actions of our political leaders and policy makers and whether these values reflect our own. As Rachel Smalley asks, what is more frightening?

There is nothing frightening about a refugee, nothing at all.  But there is everything to fear about an ignorant and xenophobic society which increasingly shuts the door on humanity

Leunig July 1 2015: 40 current and former workers at Australia’s detention centres on Nauru and Manus Island challenge Tony Abbott and Peter Dutton to prosecute them under new secrecy laws for speaking out over human rights abuses in this open letter.

 

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Cultural safety in Aotearoa New Zealand 2nd Edition

Very excited about the 2nd Edition of Cultural safety in Aotearoa New Zealand being published by Cambridge Press in December 2015.

I’ve contributed two chapters and I have excerpted the introduction of each chapter below:

8. Navigating the ethical in cultural safety

Caring is an ethical activity with a deep moral commitment that relies on a trusting relationship (Holstein & Mitzen, 2001). Health professionals are expected to be caring, skilful, and knowledgeable providers of appropriate and effective care to vulnerable people. Through universal services they are expected to meet the needs of both individual clients and broader communities, which are activities requiring sensitivity and responsiveness. In an increasingly complex globalised world, ethical reflection is required so that practitioners can recognise plurality: in illness explanations; in treatment systems; in the varying roles of family/whanau or community in decision making; and in the range of values around interventions and outcomes. To work effectively in multiple contexts, practitioners must be able to morally locate their practice in both historical legacies of their institutional world and the diversifying community environment. This chapter examines the frameworks that health professionals can use for cross-cultural interactions.I then explore how they can select the most appropriate one depending on the person or group being cared for.

IMG_2910

13. Culturally safe care for ethnically and religiously diverse communities

Cultural safety is borne from a specific challenge from indigenous nurses to Western healthcare systems.It is increasingly being developed by scholars and practitioners as a methodological imperative toward universal health care in a culturally diverse world. The extension of cultural safety, outside an indigenous context, reflects two issues: a theoretical concern with the culture of healthcare systems and the pragmatic challenges of competently caring for ethnically and religiously diverse communities. As discussed throughout this book, the term ‘culture’ covers an enormous domain and a precise definition is not straightforward. For the Nursing Council of New Zealand (‘the Nursing Council’) (2009), for example, ‘culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability’.

In an attempt at a precise two-page definition, Gayatri Chakravorty Spivak (2006, p. 359), captures the reflexive orientation required to grasp how the term ‘culture’ works:

Every definition or description of culture comes from the cultural assumptions of the investigator. Euro-US academic culture… is so widespread and powerful that it is thought of as transparent and capable of reporting on all cultures. […] Cultural information should be received proactively, as always open-ended, always susceptible to a changed understanding. […] Culture is a package of largely unacknowledged assumptions, loosely held by a loosely outlined group of people, mapping negotiations between the sacred and the profane, and the relationship between the sexes.

Spivak’s discussion of the sacred and the profane links culture to the more formal institution of religion, which has historically provided the main discourse for discussion of cultural difference. Particularly important for cultural safety is her discussion of Euro-US academic culture, a ‘culture of no culture’, which has a specific lineage in the sciences of European Protestantantism. Through much of the 19th century, for example, compatibility with Christianity was largely assumed and required in scientific and medical knowledge, even as scientists began to remove explicit Christian references from their literature. This historical perspective helps us see how the technoscientific world of the healthcare system, and those of us in secular education, are working in the legacy of white Christian ideals, where the presence of other cultures becomes a ‘problem’ requiring ‘solutions’. Cultural safety, however, attempts to locate the problem where change can be achieved in the healthcare system itself.

 

IMG_2906

Other contributors include: Irihapeti Ramsden, Liz Banks, Maureen Kelly, Elaine Papps, Rachel Vernon, Denise Wilson, Riripeti Haretuku, Deb Spence, Robin Kearns, Isabel Dyck, Ruth Crawford, Fran Richardson, Rosemary McEldowney, Thelma Puckey, Katarina Jean Te Huia, Liz Kiata, Ngaire Kerse, Sallie Greenwood and Huhana Hickey.

Book cover

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Babies on board: Families in detention

The rather time-worn yellow sign “Baby on Board” seen in the back window of vehicles is meant to encourage safe driving, but also is a public announcement of one’s new status as a parent (It’s also a pun referring to pregnant women commuters in London, as an incitement for commuters to offer their seats to pregnant women). In Australia, when I think of “Babies on Board” there is a poignancy and a deep and overwhelming sadness, because it evokes images of people seeking asylum via boat. The official term is “unauthorised maritime arrivals”, a dehumanising and bureaucratic term rather like the hardline policies of deterrence and detention. Abbott’s cruel “stop-the-boats” strategy ensures that maternity and infancy cannot be the celebrations they are in every culture. Mothers, babies, children and families will encounter the opposite of tender loving care at the hands of the Australian Government who will send them to detention centres in remote locations run by global companies including G4S, Serco and Transfield (See Cathy Alexanders Crikey post for more details). This outsourcing of misery costs the Australian taxpayer a load of money ($2.97 billion has been budgeted by the Federal Government (2013-2014) for detention-related services and offshore asylum seeker management while $19.3 million is  allocated ($65.8 million over four years) for regional solutions).

baby-on-board-2

Consistent with other responses to asylum seekers in western countries, Australia has developed policies of deterrence and detention for boat arrivals without a valid visa. Australia’s Migration Act 1958 requires all “unlawful non-citizens” (people who are not Australian citizens and do not have permission to be in the country) to be detained, until they are granted a visa or leave the country. This detention policy was introduced in 1992 and continues until today. What makes Australia’s response to a legitimate right to seek asylum is the uniquely cruel policy of mandatory, indefinite detention and offshore processing. Without an age exemption it means that detainees can include families and unaccompanied children with processing taking months or years. A range of international literature shows that detention is highly distressing for both adults and children with long-term consequences. The majority of asylum seekers are found to be refugees under the 1951 Convention.

Everyone has the right to seek and enjoy in other countries asylum from persecution. Article 14, Universal Declaration of Human Rights (signed by member countries in 1948, including Australia).

The child shall have the right to adequate nutrition, housing, recreation and medical services. Principle 4. United Nations Declaration of the Rights of the Child. Proclaimed by General Assembly resolution 1386(XIV) of 20 November 1959.

I am horrified that many new babies and new parents will be starting their lives in detention, the latter having already navigated treacherous borders, war strife and dangerous seas but now officialdom to meet the needs of their babies. Most of my professional career has involved supporting new parents. Aside from working on a postnatal ward, I helped to set up a service for women with postnatal depression in Auckland in the mid-nineties, my colleagues and I offered assessment, consultation and therapy to women. Aside from the hundreds of women I met I also heard many stories in the weekly support group I facilitated for depressed women for three years. My Master’s research considered the experiences of new migrant mothers and the challenges of establishing a new life without support and access to cultural rituals. In my PhD research I looked at the “the politics of the womb” and the role of maternity in projects of capitalism, nation building, imperialism and globalisation. See my other blog posts on supporting migrant fathering, ‘good’ mothering, pronatalist and antinatalist policies (including Australia’s forcible removal of Aboriginal – and some Torres Strait Islander – children). I’ve also researched and written about the experiences of Refugee women in New Zealand, Korean migrant mothers and the discursive repertoires of Plunket Nurses. I have spent decades educating organisations and professionals about the needs of new mothers and I developed a brochure about Postnatal depression for the New Zealand Mental Health Foundation with the help of consumer organisations and many new parents and professionals. So you could say I know a little about what new mothers and babies might need to help them thrive.

Parenting and mothering are not easy. The transition is challenging emotionally, physically and socially. That’s why so many cultures have rituals for protecting and nurturing new mothers, whether it’s special foods, attention or ceremonies. The mother has experienced a massive transition requiring time to recoup, hence postpartum rest and loving attentive care are provided to women. Maternity professionals have a unique role in supporting the health and wellbeing of new migrant and refugee families, as they have privileged access to women at a time that is culturally and spiritually important to a woman and her family. However, women’s experiences of maternity services that are designed to meet their needs, can lead them to feel isolated, disrespected and invisible (and that’s when they aren’t in detention). 

Detention centres have been called factories for mental illness. The conditions in immigration detention are not conducive to establishing or maintaining family life, let alone helping families thrive. For asylum seekers who may have experienced torture or trauma, there is a vulnerable to experiencing mental health problems even before they reach countries of resettlement. The conditions of detention are demanding and difficult without the resources and support of family and friends, community and culture, no direct access to services and support. This situation is exacerbated by the unknown length for which people will be detained and to where they might be sent. It is further compounded by the punitive and coercive ways in which people are treated in detention. Existing trauma is only exacerbated while in prolonged detention which has an impact not only on the individuals in a family, but families themselves with the role of parent being undermined. Imagine powerless parents in unpredictable, hostile and degrading surroundings who cannot ensure their children’s safety or comfort. Yes, Australian policies of detention and deterrence are contributing to long term mental ill health for children and their families. Detention facilities have been criticised for the “culture of punishment, humiliating treatment of detainees, including children, and a failure to provide appropriate psychological support for high-risk populations”.

Children in detention

 In all actions concerning children … the best interests of the child shall be a primary consideration. UN Convention on the Rights of the Child (1989)  – Article 3.

.. a child who is seeking refugee status … whether unaccompanied or accompanied … [shall] receive appropriate protection and humanitarian assistance.

UN Convention on the Rights of the Child  (1989) – Article 22 .

 

No child shall be deprived of his or her liberty unlawfully or arbitrarily. The arrest, detention or imprisonment of a child shall be in conformity with the law and shall be used only as a measure of last resort and for the shortest appropriate period of time.

UN Convention on the Rights of the Child  (1989) – Article 37 (b).

 

Children subjected to abuse, torture or armed conflicts should recover in an environment which fosters the health, self-respect and dignity of the child.

UN Convention on the Rights of the Child (1989) Article 39.

Children, accompanied or on their own, account for as up to half of all asylum seekers in the industrialized world. Australia is not the only country to detain children, The United States, the United Kingdom, Germany and Italy also directly contradict The Convention on the Rights of the Child (UNCRC), which stresses that detention of children should only be a last resort and for the shortest appropriate period of time. In Australia up till 1994 there was a 273-day time limit on detention, however, after this time indefinite detention became the norm with no exemptions made for children or unaccompanied minors. A Human Rights Commission National Inquiry into Children in Immigration Detention in 2001 noted that (CRC)  requires the detention of children to be ‘a measure of last resort’, but Australia’s detention laws make detention of unauthorised arrival children ‘the first, and only, resort’. Mandatory detention overrides the rights and protections of child asylum seekers as enshrined in other international and regional conventions and declarations the European Convention on Human Rights, the Geneva Convention, the International Covenant on Civil and Political Rights, and the International Covenant on Economic, Social and Cultural Rights. 

Source: Department of Immigration and Citizenship, 13 September 2013. Adapted by the Australian Human Rights Commission.

Source: Department of Immigration and Citizenship, 13 September 2013. Adapted by the Australian Human Rights Commission.

The Australian Department of Immigration and Border Protection (DIBP) statistics (2014) show that:

  • 1106 children are held in Australia’s secure immigration detention facilities,
  • 356 on Christmas Island and 177 of the children in Nauru
  • 1579 are detained in the community under residence determinations.
  • 1816 children live in the community on Bridging Visas (their parents have no work rights and limited access to Government support).

Research shows that even “brief” detention is detrimental to children. Prior to 2008, all children seeking asylum In Australia were faced with mandatory detention for an average of two years. In a summary of the impacts on children’s physical and mental health, Kronick, Rousseau, & Cleveland (2011) noted all manner of behvioural problems including disruptive conduct, nighttime bedwetting, separation anxiety, sleep disturbance, nightmares and impaired cognitive development. More severe symptoms includied mutism, stereotypic behaviours, and refusal to eat and drink. Mental health problems such as post-traumatic stress disorder, major depression, self harm and suicidal ideation were common. Younger children experienced developmental delays, attachment and behavioural problems Parents self-reported a decrease in the capacity to parent while in detention, and detention can trigger memories of previous trauma, humiliation and hopelessness. United Kingdom research has also found behavioural difficulties, developmental delay, weight loss, difficulty breast-feeding in infants, food refusal and loss of previously obtained developmental milestones. The neurodevelopmental vulnerability of infants means that they are highly sensitive to their socio-cultural environments. The Australian Human Rights Commission is conducting an inquiry into children in immigration detention. You can read powerful testimonials from children themselves, educators and health professionals including this account from Paediatrician Karen Zwi who visited Christmas Island:

Babies are unable to crawl because the ground is so rough and the only playground is unusable during the day due to the extreme heat.New mothers are forced to queue up for strictly rationed nappies, baby wipes and powdered milk, with staff telling them constantly they will never be resettled in Australia.

Parenting in detention

Changes to the Migration Act since July 19, 2013 mean that pregnant asylum seekers in offshore detention (classed as “unauthorised maritime arrivals”) can be removed offshore. Recently babies have been sent from Darwin to Nauru and Greens Senator Sarah Hanson-Young plans to introduce a bill banning the removal of Australian-born babies to offshore detention centres to Parliament in May. She says:

‘‘We are, by incarcerating these newborn babies, creating the next damaged generation . . . we know the damage the detention of children has (on them),’’ she said. ‘‘If we allow this to continue, we are knowingly destroying them,’’ she said. ‘‘I don’t think that’s a political issue, it’s a moral issue.’’

(Note that Section 21(8) of the Australian Citizenship Act makes clear that a baby, born in Australia, who is stateless, is eligible to apply for Australian citizenship).

Louise Newman (see reference below) has worked extensively with women asylum seekers and notes that they have unique health and mental health needs related to pregnancy and delivery which can be exacerbated by limited antenatal care or screening. Their histories can include sexual trauma and abuse and perinatal loss. Receiving perinatal “care” in a detention facility means that professionals are balancing competing priorities and subject to varying forms of regulation and administration which put complex demands on their time. There may be ambiguity about how to respond to the needs of pregnant or postpartum women who they might be ill-equipped or resourced to support as reports have indicated.

In a detention context, women are isolated from their cultural traditions and supports and sometimes physical isolation begins weeks prior to delivery. This cultural isolation compounded with a lack of access to interpreters during delivery can increased fear and distress and is implicated in the high rates of postnatal depression and anxiety and attachment difficulties with infants seen in women in detention. Newman notes that research in the United Kingdom would resonate with women’s experiences and clinician observations in Australia. Where women expressed high levels of of distress and reported poor care. The context also impacted on their capacity to parent with women feeling isolated, incompetent, ashamed and guilty for delivering a baby in detention. Consequently, a highly anticipated, magnificent, sacred and profound time in a woman and her family’s life becomes one that is painful. In a powerful article describing his visit to Christmas Island, acting for some 26 babies born in detention Jacob Varghese notes how cruel asylum seeker policy is for new parents:

…what it is like being a new parent in a remote prison, with no control over your circumstances, every daily routine determined for you by guards and bureaucrats.

 

How the Australian government reports on conditions in detention differs from the reality. In an article for Crikey, Caroline de Costa, Professor of Obstetrics and Gynaecology and Director of the Clinical School at James Cook University School of Medicine, Cairns Campus in North Queensland notes:

We were told that there is 24/7 access to a nursing triage service, with a doctor on call, for asylum seekers (male and female, adults and children) in all three camps.  We were also told that there are regular playgroups and ‘Mums and Bubs’ sessions held in all three camps for pregnant women and new mothers. Meeting individual asylum seekers, in the visitors’ rooms of all three facilities, in the two days following our formal visit, we heard stories quite different from the official accounts. We observed in many parts of the camps that asylum seekers including children and women are routinely listed, dealt with and addressed by the numbers given to them on arrival by boat in Australia, rather than by their names.

Caroline de Costa also “unequivocally” states that neither Manus nor Nauru are suitable places for the detention of very young babies and their families. She suggests that:

the greatest and most pervasive risk is to the mental health of children and their families. The fact of ongoing uncertain detention is bad enough; adding to it with an extremely isolated hot and crowded environment with few diversions within the detention facility and none outside is demonstrably contributing to very high levels of psychiatric presentations among asylum seekers, well documented by many of my colleagues in recent weeks. My own observations of recent mothers I met in Darwin is of a high level of postnatal depression that is continuing on well past the postnatal period…

The Australian Immigration Minister’s (Scott Morrison) office says:

the Government’s policy is to transfer illegal boat arrivals to offshore processing centres and families are transferred to Nauru. The statement says creating exemptions for offshore processing will only create dangerous incentives for people smugglers to fill boats with women and children.

Cartoon by Oslo Davis Source: Museum Victoria

Cartoon by Oslo Davis
Source: Museum Victoria

So what can we do?

The good news is that there is plenty of resistance both professionally, in the community and among refugee advocacy organisations. DASSAN (Darwin Asylum Seekers Support and Advocacy Network) believe that families should not be detained and babies should not be born into detention. They advocate for policy change but have also been providing practical help and support including: making welcome packs for new babies; sewing gifts: and collecting clothes for babies and women in detention on Christmas Island. They observe:

At a time when families should be focused on preparing for the joy of welcoming new life, they are instead dealing with the trauma of having fled from their home, the great anxiety of being told they will be sent to Nauru or Manus Island, and the daily despair of being kept locked up.

(Note, if you’d like to support their work there are details on the DASSAN site). Chilout (Children out of immigration detention) have worked tirelessly to lobby for children aged from zero to eighteen. I recommend reading their Factsheet and accessing the extensive range of resources and reports on their website.

The use of prolonged detention for pregnant women and mothers with young children inflicts physical and psychological harm disproportionate to the policy aim of immigration control and should be stopped immediately .

 

The Royal Australasian College of Physicians (RACP) made a passionate plea on World  Refugee Day for the Australian Government to end the mandatory detention of children and adolescents seeking asylum in Australia and in offshore centres. Their Position Statement Towards better health for refugee children and young people in Australia and New Zealand advocates for the abolition of  Australian legislation that allows children to be housed in detention centres and they propose that the Australian Government  immediately place detained children in the community with their families where they can be provided with appropriate health and social support. There is a Paediatrics & Child Health advocacy campaign for health and well-being of children in detention/refugees which was launched on 7 June 2013. Information and template letters addressed to Government Ministers can be used to advocate for health of children in detention. These are just a few of the national and local responses to mothers, children and families in detention.
There is also a National Inquiry into Children in Immigration Detention 2014: Discussion Paper. The the Australian Human Rights Commission (HRC) is investigating the ways in which life in immigration detention affects the health, well-being and development of children and inviting people previously detained as children in closed immigration detention and assessing the current circumstances and responses of children to immigration detention. A follow up to their report ten years ago A last resort? the report of the National Inquiry into Children in Immigration Detention (National Inquiry). After the National Inquiry positive developments including the removal of children from high security Immigration Detention Centres, the creation of the Community Detention system and the use of bridging visas for asylum seekers who arrive by boat. However, there are still around 1,000 children in closed immigration detention, a higher number than the last inquiry, and the Commission’s monitoring work reveals that key concerns remain. Their aim is to discover if there have been any changes in the ten years since the last investigation, and whether Australia is meeting its obligations under the Convention on the Rights of the Child (CRC). You can read the inquiry discussion paper and make a submission that addresses the inquiry terms of reference. This inquiry is focused on closed detention facilities (not community) and the impact of detention on children under 18 years. You can also read about their work on alternatives to closed detention The last words really belong to Murray Watt who in an article Why is an Australian baby locked up in detention? says:

 

It’s not fair that children – or anyone for that matter – should be locked up for years on end, without any consideration of their claims to protection.   It’s not fair that the conditions in offshore detention camps, overseen by our own government, are dangerous, inhumane and deliberately designed to break people’s spirit.   And it’s not fair that Australia – ranked by the IMF as the 10th richest country in the world – should pass our refugee “problem” on to countries that are far poorer and less safe than many of the countries from which refugees come in the first place.   Australia can do better than this. Over our history, we have led the world in protecting others in distress, and in improving the rights and living conditions of our citizens and those across the world. We should live up to our history.

References

  • Kronick, Rachel, Rousseau, Cécile, & Cleveland, Janet. (2011). Mandatory detention of refugee children: A public health issue? Paediatrics & child health, 16(8), e65.
  • Mares, Newman, Dudley, & Gale, (2002). Seeking Refuge, Losing Hope: Parents and Children in Immigration Detention. Australasian Psychiatry, 10(2), 91-96. doi: 10.1046/j.1440-1665.2002.00414.x)
  • Newman, Louise K, & Steel, Zachary. (2008). The child asylum seeker: psychological and developmental impact of immigration detention. Child and adolescent psychiatric clinics of North America, 17(3), 665-683.
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From bystander to ally: Can small acts help?

I’m interested in what moves us from being bystanders and witnesses to injustice to being moved to act. This has been prompted by several incidents since I arrived in Australia and a few days ago, the savage beating to death of a transgender woman of colour. In our increasingly surveilled and fear based society, there seem to be more effective structures and mechanisms for contributing to injustice than remedying it. In many cases our political leadership promulgate fear and distrust in a bid to retain or increase voters, hate which is then fanned and fuelled by the media. Take the invitation to police our neighbours in the form of immigration policy in both the United Kingdom and Australia. The Immigration Dob-in Service on the website of the Australian Government’s Department of Immigration and Citizenship (DIAC) being a prime example of how with a few clicks and some information “the community” are encouraged to “dob in” people. Similarly the The UK Home Office had vans warning illegal immigrants to “go home” which demonstrated how easily the government could ignore and breach its responsibilities under the Equalities Act (eliminating discrimination and harassment based on race and religion, fostering good relations between people from different racial and religious groups).

Go home van

Photograph: Rick Findler

Luckily the racist vans were subverted with civil liberties group Liberty organising an alternative message. Other advocacy groups such as Amnesty, Refugee Action and Freedom from Torture claimed in a letter to the Guardian:

As organisations with expertise in supporting people who are seeking protection in the UK, we deplore the highly controversial advertising campaign delivered on the side of vans driven through selected London boroughs

The ‘illegal immigrants go home campaign’ is cynical and giving rise to a climate of fear. The heavy-handed ‘stop and search’ activity outside London tube stations harks back to a period before the Lawrence inquiry and raises questions about racial profiling in immigration control

Van

But what if you are an individual who would like to respond to racism but feel overwhelmed and powerless? A recent study by VicHealth (with the University of Melbourne and the Social Research Centre) investigated the role of bystanders and racist incidents by sampling 601 Victorians and asking them whether racism was acceptable in various scenarios in social settings, workplaces and sports clubs; what they would do if they witnessed racism in these scenarios and what they did the last time they witnessed a racist incident. You might have heard about the many incidents of racist violence and abuse on public transport and in sport.

The purpose of the study was to consider whether reducing racist incidents or the impact of incidents could prevent distress and illnesses in Victorian people from Aboriginal and culturally and linguistically diverse backgrounds. People from Aboriginal and culturally and linguistically diverse backgrounds experience the highest volumes of racism and record the most severe psychological distress, which places them at higher risk than others of mental illnesses (Ferdinand, Paradies & Kelaher, 2013a; 2013b). The VicHealth study found that individuals’ coping strategies provided insufficient protection from harm, and therefore broader community and organisational efforts were needed to stop racism from occurring and that the role of bystanders was a particularly important one.

Encouragingly the study found that 83% of participants felt that more could be done to address race-based discrimination in settings such as workplaces and sporting clubs such as education, promoting cultures of respect and taking action when racist incidents occurred. 84% claimed they would take action against racism with 30 per cent willing to act on every occasion. However, 13 per cent to 34 per cent (approximately one in four people across the sample) claimed they would feel uncomfortable if they witnessed racism, but would not do anything. I agree with the authors that this group of people hold the potential for a new, powerful wave of action. Take this lovely example of an intervention in a supermarket from Upworthy: One Easy Thing All White People Could Do That Would Make The World A Better Place.

That action was a powerful one, but not all bystanders would be willing to act. Imagine though if all bystanders could be moved to act in small ways in their own workplace or social setting and their efforts were co-ordinated. That’s one of the reasons I love the New Zealand Diversity Action Programme, facilitated by the Human Rights Commission who hold their annual forum this week. The programme brings together organisations taking practical initiatives to:

recognise and celebrate the cultural diversity of our society (diverse) promote the equal enjoyment by everyone of their civil, political, economic, social and cultural rights, regardless of race, colour, religion, ethnicity or national origin (equal)foster harmonious relations between diverse peoples (harmonious)fulfill the promise of the Treaty of Waitangi (Treaty-based)

Any organisation that supports the vision of an Aotearoa New Zealand that is “culturally diverse, equal and harmonious” can take part. All they need to do is to commit on an annual basis to taking practical steps to making this vision happen and these steps can be big, small or celebratory.

In the spirit of the Diversity Action Programme, this story about Mariam Issa a former refugee is delightful. Mariam transformed her backyard into a public garden, complete with chooks. She runs regular storytelling sessions bringing women from her middle-class suburb together with former refugees to share stories and better understand each other. Her story inspired me to think how food and conversations might also help us to to shift from bystander to ally and address unequal power relations and racism. I wonder if her new middle-class friends have made that transition?

I loved Mariam’s story because it made me think that the domestic worlds of food and garden can be such potent sites of transformation for social justice. I am a committed foodie (“somebody with a strong interest in learning about and eating good food who is not directly employed in the food industry” (Johnston and Baumann, 2010: 61), who is also interested in the politics of food. My partner and I moved to Victoria, Australia this year near Melbourne, a foodie paradise. Melbourne’s food culture has been made vibrant by the waves of migrants who have put pressure on public institutions, to expand and diversify their gastronomic offerings for a wider range of people. However, our consumption can naturalise and make invisible colonial and racialised relations. Thus the violent histories of invasion and starvation by the first white settlers, the convicts whose theft of food had them sent to Australia and absorbed into the cruel colonial project of poisoning, starving and rationing indigenous people remain hidden from view. So although we might love the food we might not care about the cooks at all as Rhoda Roberts points out:

In Australia, food and culinary delights are always accepted before the differences and backgrounds of the origin of the aroma are

Imagining an alternative Australian future, David Liddle asks if instead of clearing the land and its people and replacing them with cattle, the new settlers had eaten with Aboriginal people a new form of co-existence might have come into play. As a newcomer to Australia I am only just beginning to grasp this history and I know I have a lot to learn.

Which brings me to the crux of this post, can the consumption of food move us from being passive consumers, bystanders if you like, to being engaged allies in the face of racism? The example of the Conflict Kitchen, a restaurant in Pittsburgh which prepares food exclusively from countries currently in conflict with the U.S makes me think it’s possible. Highlighted in a piece in Take Part, the idea is that by eating food from such a country, “the enemy” is humanised and the consumer has an opportunity to deepen their appreciation of cultural difference. Not only is a meal provided but insight into political conflicts and world affairs through performances, discussions and stories about that country is part of the whole experience. Their website says:

…Conflict Kitchen uses the social relations of food and economic exchange to engage the general public in discussions about countries, cultures, and people that they might know little about outside of the polarizing rhetoric of governmental politics and the narrow lens of media headlines.

Closer to my new home is the wonderful initiative by the Asylum Seeker Resource Centre (ASRC), which has a Hot Potato travelling van rolling out across Australia and challenging Australia to 10 million conversations in the lead up to the federal election. The idea is to take the heat out of the asylum seeker conversation and debunk the myths—given that everyone in Australia has an opinion, the ASRC’s aim is to attempt to cool a highly politicised debate with facts. The ASRC claims this Australian political Hot Potato, has been manipulated and passed from one politician to another and heated up by the media.

Drowning

Unless you’ve been sleeping under a rock, you will know that Australia’s Humanitarian Program has made the news for all the wrong reasons, namely it’s harsh treatment of asylum seekers arriving by boat (Irregular Maritime Arrivals). There’s a huge drive to deter people arriving in this way (you can watch the videos on the DIAC webpage called “Don’t be sorry” which features prominent sportsmen). Australia has been roundly criticised for its migration policy of August 2012 which instigated offshore processing of protection (asylum) claims in Nauru and Papua New Guinea.

Settled in Australia

What I love about the hot potato venture are two things. First of all, food is an expression of generosity and hospitality. So these folk aren’t charging anyone for the food. Secondly, the consumption of the food moves away from the foodie zone which:

operate[s] as a field of distinction, marking boundaries of status through the display of taste … The professional and managerial classes are thronging to ethnic cuisine restaurants, while poor, working class, older, provincial people are not. Familiarity with ethnic cuisine is a mark of refinement. (Warde and Martens 2000: 226)3

So anyone can go and have a conversation with the hot potato van regardless of income.

Hot potatoI’ve always thought that eating food from other cultures offered a bridge to empathy and affection for different people as a starting point, and potentially a non-threatening way of developing an ongoing engagement, even ultimately world peace. I mean imagine if instead of bombing and fighting, we had cook offs? Perhaps if we all do a little something, whether it is food and conversation, we might have a chance of realising a vision of a world without racism.

Going back to the VicHealth study, the characteristics of allies (or as they call them active bystanders) were that they were more likely to recognise race-based discrimination, understand the harm it caused, feel a responsibility to intervene, and feel confident to intervene. They were more likely to act in work or social settings if they were supported by their organisations (via policies, culture etc) peers and colleagues. If we are to do our part to reduce or eliminate the harms of racism it will take all of us.

If you want to know where to start, here are some resources:

  1. A terrific video of Dr. Omi Osun Joni L. Jones’ keynote speech from September 2010 at a lThe Seventeenth Annual Emerging Scholarship In Women’s and Gender Studies Conference UT Austin, where gives 6 rules for allies (cross race/gender/sexuality/nationality/religion etc).
  2. Read this terrific blog from SMARTASSJEN about being a trans ally.
  3. AWEA (Auckland Workers Educational Association) is a not-for-profit organisation that supports groups and runs community education related projects. Their core aim is to promote a just and equitable society in accordance with Te Tiriti o Waitangi. They have many useful links and resources for social justice in particular the role of non-indigenous supporters of indigenous justice struggles.

  4. A new book, Working as Allies: supporters of indigenous justice reflect written by Jen Margaret is now available.

 

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Refugee women in New Zealand: Findings and recommendations

Today on International Women’s Day, it seems apt to share this article that I wrote on behalf of our research team for the Women’s Health Action Update, volume 16, Number 43, December 2012. Women’s Health Action is a charitable trust, that works to “provide women with high quality information and education services to enable them to maintain their health and make informed choices about their health care”. Their focus is on health promotion and disease prevention and they are particularly supportive of breastfeeding and screening. Their vision is ‘Well women empowered in a healthy world’.

More than 80 per cent of the world’s refugees are women and their dependent children. Often women of refugee backgrounds [1]are constructed within deficit frames as having high needs. This representation is problematic as it deflects attention from considering broader historical, social, systemic and political factors and the adequacy of resettlement support.

Little is known about the experiences of women who enter New Zealand through the Women at Risk category identified by The Office of the United Nations High Commissioner for Refugees (UNHCR). This category constitutes up to 75 places (10%) of New Zealand’s annual refugee quota of 750. Refugee Services worked with AUT University and the three Strengthening Refugee Voices Groups in Auckland, Wellington and Christchurch to undertake a project to examine the resettlement experiences of women who enter New Zealand through this category or become sole heads of households as a consequence of their resettlement experiences. This project was funded by the Lotteries Community Sector Research Fund.

The project was important not only for its findings but also for the research process, which focused on strengths, social justice, community development and transformative research. This transformative agenda aimed to enhance the wellbeing of refugee background women by focussing on the roots of inequality in the structures and processes of society rather than in personal or community pathology (Ledwith, 2011). Within this frame we were committed to constructing refugee women as an asset rather than deploying a deficit model of refugee women as a burden for the receiving society (Butler, 2005).

Focus groups were held in 2009 and 2010 with women who entered New Zealand as refugees under the formal category ‘Women at Risk’ or became women who were sole heads of households once they arrived in New Zealand. Women that took part had lived in New Zealand from between five months to sixteen years.  Lengthy consultations were held with the three Strengthening Refugee Voices groups in Auckland, Wellington and Christchurch prior to undertaking data collection, in order to scope and refine the research focus and process. These groups were subsequently contracted to provide services and support.

Key findings

Although support needs are similar to all refugees arriving in New Zealand, there were unique and exacerbated gender issues. Refugee background women experienced a double burden of stress with half the support, especially as they parented on their own. This is despite the tremendous unpaid and voluntary support provided by faith and ethnic community members. Women frequently postponed their own aspirations in order to assure the future of their children. When they were ready to take up further education (including English language classes) or employment, limited assistance was then available (given the focus on early resettlement) leading to women feel disadvantaged.

We have made several recommendations based around several specific themes. More broadly we recommended that:

  • More intensive and longer term instititutional support be made available from agencies such as Refugee Services.
  • Subsidised practical help be made available.
  • Assistance to broaden sources of support and networks is goven.
  • Subsidised English language lessons and childcare are available.
  • That a one stop shop/holistic support from culturally and linguistically skilled refugee community insiders be provided.

Parenting

Raising children in New Zealand brought new stresses. These included concern about the loss of culture, values and language and losing their children to less palatable values including the consumption of alcohol and drugs, gender mixing and loss of respect for elders. Women addressed these issues in a range of ways that included trying different less hierarchical styles of parenting, attempting to spend more time with their children, engaging them in broader supports eg mosque. However, a few women had the experience of losing their children through the intervention of CYFS and felt disempowered in their interactions with CYFS and with schools.

  • Programme for parenting for Refugee women, particularly around issues such as discipline, inter-generational gender issues
  • Programmes for young people.
  • Cultural competence training for CYFS.

Family reunification

Living in New Zealand is difficult for women who are conscious of their own comfort while other family members struggle. However, the cost of bringing family members over is prohibitive and the costs involved in providing support in the form of phone calls and remittances add a burden to already stretched lives of the women. The importance of extended family is highlighted for women on their own and the kinds of help that could be provided by family members. Additional stresses are the requirement that refugee women are able to support their families once they arrive in New Zealand. The process is also made difficult by the lack of transparency in the immigration process.

  • Prioritise the reunification with family for women who are here on their own.
  • Provide financial support to women.
  • Increase transparency of the processes and decisions that are made.

Health system

Women encountered a different health system that at times was difficult to navigate. Many women felt that their health concerns were not taken seriously and that the health system created new problems. In terms of some health beliefs and stigma there was value in having more culturally appropriate services available. The surfeit of refugee background health professionals was a potential resource that was not being used.

  • Train and employ a more ethnically, religiously, and linguistically diverse health workforce at all levels
  • Develop culturally responsive services.
  • Examine the affordability of services.
  • Develop cultural competence of staff working in health services.

Education

The cost and availability of day care for Refugee women on their own is prohibitive in some cases consuming the lion’s share of their income/benefit. Taking up loans in order to finance their own educations is also a problem. This prevents women from achieving their own goals such as learning English, driving or further education, which would assist them in the long term with employment and independence. Women generally considered their own advancement as secondary to their children. If women were resourced financially to gain an education this would assist them to also be a resource for their children. Having long-term support to enter the workforce would also be of benefit.

  • Subsidised day care for women on their own.
  • Mentoring.
  • Scholarships for further education.

Employment

Women were concerned that their children were not getting employed despite tertiary qualifications. Barriers to employment included: ‘lack’ of New Zealand experience, language barriers, their perceived difference (clothing, culture, skin colour) and paucity of appropriate childcare, poor public transport. The impacts of unemployment included losing their dignity, health impacts of taking inappropriate jobs, boredom

  • Subsidised driving lessons, support with transport
  • More work with employers to destigmatise refugee workers
  • Work mentoring/brokering services
  • Support for family members who come into New Zealand through the reunification category to obtain further education

Racism

Refugee women and their families experienced a range of racism related harms that were instititutional and interpersonal taking physical and verbal forms. Their clothes and accent marked them out, and verbal altercations saw stereotypes being invoked particularly around Islamophobia and discourses of war on terror. Women deployed a range of strategies to cope with racism including minimising the racism and helping their children to cope with it.

  • Social marketing campaigns
  • Community education
  • Addressing structural racism
  • National conversation on racism
  • National campaign against racism

The research team hope that this research provides a snapshot of the role and value of various sectors in enabling or constraining the resettlement of refugee background women. This could contribute to better informing theory, practice and policy in order that the self-determination and resilience of refugee background women and their communities is supported.

 

[1] Note that terms like ‘refugee background women’ and ‘communities’ refer to highly diverse groups of people (Butler, 2005). In capturing the experiences of refugee women as sole heads of households, we were mindful of the potential that using a category could imply a “single, essential, transhistorical refugee condition” (Malkki, 1995, p.511).

 

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Finding more humane solutions: New Zealand’s refugee deal with Australia

Last weekend the New Zealand government made a deal with Australia to take 150 asylum seekers held in Australian detention facilities. New Zealand accepts the fifth highest number (equal with Canada) of refugees per capita, but this move reduces the number of refugees selected through New Zealand’s quota of 750 by 150 (600 refugees a year compared with 50,000 in the United States and 20,000 in Australia). What’s even more alarming as Gordon Campbell notes, is the way in which this new deal conflates two very different mechanisms for refugee arrival.

KeyGillard

There are two ways in which refugees are able to remain in New Zealand. The first is the quota category, which in New Zealand is presently 750 persons per annum. People are recommended by the UNHCR to Immigration New Zealand (INZ) for selection. The refugees who apply for resettlement in New Zealand must meet the definition of a refugee given below. The second resettlement category includes Convention Refugees, or Asylum Seekers. Asylum seekers most often arrive at Auckland International Airport and then need to go through an application process to be granted refugee status and be able to settle in New Zealand. A boat of asylum seekers has never reached New Zealand.

It is a right under the UN Refugee Convention to claim political asylum and there is no queue. A claim for asylum is carefully assessed and if there are grounds for political persecution, asylum has to be granted. It is a completely different procedure from the UN annual refugee quota of 750. The 1951 United Nations Convention Relating to the Status of Refugees is the key legal document, outlining the rights of refugees and the legal obligations of signatory states. Article 1 (2) of the United Nations’ 1967 Protocol Relating to the Status of Refugees modifies Article 1 A (2) of the 1951 Convention to define a refugee as a person who:

owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such a fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence, is unable or, owing to such fear, is unwilling to return to it.

This definition only refers to people who have fled their country of origin and then sought sanctuary in a second country for protection.

The Office of the United Nations High Commissioner for Refugees (UNHCR) is an international agency that provides protection for refugees, Internally Displaced Persons (IDPs), asylum seekers, and stateless persons—it attempts to find long-term solutions for a number of the world’s refugees. There are three options: the first is voluntary repatriation; the second is local integration in the country of asylum; and in the third, the UNHCR works with eighteen countries with established or developing resettlement programmes to resettle refugees in a third country, including Australia, Canada, Denmark, Finland, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States of America. Countries with emerging programmes are Benin, Brazil, Britain, Burkina Faso, Chile, Iceland, Ireland and Spain.

The earliest refugees to New Zealand arrived between 1870–1890 and included Danes, Russian Jews and French Huguenots. Subsequently, refugees from Nazism (1933–39), Poland (1944), Hungary (1956–58), ‘handicapped’ refugees (1959), Chinese (1962– 71), Russian Christians from China (1965), Asians from Uganda (1972–73), Chileans, Soviet Jews, Eastern Europeans, people from the Middle East, South-East Asia (Indo-Chinese), Somalia, Zimbabwe, Afghanistan, Bosnia, Ethiopia, Eritrea, Iran and the Sudan have resettled in New Zealand—over 40,000 refugees.

New Zealand only developed its quota programme in 1987. The development of a formal annual quota for refugees occurred concurrently with the Immigration Policy Review of 1986 and subsequent Immigration Act 1987. This legislation brought into being more diverse migrants to New Zealand. Whereas previously, migrants had been selected on the basis of country of origin (primarily European), the new legislation liberalised migration so that migrants entered New Zealand by way of a points system on the basis of skills. Other significant changes included the development of four migration categories—occupational, business, family, and humanitarian. The latter category represented refugee policies and saw the introduction of an annual quota for resettling refugees.

The Minister of Immigration and the Minister of Foreign Affairs set the composition of the refugee quota. This process takes into account the UNHCR’s international protection priorities, the needs of refugee communities settled in New Zealand, and the capabilities of New Zealand as a host country. The UNHCR refers refugee cases to Immigration New Zealand for consideration under the refugee quota. The refugees are then assessed by Immigration New Zealand, which makes a final decision on the refugees’ admission to New Zealand. The quota comprises up to six intakes a year of around 125 people each.

One of my concerns is that this move will impact on special categories within our NZ Refugee Quota Programme such as national, ethnic and religious groups, as well as special needs groups such as ‘handicapped’ refugees, long stayers in refugee camps, and refugee “boat people” rescued at sea (Tampa). In particular from these formal categories introduced in 1992:

  • Protection (600 persons)—This category includes up to 300 places for family members, covering hgh-priority refugees needing protection from an emergency situation.
  • Medical and/or disabled cases (75 persons)—Refugees with a medical condition or disability that cannot be treated in the country of asylum but can be treated in New Zealand. This special category “provides for the resettlement of refugees with medical, physical or social disabilities which place them outside the normal criteria for acceptance by resettlement countries” (Parsons, 2005).
  • Women at risk (75 persons)—Women refugees (alone or with dependant children) at risk in a refugee camp, especially from sexual violence (75 persons). New Zealand, like Canada and Australia, has created a special category for resettling women at risk. The UNHCR definition for refugees in this category includes:

Women and girls who have protection problems particular to their gender…including expulsion, refoulement and other security threats, sexual violence, physical abuse, intimidation, torture, particular economic hardship or marginalization, lack of integration prospects, community hostility, and different forms of exploitation. Such problems and threats…may render some refugee women or girls particularly vulnerable. (UNHCR, 2002, p. 22).

In addition to the refugee quota, 300 places are made available per year for family members to be sponsored under the Refugee Family Support category who would otherwise be unable to qualify for residence under any other category of government residence policy. The government has recently made changes to the category, including expanding the definition of family member, to recognise a wider range of family structures. It also introduced a ballot system in 2002.

My other concern is that New Zealand should be doing more not less. For all the criticism of Australian policy, its annual refugee intake as a proportion of its population is still five times ours. Why not either increase our overall refugee quota to 900 so that it includes the number of people from Australia as this Dominion Post editorial suggests:

And this means that 150 other refugees, typically rotting in wretched camps near some of the ghastliest places on earth, will not be able to come to New Zealand.

Their places will be taken by those who were lucky enough to have become the responsibility of Australia. This isn’t really fair. Australia’s rejected refugees are not necessarily more deserving than the 150 who will miss out.A more compassionate approach would have been simply to increase the overall refugee quota by 150, bringing it to 900.

Race Relations Commissioner, Mr Joris de Bres supports this increase and advocates for refugees accepted from Australia to be subject to a bilateral agreement and distinguished from the humanitarian refugee quota:

 The 150 places should be in addition to the annual quota. The quota is a separate arrangement, and the Government’s announcement could constitute an ongoing reduction in New Zealand’s humanitarian commitment to the UNHCR to accept up to 750 refugees in need of resettlement. The present 750 refugee quota includes specific groups including women at risk, disabled people and family linked cases. The announcement may diminish New Zealand humanitarian response to these vulnerable groups of refugees.For transparency, any refugees accepted from Australian detention camps should be subject to a bilateral agreement separate and distinct from the humanitarian refugee quota.

Another concern is whether in tone, language, media and treatment we are emulating a punitive and dehumanising Australian asylum seeker policy. Bryce Edwards in the National Business Review notes that:

we have effectively approved and given international legitimacy to an Australian policy that ‘is the outcome of squalid politics, beginning with John Howard’s demonising of the boat people and exaggerating their threat. The effectiveness of the scare tactics, also employed after Howard left the scene, forced Gillard to reopen the foreign detention centres – centres of human misery.

Photos received by Sarah Hanson-Young of the Manus Island Detention Centre, Nauru. from an article by Bianca Hall

Brian Rudman in the Herald observes that John Key is embracing a particularly hellish vision:

Amnesty International’s refugee expert, Dr Graham Thom, after a visit to the Nauru camp in November, called the conditions “cruel, inhuman and degrading”, with 387 men cramped into five rows of leaking tents “suffering from physical and mental ailments – creating a climate of anguish as the repressively hot monsoon season begins”. Dr Thom said “the news that five years could be the wait time for these men under the Government’s ‘no advantage’ policy added insult to injury”, with one man attempting to take his life while the Amnesty group were visiting.

 

Even former MP’s have jumped in Aussie Malcolm in the Herald:

Australia and Australia alone stands out from the rest of the world with arguments about queue jumpers and all sorts of populist jargon that actually hides racism, and now New Zealand has joined Australia it’s a tragedy,” Mr Malcolm told Radio New Zealand…It couldn’t be a worse outcome.

 

Jan Logie of the Green party asked questions in parliament but interestingly enough there’s been silence from our Labour party as the National Business Review points out:

Yet opposition parties have been noticeably weak in their critiques of the policy, choosing to play it safe. A Labour-led government, David Shearer says, wouldn’t necessarily reverse the policy, and instead ‘Labour would discuss the policy with Australia’

 

I’m with Michael Timmins a New Zealand refugee lawyer when he suggests that New Zealand could play a positive role and improve protection in the region rather than “cosy[ing] up to Australia’s broken asylum system”. In his excellent article, he suggests engaging in regional co-operation and working with South East Asian countries so that they can properly process refugees. New Zealand is at a cross-roads, we can choose to punish groups of people who demonstrate incredible courage to leave horrendous circumstances or we can attempt to find some solutions that uphold people’s human rights and dignity.I know which I would prefer.

courage 2 courage1

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Unsettled in Australia: Reflections on my first Australia/Straya/Invasion day

koala bear

My first stuffed toy as a child in Nairobi was a koala bear and I’ve been besotted with them ever since. So you can imagine that I was captivated by this meme where the koala realises that she’s not a bear but a marsupial. To draw a very long bow, I think her puzzlement captures the experience of so many visibly different migrants in settler societies who believe they are part of a nation and then find that they aren’t, whether it’s because their qualifications aren’t recognised which leads them to be unemployed or under-employed or they begin to realise that their skin colour doesn’t lend them to being neatly absorbed into the imagined community on national days of celebration. So here I am in Australia, not as a nine year old (when my family were looking to migrate from Nairobi) but as an adult in mid-career, here to live and work. Joining a multitude of other New Zealanders (the most common country of birth of Australian residents outside of Australia is the United Kingdom followed by New Zealand, you’ll find other interesting nuggets on cultural diversity on Esther Hougenhout‘s blogpiece) who’ve also crossed the ditch. I’ve visited Australia for conferences and to visit my partner’s family, but it’s been over twenty years since I lived somewhere other than Aotearoa. In my work and community life I’ve carefully considered how migrants engage with settler institutions and their relationships with indigenous communities, but I am having a powerful opportunity to examine my own complicity in forms of oppression (in the context of another settler society) as Harsha Walia so powerfully puts it in a video on anti-oppression, decolonization, and being a responsible ally.

992894-australia-word-cloud

From news.com.au

australia-map-aboriginal-nations

Courtesy of Brisbane Murri Action Group

We’ve arrived in time for Australia day which commemorates the 225th anniversary of the arrival of the First Fleet in Sydney Cove, New South Wales in 1788, when British sovereignty was also proclaimed over the eastern seaboard of Australia. It’s a day of festivals, concerts, citizenship ceremonies and acknowledgements of the contributions Australians have made with the recipients of honours and Australian of the year announced. Entrepreneur and electrical retailer Dick Smith even got into the jingoistic spirit with his casually racist advertisement for Aussie foodstuffs, beautifully critiqued by Sunili. I’m not sure if the stones that hit both our heads as we were walking along the Nepean highway to look at housing options were an important Australia day cultural tradition for young blokes in fast cars (I’d like to know how their aim was so brilliantly accurate). Nevertheless fervent nationalism is everywhere, cars and houses are adorned with Australian flags and there is an exacerbation in bogan behaviour as comedians Aamer Rahman from Fear of a Brown Planet and Robert Foster/Kenneth Oathcarn observe.

S Peter Davis who made a YouTube video Straya Day, notes that

as January 26 rolls around, you begin to see cars on the road with little Australian flags poking out the windows like a diplomatic cavalcade. In what is usually a pretty tolerant and multicultural nation, this is one day of the year when folks start casting suspicious and slightly disapproving glances toward brown people. Anti-immigrant slogans like “We grew here, you flew here,” and the somewhat more direct “Fuck off we’re full” begin to make the rounds. Understand, it’s the minority of people, and Australia does not hold the patent on racism. But when you combine this with a cocktail of youth, alcohol and barbecue…parts of the country just explode in a shower of beer, singlets and thongs.

Or not as the pictures below reveal.

Beer baby

Via Chalk Hotel’s Facebook page

This day of barbecues and beer is also called Invasion or Survival day. It represents “an undercurrent of division and inequality that belies the happy, egalitarian culture that the day is meant to convey, “a day of mourning for the land that was taken and the ensuing two centuries of social alienation and discrimination” as Robin Tennant-Wood puts it. There are also Survival Day celebrations like the 2013 Share The Spirit Festival featuring Indigenous music, dance and culture. Numerous Invasion day marches have also taken place across Australia.

Grandtheft Australia

Via Idle No More Facebook page

Hip hop artists Reverse Polarities recent release “Invasion Day” acknowledges the historical and continuing injustices faced by Indigenous Australians and pushes for Australians to understand their history rather than being immobilised by guilt (white Australians) or innocence (visibly different new Australians):

Many Australians feel guilt for the actions their white predesessors and claim non- involvement due to being new Australians. We must be active in our understanding of history. The past is not ours to change, but the future can be shaped.

INM Invasion day

Via Idle No More Australia’s Facebook page

Peter Gebhardt a poet, retired County Court judge and former principal asks for accountability and reckoning with the history of genocide “What might an Aboriginal person say of Australia Day? Why should the Aborigines celebrate that day?” He adds:

It was the day that marked the theft of a land (terra nullius), the day that marked the theft and abduction of a people, of a culture, the day that initiated the pathways to the Stolen Children and, to our ultimate shame, the deaths in custody. It is a day that stands as a reminder of massacres. The wind-stench of bodies burned in bonfires hangs heavy upon the nation’s conscience and in the clouds…You can shuttle history, but you cannot shuttle facts. It would be a great Australia Day if it faced honesty, historical facts, abandonment, hypocrisy, shelved superiority and embarked upon an exercise of spiritual empathy rather than religious hubris.

A point supported by Tristan Ewins, who calls for celebration and critique of this national day:

There is a problem, here, in that there is still no formal resolution: comprehensively righting the injustices suffered by indigenous people. Without the closure provided by a just, representative and inclusive Treaty between the modern Australian nation and our indigenous peoples, it is hard to imagine a fully inclusive celebration of the Australian nation. Perhaps in the future – should such a resolution be achieved – then maybe this could become the focus of a new ‘national day’ for all Australians.

The desire for redress and accountability has a long way to go to being realised, but small steps toward reconciliation are evident. This year for the first time both the Aboriginal and Australian flags were simultaneously hoisted on the Sydney Harbour Bridge.

Aboriginal flag on bridge

Picture: Sam Ruttyn Source: News Limited via new.com.au

Apparently, more than 17,000 people from 145 countries took the citizenship pledge to become Australians on January 26th. Without any sense of irony whatsoever, Tony Abbott Leader of the Opposition told an Australia Day breakfast and citizenship ceremony in Adelaide that change should be welcomed “when it’s in accordance with the customs and traditions of our people” and he added that new citizens were “changing the country for the better”.

Being a new arrival in Australia myself has been interesting, there are many similarities with New Zealand. The neoliberal multicultural success stories of refugees and migrants loom large both in media and in private conversations. Take Akram Azimi, Young Australian of the Year 2013 who arrived  in Australia 13 years ago from Afghanistan and went from being ‘an ostracised refugee kid with no prospects’ to becoming his school’s head boy. Or diasporic Maori, Frank (name changed) who repeatedly called himself and other Maori “niggers”in front of his car salesman colleagues. He told me that his wife wanted to return home six months into their stint here and he insisted they “tough it out”, he quipped “things are fine if you just work hard”. He’s taught his children important aspects of Te Ao Maori and has disdain for the various groups that have formed stating that “if you want to learn about your culture you should go home to do it”. Rauf Soulio (chair of the Australian Multicultural Council and a judge of the District Court of South Australia) peppers an opinion piece with words and phrases like “enterprise”, “courage and commitment” and talks about people who “strove to build new and prosperous lives”.  Extolling a neoliberal narrative combined with a commitment to reconciliation:

It is one of the hallmarks of our multiculturalism that we work hard to ensure that those who come here have every opportunity to become fully participating members of Australian society, rather than remaining guests or temporary visitors. It doesn’t matter that you don’t have Australian lineage or ancestry when you arrive – as long as you contribute.

Aus-strayer

Illustration: Ben Sanders/The Jacky Winter Group in the Sydney Morning Herald

Yup, I’m here to work and become a “fully participating member” of Australian society, and to that end have also been consuming multiculturalism with relish and delight. I am blissfully happy at being able to access ingredients and cuisines that are difficult to find in Aotearoa. But consumption aside, I do want to find a way to engage ethically with this place. Shakira Hussein‘s incisive critique of Scott Morrison’s speech at the Menzies Centre for Australian Studies in London brilliantly skewers Morrison’s selective consumption of multiculturalism:

Morrison doesn’t spell out which aspects of “diversity” would be considered acceptable under a more balanced post-multicultural regime, but I’m guessing he subscribes to the consensus view that multiculturalism has had a beneficial effect on the Australian diet. (Sharia tribunals? No thanks. Homous and baklava? More, please.) Even those most ardent racists participate in the multiculturalism of consumption. But while enjoying our pizza and laksa, we need to “send a message” that such tolerance “is not a licence for cultural practices that are offensive to the cultural values and laws of Australia and that our respect for diversity does not licence: the primacy of the English language”.

His comments come just in time for Geert Wilder’s visit to Australia next month. See Deborah Kelly’s kit below.

Veiled woman

I was in Sydney almost seven months ago when I caught up with a friend of the family who asked me why I hate white people. I had to explain to him that my work is about critiquing white hegemony and that is a different thing. Critiquing hegemony and racism and advocating for indigenous rights is viewed decidedly un-Australian, as effectively parodied by Don Watson:

We’re pragmatists. It comes with being Australian that we don’t upset ourselves about things of no practical consequence. Of course, for some people the wine’s always corked. You’ll hear them from Ballarat to Bali, running the country down. Fair dinkum, you want to deck the bastards sometimes. But, as I said, we don’t upset ourselves. Poor things, they can’t think of the foundation of the country without thinking of the people it was taken from. They can’t think of dear old decent Arthur Phillip without thinking of the time he sent out men with bags to collect half a dozen Aboriginal heads. Nothing in the manifold benefits of British rule, British institutions, British customs and British capital cheers them up or excites a little gratitude.

Remind them of the nation’s progress, show them how human health and happiness have in general flourished here, and in return you’ll get the vale of tears it has been for the Aborigines, or the grave injustices to women, or the treatment of refugees arriving on boats: as if because some people got the rough end of the pineapple we are all supposed to be abraded by it.

Michel Foucault the French philosopher said that the point of “a critique is not a matter of saying that things are not right as they are. It is a matter of pointing out on what kinds of assumptions, what kinds of familiar, unchallenged, unconsidered modes of thought the practices we accept rest”. For me, as an academic with a commitment to social justice, blindly supporting the status quo is not an option. I know that I have a long journey of learning and unlearning ahead of me, without the reassurance of state sanctioned biculturalism or a biculturalism grounded in treasured processes and relationships in Aotearoa that have inflected my adult life. But this grounding from the place I’ve called home for most of my life will be fundamental to examining my complicity in the maintenance of oppression, my understanding of the multicultural project and to forging my own rather than received understandings of indigineity here in Australia. Luckily there are many who’ve already walked this path. Between their wisdom and those of my global intellectual and political community I think I am koalified to undertake this next adventure.

Via Colourfest film festival

Via Colourfest film festival

 

 

 

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