Having worked as a nurse with asylum seekers in immigration detention, Amelia Tauoqooqo has seen how healthcare can become highly politicised.
Nurses are not educated in the delicate dance of politics but as a nurse working with refugees and asylum seekers Ms Tauoqooqo must help her clients navigate a health system that is subject to politically-motivated changes of government policy.
‘It’s very tumultuous,’ she says. ‘You might go to work on Tuesday and your job is different to what it was on Monday because something changed in Canberra on Monday night.’
Ms Tauoqooqo’s current role as a refugee health nurse with cohealth in the Maribyrnong catchment involves working with refugees who have arrived in Australia through the humanitarian program and asylum seekers who have been released into the community from detention on bridging visas, awaiting a decision on their refugee status.
‘They have a lot of health needs,’ Ms Tauoqooqo says of this latter group. ‘Apart from the normal non-communicable diseases like heart disease and diabetes, depending on where the person has come from there’s tropical and infectious diseases like tuberculosis, different types of gastro-intestinal bugs (like) schistosomiasis, strongyloides.’
The types of common presenting illnesses vary depending on which countries refugees are fleeing. Over the three years that Ms Tauoqooqo has been working for cohealth, she has seen clients from Myanmar, Tibet and increasingly, Iraq and Syria.
About 60 per cent of Ms Tauoqooqo’s current clients need help for complex mental health issues. For asylum seekers, the protracted process for determining refugee status coupled with the stressful environment of immigration detention is a breeding ground for mental illness. Refugees may also need mental health treatment if they have experienced trauma or torture in their country of origin.
Physical and mental health needs are often inter-related, Ms Tauoqooqo said, particularly if chronic pain is a factor.
‘You can imagine, if you’ve been tortured and you have a bad back because of that and you have chronic pain every day… Having a bad back from being a nurse is different from your chronic pain where every day you’re reminded of being tortured.’
Prior to her current role, Ms Tauoqooqo worked as a nurse at the two immigration detention sites in Melbourne, and the detention centres on Manus and Nauru islands.
The politicisation of the asylum seeker issue in Australia has meant that even saying she works with refugees appears to be a political statement, Ms Tauoqooqo said, unlike her previous role as an emergency department nurse.
‘I have colleagues who say “I’m a public health nurse”. They don’t say they’re a refugee health nurse because they get sick of trying to have the on-the-spot justifications for policy. Or people say “What’s your stance on it? I don’t reckon they should be coming here…”
Ms Tauoqooqo is very clear about the legitimacy of ANMF’s role in supporting the rights of refugees and asylum seekers, and the advocacy role of nurses and midwives who provide healthcare to refugees and asylum seekers.
Under the ANMF’s policy, we do not support offshore detention or the detention of children and oppose the policy that asylum seekers arriving by boat should never be allowed to settle in Australia. The ANMF believes that asylum seekers and refugees should receive treatment which is consistent and humane, regardless of how they came to seek asylum in Australia. Nurses and midwives must be enabled to meet their codes of ethics and professional practice standards in the provision of healthcare.
‘The ANMF is our union and the union movement has always been community-centred and about standing up for the underdog. The ANMF is one of, if not the most powerful union in the country and with that power comes great responsibility,’ Ms Tauoqooqo said.
‘We can lend that voice to causes like this, which, just like championing your working hours and pay rates and patient ratios, are issues about fairness and equality.
‘It’s incredibly supportive when we go to rallies as private individuals and see the teachers’ union and the ANMF and the AMA there and know they have the courage to make really firm position statements about what they believe is the right course of action around this issue.’
Working as nurses and midwives in detention centres presents an inherent ethical dilemma, Ms Tauoqooqo said, as government policy – centred on deterrence – has created environments which are damaging to asylum seekers’ physical and mental health.