Lessons Learnt in Asylum Seeker Health, a Personal Reflection

By Katrina Sanders In   Issue Volume 19 No. 3 .

Operation Resolute is the ADF’s contribution to domestic maritime security activities.  At any one time up to 400 ADF personnel are assigned to Operation Resolute.  The commitment includes RAN Armidale-class Patrol Boats (ACPB), AP-3C Orion Maritime Patrol Aircraft, Australian Army Regional Force Surveillance Units, a Transit Security Element and standby RAN fleet units.  A Medical Officer is assigned to the commitment and is present on board an ACPB in the northern waters at all times.
Having researched asylum seeker health prior to deployment I was expecting to be confronted with:
– infectious diseases including TB, malaria and intestinal parasites
– nutritional deficiencies
– poor oral health
– unrecognised chronic disease
– chronic pain
– psychological disorders such as post traumatic stress and anxiety
– sequelae of torture and trauma
It was not until I first boarded an asylum seeker vessel that I was confronted with the reality of asylum seeker health – that is, desperation.  The vessel was a wreck, falling apart and slowly sinking.  It was overfilled with men, women and children, empty packets of two minute noodles and empty water bottles strewn over the deck.  I tried to ignore the scorpions, ants, vomit and faecal debris as I began to review the pregnant women and children on board.  I was prepared to treat the likely potential medical conditions, however was not prepared to treat their desperation.
Many feigned chest pain, seizures, varying degrees of unconsciousness and from some, even psychosis, to gain my attention.   Whilst I was overwhelmed by the pervasive atmosphere of desperation, I was also acutely aware that rumours existed that if you were ill the Doctor would take you to the mythical land called Australia.  It is this balance with which I struggled.  Was the patient truly ill and in need of medical attention, or were they so desperate they would go to extreme lengths for help?
On reflection, I was excited to be a part of Operation Resolute, looking forward to testing and improving my clinical skills in asylum seeker health.  In reality, I faced a desperation that I had never seen before.  I didn’t get the balance between acute illness and desperation right every time, but I certainly learnt that the balance is the key element to managing asylum seeker health and it influences all other aspects of their healthcare.
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