Last Updated 10 October 2002.
This statement was provided by Bernice Pfitzner to the National Inquiry into Children in Immigration Detention
STATUTORY DECLARATION
I, Dr Bernice Pfitzner, of [address removed], Medical Practitioner, do solemnly and sincerely declare as follows:
Background
1. I make this statement for the purposes of the Human Rights and Equal Opportunity Commission's Inquiry into Children in Immigration Detention.
2. I was employed from October 2000 to June 2001 by Australasian Correctional Management (ACM) at the Woomera Immigration Reception and Processing Centre (WIRPC) as a Medical Officer.
3. I am currently employed as Senior Medical Officer with the SA Drug and Alcohol Council. I hold an MBBS (Adel) and an MD on child development. Previous work includes work with children in child development and as a GP.
4. I was the only full-time doctor employed at the WIRPC. I received assistance from the doctor from the Woomera hospital who came in for 3 hours per day and was on call on alternative weekends.
5. I understand that there are now 2 full-time doctors at the WIRPC. I regard this as a more appropriate level of staffing to provide adequate medical care.
Environment at the WIRPC
6. The environment at the WIRPC was highly stressed and this acted as a significant detrimental factor on the wellbeing of fathers and mothers and therefore children.
7. The main cause of this stress was visas processing. The length of time taken was inordinately long and information given to applicants was almost non-existent. People were therefore suspended in limbo.
8. The observable effects of this, was, in medical terms, depression, anxiety and more severely psychosis. I would expect the same result for any human beings in the same situation.
9. There were 1,500 detainees at the WIRPC when I was working there. Depression was almost universal amongst detainees.
10. I observed 3 or 4 cases of psychosis amongst adult detainees and severe personality disorders in about 10 adult detainees. I observed the deterioration of these people from normalcy to their more severe abnormal state. They had not initially presented as depressed or abnormal.
11. Deterioration amongst detainees was clear, and it is my view that if this was not initiated by the conditions at WIRPC then it was precipitated by it.
Treatment of Detainees
12. While in my opinion the main factor impacting upon the mental health of all detainees was insecurity and their unknown visa status, the attitude of the correctional officers was also damaging. Many of the officers did not seem to be aware of appropriate cultural reactions. I observed amongst the detainees from the Middle East a particular sensitivity to "saving face" and preserving their dignity. This was impacted upon significantly by the treatment of officers who had come from criminal detention background and treated detainees accordingly. This resulted in detainees being treated as criminals and ordered around. This had obvious effects on the self-esteem of detainees.
13. I also regarded the treatment of "trouble-makers" as inappropriate. They were isolated and subjected to constant checks and this increased stress and its symptoms and signs. I raised this with management but told it was not a hospital and told that this treatment was appropriate in a correctional environment.
14. To my mind there were not that many detainees who had a significant mental disorder when they arrived at the WIRPC. I therefore concluded that the mental disorders that manifested themselves amongst detainees (from one end of the spectrum to the other) must have been brought on by harsh environment and treatment. I am of the view that had they been treated more appropriately there would not have been as many mental problems and they could have been alleviated through things such as proper cultural training.
15. While initially it might have been hard to provide this sort of training with large increase in arrivals, it appeared that no training was put in place once these problems were obvious.
Provision of Health Services
16. In terms of physical health, I was of the view that children received appropriate levels of care at the WIRPC when I was working there. I did not think that medical care was denied on the basis of cost. In my opinion it was always available when it was pressed for.
17. I was fully occupied with the immediate illnesses and diseases of detainees, and therefore was limited in my ability to provide any preventative health measures.
18. In my opinion there was adequate screening in terms of physical health, but the screening of mental health was not adequate. Having said this, it is hard to screen for mental health as there are cultural issues and our tools that can be used for screening may not be appropriate. I tried to screen when people presented with a symptoms indicating that they had a mental health issue that needed to be addressed.
19. I did try to initiate mental health screening for children as I was particularly concerned about their wellbeing. I tried to get SA Department of Child and Youth Health to conduct this and they agreed in principle. However, in the end it did not go ahead as I understood there to be a dispute between them and the Commonwealth about who would pay. The aim was to identify children who needed care and provide a "baseline" for children when they were released from detention. I gave up pursuing this after numerous (10) attempts.
20. I was not able to get an appropriate programme in place for immunisation. Again this was because of a dispute between SA Department of Child and Youth Health and the Commonwealth about who would pay for this. Nurses at the WIRPC lacked the training or confidence to perform immunisation so I therefore tried to immunise children myself. I was critical of the failure to properly immunise children as it was important not only in the immediate individual case but also for when the child was released in to the community.
21. I saw about 10-12 children with physical disabilities. When they were identified we investigated their health needs and where appropriate they were sent to paediatricians in Port Augusta. We had to work harder to get appropriate people to look at them because of the isolation of WIRPC and this also made medical follow-up more difficult.
Self-Harm and Child Abuse
22. I did not witness, nor was I aware of, any child self-harm while I was working at the WIRPC. I presume that the learning of self-harm had not percolated to the children from parents at this stage.
23. There was an allegation of child abuse that had happened before my time at the WIRPC. I understand that the incident was investigated. Nobody was brought to me in relation to child abuse and I was of the view that adequate and appropriate procedures were in place to deal with any allegations of child abuse after the first allegation of child abuse to which I have referred. From my previous experience I was fully aware of the reporting that should take place and I was satisfied that the policy was appropriate in relation to mandatory reporting whilst I was there.
24. I had no involvement with the Hight Risk Assessment Team (HRAT). I did ask to be involved and thought that it was appropriate that a doctor be involved. I tried to go to two meeting but they were postponed on each occasion. In principle I regarded the HRAT as a good idea a good idea, however my main criticism was that it did not meet regularly enough.
I make this solemn declaration by virtue of the Statutory Declarations Act 1959 as amended and subject to the penalties provided by that Act for the making of false statements in statutory declarations, conscientiously believing the statements contained in this declaration to be true in every particular.
This statement was signed on 16 July 2002.
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