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3CR: Two NADA News broadcasts

Chemical restraints and forced deportations

Forced deportations of 'failed' asylum seekers from Australia take place. People have been handcuffed. They have been 'drugged'. The use of sedation raises a significant number of serious moral and ethical issues, and places medically qualified staff in an ethical conflict. Yet the Howard government does whatever it pleases.

Two members of the National Anti-Deportation Alliance, recently formed in Australia, talk on-air at 3CR Community Radio in Melbourne. The transcripts of the two episodes are below.

Related pages

29 August 2004: Cork vs ACM: Operation Long Haul, a Forced Deportation - Sometimes reports of forced deportations appear at unlikely places, in this case a transcript of the NSW Industrial Relations Commission of an unfair dismissal claim against Australasian Correctional Management (ACM) after a deportation of 31 immigration 'removees' from Australia.

12 January 2005: The man with the gag: witnessing a forced deportation - It had to happen sooner or later: someone on a flight, bound, gagged and muffled, moved under the highest secrecy, deported by force, not only with duct tape over his mouth, but the entire story covered up. Using the Christmas holidays, the absence of the lawyers, the expected silence of those advocates that can block their work...

17 May 2003: Forming the National Anti-deportation Alliance - On Saturday 17 May 2003, 37 participants in a phone conference, representing many refugee groups from all States and territories around Australia, formed the National Anti-Deportation Alliance (NADA). This is the resource page for NADA.

15 March 2003: Self harm: answer to Government torture and powerlessness in detention - Indefinite incarceration of people without a criminal charge is one of the world's most severe breaches of International Human Rights conventions, yet this is what Australia does with the asylum seekers who, under the 'stitched-up' Migration Act, have been excluded from becoming successful in their determination by Australia as refugees. This page highlights the situation of some of the Iranian asylum seekers held in detention centres around Australia.

Second Opinion Health Issues

a program broadcast on 3CR Community Radio

8.30am to 9am
Tuesday, 15 July 2003

Barbara Hurley

with Barbara Rogalla
and Charandev Singh
National Anti-Deportation Alliance (NADA)

transcribed with permission from
3CR Community Radio, Smith Street
Fitzroy, Victoria, Australia

transcript provided by Grace Gorman

BARBARA HURLEY: Forced into isolation, chemically sedated, physically restrained, and deported in secrecy. It's a process most of us know nothing about, but it happens on a regular basis to asylum seekers and refugees in this country.

I'm Barbara Hurley with Second Opinion Health Issues, an alternative progress program about health and related themes.

NADA, the National Anti-Deportation Alliance, was only recently set up. It's an umbrella organisation of some 35 member groups and individuals from non-government organisations, including refugee and asylum seeker advocacy groups, activists and concerned people in the community. It's a loose alliance focussing on issues around deportation; what actually happens before and during the deportation process, how much documentation about it enters the public domain, and what are the rights and responsibilities of the medical professionals involved in a clinical role with the people in their care who are being deported.

To talk about these issues, Barbara Rogalla, a member of the chemical restraint group which in turn is a NADA member. Barbara is an e-volunteer representing the Roma Mitchell Community Legal Centre in Adelaide, and she is a human rights activist; and Charandev Singh, a human rights advocacy worker at the Brimbank Community Legal Centre in Melbourne's west.

The National Anti-Deportation Alliance is new, but, as Charandev Singh explains, has developed from long-standing concerns.

CHARANDEV SINGH: It came about, partly in direct response to an agreement that the Australian government had completed with the Iranian government to allow for forcible deportations of Iranian asylum seekers back to Iran, but there has been long-standing concern about many practices in relation to the Australian government's use of deportations in the context of refugee and asylum policy, and they stretch from concerns about the use of force and the role of health professionals when undertaking forcible deportations, to the extent of people - asylum seekers and refugees being returned - actually being killed on their return to home countries. So there is a wide gamut of very serious concerns that make up the background of the alliance forming.

HURLEY: How many people are deported in a forcible way - do you have any idea - compared to the number of people who are deported in a non-physical way, or without any duress?

SINGH: It's difficult to get the specific statistics on deportations. One of the issues that characterises deportations is the high level of secrecy and invisibility and the vacuum of accountability around deportations. We know that about 13,500 people every year in Australia are detained, and that the government intends to increase that in the years to come, up to 17,000 and so on in the next few years.

I think a significant group of those people are subject to removal or deportation - the words are used interchangeably - and I understand that forced removals happen on a monthly basis. As I said, because of the enormous secrecy that surrounds all issues around detention/deportation, it's hard to get very specific figures, but it's a day to day, sometimes hour to hour, but definitely a weekly and monthly reality in detention centres right round the country. It's a reality right now.

Under the Migration Act, the words 'deportation' and 'removal' refer to different groups of people. Under the Australian migration law, 'deportation' refers to people with a criminal conviction who are being removed, and 'removals' refer to everybody else, including asylum seekers and refugees, but the words are used interchangeably, so in the overseas context 'deportation' is used more often, and deportation is a far more accurate word than the benign kind of inferences of what a removal means.

ROGALLA: I guess the key element would be that it occurs against the person's will; is that right?

SINGH: Absolutely. Yes. There is a range of mechanisms of how deportation works, from the one end of the spectrum where someone agrees to leave, and goes of their own so-called will, to a second level where a person does not want to go but does not accept the use of force and goes to the airport and leaves, probably with guards, and then there is a third level where there is an expectation that high levels of use of force or use of violence will be used against the person to physically coerce and force them to leave the country.

That involves the use of isolation, the use of chemical restraint, the use of physical restraint, and the use of paramilitary tactics in terms of use of force. Those forced removals or forced deportations often occur in large numbers, so a large number of people will be dealt with in that way, put on a charter flight with a non-unionised crew, using an isolated international airport like Port Hedland, and that will constitute a mass deportation.

HURLEY: And you are saying a non-unionised crew; so that is a deliberate attack.

SINGH: Certainly. It's a non-unionised, almost ostensibly a foreign crew; a foreign airline, a charter flight. Crews from places in Europe or Asia are often used, so as to isolate and sever the entire practice of deportations, and what occurs in the course of a deportation, from any kind of domestic scrutiny and accountability.

ROGALLA: A non-unionised labour force; would that be more reflective of the Australian or the overseas experience during deportation, Charandev? Do you know off-hand?

SINGH: I think it's more reflective of an overseas experience. I mean, if they were members of unions, they are certainly not members of Australian unions, and the capacity for trade unions to affect the carrying out of a forcible deportation is much more minimal in that case.

HURLEY: On Second Opinion, health issues around Australia, two member representatives of the National Anti-Deportation Alliance are explaining the process of deportation. One reason why deportation occurs is because asylum seekers do not meet the Australian criteria to be legally determined as and admitted as refugees. Barbara Rogalla, representing the chemical restraint group, is a registered nurse and she has concerns about the role that health professionals play in the forcible administration of chemicals used in the whole process of forced deportation.

ROGALLA: Charandev, you've said that force is often used, and some of that force includes the forcible administration of medications. Generally, what happens, medications are usually prescribed by a doctor, administered by a nurse, although sometimes the doctor may administer the medication him or herself. The problem with using medication during deportation is that the normal trust relationship that underlies the medical interaction between doctor and nurse, and also between patient and doctor and nurse, seems to be totally demolished by the political purpose that lies behind the deportation.

HURLEY: So in that case, if you were a nurse being put in this particular situation, what would it feel like? And what are the issues around that that would be affecting your way of performing your duty?

ROGALLA: I have been in one situation where deportation was not the issue, but where somebody was sedated against their will. As I said, it had nothing to do with deportation, but that person was in the medical centre. The person was subdued by several guards, the doctor administered the medication, and usually these medications are then administered by way of intramuscular or intravenous injection, because the person who is subdued and sedated against their will is most unlikely to then want to swallow the tablet that is then put into their mouth.

The problem that arises when you've got drugs that are mind-altering, they sedate people, they interfere with people's breathing, and this is often where the deaths occur during deportation.

So we've really got two underlying issues here. One is the chemical issue, if you like, that exerts certain effects on the body, that sedates the person, that may stop the person from breathing. The other issue is also the trust relationship where the actions of the health professionals totally and utterly contravene anything that has to do with professional ethics and professional accountability.

HURLEY: I think you have already said earlier, that when you are treating someone as a health professional, it doesn't matter whether they have been detained in immigration detention, or whether they are in a prison, or whether they are outside those two environments; they still have to be treated in the same way and under the same ethical - - -

ROGALLA: Yes. Constraints. What have you. Yes. Basically, what happens is - OK, let's stick with nurses, but the same principles apply to doctors. If I choose to practice nursing, either in a prison environment, in a detention environment, in the community or in a hospital, my obligations are always the same to that person, because that person is then a patient, and it does not matter whether the patient arrived in Australia by boat, whether they came over on a plane, or whether they happen to be in Australia. To me, that person is a patient, and I am not there as an official of the detention authorities.

HURLEY: I'm Barbara Hurley, and I am speaking with Barbara Rogalla and Charandev Singh, both from the Anti-Deportation Alliance, a national organisation. While the situation of Australia's immigration detention centres could easily be described as physically isolated, another layer of isolation is added during the process leading up to forced removal or deportation. Again, Charandev Singh.

SINGH: With the most extreme or not unrealistic forms of forced removal or forced deportation, a number of practices have become well-known to us. One is the use of isolation prior to deportation, where an individual or family or a group of people who may be subject to deportation in the next day or the next few hours, are placed in special isolation units within detention centres.

Isolation is often experienced as forms of punishment because those units that are used for that isolation are also often used as places of punishment within the detention centre. So that's one thing. So a person is potentially tricked into going to have an appointment with the nurse, or a manager, or something, and then forcibly taken to a place of isolation.

There are isolation cells and units in every detention centre in the country, and often in places like Baxter there is a number of places where they can hold people in isolation. That cuts those people off from family, from friends, from any capacity to contact lawyers, any capacity to contact human rights organisations; they are completely isolated; sealed off from their world.

In the context of isolation, there may flow from that the use of chemical restraints, or the use of forcible sedation. And we must be clear about this. This is about non-consensual medical treatment. In any other setting apart from a detention centre it would be considered a grave bodily assault. It would constitute a fundamental violation of the bodily integrity of that person.

ROGALLA: Yes, you are absolutely right on that count, Charandev. If I can just reflect on the legal responsibilities of doctors and nurses here. There are some situations where the law allows for the involuntary restraint of people. It's usually done when a person has a medical condition and they are so disturbed that the person totally lacks insight. In that case, the person can then be administered an injection, or whatever, until they settle down, and that restraint is then removed.

However, for that to occur, there are a whole lot of legal procedures that have to be followed. For instance, one special form has to be sent off to the health authorities, just so that they are aware that restraint has occurred under those circumstances. And the other thing that is absolutely crucial here is that, once the person has been given that injection, they are then placed under very strict observations; (a) to make sure that the effect of the drug does not kill them, but also they then have to be observed for the side effects of those drugs.

HURLEY: And I am assuming that there is a time factor involved here, because if you've got to send medical information off to an authority, that there is a lapse of time which does not appear to occur in this other circumstance.

ROGALLA: But that sort of notification does not even occur in the detention - during detention, anything just goes. The nurse or the doctor may well write a note in the medical record, but we already know from previous enquiries, such as the Flood inquiry and the Ombudsman inquiry, that great big chunks out of medical records have disappeared from patients' medical files. So where does one go? We have basically got a system whereby people are restrained, they are put in grave physical danger, and the normal accountability structures are totally lacking.

HURLEY: For example, the medical history might not be available for that person after their deportation.

ROGALLA: It may have just disappeared. That is what has happened.

SINGH: So you have got this context where forcible sedation is used for the purposes of deportation, not for any fundamental best interests of the patient treatment decisions. It's a very politicised act for a health professional to forcibly sedate or chemically restrain people, and it also often occurs in a context where those individuals are also physically restrained, using a wide range of physical restraints and the use of guards there.

So the risks of death, as we have seen in Europe, has occurred in exactly those circumstances where people have been chemically restrained, physically restrained, often assaulted, often had vital organs compromised by the use of tapes and restraints around people's nostrils and mouths, often being held down in positions where they cannot breath and have thus died from positional asphyxia, and in fact doctors who have been engaged in these practices, particularly in Switzerland, have been successfully sued for negligent manslaughter.

So it's not just an issue about violations of medical ethics and human rights and the bodily integrity of their patients, but it's an issue of grave criminal liability.

ROGALLA: It's a shame to think that doctors and nurses may have some contribution in that process. It really - - -

SINGH: Well, it's a human rights issue that affects all health professionals all over the world. In the deportation context, there is a couple of additional issues. One is, the doctor or the nurse, or any other health professional, has a legal and moral and ethical duty not to engage in practices that may constitute torture or inhumane treatment, or a violation of bodily integrity. The basic duty not to do harm to their patient.

But there is also another duty we can quite clearly define in relation to deportation. It's about not being complicit or active in practices that may lead this asylum seeker or refugee to be returned to a country where they face torture, imprisonment or death, and the complicity of health professionals in any such practice is a grave, grave issue.

HURLEY: Documentation about the well-being of people once they have been deported is generally scant, although some information usually slips through, noting tragic circumstances.

SINGH: There has been at least two case examples in the last year. One Colombian man, Alvaro Morales, and one Pakistani man, Bilal Ahad, who we have got clear documentation that they have been killed upon return from detention in Australia to their home countries. There is evidence about other deaths, but the whole process of deportation return is, as I said, shrouded in secrecy, and it is very, very difficult to monitor the lives and safety of people who have returned.

There is also the example of two Iranian brothers who were forcibly deported and have now gone missing back in Iran. So not only do we have concrete examples, but we have a multiplicity of other stories and concerns where people have seemingly disappeared. So it's a very concrete reality that health professionals and other professionals, engaged in deportations or health care in detention centres or on airlines, must confront.

HURLEY: Well, obviously the National Anti-Deportation Alliance is against deportation by itself and of itself. Is that correct, that they wouldn't be seeing deportation as a legal framework for any asylum seeker to leave the country? What would be the alternative to that?

SINGH: The alternatives are very important to focus on and to articulate, because the question many people ask, particularly inside detention camps, people have experienced three to four to five years of detention. If not deportation, if I am not forcibly deported, am I to remain here in perpetual imprisonment?

I guess the answer lies in a profound examination of Australia's refugee and detention policies, and greater community awareness and activism and advocacy for release for refugee determination systems in the community, for a proper process of allowing people to stay here on a humanitarian basis.

The alternative is not perpetual detention. The alternative is humanitarian intervention and allowing people to stay, and permanency in their protection.

I raise the issue of permanency of refugee protection in this country because deportations do not just affect people in detention centres, or people who have been refused asylum by this country. The Minister for Immigration is now on record as saying that he is committed to returning people who have previously had Temporary Protection Visas. So people who Australia has previously found as refugees don't get their Temporary Protection Visas renewed.

So people who, everywhere else in the world, would be permanent refugees, the Australian government may be committed to forcibly returning to countries like Afghanistan, Iraq and Iran. So we are not talking about just a small, marginalised, invisible, assailed community in detention. We are talking over 9,500 people on TPVs in the Australian community for upwards of three years that may be liable to this kind of violence.

ROGALLA: And I think it's probably reasonable also to understand here that once somebody has been granted a Temporary Protection Visa the refugee status of that person is not in doubt. If they were not considered to be refugees they would never have received that Temporary Protection Visa. For a government to then step in and say, "We still reserve the right to forcibly remove you to a country that we have just reduced to rubble," I think it is totally unconscionable, and I really think it is high time to give these people a temporary protection status, and also to release all of the people.

It's only about 500 people or so who are still in detention in Australia. I mean, these are not people who are criminals. OK, so they may not have passed some of the requirements, but surely, 500 people we could easily absorb in this country.

HURLEY: And also they are in immigration detention centres because of an act of Parliament, not because they have done something that is criminal.

ROGALLA: Yes, the only way they have broken Australian law is that they came in without valid travel document. For that so-called crime, some people are detained for years.

HURLEY: You're listening to Second Opinion with Barbara Hurley. The chemical restraint group has contacted some 35 professional and industrial bodies, but so far the most positive response has come from the Australian Medical Association. Barbara Rogalla says the AMA has been involved for the last two years to ensure that doctors who practice in detention centres follow ethical requirements and uphold the standards of their profession.

Being involved in the administration of chemical substances for the purposes of control or sedation when it is against the patient's will also calls up the question of professional clinical care versus political purposes, and there can be debilitating after effects of treatment for restraint, even when seemingly minor physical problems exist.

ROGALLA: See, when you sedate somebody, I mean, if that person, for instance, has just a touch of asthma, if that person then gets something put over their mouth so they cannot breath, apart from the fact that people can actually become injured - they can stop breathing as a result of their sedation - there is that on-going sort of thing where - in most cases people do not die when they get forcibly sedated. The fact that it does actually occur without anybody taking any notice of it, I think, is totally unconscionable, and I really think the public have a right to ask themselves whether the doctor or the nurse who are treating them, whether they have had anything to do in the way of treating a patient that is totally unconscionable, and I think we need to remember that.

HURLEY: And where does that doctor or nurse get - where does the decision come from for that doctor or that nurse to do this to that person in the first place? And how are they legally situated as far as keeping up to their ethical standards and their normal duty of care for someone that they are treating?

ROGALLA: Usually what happens is, that somebody is disturbed, and whether to sedate a person or not ultimately is a clinical judgment call. As I said, the law is very clear about it; it can be done.

SINGH: I think in some contexts it is unclear whether it would be legal to sedate someone purely for the purposes of effecting their deportation.

ROGALLA: Thanks, Charandev. I couldn't think of it. That's the part that is missing. I think, if we are being told repeatedly that sedation occurred for clinical reasons, in the best interest of the patient; however, it just happens to occur time and time again when a person is being deported against their will; I think it's reasonable to then say, well, the action of the health professional is really removed from the clinical thing and it's taking it right into the political arena, where you have health professionals who are nothing more than puppets of an immigration detention regime.

HURLEY: From the chemical restraint group, Barbara Rogalla, an e-volunteer at the Roma Mitchell Community Legal Centre in Adelaide, and before her, Charandev Singh, human rights advocacy worker at the Brimbank Community Legal Centre in Melbourne. Both are NADA members. Next time, the conclusion of that conversation about forced deportation of asylum seekers and the work of NADA, the National Anti-Deportation Alliance. In the meantime, you can check out what the alliance is up to by visiting the Westnet or Safecom web sites. Start at or and then negotiate your way through to the National Anti-Deportation Alliance.

As a member of the chemical restraint group, Helen Browning from Brisbane has been instrumental in highlighting and making the relevant issues about deportation understood by the professional health and industrial bodies she has liaised with. Barbara Rogalla is available to discuss questions around chemical restraint in deportation on telephone 0419 128 304.

Just before I go, the usual thanks to ComRadSat at the Community Broadcasting Association of Australia for transmitting the show around the national community radio network. I'm Barbara Hurley, the Second Opinion Health Issues producer. You can contact me at 3CR Community Radio in Melbourne with comments or queries on telephone (03) 9419 8377. If you've enjoyed the program, why don't you tune in next time?


3CR: NADA News broadcast PART TWO

Second Opinion Health Issues
a program broadcast on 3CR Community Radio

8.30am to 9am
Tuesday, 22 July 2003

Presenter: Barbara Hurley

PART 2 of an interview with
Barbara Rogalla
and Charandev Singh
National Anti-Deportation Alliance (NADA)

transcribed with permission from
3CR Community Radio
Smith Street, Fitzroy, Victoria, Australia

transcript provided by Grace Gorman

BARBARA HURLEY: The program begins with the conclusion of A conversation recently broadcast about the health and human rights impacts on asylum seekers and refugees, and the people treating them, resulting from the process of forced deportations or forced removals.

Two member representatives of the recently formed National Anti-Deportation Alliance include Barbara Rogalla, community nurse and human rights activist involved in the chemical restraint group, representing the Roma Mitchell Community Legal Centre in Adelaide; and Charandev Singh, human rights advocacy worker at the Brimbank Community Legal Centre in Melbourne's west.

Forced deportations often occur in secrecy with a process involving isolation of the asylum seekers / refugees, a family or a group of asylum seeker / refugees from other people at the immigration detention centre where they are incarcerated, and, depending on each situation, levels of physical force or pharmaceutical interventions used to control them.

Next up, Charandev Singh.

CHARANDEV SINGH: Various reports that have been published in the last year, analysing the case histories of people who have died during deportation, either in detention centres or on planes, constantly refer to the use of restraint, often the use of elastic tape, the use of body belts, the use of handcuffs, the use of helmets, people being assaulted, people being held face down; so it's a wide variety of violent acts as well as the use of sedation, that have contributed to the deaths of these people.

I think this issue about what happens, when a nurse or a doctor is asked to engage in forcible sedation in deportation questions, raises the issue of dual loyalty or dual responsibility, because they are employees of the detention centre. They may be employees of the Department of Immigration, but their first and primary and core obligation is to the best interest of their patient.

BARBARA ROGALLA: I am pleased you added that last bit, Charandev, because that is exactly how it should be. We are there for the patient.

SINGH: And no circumstance, no order and no directive can abrogate their fundamental responsibility to the dignity, the integrity and the human rights of their patients, regardless of the political directive they are subject to.

ROGALLA: Absolutely. Yes. That sums it up very beautifully.

HURLEY: What are the different chemical restraints that can be used, and you believe have been used?

ROGALLA: They usually fall under the broad definition of anti-psychotics. They are usually anti-psychotics that have a sedative property, or sometimes it may be just a pure sedative rather than anti-psychotic drug. But rather than listing all of the drugs now, I think it is important to remember that, apart from the sedation, there is actually the side effects that can occur.

One of the side effects from a group of group of anti-psychotics, for instance, is what's called lockjaw, where the tongue swells up in the back of the patient's mouth, and it can be so bad that the person actually stops breathing unless that effect is resolved with a specific injection. Now that side effect has been known to occur up to 24 hours after an injection was given. Again, this is one extreme example.

But apart from the chemical things that occur, the whole system of nurses and doctors being complicit in this process I think is something that needs to be tackled, rather than - I think it is just totally appalling what is happening here in the name of Australia.

HURLEY: And what would be the legal standing of the people who are involved as health professionals in doing these things?

ROGALLA: Well the legal - I am not sure if it has ever come to pass in Australia - I guess it would be up to the health professional to say - to justify the reasons for giving - to say that sedation under those circumstances was justified. I am not sure whether any manslaughter things are likely to kick in later if anything did happen.

SINGH: I think the whole issue around medical treatment in deportations, it must be said, occurs in quite a vacuum of accountability. In fact, it could be said it occurs within a culture of impunity in that the victims of such treatment are deported outside of the country, often placed in very dangerous situations upon their return, and may not have the resources or the capacity to ever complain or even document what has occurred to them.

So for the health professionals involved, there is a certain level of knowing that they are operating in an enormous vacuum of transparency and accountability, and I guess it increases the onus on health professionals to interrogate their own practices before they engage in such acts, and also on other health professionals that work with them, their colleagues, to monitor their colleagues, because to be culpable in such acts, or complicit in them, as I said, is a grave violation of medical and legal ethics, as well as the fundamental integrity of their patients and their human rights.

So I think that whole vacuum of accountability and effective impunity that these medical practices are engaged under is a real issue as well to assess.

HURLEY: From the chemical restraint group, a member of the National Anti-Deportation Alliance, Barbara Rogalla.

ROGALLA: As a member of the chemical restraint group of NADA, I would like to see that all professional organisations instruct the health professionals not to give any sedation whatsoever in the context of deportation. I think, while a member of NADA I would ultimately see all of the forcible deportations being stopped, but I think if we just focus on the professional side of it, it should just not be the case where health professionals purposely sedate somebody so that person can be picked up like a bag of meat and thrown into an aeroplane.

SINGH: Yes. I would concur. I think all health professionals in detention centres, and their professional and regulatory bodies, need to make a principle assessment of the risks and the very real implications of complicity or culpability in administering medical treatment against the will of their patients for the sole purpose of effecting deportations, effecting so-called government policy, and that those considerations and those principled stands need to be made well in advance of health professionals being placed in the position of having to either undertake or refuse to undertake forcible sedation, and be complicit in deportations.

HURLEY: Do we know that health professionals who have had to do this have resisted doing it, and find it unethical for themselves?

ROGALLA: I am not aware of any information that has come forward. Mind you, I can imagine how people who are involved in this sort of process, that they would be very quiet, not to be noticed by anybody. I really just wish that the professional bodies would actually instruct their members not to do this. The Nurses Board from South Australia, for instance, in response to our letter, just sent us a copy of their standards of ethics for nurses.

HURLEY: Without taking it any further.

ROGALLA: Yes. The best response so far has been from the Australian Medical Association.

SINGH: I think there is a pall of silence around health professionals in immigration detention centres, and that is perhaps because health professionals feel under enormous pressure from their employers; either the private company running detention centres or the Department of Immigration; to carry out their directives. In my discussions with health professionals who have worked in detention centres, they always talk about their clinical judgment and their independence, which was alway sacrosanct, just being entirely eroded away in the detention context. So that needs to be something that needs to be taken into account.

On the issue about medical professionals taking a stand and not being implicated and not participating in practices that violate human rights, there are numerous doctors in detention who are actually refugees and asylum seekers, who in their home countries refused to participate in the directives of the government or regime; refused to engage in forcible amputations, refused to engage in acts of torture.

In the Australian prison system there have been doctors who have refused to undertake invasive body cavity searches, and they have said, "This person is my patient. I will not engage in a violation of their bodily integrity." So I think there is history, and there is a tradition of refusal to act in ways that violate the fundamental rights and integrities of doctors' and health professionals' patients, either in camps or in prisons, so there are precedents there.

ROGALLA: It would be nice if the directive would still come from the official organisations, if only to safeguard the employment of people who would then say, "I refuse to participate in this" because, as a former employee of Australasian Correctional Management, I can assure you, if you do not go by company directives, whilst your professional autonomy will not be challenged, you can be 100% sure that you will not remain as an employee of the company for very long.

HURLEY: Barbara Rogalla, representing the Roma Mitchell Community Legal Centre in Adelaide, who, with Helen Browning from Brisbane, is actively involved in the chemical restraint group. And before her, Charandev Singh, human rights advocacy worker representing the Brimbank Community Legal Centre in Melbourne. They are part of the recently formed National Anti-Deportation Alliance, a loose alliance focussing on issues around the forced deportation of asylum seekers and refugees.

For information about the chemical restraint group, telephone Barbara Rogalla on 0419 128 300 and check out two relevant web sites, starting with or and follow through until you reach the National Anti-Deportation Alliance.