The Voice of Victor

For a few years my daughter lived in England where she met lots of other young mothers, ordinary white middle class women with orderly lives, healthy babies and toddlers. They all had husbands with jobs, all were native English speakers in an English speaking country. They were all OK. Their babies got croup and cradle cap and they saw competent doctors in a timely way and had access to suitable, safe and effective medicines, and soon their babies were OK again; and they were all OK. 

But one day, one of my daughter’s friends saw the papers, watched the TV news and she stopped being OK. The friend’s name is Ros. And although Ros – a person in London with an ordinary life, who abandoned her day job and roused herself and roused one hundred thousand other ordinary English mothers and fathers and children to demonstrate and campaign for refugees, and this led to David Cameron rousing himself and his government, and this roused Britain to admit many whom they previously would have turned away – this story is not about ordinary Ros.
My daughter left England and returned home to Australia. She and Ros remain in touch. Ros sent a photo that broke my daughter’s heart. She wrote me a letter that included the image below:
 

My daughter’s friend Ros sent her this photo in a letter she came across in a camp on the Greek Island of Thessaloniki. In shrinking lettering near the foot of the letter the writer signed his name, “victor”.

 
My daughter says Victor’s is the despairing voice of one refugee so desperate to be heard he writes on the wall of his tent. He knows no-one hears. She says the world has turned its back. My daughter turns to her writer father with a plea of her own: “Maybe your writing could give Victor a voice. I’m just saying it made me think of you. Do with that what you will.”
I read my daughter’s letter. I read Victor’s letter.
Do with that what you will, she says, then adds, “Going to sleep with a heavy heart.”
Days pass and I don’t do anything.
Every time I switch on my computer, my daughter’s letter asks me, what will I do to make Victor’s voice heard? Something indistinct echoes, something about the unheard voice. It is a voice from a cattle car.
WRITTEN IN PENCIL IN THE SEALED RAILWAY-CAR:

here in this carload 

i am eve 

with abel my son 

if you see my other son 

cain son of man 

tell him I

  

What can I do? What can any of us do? We can try to emulate ordinary Ros. We can write to our local Member of Parliament, write to our faith leaders, speak to our friends. We can do as an ordinary friend of mine does – she organises aid packages. (That friend – a lapsed fundamentalist Christian – writes annually to this Jewish friend, seeking donations of Christmas gifts for Muslim refugees.) We can adopt a Victor – there are so, so many – and write to him. We can send him books. We can remind him he is not alone, not forgotten.

 

What good will these ordinary acts do? In the case of Ros they led to the saving of thousands. In Australia, our ordinary voices were raised enough to encourage our very ordinary leaders to find our captives place of safety in the USA. Our leaders are timid. It is for us to lead them.
(You can find out how to emulate ordinary Ros if you visit http://www.swruk.org/ )

Should Nurses and Doctors Accept Work in Australia’s Detention Centres?

In 2010 I worked in an Australian detention centre for short time that felt like a long time. The experience was the worst in my fifty years in Medicine. I signed a confidentiality agreement, sewing my own lips in the process. I saw no atrocity, no wrongdoing, other than torture by impersonal and meandering bureaucracy. Yet the suffering was general; it saw inmates, guards, nurses and doctors all resorting to self-harmful acts. I saw honourable people treating the detained with skill and humanity. I saw them constrained by employers and distrusted and insulted by patients, who felt sure that we too were liars. Yet we did some good. People, whether sick in body or in spirit, were treated with kindness and respect.

For six months after I returned to the mainland I was visited by dreams in which I sat on Tribunals without name, determining the fate of nameless individuals doomed by history and by Australian laws. Captive in these dreams, I doled unequal laws to defeated supplicants. I’d awaken and ask myself, did I really do that? But, inescapably, I knew I was implicated.

My island was a paradise of procedural propriety compared to today’s islands of Nauru and Manus. Doctors and nurses have returned from these places with distressing reports. Some have argued that, knowing what is now known, it is in unethical to work in these places; that the system tortures inmates; that participating is to become complicit in torture. More moderately, all clinicians and observers who return seem to agree that incarceration harms the inmate. The first law of medical ethics being, first do no harm, is not an ethical practitioner obliged to refuse to share in that harmdoing?

A new element affecting the work of a detention clinician is the outlawing of reporting wrongs seen in that work. Offenders face the threat of two years gaol. Nice systematic irony: to protect the liberty of Australians we incarcerate boat people; to protect the integrity of the system we incarcerate truthtellers. Interestingly, the flood of job offers to work in Detention that recruiters used to send to remote doctors such as myself has dried up. Someone, somewhere must have decided Australian clinicians are unreliable.

What then must a nurse or a doctor or a psychologist or a psychiatric nurse do? If offered, may we accept this work? Even if we are forbidden to speak of what we see?

I compare the situation to working with patients in places of dangerous epidemic disease. The first such case I read of was the cholera that broke out in eighteenth century Naples, where a young Swedish doctor left his fashionable private practice in Paris to work with the afflicted. He found himself working alongside a young nurse who was both beautiful and a nun. At any moment the disease might take them. The two work steadily on, afflicted by the losses and by the erotic fever that seizes them both. The drama of the two who risk all for strangers has never left me. The doctor, Axel Munthe, wrote of this in his memoir, The Story of San Michele.

We saw just such heroism played out by Australian nurses and doctors who went to Africa recently to save people from Ebola. We saw it, and -as a nation, as individuals – we prayed for our heroes and we applauded them.

Nothing new here: nurses and doctors work with AIDS, with multi-drug-resistant TB, with Lassa Fever. It is natural to the species to measure the need before the personal risk.

The second precedent is an unhappy one; during the twentieth century doctors working under dictatorships accepted orders, accepted payment, enjoyed promotion and protection, and participated in abuses ranging from imprisoning sane dissenters in psychiatric institutions, to ‘eugenic’ murder, to torture. And being bought, they shut up about it. If clinical ethics learned anything from these abuses it was the imperative to speak out.

In the light of history I see the duty of free citizens, clear and uncomplicated. It is to go to the camps, to do such good work as might be done, and to speak out.

Outrage at Whitegate

A few weeks ago someone cut the water supply to a town camp on the outskirts of Alice Springs. The ‘camp’ belongs, by ancient practice and by government fiat, to a local clan of Aboriginal people, heirs to a tradition of tenure that goes back beyond white settlement, beyond the dawn of written history. Whitegate is far from how we might imagine a camp, being neither an attractive resort nor a place of refugees. Whitegate Town Camp is not in any sense a place of temporary habitation. It is habitat, it is country. It belongs to the Hayes clan as the clan belongs to Whitegate.

Governments wish to take over the camp, ostensibly to modernise and improve it. They seek to unseat tenure and replace this with long leases. The longest paper lease imaginable would be but momentary in the context and the conception of the Hayes family. Such paper devalues and threatens a connection which is inalienable in nature and beyond secular legal conception.

So someone cut the water supply. Just possibly the government is not responsible. Responsible or not, government could quickly supply water but this has not happened. Nor has repair of the camp’s long defunct solar generation. Whitegate, long a garden of neglect is now a wilderness, occupied by human Australians. Other Australians, notably whitefella writer-artist Rod Moss, supply water and burnable fuel for heating and cooking.

In the present historic moment of human barbarity it is noteworthy that none of the parties to the conflict in the Middle East – not even Assad’s Syria – has ever cut water supplies to its foe. Such an act seems to be beyond human imagining. Except in Alice Springs.

Actions to protest this barbarism will take place in coming days and weeks, actions that are notably harmonious in nature and intent, ‘Aboriginal way.’

How have we fallen so low?

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All Those Christmases at Once

NEWS BULLETIN, DECEMBER 2010

Christmas Island tragedy: Screams, yells and then they drowned…Devastated Christmas Islanders …witnessed yesterday’s horror…

After three days on Christmas Island it is my turn to take night call as doctor at the Detention Centre. At ten PM I receive a call from Team Leader, the always-smiling Henry. I hear no trace of a smile in his voice: “Security is bringing five men in to the clinic who’ve slashed themselves and another man who tried to hang himself.”

When I arrive in the clinic, all cubicles are full. There are the five men who have cut themselves, and not one, but two, who’ve tried to hang. I don’t know where to look first. I don’t want to look at all.

In the nearest cubicle a man lies flat on his back, his throat livid in the glare of the examination light. He does not move.

I speak, asking his name.

No word, no movement.

I speak loudly into his ear.

Nothing.

I press my index finger tip hard against his sternum, a really unpleasant experience for a person whose body parts retain their connections with the brain. A person with a broken neck loses such connection. The really unpleasant stimulus evokes no response. I press harder: nothing.

I rest the pulps of my fingers against the inside of his wrist. The heart does not dissimulate: it sends a pulse of blood along the man’s radial artery, at a rate of seventy times a minute.

My racing heart slows.

I try not to look too hard at the man’s throat. The damage here is only skin deep. There are more vital sites elsewhere: I check for damage to the neck vertebrae, assess pupils and reflexes and muscle tone. All are reassuring.

Finally the throat – inescapable. It is a horrible thing to see – a human neck skinned at the front. There is little or no bleeding, just a broad scarf of raw red meat, overlying a peeled adam’s apple. It is the neck of a rooster in a slaughterhouse, grotesque, the more so with a good-looking face above it and a normal torso below.

To this delicate bodily junction the detained man applied twisted sheeting, then jumped. There was not sufficient fall to damage neck bones or spinal cord; just enough to skin him.

In the bright light he is a painting, a human still life: on one side his bronze skin sheens; on his shaded parts, it darkens. A stubble bristles on his chin. I return to my patient. His arms, lightly muscled, lie flaccid at his sides. His legs neither move, nor resist movement. I watch his thin torso for rise and fall. A hint of expansion only, unconvincing, inconclusive.

This man is alive. But he does not betray any sign of consciousness. Why?

I look at his file for his SIEV number. The lower the number, the earlier the date of arrival. His is in the low 100’s. He has been waiting here a long time. Tonight was to be the end of his wait.

Now, defeated by life, he is embarrassed to know and be known by us. He lies and he pretends his wish had come true. I can make out a faint snoring sound, very soft, almost inaudible. I think of my wife and the snorer in her bed.

NEWS BULLETIN 24 JULY, 2014:

One woman putting a bag over her head, drinking half a bottle of detergent….using a broken mirror to cut herself…

On their separate couches lie the slashed men. Rising above intact skin, parallel lines of red glisten and coagulate. The lacerations are multiple, situated on left arms and the left side of abdomens.

The sole left-hander has slashed his right shoulder. A dozen narrow ribbons of his skin lie, oozing slightly, a bloody epaulette. There is insufficient width of skin here to accept an anchoring suture. Unsutured, his wounds will heal in time, leaving a grid of ugly scar, an obscure tattoo. All of his cuts are shallow: human meat as sashimi, unrepaired.

One more, one last harmer in this outbreak of harm. The nurse says: “He’s swallowed a razor blade.” A razor blade! I am sixty five years old. I am too young for this horror.

In time, the dressing station is emptied of the skin-wounded. The hanged men will stay here overnight, under observation.

MORE FROM TODAY’S NEWS:

A spokeswoman for Immigration Minister Scott Morrison said “It is longstanding Government practice not to confirm or comment…”

There remains one man, older, silent and red-eyed. I search for the site of his wound. It is too deep to be seen. The weeping man weeps for all he has witnessed, for the sorrow, for his sons.

I look at his face. O, what a grief looks through his eyes. In his crying, his mouth twists in a tragic smile. His old eyes look into mine. Lost for words, I take his hand and sit down beside him. He gazes into my face as if into a mirror. He shakes his head sadly and presses my hand.

Why is he here? His guards were troubled and decided to bring him to the clinic. His grief overwhelmed them, those large phlegmatic men. It is they, the guards, who seek treatment for him: some sedative, some vicarious remedy for the circumambient pain.

Through an interpreter, I offer him a tablet. I tell him it will help him to sleep. Before the interpreter can translate, the old man shows me again that woeful smile. He has no more tears.

He presses my hand.

He says: Ta shakour, ta shakour. Thank you, thank you.

CLOSING TODAY’S NEWS BULLETIN:

…not to comment on individual acts of self-harm.

Now, three years distant from my term on the island, haunted by guilty dreams, I can appreciate the soundness of the minister’s judgement. One must never comment on an individual. The individual is the basic unit of the human. If the minister allowed himself to see, to feel, to know the single pulsing person, he might lose his equanimity, his tight-lipped resolve. If one human saw the plight of another he’d pale, he’d shudder, he’d cry out, he’d tear apart his self-sewn lips.

And then where would we be? The boats mightn’t stay stopped.

376,000 Footsteps in the Sisterhood of Man

It was the running of the Jews. Not in Khazakstan but at Melbourne’stan.

Historically, you only saw a bunch of Jews running if there was a fire or a pogrom. But yesterday hundreds of Jews were afoot, an infrequent event since the original Fun Run across the Red Sea. (On that occasion all the Israelites crossed the line. The Egyptians failed to finish.)

We Jews were not alone at the Tan: joining us were Africans from the Horn and from Mandela country; a pair of Iranians, a smiling Swiss, sundry Catholic Australians; the odd Chinese, a couple of Argentines and their Australian born progeny. And my wife and my not-very-old oldest grandchild.

If a kilometre is one thousand metres and the average human pace is one metre, and the circumference of the ‘Tan’ is 3.76 kilometres, then a single lap represents 3760 paces. Yesterday saw 376000 paces in the sisterhood of man.

My team, “Queue Jumpers”, named in honour of those disgraceful individuals who do not go through the correct channels, raised about 1800 dollars. The entire event raised in excess of $20,000, to be spent in two struggling Aboriginal communities in far north NSW and in a Community Centre for queue jumpers from Darfur.

Over coffee, before the event Akbar the Persian storyteller told a story. Akbar has elevated my runs over 25 years – ‘one quarter of a century’, he observes – with folktales from his homeland. Yesterday’s story: The revolution was coming in Iran. We knew people, Bahai, whose houses were burnt by militants. A friend said to us – do not stay in your house. It is not safe. They will burn your house next.

We decided to leave. We went to a cousin’s house. But another warned – ‘this house will be burned tonight.’

We had to leave. We all ran from the house but a man with a big automatic weapon stood outside. He said: ‘Do not go. They will burn this house only when my body is dead.’

That man was Savak. Secret Police. But we did not wait. Instead we ran. We ran to the house of the parents of this young woman…

Akbar here indicated his niece, Paloma. It turns out that Paloma -‘dove’ in Spanish – speaks Spanish fluently. This dove was born in Bristol. She takes up the story: My father was in America. He bought a red Ford Mustang. I sat in the back; there were only two doors. He brought the Ford Mustang to Bristol and he drove us, Mother and me and Father, to France, then all across Europe, all the way to Iran. I was four when we left Bristol, but I remember the red car, I remember I sat in the back.

Akbar takes up the story: We ran to the house of Paloma’s father and mother, all of us – myself, my parents and my cousin. Paloma’s family took us in and we stayed. We stayed in their house for nine months and we were safe.

And then we came to Australia.

Akbar smiled. He said it was time for a real Persian story. He told a folk story, of Mullah Nasruddin. Akbar’s story took us to a different age, a different place. We sat in the sunshine and watched and listened to the genial teller of tales as he smiled and talked.

Then we arose and ran, we Aussies, we Jews, we Muslims; we Africans and Catholics; we old and wrinkled ones, we new and sprightly ones; we arose and ran 376,000 footsteps in the Sisterhood of Man.