Asylum seekers: post-natal care inadequate, report finds

http://www.theguardian.com/world/2013/dec/18/asylum-seekers-post-natal-care-inadequate-report-finds

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Medical staff without obstetric qualifications are providing post-natal care for asylum seekers who have given birth in a Darwin detention facility, according to a report from Chilout, an advocacy group for children in detention.

About 50 pregnant asylum seekers are being held in the detention facility.

The report found that the post-natal care of asylum seekers was “not in keeping with Australian community standards”.

“There are three general practitioners providing care for all asylum seekers [male and female, adults and children] but none of these has any obstetric qualifications and it would appear that their clinical experience of antenatal and obstetric care is limited,” the report states.

“There is clearly an urgent need for one or more doctors with such qualifications to provide care to pregnant women.”

"We met a 12-day-old baby clearly in need of medical attention. The only frontline health service available to this family did not look at the baby and told the parents to come back in two days. That is appalling and at odds with Australian community standards of healthcare," said Professor Caroline deCosta, who produced the report with Dr Emma Adams and Chilout’s campaign director, Sophie Peer.

According to the report, International Health and Medical Services, which provides healthcare for detainees, said they employed two midwives in Darwin, but this was contrary to the findings of Chilout.

“Not one pregnant woman we met [some of whose babies are due in a week] nor any new mother we met could recall being seen by any health professional at a detention facility who identified themselves as a midwife.”

The report was also critical of the arrangements in place for when asylum seekers are transferred to Royal Darwin Hospital (RDH) to give birth.

“The operational aspects of giving birth for asylum seeker women in Darwin left us very concerned. Women are routinely escorted by Serco to the RDH, having never been seen at the hospital before, usually without even a call ahead to let the labour ward know to expect a woman giving birth.”

The report describes how asylum seekers in labour are often left without an interpreter as they give birth and usually do not have medical files with them. When an interpreter is needed, even for emergencies, it is usually done over the phone.

It also describes how “the birth of a baby is recorded by RDH but the mother is not provided with any formal documentation that could lead to her baby having a recognisable identity”.

Guardian Australia has previously reported that the guidelines for reporting incidents in detention centres was changed and that childbirth is no longer an internally reported incident.

Chilout recommended that families never be separated when pregnancies happened and that as soon as a pregnancy is detected the family is moved to the mainland. The immigration minister, Scott Morrison, has previously ordered a review of the separation of a mother and child at the hospital overnight.

Concerns were also flagged about the speedy transfers of new mothers to Christmas island or elsewhere offshore, which is now being done when the baby is four weeks old.

“At an absolute minimum no transfers to Christmas Island or Nauru should take place until the mother has had her six-week post-natal check and the GP/midwife is confident that the baby is feeding well.”

Morrison has repeatedly said there are “no exceptions” to the transfer of men, women or children in his weekly briefings and that family groups could still be sent to Nauru.

The report also calls for more thorough mental health screening for all asylum seekers. The health advisory group that was abolished by the Coalition government should also be reinstated.

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