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Unveiling detention and health care on the Island of Hungry Ghosts

MAX COHEN  |  15 FEBRUARY 2019  |  ISSUE #1
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Christmas Island Immigration Detention Centre. Picture by DIAC images on Wikimedia Commons (CC BY 2.0).

Gabrielle Brady’s Island of Hungry Ghosts (2018) is a powerful documentary set on Christmas Island – home to both an annual land-to-sea migration of millions of red crabs and one of Australia’s most notorious off-shore detention facilities for migrants. Shot solely through the perspective of trauma counsellor Poh Lin Lee the film explores the disturbing realities of migration detention through detained people’s intimate testimonies in counselling sessions and the familial and work relations of Poh. Watching the counselling sessions with nameless subjects who recount the trauma of their dangerous journeys by boat and the re-traumatization of being locked up upon arrival at Australia’s shores makes for uncomfortable watching. At first, the film’s first-person point of view seems to use rather than listen to the voices of the detained, while lionising the counsellor Poh. But as the movie continues it sheds light on an overlooked aspect of migration detention: the experiences of those working within the system particularly in health-care roles.


Over the course of the film’s four years, Poh is evidently troubled by the stories she hears in her counselling sessions and by the institutions she is working for. Mainly, Poh is frustrated that she is unable to help her patients when they don’t turn up to her sessions because they have been moved around Australia’s detention estate. The forced mobility of detainees around detention estates is something that has been recorded in detention estates around the world including in the UK with implications for legal and political actors trying to support those caught in the detention system. Health and legal professionals find it difficult to support the cases of their patients or clients when their whereabouts are unknown. The response of the authorities on the island is typically bureaucratic with ambiguous answers and officials deflecting Poh in different directions as to the location and wellbeing of her patients. Moreover, Poh is concerned that when patients do attend meetings, she only ever sees declines in their health. This is something that she has not experienced outside of detention environments where health professionals can expect to see improvements in patients’ mental and physical well-being. As the film creeps on, Poh’s fatalistic sympathy is expressed for detainees who turn to suicide in detention centres: ‘their life is the only thing they feel they have control over’.


In the end, Poh feels complicit in the detention system, her duty of care reduced to performing a ‘box ticking’ exercise for immigration authorities. She ends her contract and leaves Christmas Island with her family. Poh’s experience is troubling, but it is not uncommon around detention environments. The impact of detention on health professionals and other sectors working inside them is little discussed in immigration politics. In 2017, the British Medical Association (BMA) released a report on health and human rights in detention in the UK calling for an end to indefinite detention (the UK is the only country in Europe without a statutory time-limit on detention). In their comprehensive study they found that many doctors working in immigration detention centres, in common with their colleagues working in prisons, report ‘a sense of profound professional isolation from their colleagues in the community’ which is a consequence of ‘a lack of peer support and clinical supervision from within their workplace’. Also reported is a ‘lack of understanding from colleagues in the community and from the general public’. The result is a sort of ‘Cinderella service’ – under-funded and underappreciated.


One dangerous consequence of this is that doctors can become so inured to abusive and negligent practices that they absorb the ‘culture of disbelief’ that is prevalent in detention environments: the assumption that ‘individuals complaining of physical or mental health problems are… lying about or exaggerating them in an attempt to manipulate or disrupt the system’. In the case of Poh, she internalises a sense of anger and pessimism about the system rather than absorbing its worst pathologies. But her experience is a usual one and it is evidently not uncommon for health professionals to move on from detention settings.


Another important feature of the film is its illumination of the invisibility of detention centres. This might seem like a contradiction in terms, but the secrecy and invisibility of detention centres around the world serves a particular political purpose. In the film’s most memorable scene, Poh is chopping tirelessly with a machete through a dense forest somewhere in the middle of the island, eventually reaching an opening onto a cliff-view. The camera follows and reaches her, moving out of the dark entangled jungle to reveal a vast industrial detention complex nested within the island’s natural landscape. The detention centre is almost city-like – row upon row of concrete buildings divided by strictly cut pathways and surrounded by a fortified boundary. But as the camera focuses the image resembles nothing less than a terrifying prison. The secrecy and invisibility of detention centres is a central component of immigration policies that intend to keep people detained and detention institutions ‘out of sight and out of mind’.


The geographical isolation makes it difficult for detainees to keep in contact with ‘family members, co-workers, friends, resources and potential advocates’. From my own experience as a music practitioner volunteer at Campsfield Immigration Removal Centre in the UK I remember being bemused by the secrecy of the centre’s location: there were no road signs to the facility and I had to travel by train to a remote station in Oxfordshire followed by a taxi-ride through non-descript fields and forest areas, before the detention centre eventually emerged through the taxi window.


The physical remoteness of detention centres is compounded by their operation by private security companies which further removes detention sites from accountability and introduces a profit logic into the detention system. The two businesses which collectively manage more than half of private prison contracts in the US (including immigration and non-immigration detention), CoreCivic, Inc. and GEO Group, Inc., earned a combined revenue exceeding $4 billion in 2017. Serco which has contracts to operate detention centres in the UK and Australia, including the facility on Christmas Island, has an annual revenue of around £3 billion. Detention is big business.

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During the red crab migration from late October to December many roads on Christmas Island, Australia, are closed to prevent the millions of crabs from being crushed by vehicles (No directions to the detention centre are visible in this photo).

Picture by David Stanley on Flickr (CC BY 2.0).

The way in which detention is kept secret permits a certain amount of ignorance on the part of policymakers who know little about the detention centres that are operating in their own countries. In 2017, a British MP wrote a revealing article about the harmful conditions of the UK’s detention estate and the impact of detention on detainees’ mental health, entitled, ‘I’m an MP, and I visited an immigration detention centre undercover – what I discovered was shocking’. Just as revealing as the hidden realities of detention in this article, perhaps, is the fact that the elected representative felt compelled to go undercover in order to discover what detention is like. Journalists, researchers, members of the public are rarely allowed access to detention facilities and information from within detention centres is heavily secured. During the filming of Island of Hungry Ghosts, the Australian Government implemented controversial ‘secrecy laws’ which threatened workers in Australia’s offshore detention centres with two years in prison if they disclosed information publicly about abuse or neglect in the detention facilities. After high-profile challenges in the high court, the government was forced to water down these provisions to make it easier for social workers, lawyers, nurses and security guards working in Australia’s offshore detention centres to talk publicly about the shocking treatment of detainees without being jailed. Only when undercover investigations and inquiries take place do the realities of abuse and the mental health crises ensuing within detention facilities come to light.


As detention has hit the headlines over the past two decades and news about their inhumane conditions have become more prevalent politicians have seemingly begun to listen. In the UK, following a litany of official reports including the BMA’s 2017 report, the highly critical Shaw Review (2015; 2018), the UK Joint Committee on Human Rights’ Inquiry into Immigration Detention (2019) and the embarrassment of the Windrush Scandal, the Home Secretary Sajid Javid declared plans to reduce the immigration detention estate by almost 40% since 2015.  In Australia, after similar levels of pressure and official inquiries it was announced at the end of 2018 that the detention centre Poh worked in on Christmas Island had quietly closed (for now) with the last remaining detainees flown to the Australian mainland. However, there are broader concerns in the politics of migration to take note of. At the live screening of Island of the Hungry Ghosts which I attended in Glasgow in the UK, Poh was supposed to attend to contribute to the audience Q&A with the director Gabrielle Brady. However, in a cruel irony it was revealed she was unable to attend due to immigration restrictions at the border of the UK and she had to return to France. This was something that Poh had apparently never experienced before, but under the harsh conditions of the UK’s ‘hostile environment’ are becoming more the norm. The increasing concerns about border security across the Western world are overshadowing any step-changes to reform within immigration regimes and detention environments. The importance of journalistic inquiry and film-making at the margins and borders of society where the harsh realities of migration politics take place has never been clearer.

Max Cohen

Max comes from Glasgow in Scotland. After completing the MSc Migration Studies at Oxford University he is currently travelling, reading and researching while in the process of applying for a PhD in Economic Geography. He is interested in a broad range of social and political issues from political economy to musicology. As well as loving to write and research Max is a keen musician and footballer, playing the piano and scoring hat-tricks on a frequent basis.

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