How Australia treats refugee women

Last week in Brisbane’s Courier Mail, federal political editor Renee Viellaris wrote that women asylum seekers on Nauru are ‘blackmailing doctors to get to the Australian mainland’.

The women, apparently numbering three, are said to be pregnant and requesting termination of pregnancy, which is illegal in Nauru. They are said to have been transferred to Australia and then declined termination, and that they have subsequently taken out injunctions against the Department of Immigration (DIBP) to be allowed to stay in Australia. No real source is given for the information about the pregnancies and none at all in regard to the injunctions.

I have no involvement or knowledge of these women but as a specialist obstetrician and gynaecologist with more than forty years’ experience (including providing surgical services on Nauru in the Howard era), I was asked by lawyers in 2015 and again this year to give expert opinions on the cases of two other women who became pregnant on Nauru and sought termination, and I have reliable evidence from another doctor about a third woman.

It is worth noting that I also practiced obstetrics and gynaecology in Western Sydney from 1981 until 1999 and a large part of that practice involved the care of thousands of Muslim women from a variety of countries, many of them recently arrived in Australia. The Muslim women I encountered were often modest in dress and demeanour. I also know that many of the women I cared for had undergone traumatic experiences in their own war-ravaged countries and in refugee camps, and as a result understandably experienced significant mental health symptoms.

In my recent role as expert witness, the first woman I provided evidence about I will call Amira for the purposes of this article. Amira became pregnant allegedly as a result of rape, although her allegations were not treated seriously by authorities on Nauru.  She sought an abortion from staff of International Health and Medical Services (IHMS) who supply (limited) medical care on Nauru. While doctors were supportive of her request, it took sustained pressure from Amira’s lawyers for DIBP to transfer her to Australia more than two weeks later. She was by then more than eleven weeks pregnant.

Amira received no specific rape counselling but an appointment was made for her to attend a clinic for a surgical abortion. Amira had only been in Australia a couple of days; she asked for a little more time and more information about how the abortion would be done. Her questions were not answered. Instead, she was rapidly transferred by a specially chartered flight back to Nauru. She again made clear that she wanted an abortion. She was finally transferred back to a health facility in Australia – but by then had passed the point at which termination could be provided. She went on to give birth; both she and her child have major ongoing health problems that require them to remain, for the moment, in Australia for treatment.

The second woman I will call Bisma. Like Amira, Bisma allegedly became pregnant as a result of rape on Nauru. She also has a major medical problem requiring specialist care and severe mental health problems as a result of horrific scenes she witnessed during the ongoing war in her country of origin, and specific threats made against her when she was in a refugee camp in a second country. Bisma requested an abortion; there were major delays before she was transferred not to Australia but Papua New Guinea, where there were no specialists in the medical condition she suffers from. Abortion is also illegal in PNG.

Applications to the Australian High Court and then to the Federal Court were made on her behalf. The judge’s decision was that Bisma should receive medical care not in PNG but in some other country that could provide appropriate facilities. This was not specified as Australia: Singapore and New Zealand were also considered. However after two weeks of indecision DIBP brought her to Australia where she was at last able to access the care she needed.

The third woman, also pregnant as a result of alleged rape, was transferred to PNG, had a surgical abortion carried out there, and was returned to Nauru.

These (alleged) rapes are only known about because the women became pregnant. For a large part of a woman’s menstrual cycle the chances of pregnancy are almost zero. So a number of women actually pregnant following rape strongly suggests a much larger number being raped but not becoming pregnant. These facts strongly support claims that rape is endemic on Nauru especially among these young, vulnerable, unaccompanied women who have been housed in poor conditions in the community. Nauruan men and Australian-employed security guards who are the alleged perpetrators of rape are physically much larger and stronger than these women; they also occupy positions of power on Nauru. And, as I know from my own experience of being raped when I was fourteen, rape is as much about power as it is about sex. My own experience tells me how powerless these women must feel, and allows me to understand how difficult it is for them to talk about it, and the guilt and shame that engulfs them. It’s horrifying for me personally to know that rape and sexual assault are happening on a daily basis on Nauru.

What is particularly repugnant about this situation is that women who make allegations about rape and sexual assault are not being heard or believed – the Courier-Mail article depicts them as conspirators who plot to become pregnant and deceptively make their way to Australia. Male politicians in Australia dismiss these women as liars in the media. In fact any conspiracy around rape on the island is against women asylum seekers not by them.

Moreover, doctors on Nauru are not being ‘blackmailed’, a term oddly used here, implying as it does improper behavior on the part of the doctors. These doctors are trying to do their jobs, but in conditions that make the safe and compassionate delivery of medical care impossible. The only solution to this ghastly situation is to transfer all women on Nauru to Australia, or if that is too hard to a third country such as New Zealand, which has been offering to take Nauruan asylum seekers for years now. Until this happens we are all responsible for the fate of these women.


Image: ‘Woman’ / flickr

Caroline de Costa

Caroline de Costa AM is Professor of Obstetrics and Gynaecology at James Cook University College of Medicine, Cairns Campus in North Queensland, Australia. Caroline has been a specialist obstetrician and gynaecologist for 37 years and is firmly committed to the pro-choice position on abortion rights for women. She has been awarded honorary life membership of Children by Choice, Brisbane, and is a member of Reproductive Choice Australia. Caroline is also a writer of both fiction and nonfiction. See

More by Caroline de Costa ›

Overland is a not-for-profit magazine with a proud history of supporting writers, and publishing ideas and voices often excluded from other places.

If you like this piece, or support Overland’s work in general, please subscribe or donate.

Related articles & Essays

Contribute to the conversation

  1. I never thought the level of hatred for people fleeing persectuion would get this low. You are right to highlight the continual torture and crimes against women as they are often at the mercy of every power wielding person – in any war.
    I suffer from a mental illness so knowing what is happening in our name tends to make me sick so I have to pull back from the news and escape into history. Trouble is this kind of thing happened every century. So naive to think Australia was a beacon of civilisation free of white australia policy.
    We now have to work towards a Bill of Rights including off-shore prisoners.
    Thanks Prof. de Costa. Will send this to my MP now shadow Minister for Immigration etc Shayne Neumann

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.