Prolonged Detention and the Terrible toll on Childhood Development

Four year old Karim with his mother and father
At the time of Doctors For Refugee’s involvement in 2016, Karim* was a 4 year old boy from Iran who had arrived by boat in 2013. Both of Karims’s parents, Amir* (father, aged 38) and Jaleh* (mother, aged 38), had a history of trauma and torture. On arrival the family of three were transferred to the Nauru Offshore Detention Centre.

Prolonged detention was taking a very serious toll on the health of this already traumatised family. Karim had regressed significantly when reviewed by an IHMS (International Health and Medical Services) psychiatrist in 2016, after 2 ½ years in detention, with impaired speech and motor development and behavioural problems. Karim was unable to form any sentences and had no interaction with peers. He often awoke at night crying due to pains in both his legs.

It was stated by the IHMS psychiatrist, and the later D4R involved Specialist Paediatric Consultant, that this regression was a direct result of prolonged detention.

His father Amir noted that that although he is growing 'in his body, he is not growing in his mind'. He behaves like a two year old. Amir notes he does not seem to feel pain and often gets so frustrated that he cannot make himself understood that he 'hurts himself' sometimes banging his head and moving erratically.

Understandably, his parents were very distressed and their own health was deteriorating. Jaleh had expressed suicidal ideation and was classed as severely depressed in a psychiatric assessment. She showed none of these signs before arrival on Nauru, despite her previous history of trauma. Amir was on Hunger Strike in protest of the lack of care given to his son and would later make an unsuccessful attempt on his own life in desperation.

As far back as 2014, various IHMS psychiatrists had made recommendations for a comprehensive assessment in Australia, which were repeatedly ignored. Indeed, this was repeated by the IHMS psychiatrist who reviewed him in 2016.

Doctors For refugees reviewed the family’s case notes and began the process of lobbying for them to receive the healthcare they, increasingly urgently, required. Repeated emails were sent to IHMS and the DIBP (Department of Immigration and Border Protection). The eventual replies were woefully inadequate and did not adequately address the recommendations made already by medical specialists.

Doctors For Refugees sought the opinion of a Consultant Paediatrician who gave a detailed review of the case. A number of recommendations were made, which again included immediate transfer to Australia for a Multi-Disciplinary Team assessment and urgent mental health assessments for both parents.

The reply to this review from DIPB was deemed “completely inadequate” by the Consultant Paediatrician and “not in Karim’s best interests for a number of reasons”.

It was at this point that Doctors For Refugees made the decision to alert the media to the case. In the hope that this would motivate DIBP and IHMS to finally act in the best interests of Karim and his family.

Karim is now in Melbourne having had an assessment at the Royal Children’s Hospital with his family. The family are in community detention and are asylum seekers currently going through the application process to stay in Australia.

Questions still remain from this case. Including, as noted by the review from the Consultant Paediatrician, which individuals repeatedly overrode the recommendations of medical specialists? What qualifications did they have to make these decisions?

Doctors for Refugees are urgently requesting for new volunteers to assist with cases. See below for information on how to help.

*Names have been changed to protect the family's identities

VOLUNTEERS Urgently Needed

Due to the increased awareness and profile of Doctors For Refugees, the Case Management Team are becoming increasingly overwhelmed with an ever rising number of asylum seeker and refugee cases.

Doctors for Refugees are urgently seeking VOLUNTEERS for help with reviewing medical records. This does not involve any face to face contact.

Please email to express your interest/receive more information and help refugees like Karim and his family.

Palm Sunday Refugee Rally

Dr Paddy Mclisky speaks to NBN news in Lennox Head

Refugee Advocacy Forum- Brisbane

Talking Change- Making it happen

The Australian Refugee Action Network (ARAN) is organising a National get-together and conference -  Sat 20 and Sun 21 May.  The Talking Change – Making It Happen conference is being organised by a committee of ARAN reps from across Australia and will be held on the ANU campus in Canberra.   Presenters and facilitators at the conference will include advocates from refugee backgrounds, and activists from many and various groups across Australia.   Lots of discussion workshops and opportunities to share your experience, and hear about what others are doing. 

Click here for the program of the 2 days.

Ongoing Action

The continued challenge to the Australian Border Force Act: Last year, following the action of Doctors For Refugees and the Fitzroy Legal Centre, the Federal government amended the Border Force Act to exempt Health Professionals from criminal prosecution for reporting abuse or neglect to individuals in detention. This notably did not include teachers, social workers or other guardians. Doctors For Refugees will continue its challenge to the Australian Border Force Act so that teachers, social workers or other guardians are also included in exemption from criminal prosecution.

Notice of Doctors for Refugees AGM

To be held on Sunday 18th June
Place: 482 Old South Head Rd, Rose Bay , Sydney 2029
Time: 7pm (EST)

There are limited spaces for online attendance. Please email us at if you wish to partake online.


1. Adoption of minutes of the last preceding annual general meeting and of any special general meeting held since that meeting
2. Reports on the activities of D4R during the last preceding financial year, including
3. Treasurers report
4. Other matters providing notice given at least 7 days prior to the AGM
5. Election of committee members.

Nomination for election to the committee must arrive within 7 days of the AGM to the above address or by email to: with the subject line: “Attention Returning Officer “The Nomination needs to have your full details including name, address and occupation with a current CV and to be seconded by a current financial member of the association. Both members will need to sign. As per our constitution, no proxy votes are allowed.

Expressions of interest for our subcommittees are also invited, which include Case Management, Campaign, Fundraising, Legal, Media, Student and others.

Dr Igal Augarten

Returning Officer
Doctors for Refugees
Copyright © 2017 Doctors for Refugees, All rights reserved.

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