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Indonesian perspective on Medevac



On 7 February 2019 in Manado, Sulawesi, Sajjad, a 24 year old man who had just finished his undergraduate degree in information technology at a local university, doused himself with petrol and set himself on fire.

A drawing by a detained refugee in an Indonesian detention centre asking for freedom.Sajjad and his parents arrived in Indonesia and claimed asylum in 2000. An initial attempt to get to Australia failed, and the family's priorities changed. They moved to Sumbawa where they focused on integrating into the local community. Sajjad and his younger sister attended school, but the family struggled to make ends meet.

In 2011, the passage of a new immigration law in Indonesia and increased pressure from Australia to detain refugees in Indonesia saw a significant change in the family's circumstances. Sajjad and his siblings were taken out of school and sent to an immigration detention center (IDC) on the northern tip of Sulawesi. This was to be their home for the next eight years. Life in prolonged detention fuelled frustration, anger, and mental anguish for Sajjad and his family.

Sajjad died of his injuries on 13 February 2019, six days after self-immolating. On the day of Sajjad's death, Australians woke to the government's claim that the passage of the 'Medevac Bill' would restart boats from Indonesia and weaken Australia's borders. But as Sajjad's life in Indonesia demonstrates, getting on a boat to Australia was either not a priority (he was a student) or not possible (he was detained).

There are 14,015 refugees in Indonesia. They live across the archipelago in locations as diverse and geographically dispersed as Jakarta and its surrounding areas (6885), Medan (2104), Makassar (1880), Tanjung Pinang and Batam (1022). The majority of people live in urban or semi-urban communities without legal status, the right to work, study or marry or, for those arriving after July 2014, access to resettlement in Australia. 4079 are children.

From years of working with refugees in Indonesia, Jesuit Refugee Service (JRS) Indonesia knows that many people's primary concerns revolve around access to food, shelter, adequate healthcare, and education, not on boat journeys to Australia. Homelessness and destitution have been made worse by the Australian government's decision to cut IOM funding and refuse material assistance to refugees arriving in Indonesia after 15 March 2018, while continuing to fund an array of migration control policies. Approximately 5200 refugees and people seeking asylum now depend solely on savings, family support, or acts of charity. Many sleep on the streets or in mosques or move between places.

Equally important is the fact that many refugees have created their own life opportunities, and built strong relationships, despite the hardships they face. Trying to build a life in Indonesia, not getting on a boat to Australia, is their focus. At this week's Refugee Alternatives conference, Mozhgan Moarefizadeh, co-founder of the Refugee and Asylum Seeker Information Center (RAIC Indonesia) told the audience that Australians must stop obsessing about boats from Indonesia, and focus on providing advice, training, and financial resources to refugee-led education, social enterprise, and humanitarian initiatives on the ground. RAIC provides care packages, legal aid, eye check ups and other essential services to hundreds of refugees every month.


"The perspective from Indonesia highlights that there is little demonstrable basis to the purported causal link between Medevac and the restarting of the boats."


Other refugees are driving their own education opportunities. According to the UNHCR December 2018 statistical snapshot, 1751 people were involved in educational initiatives led by organisations such as Cisarua Refugee Learning Centre, and a further 1238 people were enrolled in online university courses.

By most accounts, refugees in Indonesia know about Australia's boat turn-back policy and do not view attempting the journey as a worthwhile risk. Years of living without the ability to make an income has meant that people can no longer afford to pay operators to take a journey; what little money does exist is spent on food, clothing, shelter, study materials and other essentials.


The perspective from Indonesia highlights that there is little demonstrable basis to the purported causal link between Medevac and the restarting of the boats. This conclusion can be supported by a number of other arguments that must be restated.

Under the bill, passage to Australia for medical treatment only applies to people currently on Manus Island and Nauru. While it is impossible to gauge how many refugees in Indonesia are aware of this particular fact, knowledge of it surely acts as a key deterrent to any new boat journeys. It is telling then, that when invited to reiterate this element of bill on Sky News Australia, the Prime Minister equivocated and deflected.

Boats kept arriving after the commencement of Operation Sovereign Borders. There have been 33 known boat turn-back operations since the announcement of Operation Sovereign Borders in 2013. The number of operations peaked in 2014, and declined steadily after. There were three in December 2013, 11 in 2014, nine in 2015, five in 2016, three in 2017, and one in 2018.

Legal and civil society efforts to bring sick refugees to Australia began in late 2015. The 'Let Them stay' campaign led by doctors and advocates matured in early 2016. The US resettlement deal was only announced in November 2016; the first refugees departed Papua New Guinea and Nauru in September 2017. The 'Kids Off Nauru' campaign began in August 2018.

By the government's logic, each of these efforts to ensure safety for the children, women, and men should have sent a signal to the so-called people-smuggling trade and generated a spike in boat turn-backs. But as the timeline above indicates, we have seen nothing of the sort.

The government's move to reopen Christmas Island in response to the passage of the MedEvac Bill serves no purpose but a base political one. Reopening the island has no added deterrent value, given conditions in Indonesia and continued boat turn-back operations. More importantly, Christmas Island is — albeit selectively — an Australian sovereign territory, but it is not a place where acutely sick people can obtain adequate medical treatment.

In its most recent published report on Christmas Island IDC (CIIDC), the Australian Human Rights Commission (AHRC) noted that facility staff themselves 'advised that people who are seriously ill or have complex health needs will not be placed at CIIDC given the limited health services available on the island, and its remote location, which may hamper rapid medical evacuations in emergencies'. The Commission also conducted a Kepler Psychological Distress Scale (K10) test with a small sample of detainees and concluded that a significant number of people detained at CIIDC are likely to be experiencing moderate to severe mental disorders, which may be caused or compounded by their experiences of detention.

Moving sick people from one remote island with limited facilities to another is antithetical to the spirit of the bill that the Parliament passed last week.


In his last days, Sajjad said that powerful interests had taken his family's opportunities, rights and dignities away. Authorities had recently taken away his hand phone, disallowed his siblings from attending school, and talked of possible removal back to Afghanistan. Far from waiting around to get on a boat, he and his family were fighting a very different battle for survival in Indonesia, one that was much to do with Australia's influence on immigration policy in that country.

For Sajjad's family, thousands of other refugees, and civil society in Indonesia, it is the forthcoming election that holds hope, not the Medevac Bill. It is the hope that a change in the Australian government may lead to an increase in refugee resettlement to Australia and a more human rights-centric approach to migration in the region.



Carolina Gottardo and Nishadh Rego are Director and Policy and Advocacy Coordinator respectively for Jesuit Refugee Service Australia. Lars Stenger is National Advocacy Officer for Jesuit Refugee Service Indonesia.

Main image: A drawing by a detained refugee in an Indonesian detention centre asking for freedom.

Topic tags: Carolina Gottardo, Nishadh Rego, refugees, migrants, asylum seekers, Medivac, Nauru, Manus Island



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Existing comments

Well presnted article i would like to re quote it on facebook perhaps a link would be good !

christopher Reynolds | 23 February 2019  

Thank you for this excellent, highly informative article. I often think of all the people stranded in Indonesia, with no right to work or take a meaningful part in society. Australia has devoted a vast amount of money and resources to keeping them out of Australia, supposedly because we do not want them to drown at sea. In fact the Government, supported by many citizens, does not want them alive or dead, and we turn our faces away from them completely. We could not sustain a deluge of asylum seekers, but in fact we could take in more than we do. The Government's latest statements on 'Medevac' are nothing more than the usual fear-mongering - and too many Australians are only too ready to fall for it. Are we driven mainly by fear of outsiders?

Rodney Wetherell | 25 February 2019  

Your article is deeply upsetting. Jesuit Refugee Service and the Indonesian organisations mentioned in the article are heroes. And RAIC is right: privileged, affluent Australia is obsessed and at the very least should provide more on-the-ground practical support to enable your organisations to do more. Let's make sure the ALP hear this during the election campaign. I will forward your article as widely as possible.

Pat Walsh | 25 February 2019  

14,015 is not many. Australia could take all of them now. Then, what about the asylum-seeker shaped vacuum in Indonesia? Given that 14,015 is a strangely small number in comparison to the hordes attempting to enter Europe, how do we know that Operation Sovereign Borders isn’t also doing a favour for Indonesia in making it less of a target for asylum seekers? Since it’s self-evident that Australia cannot sustain the sort of numbers that would drain a camp, turnbacks cannot be immoral. Without them, the country would be deluged with applicants for asylum. The IT analogy is the denial of service cyberattack, with Australia’s refugee-processing facilities and the social welfare benefits budget standing in place of the hapless computer. Australia cannot provide special aid to support the asylum seekers in Indonesia without ruffling the feathers of a people which has millions of its poor receiving no social security payments. Turnbacks and indigent asylum seekers in Indonesia are therefore rusted-on realities which Australia cannot change.

roy chen yee | 25 February 2019  

Thank you for this important article. It should receive much broader exposure! Indeed if we, as a world, cooperated and invested in helping people rather than demonising them the worldwide refugee story would be different. Change the language: refugees and asylum seekers are people who want a safe, stable productive existence - just like everyone else. Let's shift the rhetoric and policy from disregard, disrespect - disdain - to a respectful humanitarian point of view, a cooperation where we recognise people's vulnerability and our responsibilities in countering and helping them. That would take us towards a better society all round.

Susan Faine | 26 February 2019  

Roy Chen Yee, if Australia were to take all 14,000 refugees in Indonesia, it would likely result in making Indonesia more attractive to others seeking asylum or the groups that facilitate their movement. This is not an argument against substantially increasing our humanitarian intake, but it highlights this as a "wicked" problem. ie. a problem where aiming for one outcome might cause unintended consequences that subvert the outcome sought.

Harold Zwier | 26 February 2019  

Thank you for raising some interesting points. Labor's $500 million promise to better fund UNHCR activities in Asia should be a help to the 14,000 in Indonesia. Indeed, should place the UNHCR in a position to provide some of the support suggested in the article. The article does not list the current means of help to refugees in Indonesia provided by Australia. Extensive not for profit organisation help; also Australia contributed $42 million to International Migration Organisation to assist. The increase to 30,000 per annum humanitarian visa places also promised by Labor is helpful, although Harold's point about the "wicked" nature of the problem - unintended or unforeseen consequences of policy - is valid. Increasing intake from Indonesia directly may raise expectations. More broadly, Malaysia has 10 times as many refugees as Indonesia. It all points to one outcome needed - a rational, co-ordinated regional plan for Asia, one fit for purpose. Labor's 30,000 is closer to the Greens policy. Australia will quickly pass its 1,000,000th refugee arrival since 1947. Too much focus on migration [less than one in 18 are resettled in countries of second asylum] and more focus needed on assistance where it is needed.

John Kilner | 08 March 2019  

This is an excellent article. Would that all Australians would read it and see the fallacy in the 'political' response by the Govt. to the medivac Bill. Thank you.

Elizabeth Morris | 15 March 2019  

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