Saturday, May 28, 2011

Immigration Detention

Yesterday, I had the most depressing interchange, on Twitter, with a fellow called @StreetSmarts111 . His profile called out his conservative political bent. The reason the interchange was so depressing, and indeed the reason I ultimately blocked him, was that there appeared no intent on his part to engage in an exploration. This Tweeter simply wanted to pound a mandatory detention path.
What frustrates me also is that 140 characters is only the first intake of breath on a subject like this. So here goes.
Firstly about Tony Abbott and Julia Gillard. Reprehensible is the only word that works for me when I think about their refugee policies. They and the parties they lead continue to chase each other to the bottom of a very unpleasant slope. They are both playing to first world paranoia. They are seeking to garner even a few voters by playing to anxieties and misapprehensions amongst the population. They are doing this by causing irreparable damage to the lives of asylum seekers and, increasingly, damage to Australia's international reputation.
@StreetSmarts111 stubbornly equated mandatory detention with the need to "process" people. Let's just unpick that. Australia engages in mandatory, indeterminate, arbitrary detention of asylum seekers arriving by sea.
  • Mandatory - you come in by sea, you must be detained;
  • Arbitrary - the mandatory nature of detention means that, no matter who you are and what your risk, origin or claim you are nevertheless detained;
  • Indeterminate - it is impossible to say how long you will be detained for.
Now @StreetSmarts111 argues that all that is necessary in order that we be able to "process" what he chooses to call "illegal immigrants". Firstly let's put the illegal to bed. It's anyones' right to seek asylum in another country. That other country has the right to determine their view of the veracity of that claim. These people are not "illegal immigrants" they are asylum seekers.
So let's look at processing. What does Australia need to do in this regard? I'd argue that the necessary components of a processing system are:
  • It focuses firstly and quickly on simple things like "who are you?", "where did you come from?" and "who came with you?". That check is done daily at our airports to thousands if not hundreds of thousands of people. Not all of them have pre-issued visas. That system does not lack integrity suggesting that such immediate information should be accessible, even for quite large boatloads in 24-48 hours. That information also allows the commencement of security checking (more on that later);
  • Health checks. We would reasonably want to know whether arrivals were suffering from a communicable disease. We would also want to know, for the sake of the arrival, whether they were suffering from medical conditions requiring treatment;
  • The next step is to determine the nature of the claim that each person is making for asylum. This is a longer step, but in fact does not require continued detention for its conduct. By now we should be in a position to know who each arrival is and to have made an accurate assessment about whether they pose a security risk, or whether there is a high level of uncertainty about their identity, or the risk they pose. In default of such risks they are ready to be released from detention. That is not to say that they have a place in Australia as a refugee, it is not to say that they are in fact a refugee. It's simply to say that we have adopted a risk-management approach and formed a view that they can be released into the community pending a decision on their status and whether they will be granted Australian residency.
Such an approach would leave the vast majority of arrivals in our community within a month or so. Some small proportion would be detained on the basis of their risk and perhaps even removed to their country of origin (after the exhaustion of their avenues of appeal under Australian law).
So what are the risks to Australia from such an approach, rather than mandatory detention? There are none. You are more likely to be run over by a car on your way to work than harmed in any way by one of these arrivals with such a sensible managed, streamlined processing system in place. There is no physical risk beyond that which already exists through homegrown extremists, organised crime and bikie gangs - none of which have anything to do with people arriving by boat. There is no economic risk. These people in the main are hard workers, delighted to be in a place of opportunity. They contribute to economic growth which we all benefit from. They do not steal jobs from "Australians".
But there are a couple of issues. Firstly the government needs to deal with both the legislation and the performance of ASIO with respect to security vetting. As I understand it, if you receive a negative security vetting you cannot find out why and on what it is based. You simply have a negative vetting. Why is that acceptable in a democratic country? Where is ASIO's accountability to parliament, the courts and the populace? How do we know what standards are being applied by ASIO? How can we know whether their standards are hopelessly laissez-faire, entirely appropriate to the needs of modern Australia or based on utter, unfounded paranoia? We can't under the legislation and the recipient of a negative vetting is unable therefore to effectively challenge it. The legislation needs to be changed to allow proper scrutiny and review of decisions.
Equally as important, the process of security vetting needs to take place at a brisk clip, not the current inefficient, glacial pace. If it's a matter of resources then the government needs to act. If it's a matter of priorities then the government needs to set ASIO straight about what's required. In any event the current pace and framework seems unacceptable.
So what would be the benefits of ending mandatory detention and briskly processing arrivals?
  • The massive cost of mandatory detention - the financial cost - would end;
  • The irreparable human damage caused by indeterminate and arbitrary detention would be greatly reduced, perhaps eliminated;
  • Australia would begin to benefit rapidly from the contribution of these people to our society and to our economy. Yes there's a cost - people need access to support and to healthcare and education - but that cost is minuscule compared to the costs of mandatory detention and it is a cost that accrues for every member of society.
  • Australia's international reputation would cease taking the battering it is now.
  • The politicians could focus on matters of real national importance such as overhaul of the health system, implementation of an appropriate carbon strategy and ensuring the country enjoys long term benefit from the "minerals boom" rather than ending up as a bankrupt hole in the ground.
Let's not either begin imagining a mass exodus from countries around the world, all attracted to Australia by these new arrangements. That's simply a paranoid fantasy. Asylum seekers are "pushed" to leave the place they know by circumstances we can barely imagine. They are not "pulled" from the comfort of their homes by some vision of an Australian nirvana.
Asylum seekers make up such a small proportion of the immigrants coming to this country each year, that even a doubling of the numbers would have an almost negligible effect...except for the massive burden that we have imposed on ourselves by our mandatory detention policy.
There is only one thing that is needed in order for this situation to change: some sensible, ethical and moral leadership from our politicians. Our politicians need to start informing the population, they should lead the change in thinking about this situation. Instead they resort to the politics of fear, they dog whistle to those who fear everything including their own shadow.
All we need is a clear political message that asylum seekers are a positive and welcomed part of Australian life for this whole issue to vanish.
That won't unfortunately happen whilst we have the current morally bankrupt political leadership that we have - on both sides of parliament. I'd rather spend a day with any of the refugees that I know than be caught in the same room as our current political "leaders".

Thursday, May 26, 2011

Spinal Fusion - The end of stage one

The last week has been a bit of a milestone week in terms of my recovery from the surgery. It's also caused me to pause and reflect about the whole process. So this post is really a brief review of the achievements and a little bit of reflection and recounting of my learning.
First the milestones. I had my 8 week review with the surgeon. That was great. Many surgeons only want to hear the good, mine however listened to and explored both the good and the not so good. We charted a path forward - with two more milestones - and we worked through a list of dos and don'ts. The next milestone is at 4 months. Until then I'm allowed to flex (bend forward) but I can't lift, pull or twist and I can only extend (stretch backwards) in a very minor way. I got to do my own shoes and socks for the first time in his rooms as he examined me - that was so tough! I'm also only allowed to sail on calm days for the next two months. The aim being not to fall on my arse until the bone has had a little more time to heal. The great thing was I got to chuck away the orthotic brace I've worn since the surgery.
I left the surgeon's rooms feeling buoyed up and positive.
On Friday of last week I finally finished all the opioid painkillers. I'd been going through a process of tapering those off and that finished on Friday. That also felt like a huge achievement and the pain - such as it is - is easily managed with some paracetamol. This is a hurdle that I'm told many people find hard. Indeed a fair proportion find it too difficult to get over the painkiller hurdle. So that felt like an achievement and I feel more energetic now that they have gone.
On the Sunday I drove for the first time in exactly 9 weeks. I refused to drive whilst on the opioids, even though there was apparently nothing to stop me doing so. I didn't feel it was right. I also liked being forced to walk everywhere I needed to go. Not driving kept me walking.
The actual driving part was easy - like riding a bike - once learned never forgotten. What quickly became clear was that it was going to be very hard to find a comfortable driving position. The actual process of driving and sitting in the car triggered off all sorts of pain and I'm still working on the best driving position.
Monday brought a return to work. That was easier than I expected. The drive to and fro was hard but the actual process of going back was easy, made easier because the work environment demands a lot of walking.
So what are the lessons?
Firstly, would I do it again? The answer is a resounding yes! I had substantial pain and very limited capacity to stand and walk prior to the surgery. I could only stand comfortably for less than 5 minutes, sometimes less than 2. Longer became intensely painful. I could not walk 150 metres. After the surgery I have virtually unlimited standing and walking tolerance and I have walked up to 7 kilometres at one go. That is a great change and it's kind of returned my life to normal. I caught myself looking for the next seat and the next tram the other day and laughed when I realised that it was an old habit and I didn't have to do that anymore.
Is it a miracle? No! I still have, and probably always will have, some pain and some lack of flexibility and function. Having had substantial back problems for nearly 30 years it's simply silly to expect one operation to wash that away like some magic wand. What I have got is hugely improved quality of life and physical function. What more could you ask for?
What would I do differently? My surgeon prefers simple walking as rehabilitation for the first 8 weeks. That however left me on my own and without a lot of guidance for those 8 weeks. My GP had little experience of rehab from this surgery so he couldn't provide much guidance. When I had a new pain, or spasm or pain was slow to go, I had nobody to turn to, nobody to help me understand what was happening and whether it was "normal" or worrying. To counter that I took myself back to my physio in the first week out of hospital and started very gentle strengthening exercises and some massage to relieve muscle spasm. She also provided very good guidance about how fast/slow I was recovering, based on the many patients like me that she sees. That guidance included letting me vent and deal with my anxiety when things didn't go well. In retrospect I should have asked my surgeon to write to her when he discharged me from hospital so that she was "part of the team" and knew what the surgeon expected.
The other thing I'd do differently is to get into the pool earlier. From 6 weeks I've been going to hydrotherapy sessions with a physio at a local hospital. These sessions are fantastic, they really aid strengthening and leave you feeling relaxed and flexible and tired. In retrospect I should have covered the one small part of the surgical incision that was slow to heal and got into the pool at 4 weeks - or earlier.
It's also important to understand that this is not just a physical challenge. It's an emotional challenge. At times I couldn't see how I would ever return to normal; I couldn't see how the pain would ever go away; I couldn't see how I would ever function "normally" (drive, tie my shoes, bend...); I couldn't see how I would ever return to work. I would get very depressed and emotional. I was also lonely. I spent most of my days walking alone or resting. I was alone with my thoughts most of the time, and when my thoughts turned dismal it was very hard to stay happy. A real blessing was ringing up my mates and arranging to have lunch with them. some weeks I had lunch with somebody every day! I don't know what they made of it, but it was a really important part of keeping me whole and happy and I thank them for putting up with me.
I think it was also much tougher than I realised on my family. Even though I had all these dark concerns about the future and about my recovery, I never felt overwhelmed by it, not after I left hospital. So for me ultimately it was a series of challenges that, in retrospect, were all pretty manageable. I've since found out how hard it was on my family and they didn't see it as very manageable for me. My wife has back problems. The other night I jokingly said to her that I could thoroughly recommend a fusion. She burst into tears, as a reaction to what she perceived I'd been through. Somehow I should have looked after them better. I'm never one to be stoic, I'd rather be truthful and accurate when someone asks how I'm going. Perhaps some more stoicism would have been better.
My final piece of reflection is that setting and knocking over goals is important and you need support for your goals and support to achieve them. For me, the biggest single challenge was to get the right strategy to taper the opioids without getting withdrawal. I didn't want pain and withdrawal together because I wanted to get it right and over with first time. I had a lot of support to get the right strategy and to implement it. The sense of achievement and of personal capability is really dramatic and in my view is the single most important step in my recovery - moving beyond artificial means to manage my pain and getting rid of the unwanted effects of the drugs.

Sunday, May 15, 2011

DX before Dinner

Last year, in a fit of boredom, I decided (for reasons still unknown to me) to go off and do my exam to become an amateur radio operator. I've been qualified as a marine radio operator for years and also have flight radio operator quals. I wanted to do my amateur license though. First off I did a two day course and got my Foundation license. This is an "operators" license and the lowliest of the amateur qualifications. It allows you access to limited frequencies and you are not allowed to make or modify your radio.
For a quite small amount of money I bought a second hand HF set and got on the air - I made my own antenna. The antenna was quite a challenge - we have no external area where we live - so I needed a compact solution. I found a simple antenna that goes on my roof, made with a 9 metre fibreglass squid pole and some wire. It works brilliantly.
A little later in the year, in a further fit of boredom, and as it turned out a fit of madness, I decided to upgrade to one of the other licenses. I targeted the Standard license which is an intermediate grade license - more frequencies and able to build your own gear. So off I went with about a dozen other souls. For 15 weeks in the depths of winter we sat in a freezing cold classroom for 4 hours on a Saturday afternoon. It was beanie, jacket, jumper and still cold kind of freezing! I toted around heavy text books and most of the time wondered if I was mad. It was all new to me and I could make very little of the electrical theory, transistors, diodes and other stuff at first.
When it came time for the exam I decided (in a further fit of stupidity) to sit the Advanced exam. This is the ultimate amateur qualification and gives you free run of all the amateur frequencies and privileges. I thought I'd give it a crack and if I failed I could still sit the Standard exam.
The exam papers are selected from a question bank by computer - a fixed number of questions on antennas, a fixed number on electrical theory, propagation etc until you have 50 questions. What that means is that, by chance, you can get a simple paper - all the simple questions in the question bank, a medium paper or a really tough paper, within each amateur category. When I opened the paper to read through all I could think of was "Beam me up Scotty". It was a bastard of a paper and I couldn't work out many of the answers. I seriously thought of getting up and handing it back and saying "I'll just do the Standard".
I decided to knuckle down and do it and knocked it off as well as I could in well under the 90 minutes allowed. It was marked on the spot. The pass mark was 70% and I passed with a modest amount to spare...who knows how!
I was relieved not to have to sit the Standard and also to know that I had, in the space of a few months (5 in fact) progressed from nothing to an Advanced license.
My main interest is HF. I find it very satisfying to use a piece of technology that dates from the late 19th century and use it effectively to communicate. DX refers to radio exchanges with distant contacts. There are many DX hounds out there who work furiously to fill their log books and to chase all the weird and wonderful places. I don't work like that. I enjoy switching on before dinner at night, just as the sun goes down and making a couple of contacts from somewhere interesting.
Tonight I spoke to Orlando on Grand Canary Island, last night Chris from Inverness in Scotland. I've spoken to people in Italy, Hungary, Spain, New Zealand, Hawaii, the Ukraine and many more.
I don't know why this old fashioned technology makes me happy, but it does. It's something about the randomness of the contact, the unplanned nature of who you might talk to, the difficulties of propagation over distances up to 20,000km, or the fact that it costs nothing to chat.
I looked at my mobile sitting beside the HF set as I talked to Orlando tonight. I could use it to call anyone anywhere with much better quality than the conversation I was having. But I never would have thought to call someone on Grand Canary and I wouldn't have known Orlando to start with.
I usually don't hang around too long - chat to a couple of people and then dinner. But it's very satisfying!

Eight Weeks, has it really been Eight Weeks?

The first week of this whole saga was spent in hospital and it was a bit of a blur, the days and nights seemed to fly by, and in retrospect I suspect a fairly heavy drug load helped that. Since then you've been able to read about the ups and downs here on a weekly basis. This is the last weekly update unless there's something pretty interesting.
This week has been all about reducing pain relief quite dramatically. By next week I'll be down to zero as far as the heavy duty pain medication is concerned. I've had some withdrawal symptoms which haven't been nice - mainly gut cramps. In reality they've been pretty mild so far.
I've continued my walking, but in line with last week it's been more moderate than earlier weeks and that's been good. Total for the week is 23.5 km. I also did another session in the pool - some walking and gentle exercise. I came out feeling like I'd done a work out but very relaxed and flexible. It was great and I think I could get addicted!
As in previous weeks I've had ups and downs with pain and discomfort. It's become clear that this whole saga has been a big success. I've gone from being unable to walk 150 metres 2 months ago to being able to reel off 7 km at a reasonable speed if I need to. That's success if ever I heard it. It's also clear that after having had various back pains and problems for most of my life - starting as a teenager in the early '70s - a single operation isn't going to solve all of that. One or two other levels in my spine that had previously been problematic but which were fairly settled before the surgery are now complaining again. I think that will settle down over time. The lumbo-sacral area of my back is best described as "fragile" at the moment. It's not hard to trigger off unsettling localised pain and discomfort - low key but annoying. I think a lot of that is about a few bits of titanium being buried there and the muscles needing to get used to sitting over and around that. It's too easy to focus on that sort of thing when you've just had major surgery. It's too easy to become a bit obsessive about things, so I've been trying to ride with that stuff and it generally passes after a few days. In addition I've got a 16cm scar from the base of my spine. That's become more of an issue over time, feeling slightly tight and "catching" at odd moments when I move. Again I'm trying not to focus on that and just working instead to maintain flexibility.
The things I still can't/haven't done are interesting: I can't put on my shoes and socks, mainly as I don't want to bend and twist enough to do that; I haven't driven for 8 weeks - I refuse to do that whilst on painkillers even though I think I'm quite OK to do it; I can't sit for long periods, though that's improving - up to about 20 minutes in the right chair; I can't lift and pull or push; I don't think I can sail yet and want to talk to the surgeon about that; I haven't flown - I can't get into the aircraft and the drugs prohibit it anyway.
So that's it. I've got a review with the surgeon on Wednesday and I'm planning to start work the week after. It is a good moment for thanks though: to my daughter who has faithfully put on socks for her ageing dad for most of the last 8 weeks; to Sandy in a local shop who smiled and got down on her knees to undo my laces one day when I got trapped in my shoes with nobody to help me get them off; to Maddy and Dan for the lifesaving Red Cross parcel of books - thanks guys you don't know how much I needed that; to the surgical team - you guys rock; to the nursing staff at 3LP - I couldn't have asked for more care and support and all with a smile; to my mates for enduring lunch with me when I needed company; to my neighbour for his words of wisdom; to my physio for holding my hand when it all got too much; to Chris for his wisdom and support; to Graham who'd been there before and was a calming force and full of great advice; and to my wife for all her support and for putting up with me at all!
It's been a real team effort and I can't imagine how much more goes into something like winning an Olympic Medal!

Tuesday, May 10, 2011

People Smugglers, Refugees and Confusing Push with Pull

There's a continuing misguided swirl of political rhetoric in Australia with respect to the role of "people smugglers" and the issue of "queue jumpers". I'm prompted to write this, in part, by an ongoing conversation on Twitter with @kristinmoore2 and @timhollo. 140 characters simply isn't enough sometimes.
Let's try to get some clarity through the middle of this highly charged argument. Firstly to the issue of refugees. That's what they are properly called. The Australian political rhetoric is all about queue jumpers trying to get to Australia quickly. This is a "pull" argument and is both fatuous and wrong. It relies for its validity on some view that the allure of Australia is so great that there are queues of people around the world with their eyes fixed on the shiny attractions of Australia. Under this argument arriving by boat is simply unfairly jumping these veritable queues and is not to be countenanced. People must be made to see that they cannot jump the queue. It's simply crap and what's most disturbing is that it only takes about 10 seconds of thought to understand that.
The alternative and accurate argument is a "push" argument. This argument says that refugees find the situation in their homelands so intolerable that they have little option but to seek an alternative place to live. The "push" arises through war, persecution, torture or other substantial perils in their homeland. People do not uproot themselves and look towards an unknown future unless there are huge pressures that close off all other options.
I go to sea in small boats a lot. Each time I do I focus intently on the safety of what I intend to do. If I'm not the skipper, I carefully evaluate the vessel, the skipper, the plans and make a decision about whether the safety meets my standards. I have on more than one occasion made a decision to stay on dry land.
Imagine being a refugee in the hands of people smugglers. These smugglers are business people: for a fee they offer to provide transport, by sea, from one point to another. From their point of view it's a one way trip for the boat - it very probably isn't coming back. So the boat is a cost and of course they must be sorely tempted therefore to scrimp on that cost. As a refugee, you get no chance to check out the crew, the boat, the plans, the safety equipment (should there be any). You simply cast yourself on the services of your chosen service provider.
I have met very few people of any nationality who do not have a care and concern for their own personal safety and that of their family, particularly their children. How must it feel to put your lives in the hands of someone whose motives and track record are unknown to you?
As @kristinmoore2 has pointed out, this issue of paid escape has a long precedent in recent history, no more so than in the run up to and during World War II. What is wrong with paying a service provider if you are under threat of your life and feel that you have no option to escape? Wouldn't you if faced with that choice? Of course you would. The lack of payment does not therefore lead to some moral high ground.
Please be clear however that I am not arguing that the people smugglers are shiny philanthropists. I am not making that point at all. I suspect that many are shady and careless of the lives of their human cargoes. Nevertheless their existence and the service they provide should be of no surprise to any of us.
What is most worrying is that both major political parties in Australia seem intent on continuing their false rhetoric about a "pull" theory with respect to asylum seekers. Please, let's all do away with that fiction and deal with the real issue: The world is in turmoil, much of it is turmoil on our doorstep. Indeed Australia is involved militarily in some of that turmoil. Under such circumstances refugees are part of what we should expect. People are being pushed from their land and the things that they know. They are being pushed into the hands of service providers they do not know and onto leaky boats for a perilous sea crossing. These are people under enormous pressure, displaying grit and determination that we should all show due respect for. We should expect refugees to arrive by boat and we should provide a proper and humane welcome to Australia for them.

Sunday, May 8, 2011

Week 7 - Up, Down, Up, Down...

After a pretty good week in Week 6 this week has been a bit of a mixture. Wednesday, Thursday and Friday were particularly bad days with a return to pain levels of a couple of weeks ago. The heat packs came back into use and my mood plummeted. I took things pretty quietly and just tried not to aggravate anything and it seems to be settling down.
I started the week pretty well with a long walk on Monday and a walk and a session in the hydrotherapy pool - my first - on Tuesday. The hydrotherapy pool was great, the water was warm and the gentle exercise with lots of my weight supported was great. Interestingly I clearly used muscles I hadn't used for some time as I could feel them the next day!
I'm not sure what caused things to go down hill later in the week but I found it particularly frustrating as I'd been going so well! Because of the progress in week 6 I'd also chosen Friday of week 7 as the day to start reducing my reliance on heavy duty painkillers. After a conference with my doctor we settled on a gradual reduction approach and the use of paracetamol as needed to take up any slack. Being stubborn I chose to continue with the plan and cut my daily intake by 25%. I've had to use paracetamol a couple of times to take up the slack but not in any continuous way. I also haven't yet suffered any untoward withdrawal effects from reducing the heavy duty painkillers. So that's all positive. Tomorrow I'm due to reduce intake by a further 33% so let's hope that goes as well!
Distance walked this week was 25.2 km which is a slight reduction on the previous week and reflects my "take it easy" approach over the latter part of the week.

Sunday, May 1, 2011

Six Weeks - It's Magical!

The physio has been saying to me "the magic date is 6 weeks." She doesn't really know why but she maintains that 6 weeks post-surgery seems to be a big milestone for people like me with a spinal fusion. Well guess what? I think she's right. I walked into her rooms this week and she said just two words: "New man". She felt that I looked different, was walking much better and overall looked like I was making big progress. I felt the same.
Today is 42 days post-op. I've walked 28.8 kilometres for the week, not including local jaunts and coincidental stuff around the house and up and down stairs. I still feel like my back aches a lot, I still have right buttock pain but it all feels much more controllable.
Immediately after surgery my weight started a slow but steady decline as I had reduced appetite and was increasing exercise. That decline had stopped, and indeed somehow in week 5 I put on 500 grams, much to my disgust. However the weight loss has resumed this week and I'm feeling good for it.
The remaining issue is sitting, I can't do that for very long at all and somehow I need to do that in order to return to work. Six weeks was always the target date for return to work. That's not going to happen but there's nothing I can do about that!
I also had an unexpected experience on Friday. I attended the funeral of a fellow pilot, killed in an air crash recently. I couldn't sit down for that long, so I stood for a bit over an hour. Standing still for an hour, however, reproduced an old back problem that I hadn't experienced for at least 10 years and which is not associated with the levels that I've had surgery on! Go figure that one!!
So in summary a really good week. Next target is to start to get off the last 2 painkillers that I'm on.