Photo: 123rf
By national regional affairs reporter Lucy Barbour and Cath McAloon of ABC
- A new report has found many women employed in Australia through the PALM migrant worker scheme are not getting appropriate information and affordable access to sexual health services.
- The research highlights issues with access to contraception, antenatal care, abortion, STI screening and treatment as well as workers experiencing coercion, discrimination and gender-based violence.
- The Australian Women's Health Alliance is calling for urgent action to address the health needs of PALM scheme workers.
An Australian researcher has uncovered shocking accounts of workers employed on temporary visas hiding pregnancies, attempting home terminations, or spending thousands of dollars to access abortions.
Australian National University's Lindy Kanan has been investigating the experiences of workers from Pacific Island countries and Timor Leste employed in Australia under the Pacific Australia Labour Mobility Scheme (known as PALM).
Ms Kanan, a senior research officer, conducted dozens of interviews with PALM workers, employers and service providers about experiences of pregnancy, childbirth, contraception and sexual and gender-based violence.
The final report, titled "It's not illegal to be pregnant", has outlined systemic issues as well as incidents of PALM participants facing discrimination, coercion, hardship, harassment, assault and difficulty accessing appropriate and affordable health care.
Ms Kanan was shocked to hear stories of female workers attempting to terminate their own pregnancies.
Ms Kanan's report did not draw conclusions about how prevalent this practice was, but she noted she had heard accounts from more than one service provider working with PALM participants.
Access to legal abortions is limited in many Pacific island nations, and in some cultures, there is stigma and sensitivity around the subject.
The ANU report suggested a lack of information about the availability of local abortion services, fear of the costs, or a sense of shame could be factors pushing PALM workers to extreme alternatives.
The PALM scheme was originally established to fill worker shortages in rural and regional Australia, predominantly in agriculture and meat processing, while also providing income for Pacific and Timorese workers to send home.
More recently the scheme has been expanded to include aged care, hospitality, retail and tourism and a pilot is underway for the childcare sector.
However, the PALM scheme has come under significant criticism for putting vulnerable workers in danger of exploitation.
Pregnant workers facing hard choices
Trudi Beck runs a women's health clinic in Wagga Wagga and publicly advertises terminations of pregnancy in an effort to reduce abortion stigma and improve access in her local area.
She estimates a quarter of the patients she sees seeking abortions are migrant workers employed in horticulture, meat processing and aged care sectors who are in vulnerable situations.
"They're aborting because they need to stay in Australia and work, or because it's an extra-marital pregnancy. And even if they do continue, their health insurance won't cover pregnancy and birth," Dr Beck explained.
"While I support a woman's right to choose, I have a moral issue with visa structures that mean a woman has to choose between a pregnancy and supporting her family at home."
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Dr Beck said migrant workers were often in difficult situations with limited finances and a lack of access to affordable health care.
Some of those interviewed for Ms Kanan's report shared stories of PALM workers concealing their pregnancies due to shame, or concern that they would lose work and income.
"We saw low engagement with antenatal care because of that," Ms Kanan said.
"A number of employers that I spoke to [were] saying, 'we didn't know she was pregnant until she went into labour on the packing room floor'."
Taboo and shame holding women back from seeking support
Tukini Tavui is president of the Pacific Islands Council of South Australia, an organisation that has supported PALM workers in Australia since the scheme's early days.
He says sex and pregnancy outside of marriage remains a taboo in many Pacific Island cultures and this adds complications for women reaching out for assistance.
"I am aware of cases where some have attempted to abort a child at home, some even out in the fields, so there's some tragic, tragic circumstances," Mr Tavui said.
The ANU report included accounts of female PALM workers being subjected to sexual harassment and assault - particularly on sites where workers shared accommodation.
"It was very common to hear about male [PALM] participants using alcohol, knocking on the doors of women's accommodation at night and sexual assaults happening as a result of that situation," Ms Kanan said.
One service provider in Queensland was quoted in the report as saying:
"I support women who are referred for termination of pregnancies … the question that consistently we ask is whether this pregnancy was consensual sex, because I would dare say that most of the pregnancies for these women are sexual abuse.
"Who designed this scheme? Who decides that they're going to bring these men and women and put them together in an environment where there's no protection? It's a violation of human rights … you wouldn't have these women falling pregnant and not accessing health support [if it was designed properly]."
Mr Tavui said his organisation had been called on to support female PALM workers who had been pressured by their employer for sex in exchange for more work hours and income.
"I am aware of one [instance] where it has resulted in a pregnancy and the female had to leave to go back home because they were pregnant," he said.
Photo: RNZ Pacific/ Koroi Hawkins
Call for action to protect migrant workers
The need for support and protection for PALM workers has been identified as an urgent priority by the Australian Women's Health Alliance.
"PALM workers support Australia's agricultural and care sectors, yet they do so under conditions that routinely deny them access to Medicare, reproductive health care, and essential legal protections," it said in a statement.
"These harms are not incidental or infrequent. They are symptoms of systemic inequity that must be addressed through cross-jurisdictional policy reform in health, labour, and migration."
PALM participants do not have access to Medicare and are required to take out private health insurance policies, which generally have a 12-month waiting period for pregnancy and related healthcare services.
Ms Kanan's research found PALM workers who fell pregnant felt vulnerable due to uncertainties about their health insurance coverage, future income, employment, visa status and parenting options.
She heard of PALM participants not being covered by insurance for terminations or pregnancy care and facing bills of thousands of dollars.
Dr Beck said women who choose to proceed with medical termination of pregnancy, with adjacent services such as sexually transmitted disease screening, cervical screening and contraception, can face out of pocket costs of more than AU$1,200.
"This is a huge financial impost to these women," she said.
NIB is the federal government's preferred company contracted to provide private health insurance to PALM workers.
But the policy documents on NIB's website do not specify whether abortions or terminations of pregnancy, or any form of contraception, are covered.
The company works with the department and PALM scheme employers to provide education on sexual and reproductive health, but Ms Kanan said those opportunities were not widely available.
She recommended changes to remove the health insurance waiting periods for pregnancy services and said there was also a need for greater education among PALM workers about the Australian health system.
"We're expecting people to seek services the way that other Australians do when that's not necessarily how things are done in the Pacific," she said.
"So, I think we need more cultural sensitivity and more information and education around that."
Precarious situation for pregnant workers
Ms Kanan also raised concerns about some countries requiring PALM workers to undertake mandatory pregnancy testing before departure and called for that discriminatory requirement to be scrapped.
In a statement to the ABC, a spokesperson for the Department of Workplace Relations (DEWR) said there were "standard health requirements across most visa categories which seek this information" as part of the visa application process.
"Then when they are in Australia, I found that it was quite common practice for women to be sacked if they were found to be pregnant and sent back to their home country," Ms Kanan said.
Ms Kanan heard stories of women who "absconded" or ran away from their workplaces once pregnant, for fear of returning home due to shame or fear of compromising their health through manual labour.
The research found some employers did provide support for pregnant workers but many were unsure of their obligations and some admitted being hesitant about hiring women because of the expense and complications involved if they did get pregnant.
One employer said the PALM scheme wasn't set up for "major life events".
"Employers need better advice on how to navigate the employment contract if someone is pregnant," the employer in Queensland's horticulture industry said.
"[Employers] aren't ready… they don't know anything about pregnancy care for women … they think they need to terminate the employment contract."
The DEWR spokesperson said an interdepartmental task force had been set up to "identify strategies to better prevent, deter and respond to disengagement" among PALM workers.
"The wellbeing and welfare of PALM scheme workers in Australia is of central importance to the Australian government and its Pacific and Timor-Leste partners," they said in a statement.
They added that PALM workers were protected by the same workplace rights and laws as Australians, and were not required to report pregnancy to the department unless it affected their ability to work or in the case of a medical emergency.
The spokesperson said DEWR was working on a long-term plan to better support PALM workers while they were in Australia, specifically those experiencing gender-based violence.
- ABC
