Let’s talk about sex – The Fiji Times

Improving the wellbeing of people participating in the Pacific Australia Labour Mobility (PALM) program is a priority for the Australian Government. Despite this, significant barriers remain for PALM participants in accessing sexual and reproductive health (SRH) services and information, including support for survivors of sexual and gender-based violence (SGBV).

Based on our collective experiences as researchers, service providers and educators, this blog outlines what we consider to be the key issues related to the sexual and reproductive health and rights (SRHR) of PALM participants during their time in Australia, along with five recommended actions.

Firstly, it is important to recognise that in most PALM countries, SRHR is a sensitive and taboo topic. Cultural, social and religious norms play a significant role in accessing SRHR care and information. Once in Australia, PALM participants may face a number of SRHR challenges, as listed below.

Access to SRH services among PALM participants is often hampered by factors such as lack of information, stigma, fear of judgement, limited access to technology or digital literacy, along with concerns about cost, language, transportation and confidentiality, for example when using translators. These issues are compounded by geographical and social isolation and cultural barriers.

It is difficult to find information about which SRH services are covered by PALM health insurance, or which providers offer free or subsidized services. For example, it is unclear whether termination of pregnancy is covered, so it is not surprising that PALM participants who receive abortion care have varied experiences with regard to cost, care, and navigation of service pathways.

There is also inconsistency around insurance coverage for pregnancy and childbirth. We know of PALM participants who have given birth in Australia with all antenatal and obstetric costs covered by health insurance, while others have paid thousands of dollars for hospital birth care.

Some participants have even been told by their employers that they have no choice but to return to their home country to give birth, despite having already served the 12-month waiting period for maternity care.

Power imbalances within the program, including the responsibility placed on approved employers to ensure the welfare and well-being of their workers, can leave PALM participants in a particularly vulnerable position. In the absence of independent support mechanisms, PALM participants may have little choice but to provide sensitive, private information to their employers, such as their pregnancy status.

At the same time, participants who have experienced SGBV in Australia may be reluctant to report violence and seek help, especially if they are unsure about their visa eligibility or if they are concerned about their safety and confidentiality being compromised.

Through our work, we have seen the physical, emotional, and financial impacts of these challenges on PALM participants. Unintended pregnancies, including those caused by rape, have forced some female participants to make seemingly impossible decisions, sometimes even hiding their pregnancies for fear of losing their jobs.

In many cases, women are excluded from their families and communities back home due to their pregnancy, and do not know where to turn for help. When participants do seek pregnancy and abortion care, they are often faced with exorbitant medical bills, often leaving them in financial difficulty.

With this in mind, we make the following recommendations to the Australian Government.

First, engage Pacific civil society organizations to provide standardized, comprehensive SRHR information to participants prior to departure. The International Planned Parenthood Federation has eight member societies in PALM-sending Pacific countries, several of which provide in-country pre-departure briefings and SRH screenings for PALM participants.

However, the pre-departure process can be overwhelming, leaving participants with little opportunity to seek advice on important health issues. Involving local organizations to provide standardized, comprehensive SRHR information to those in the “worker ready pool” phase would facilitate conversations about SRHR in a culturally sensitive manner and provide a point of contact for participants upon their return home.

Second, expand programming delivered by Australian health providers and organizations to provide culturally relevant SRHR education to PALM participants in Australia. True Relationships and Reproductive Health currently offers on-site educational sessions for PALM participants covering SRHR and respectful relationships, delivered by bilingual health educators, in single-gender groups and a culturally safe environment.

To date, they have reached over 1,500 PALM participants in Queensland, New South Wales, Victoria and Tasmania. 98.5 percent of participants agreed or strongly agreed that they understood information better when it was presented in their own language.

While this is an impressive number, tens of thousands of PALM participants have not yet received this information (currently there are 34,230 participants in Australia, 21 percent of whom are female).

Third, empower PALM-approved employers to better support their employees’ SRHR. Approved employers are required to provide PALM participants with information about local services when they arrive, including access to appropriate sexual health advice and local SRH services.

However, there is a need for employers to be better equipped to support PALM participants in accessing services and information related to SRHR, including reproductive health and SGBV. This could include training, standardised resources and tools that better enable employers to understand SRHR issues and refer their employees to services and support.

Fourth, provide PALM participants with up-to-date, accessible information about available SRH services and insurance coverage during their stay in Australia. PALM participants should know what services are covered by insurance in relation to sexual health, pregnancy, termination of pregnancy and childbirth, and where to access these.

While the Australian Government has developed a range of resources to assist participants in finding support and information (for example here and here), these resources need to be better contextualised, with an emphasis on free or insurance-approved services in each state.

Fifth, increase protection mechanisms, confidential welfare and support channels, and the capacity for PALM stakeholders to identify and respond to protection violations. Establishing an independent, confidential reporting mechanism is important to ensure that participants can report SGBV, sexual harassment, exploitation or bullying and seek support.

This includes ensuring that more Pacific Island women are involved in welfare and social support functions and establishing clear referral systems with approved service providers and crisis centres.

Tony Burke, Australia’s Minister for Employment and Industrial Relations, stresses that the welfare of Pacific and Timorese people in the PALM program is paramount.

Sexual and reproductive health and rights are essential to well-being and the Australian government can provide solutions to this.

The authors would like to acknowledge the contributions of Dolores Devesi and Tina Peau.

This blog links to ongoing research into safety and wellbeing and the PALM programme, including a 2023 ANU DPA report co-authored and subsequent research by Lindy Kanan, and a Masters thesis by Keely Moloney. This article also reflects the experiences of SRHR service providers in the Pacific region engaging with PALM participants.

This topic will be discussed at the Pacific Migration Workshop hosted by the Development Policy Centre on 3 September. Register now to attend online or in person at ANU’s Crawford School of Public Policy.

Disclosure: This research was supported by the Pacific Research Program, with funding from the Department of Foreign Affairs and Trade. The views expressed are solely those of the authors.

This article first appeared on the Devpolicy Blog (devpolicy.org), from the Development Policy Centre at the Australian National University.

•LINDY KANAN is a Senior Research Officer at the Development Policy Centre at the Australian National University. She is also a PhD candidate in the Sexual Violence Research and Prevention Unit at the University of the Sunshine Coast.
•KEELY MOLONEY is IPPF’s External Relations Coordinator for the Australia and New Zealand office.
•SERA RATU is a programme manager at the Reproductive and Family Health Association of Fiji.
•KALOWI KALTAPANG is Program Manager at the Vanuatu Family Health Association. The views expressed in this article are those of the authors and do not necessarily reflect the views of this newspaper.