Tag Archives: Society

City’s grief shows in bouquets of sorrow: Massacre in Bali

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On the steps of Parliament House it feels like the inside of a church. Trams clang past as always but knots of people stand still and silent, caught up in their own thoughts or prayers. Some read messages on the 2000-odd bouquets laid in memory of those lost in Bali.

“I didn’t even know you but I’m sorry,” wrote Carlie Nally of Frankston, who is six. The children of Heathmont Baptist Preschool made a big card “For those who feel sad” and signed it with their fingerprints in bright, splashy paints. A banner of white paper carries photos of the dead and missing and the line, “I am, you are, we are Australian.”
On Wednesday one woman stood on the steps and wept for hours beside an Australian flag she had posted herself. No one intruded on her to ask why. And no one approached the two women dressed all in black who laid their flowers yesterday, walking heavily with the burden of their grief. Melbourne mourns respectfully.

The Diana-like outpouring of flowers began after a caller to radio talkback host Neil Mitchell suggested flowers at the Shrine. A second caller, Mike Collins, suggested Parliament House was more central. “And if you look up Bourke Street, it’s a natural terrace,” he said yesterday. “I think people wanted to do something, and they didn’t know what to do.”

People do what they can. For media magnate Kerry Stokes, owner of Channel Seven, that meant offering his Falcon 900 jet to help fly the injured from Denpasar.

It made two trips, bringing back nine burns victims on Sunday and the remaining members of the Kingsley football club on Tuesday. “The surviving members of the team wanted to travel back together as a group,” a spokesman for Mr Stokes said yesterday.

At Parliament House the condolence books have been signed by more than 2000 people. There are wreaths from the Freemasons and the ACTU, from Indonesian language teachers and the plumbers and electricians union. The US consulate-general sent one with pink paper hearts; Garuda Airlines, a pot of fruit and flowers.

There are some from those closely hit: “To my beautiful cousin, Anthony Stewart. I love you so much and I am devastated that I may not see you ever again.” “To my Festa, may you rest in peace. I love you and miss you, but thank God for bringing you into my life.”

Many were laid by young people and some talk about holidays in Bali. But, while Australians feel for the Balinese, most are not willing to risk danger for them. According to travel agent Richard Ruskin, managing director of Bali Bound Holidays, cancellations are running at 80 to 90 per cent.

For him, the aftermath involves worry about the Balinese who will lose work and about trauma counselling for his staff. His reservation manager was in Bali the night of the blast and is badly shaken, he says, while his two local tour operators volunteered at the hospital. “Some of the things they have seen are atrocious; not being able to tell if a burns victim is Australian or Balinese, being there when they die from their wounds.”

Jeanette McCluskey is one of the 20 per cent who will fly regardless. The tragedy has made her even more determined to visit Bali with her 12-year-old daughter next month. Miss McCluskey, of Nunawading, has been four times in the past two years. “All the people are our friends there. We’re not deserting the Balinese, they need us now – and it’s not their fault.”

The most arresting tribute on the steps is a wooden statue. The man has Balinese features and Balinese markings on his clothes but he wears board shorts and carries a surfboard, a symbol of two cultures that might never again mesh in quite the same way.

As another card says in Indonesian, “Tidak bagus (not good).”

First published in The Age.

Meet Virginia, the woman some love to loathe

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A newsreader’s mid-life craving for motherhood has struck a raw nerve. Karen Kissane reports.

When Virginia Haussegger wrote about her grief at having missed out on motherhood in her race to a career, she did not expect a flood of responses.

Strangers in the street have said they felt sad for her (“Tears welled up in my eyes and I had to walk away”). She has had more than 70 letters and e-mails, a mixture of the savage and the sympathetic (“Even a few saying I’m praying for you”).

Many confirmed that she was not alone. “I had one woman who I’d worked with over 10 years ago almost in tears over the phone, saying I had no idea how much her story mirrored mine.”

Haussegger has also heard from parents with daughters her age who worry that they might never be grandparents because their daughters see motherhood as a second-rate option.

Haussegger, an ABC news presenter in Canberra, has been a TV journalist for 15 years. Two weeks ago she ignited a furore with an article in the opinion pages of The Age that blamed her “feminist foremothers” for the fact that she was childless as she was pushing 40.

Haussegger wrote that the women who had inspired her to believe that a career would be her greatest fulfilment in life had not warned her about her biological clock – the way her fertility would fade after 35 – because “they were all knocked up” by
their 20s.

The result, wrote Haussegger, is that women like herself who finally realise they do want children find that their chances of conceiving are slim.

Haussegger says she and her partner are reluctant to try IVF because the success rate is low. “As my brother said, `If you were a horse, Virginia, would you put money on you? Nah’.”

The response in articles and letters to The Age has been mixed. “They say the first sign of maturity is when you stop blaming everything on your parents. Grow up,” advised one reader tartly. “As for the biological clock – that didn’t suddenly drop out of the sky in 2002.”

Others pointed out that feminists have always written and talked about motherhood, which was devalued long before the women’s revolution. Still others have written Haussegger off as another gen-X whinger given the world on a platter but still bleating about the menu.

Haussegger herself has been fending off overtures from family-values conservatives who assumed she was a voice in their camp. “One radio commentator said I was a victim of Nazi feminism,” she said.

“I said no, I don’t feel I’m a victim. Certainly I’ve been a beneficiary of feminism. The point I was making about women in my generation is that somewhere along the line we have picked up a message that was devaluing of motherhood.”

She says she is now finding baby “hunger” intensely painful, “to the point where I find it very hard to look at babies. I find it very hard to look at happy family situations. I find I often have to turn away”.

Haussegger is shocked by how primal the longing is, so fundamental that it is beyond rationality. “It goes against everything I intellectually believed. I thought (deciding on motherhood) was about choice, but what I have found is that it chooses you.”

Her ache has not been eased by the sometimes bitter responses to her article about how motherhood corrals women. One woman wrote to The Age that motherhood had left her, at close to 50, with no job, no degree and no superannuation.

Another wrote that there were days she wished she had never had her children: “Can children redeem life’s pointlessness? If I can just get a leg up on this pile of laundry, nappies and paracetamol bottles to contemplate that metaphysical horizon, I’ll get back to you.”

Haussegger says she knows how hard it is to raise small children because she has watched sisters and friends do it. But she believes the fact that women still talk this way about motherhood says something about how society treats mothers. “Women have to make choices that are dramatically life-altering,” she says.

“By and large (parenthood) only causes ripples in men’s lives. It causes tidal waves in women’s careers . . . The sheer truth of gender is that women are forced into `either-or’ choices in a way men are not.”
Haussegger says that in her youth she did not absorb information about the biological clock because she was convinced she would never want children. Some of this resistance, she acknowledges, was because she was determined her life would be different to that of her mother. Her grandfather would not let her mother have a career, and she went on to raise six children.

Later, Haussegger learnt that television current affairs had little room for mothers. At one job interview, the prospective boss told her, “You employ all these women and before you know it they want to go off and have babies.” She says that as a result of her article, one family of five sisters, aged 22 to 32, is discussing how they must plan to fit children into their lives.

DEAR VIRGINIA …

Some of the e-mails sent to Virginia Haussegger after her article in The Age.

I just wanted to say how much I appreciated the piece and how I heard what you were saying – I heard some of the pain and I thought it would be dreadful to write such a thing and not at least have that acknowledged. These are painful discoveries.

My heart went out to you because you are exactly where I was a little over 11 years ago. Now 11 years later, my daughter playing in the background as I type this, the nameless emptiness has disappeared.

You are in my prayers for a little one.

What a perverse perspective, and how very petulant of you. I would expect as much from my 15-year-old.

Virginia, though the past cannot be undone I believe the future is full of possibility and hope.

Stop acting like a spoiled, immature brat and start aiming your darts where they belong. Show a bit of backbone.

First published in The Age.

Gaming: almost the end of a life

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When Bill Connellan’s sister Elizabeth visited him in jail in January he seemed “a bit like Toad of Toad Hall”.

Like Toad, Connellan had gone on a wild escapade. Only it wasn’t his friends he took for a ride, but the country’s largest bank.

Connellan, a loans officer with the National Australia Bank, cooked the books on his day job to feed his after-hours habit, a pokies addiction. Using breathtakingly simple scams, he extracted more than $1 million from his employer in less than two years.

Visiting her brother in jail just after his arrest, Elizabeth Fitzgerald found him “still very much in the performance and completely away with the fairies . . . He was very anxious to share the drama of being in jail”.

People such as Connellan, who was sentenced last week to five years’ jail, and Deidre Frederickson, a law clerk who stole $450,000 to feed her pokies habit, have highlighted the human cost of gambling.

Yesterday Frederickson was sentenced to five years in prison, with a minimum sentence of 30 months. At the same time, an extraordinary panel of people, including State Government ministers, the Reverend Tim Costello and industry figures such as Ross Wilson, the outgoing head of Tabcorp, met to discuss problem gambling.

Connellan, 44, is the youngest of six children, and his five elder brothers and sisters are all achievers. He had always tried to chase after their success, said his lawyer, Jack Rush. He used to big-note to his wife, Maddie, about his long absences from home, claiming he was doing important deals with clients.

He acted like an unfaithful husband, Mr Rush said, making up stories to cover his secret activities. He would claim he had been held up at rehearsals of the Gilbert and Sullivan opera society he loved, or that his car had broken down. With a flourish of life imitating farce, he once got out of trouble by telling his wife he had run over a pedestrian.

Mr Rush said: “It got to a stage where (he was gambling) six, seven days a week, on average four hours minimum a day, ranging up to 12 to 14 hours a day. It wasn’t infrequent that he would be going home at 7 o’clock in the morning, showering and then going to work, with the explanation that he had been with clients doing deals all night.”

Many of his “clients” were creatures of his own imagination. Connellan pleaded guilty to one charge of false accounting and five counts of obtaining a financial advantage by deception. Behind these counts lay two credit cards in a false name, 54 false bank loans and 40 false bank accounts. Connellan averaged a new loan every fortnight.

He was systematic. In April, 1999, he set up the first false bank account in the name of Robert John Quick. He had seen the name in a newspaper and chose it because they shared the same date of birth. He used the bank documents and cards from that account as identification to get a birth certificate in the same name. Then he used the birth certificate to rent a post office box that he used as the address for many of his fictitious clients.

He entered false loan applications into the bank’s “Autolock” system, knowing what assets and liabilities would be required to get an automatic approval from the computer. He was also meant to create a file for each loan and send it for checking to the lending services division. He did not.

As he drew on each loan, he sent some of the money to the Quick account for his own use. He would divert the rest to a false bank account in the same name as the false loan account and set up direct debits to make payments on the loan. He ultimately obtained $1,199,800, of which $244,563 went into repayments.

Withdrawals went straight from one machine to another. Connellan took money from automatic teller machines at gaming hotels and fed it instantly into the venues’ poker machines.

He bought himself nothing. His suits were his older brothers’ hand-me-downs. “This man was living in a rented house in Camberwell Road, the car that he owned was a 1984 Sigma, and he did not own any other type of real estate,” Mr Rush said. “The persons who have gained from Mr Connellan’s criminality have been the (gambling) establishments and, ultimately, the government.”

Connellan was caught only because a woman whose name he had taken from the phone book persistently complained to the bank when it sent her statements about a loan she had not taken out.

“Cases such as these before the courts, sadly, are becoming not uncommon,” Mr Rush said. “Twenty years ago, without the access of computers and without the access of, I suppose, carte blanche responsibility, with far more checks and balances, if one saw a bank employee stealing $30,000 that was considered to be a monumental amount of money. But . . . this matter went on for a protracted period of time.”

Putting Connellan in a bank was like putting a kid in a candy store. His gambling problems went back to his late teens, when he got caught up with illegal pokies in the Carlton area. He had two convictions for stealing from employers and one for having taken social security benefits while he was working. In 1996 he went into voluntary bankruptcy with debts of $40,000.

As with Toad, those who loved him had tried to save him from himself. Over the years there had been family meetings and family loans, his sister told the court.

This time they acknowledged defeat. Mr Rush said Connellan had not applied for bail because his family knew he would be jailed.

“How does a person get over such an addiction?” Judge James Duggan asked Ian Joblin, a forensic psychologist reporting on Connellan.

“Probably being where he is, unfortunately, your honour,” Mr Joblin replied. “He was deceiving his wife, he was deceiving his employer . . . there was no possible way leading up to the time of his arrest that this man was going to stop of his own resources. It could not happen. He had no conscience.”

But incarceration would not solve his emotional problems, he said. “The whole issue of why one needs to gamble in order to find stimulation and excitation in life, those are the issues that need to be addressed.”

He said Connellan would need coercive conditions placed on his release and should be supervised by the Parole Board for an unusually long time.

Connellan had come down from the artificial high that followed his arrest, his sister said. “I think it was a sort of defence mechanism . . . In the time he has been at the Port Phillip Prison he is a much more sober, more focused man who is, I think, seeing the fact that at 44, `What have you got to show for it? And if you don’t change, your life is virtually over.’ ”

THE PAIN OF ADDICTION

FRANK De STEFANO
The former Geelong mayor gambled away $8 million belonging to clients of his accounting firm. Mr De Stefano, 53, gambled mainly at Crown Casino. He will face charges in the Supreme Court in September over the missing money.

TRACEY ANN HENDERSON
The 32-year-old was employed as the AFL’s membership manager when she began siphoning money from the league in a scam that netted her $374,000. Over nine months Henderson wrote 20 suspect cheques that were used for gambling or to pay back “loan sharks” at Crown Casino. Sentenced to 18 months’ jail.

SAMUEL RODEN
Described in the County Court as a “pathological gambler”, Roden stole $1.3 million from his employer. Roden was employed as a financial controller by a family import business in 1996 but after seven months he began forging his boss’s signature on cheques made payable to himself. He was sentenced to 27 months’ jail.

NICK VLAHOPANAGOS
An addicted gambler who threatened to set off a bomb outside Crown Casino on May 13, 1998. He sold his wife’s car and his new utility and gambled the money away at Crown. He pleaded guilty to the bomb incident and received an 18-month community-based order. He was ordered to do 200 hours of community work.

JIE HUA YU
Played the pokies at the Ferntree Gully Hotel while her 19-month-old son Brian was dying in a scorching locked car on a hot day in a case that shocked the nation. Yu, 41, was sentenced in 2001 to four years’ jail for the manslaughter of her son but in an unusual move she was paroled almost immediately for a psychiatric assessment.

First published in The Age.

The blind prophet who fell victim to his own predictions

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Martin Stewart warned everybody that a catastrophe like this was bound to happen. He didn’t anticipate that it would happen to him.

Mr Stewart, 39, has been blind since birth, but he had lived a normal life. He has a wife, Katrina, who is also blind, two small children and a job that he used to travel to every day by train.

“Public transport is critical for blind and vision-impaired people,” he said. But he had always known of its dangers. For years he lobbied the State Government and the railways on the risks to blind people of injury or death on a system that no longer had guards or platform staff.

Then, in February, Mr Stewart stepped into what he thought was an open carriage doorway and fell into the space between carriages and on to the tracks at Richmond station.

Despite the desperate attempts of an onlooker to flag down the driver, the train took off and dragged Mr Stewart 200 metres along the tracks. The train tore off his lower right leg, his right arm and the top of his left ear. It fractured his cheekbone and ribs and left him with painful friction burns down the front of his body.

It could have been worse, he said. If the first person to reach him hadn’t been trained in first aid and staunched the massive bleeding, he’d be dead now.

And he’s grateful he hasn’t got brain or spinal damage. “If you want to believe in miracles, just look at me,” he said. “It’s a million-to-one thing that I’ve come out alive.”

He is determined to be positive – “the more determined you are, the more capacity you end up retaining” – but it has been a struggle. “When I woke up in intensive care, I thought, `There are people worse off than me. Don’t complain.’ Then I thought, `You’re close to the margin here. Where are the worse-off people?’ ” And he laughed, his humour genuine, belly-shaking and black.

But there are few laughs. He has wept a lot, mourning the loss of his limbs. He can no longer read Braille because he lost his dominant right hand. He hopes that an artificial leg will one day allow him to walk but for now he must crawl up 18 steps to get to the bedroom of his rented two-storey townhouse. “Keeps me fit,” he said.

Katrina has had to drop from full-time work to three days a week because he can’t help with the children or the housework; he can no longer hang out the washing or make up formula for baby Karralee, seven months. Their son Adrian, who wants to kick the train that took daddy’s arm and leg, is a feisty three-year-old.

Mr Stewart is not seeking sympathy but he is determined to do everything he can to ensure he is the last blind person to suffer like this. In the 1980s he worked with an advocacy group, People in Equality, Not Institutions, that unsuccessfully fought the loss of train guards and conductors because of the safety implications for people with disabilities.

They took cases to the Equal Opportunity Board and the Supreme Court and won, he said.

“But the government legislated around us”.

He said governments of both political persuasions hurt the public, and particularly people with disabilities, when they cut costs and staff. “If you’re running a swimming pool, there are lots of safety requirements, including that you’ve got to have people watching, but when it comes to trains you run it without having anyone watching on the platform,” he said.

Blind people also depended on loudspeaker train announcements, but these were often unclear or not made at all. In the months before his accident he rang the staff of Richmond station to tell them that announcements were crucial.

In the moments before he fell, Mr Stewart said he had been trying to find the train door and listen for another passenger who might be able to tell him if this was his train, as no announcement had been made.

Maryanne Diamond, executive officer of Blind Citizens Australia, said the association got about a call a week from a blind person who had had an accident on the transport system. Most were not reported to authorities because they did not involve injury, she said, but some blind people now refused to travel by train because they felt unsafe on stations.

She wanted all stations fitted with tactile ground surface indicators – long narrow grooves that indicate direction and lines of raised dots that indicate hazard. “It helps blind people walk in a straight line and prevents them walking off the platform,” she said.

A spokeswoman for Connex trains could not comment on Mr Stewart’s case as it was being investigated by the Transport Accident Commission. She said the company knew of two deaths involving people with wheelchairs and seven other cases of minor injury involving people with disabilities. One involved a blind man and his guide dog who walked off the end of a platform. She said Connex was working with researchers and disability groups to improve the system.

A government spokesman said yesterday: “Obviously this is a terrible tragedy. The government has already raised the issue with Connex and is investigating whether anything can be done to make sure this sort of thing doesn’t happen in the future.

“Government representatives will also be meeting friends of Mr Stewart next week to discuss the issue further.”

Mr Stewart faces months of rehabilitation. His wages are still being paid by his employer, the Royal Victorian Institute for the Blind, where he works as an industrial relations officer. The institute has also set up an appeal for the Stewart family.

“Blind people have been traumatised right across the country by this accident,” Mr Stewart said. “What in God’s name has to happen? Are our lives dispensable?”

First published in The Age.

The age-old quandary

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AGED CARE
You are 75. You break a hip in a fall and need surgery. While in hospital, you pick up a post-operative wound infection and develop pneumonia. Your forgetfulness intensifies into more serious dementia symptoms as you struggle to cope with the twin assaults of illness and a strange environment. You are now frail and will need weeks or months of care and rehabilitation; perhaps you will never go home again.

The hospital is not set up for convalescents and wants your bed for more urgent patients. Who will look after you, and how will it be paid for?

It is the kind of question that is central not just to your future but to Australia’s, according to Treasurer Peter Costello. This week he warned cabinet of a $50 billion-a-year budget blow-out in health, aged care and income-support programs within a generation unless the sharply rising costs of a greying population are curbed. A visionary attempt to grapple with the future – or an attempt to soften up the public for cuts to Medicare and social welfare?

“This analysis is scaremongering designed to frighten people into accepting public sector budget cuts when, in reality, they are probably not going to be required,” says Stephen Duckett, professor of health policy at La Trobe University.

But an administrator in a private hospital disagrees about the need for concern about the community’s ability to pay for the needs of older people. “Future horror scenario?” she says. “The system has trouble coping with the elderly now.”

In the next 40 years, the number of Australians aged over 65 will rise from 2.4 million to 6.2 million, with the proportion of older people doubling from 12 to 25 per cent. Towards the middle of next century, after the baby boomers have retired, there might be only 2.5 people of working age for every person over 65, compared to more than five people currently.

According to a report by Access Economics to the Federal Government, the number of workers and the level of income tax revenue is predicted to slow down from now; pension outlays will increase from 2010; health spending will rise from 2020; and aged-care demands will increase from 2030.

The figures sound daunting, and some researchers are warning about the necessity to budget for the needs of the elderly. Other analysts, however, say the outcome is unlikely to be dire, with many comparable countries already coping well with higher levels of older people. “Australia in 20 or 30 years’ time is going to be like France is now,” Duckett says. “We will be older, but we will be roughly the same as several European countries are now. These European countries aren’t bankrupt, so what makes us think that we’re going to be bankrupt?”

The current banner of the doom-and-gloom brigade is a landmark report due to be released by the government with next month’s federal budget. The Inter-generational Report by Treasury’s Retirement Incomes Modelling Unit is the first official government study of the future cost of current policies, and it predicts that advances in medical science that allow people to live longer will place a massive burden on taxpayers, mostly due to expensive new drugs and medical technology. The report is designed to trigger a public debate on the sustainability of existing health and aged-care programs.

News of the report came as the Myer Foundation announced a million-dollar project to develop a vision for aged care in Australia, and as the United Nations ended its world assembly on ageing in Madrid.

Greying is a global issue, says Professor Gary Andrews, of Adelaide’s Centre for Ageing Studies, who attended the assembly. He says developed nations face a significant increase in the very old (those aged 80-90), but ageing is also relevant to the developing world. “Already in a country like China you have more than 100 million people aged 60 and over,” he says.

While the details of the Treasury report are still under wraps, others have previously tried to estimate what ageing will cost Australia. Aged-care spending will more than double in real terms from 1997 to 2031, from $5.8 billion to $14.3 billion, warned a staff research paper by the Productivity Commission in October, 2000. But Australia will probably be richer and more able to afford it; even with relatively conservative estimates of gross domestic product, the report said, “spending grows by only about 25 per cent when expressed as a share of GDP”.

The report, Long-Term Aged Care: Expenditure Trends and Projections, predicted that nursing home beds would need to increase from 78,600 to 158,500 in 2031. But, while the aged’s health costs would rise in real terms each year to 2031, they would fall, relative to GDP, until 2021; by 2031, they will be 2.9 per cent of GDP.

Several health economists claim that the view of the elderly as a drain on health resources is wrong. Duckett has researched whether age is a factor in the cost of hospital stays, examining whether 70-year-olds cost more than 55-year-olds with the same condition. He found no systematic variation. “People think they should worry because older people stay longer, but in reality they often have substantially less investigation and interventions than younger people,” he says.

Andrews agrees: “The fact that more people are in their 70s and 80s and 90s has a relatively small impact on total health costs. A lot of research in the past decade (confirms) less than 5 per cent of the increase in health care costs is accounted for by the population ageing.”
Professor Jeff Richardson, of the Centre for Health Program Evaluation at Monash University, says it is not ageing itself that is the problem: “It’s ageing plus new technology.”

But another question raised by the Treasury report is acknowledged by many analysts as a problem: the ever-rising cost of drugs. John Goss, principal economist with the Australian Institute of Health and Welfare in Sydney, says: “The growth for the Pharmaceutical Benefits Scheme has been 9 per cent per year in real terms. If you have growth of 9 per cent, the doubling period is about eight years. It quadruples in 16 years, and it’s eight times (higher) in 24 years. It has huge momentum.”

An unknown factor in the future equation is the health status of the next generation of oldies. Does living longer just mean more years of disability and degeneration, or will increased life expectancy also mean more years of good health?
Duckett believes the latter. “The reason people are living longer is that they are healthier in old age. An 80-year-old in 20 years’ time will be healthier than an 80-year-old today.”

And it has always been the case that people usually chew up the largest amount of health care in the two years before they die, whether this is at 65 or 85, because that is when their health breaks down. “The general view across demographers and health planners is that the need for health care is not based on years from birth but rather is based on years to death,” Duckett says.

There is another, gloomier possibility. People who live longer because of a reduction in one disease might contract another that disables them; if you avoid the coronary at 70, will you face dementia at 72? The Productivity Commission report says advances such as artificial joint replacements and improved treatments for osteoporosis, arthritis and dementia might lessen disability among the aged. But technology might also increase the survival time of people with disabilities, the report says. “Dialysis for renal failure increases survival time, but the aged person receiving such treatment will still typically be unable to perform many tasks
unaided.”

Then again, disability does not necessarily mean institutionalisation. The Productivity Commission estimates that, while about 18 per cent of those over 65 have a profound or severe disability, only 3 per cent of old people are in residential care.

For some people trying to care for the aged now, the question of whether the future poses problems is nonsensical. There is already a national shortage of nursing home and hostel beds, long delays for elective surgery and cancer treatments, and problems with elderly patients acting as “bedblockers” in acute hospitals (too sick to go home, but with nowhere else to go).

“An acute hospital is not a convalescent home for looking after elderly people when they are not acutely ill,” says Denis Hogg, chief executive of Epworth Hospital. “But where do you refer them to for their on-going care?”

He denies that private hospitals cherry-pick to avoid bedblocking – “In our emergency department, 75 per cent of people admitted are over 75” – and he says Epworth has had to set up its own self-funded aged-care coordination team to try to find places for older people who need care following discharge.

“Step-down” care, between a hospital visit and home, is unfunded by private insurance and often unavailable, says Angela Magarry, director of policy for Catholic Health Australia. Like many other organisations, CHA wants aged care and health to be run by one level of government to prevent buckpassing of responsibilities and gaps in the system. CHA has also called for a Medicare “grey card” to be established to protect older people’s right to care.

Denys Correll, national executive director of the Council on the Ageing, agrees that Medicare should be strengthened and says problems such as the blowout in pharmaceutical costs can be managed by price volume agreements between the government and manufacturers.

Goss points out that anxiety over costs tends to ignore benefits: “There’s no need for doom and gloom if any increase in expenditure produces more benefits than costs in terms of older people being healthier, suffering less pain and having a lower chance of dying.”
An extraordinary number of older people are involved in the informal economy through their care of grandchildren, he points out.

“There’s often strong interests behind the position saying that `the world is falling apart’,” says John McCallum, professor of public health at the University of Western Sydney. He is concerned that an atmosphere of pessimism might encourage the belief that more health and aged-care services must be privatised if the government is not to go bust. In his view, “there are serious issues and they do have to be dealt with, but they’re not necessarily going to break the bank or destroy the Australian way of life”.

First published in The Age.

Feeling good, or bad, in a cloud of anxiety

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Psychologist Michael Kyrios has just seen his first patient with an anthrax phobia. “It’s someone who has obsessive-compulsive disorder and a lot of fears about contamination,” he says. “I was waiting for it.

“When AIDS became a big thing, a lot of people with obsessive-compulsive disorder would appear with AIDS-related phobias. They feared that they might catch it, or that they might be responsible for making someone else ill.”

The result in both cases is the same: patients obsess about safety with compulsive hand washing, repetitive checking or total avoidance of situations seen as risky. A Sydney GP reports that one patient blithely claimed she had no fear of anthrax because she was washing her hands 20 times a day. Australia is thousands of kilometres from the “Ground Zero” of the New York World Trade Centre attack, and all its anthrax scares have so far proved to be hoaxes. But the level of anxiety in the community has risen from the background hum of white noise to something louder and more insistent since September 11. We have been enveloped not in a cloud of bacteria but a cloud of emotion.

Doctors, psychologists and telephone counsellors say many people who were already struggling to cope have sought help because the news about terrorism pushed them into anxiety or depression. People are ringing Lifeline with sudden fears of tall buildings or enclosed spaces; Kids Helpline had a 400 per cent increase in calls following the twin towers attack; GPs report an average of five patients a day asking – mostly jokingly, they think
– about the risks of anthrax. Sales of emergency gear and gas masks have rocketed. Both the professionals and the retailers agree there have been twin peaks of the anxiety: the first few days after the towers crashed, followed by the days after Prime Minister John Howard’s announcement that Australia would send troops overseas for the war against terror.

But increased fearfulness is not the full story. There are at least two other elements in the nation’s emotional response to international terror, according to a wellbeing survey of 2000 Australians that asked them about their reactions to the September 11 terrorist attacks on New York and Washington. It found people were deeply saddened by the destruction and death, but that they had also become more satisfied with their own lives and with life in Australia generally.

Researcher Richard Eckersley helped produce Australian Unity’s National Wellbeing Index, released this week. He says disasters and the saturation media coverage given to them can lead to more psychological disturbance “but also to a national rallying and a greater sense of community and comradeship”.

He speculates that Australians feel better about themselves because the attacks have jolted people “out of the rut of everyday life – making them more aware of what they have and the preciousness of life”.

Ninety per cent of people surveyed said they had been saddened and 25per cent rated their sadness at 10 on a scale of one to 10: “That’s equivalent to the loss of a child or a partner, not usually something as general as this. It does suggest that quite a few people were very, very worried or distressed by what happened. And yet at the broad popular level, there has been this lift in satisfaction levels.”

The national wellbeing index rose 3.3 percentage points to 60.4 per cent and the personal wellbeing index rose 1.2 points to 74.7 per cent. The research echoes similar US findings: Americans are reporting higher rates of depression, insomnia and difficulty with concentration, along with higher satisfaction with their own lives and with their nation.

This is not as contradictory as it seems: “It makes sense in that people are responding to different questions. You can be saddened by the event, which is an emotional response, but still judge yourself to be slightly more satisfied with your own life, which is a cognitive evaluation.”

Dr Kyrios suggests Australians’ increased satisfaction might be a “post-hoc rationalisation”: “We need (to think) this in order to cope with that; we need to find meaning in order to cope with these horrible things happening around us.” It had been many years since the Me Generation questioned life: “This is something that wars tend to do, trigger a resurgence in the search for meaningful values.”

They also help detonate a resurgence of symptoms in people who have already suffered emotional trauma. Dr Bill Pring, psychiatry representative for the Australian Medical Association, says: “The terrorist event in the US has been a partial cause of a relapse or an actual episode of illness in some people.”
He says those at risk include people who have experienced warfare first-hand, such as soldiers and civilians who remember the World War II bombing of Europe, and anyone with lingering after-effects of peacetime traumas such as car accidents or domestic violence.

Many war veterans being treated for post-traumatic stress have become even more stressed, confirms psychologist David Forbes of the Australian Centre for Post-Traumatic Mental Health. “They’ve had more frequent nightmares and increased vigilance; they’re more conscious when they’re out of maintaining awareness about who is around them and what activities are happening around them, watching out for anyone that might look suspicious or have an intention to carry out harm. They wouldn’t want anyone standing behind them.”

Even children are not immune. The professional consensus is that children will take their cue from the responses of the adults around them. They did, says Kids Helpline’s Felicity Sloman. Callers in the week after the attack were worried because their parents had become so distressed – “If my parents need to be worried, then I need to be worried.” Calls are now back to normal levels, and anthrax is not a theme.

But most of the callers to Kids Helpline are teenagers. Primary school students are still anxious, according to Professor Erica Frydenberg, a psychologist in the faculty of education at Melbourne University. She says a class of teachers this week told her children are scared because they misunderstand. “They’re transferring the knowledge about what happened overseas to the possibility of it happening here. They think they are personally endangered.” Dr Kyrios adds: “Anything happening on TV could be happening outside as far as children are concerned.”

He says the ordinary person’s helplessness in the face of world events is freeing for some people; they just get on with their lives, realising there is little they can do. But others are comforted by taking action, however illogical, to protect against what they feel are their risk factors.

Alen Saynte is manager of Mitchell King disposals in Sydney, where gas mask sales have rocketed from two a month to 400. Customers have told him, “It’s OK for me, but my husband works in the city,” or “My husband works for an American company”.

The loss of trust in the environment makes people cling to the familiar. The tourism industry reports that more Victorians are booking holidays close to home. But the urge to circle the wagons has its downside. Ray Fritz, manager of Lifeline, says callers have been preoccupied not just with anxiety about the safety of themselves and their loved ones but with concerns about the future of community. The walls between in-groups and out-groups have been reinforced by fear.

“People who are on the edges of society – people who are homeless, who have some sort of disability or a mental illness or carers for those sorts of people – they’re expressing concerns that their links in the community are disappearing,” Mr Fritz says. “There seems to be a sense that people are caring less about those people who are on the edge and focusing more on the mainstream. One response of people who are fearful is to affiliate with those people they know best, so people who have trouble connecting anyway find it even more difficult.”

The political focus on “boats and borders” has made asylum seekers a clear “out” group, he says, and Lifeline workers have had to try to encourage some callers to be more tolerant. There has also been a rise in the number of employers requesting help with counselling staff who have been racially abused in the workplace, he says.

If politicians had wanted to link asylum seekers with terrorism, “(They) have succeeded. The issues are interlinked in people’s minds.”
Welcome to the not-so-brave new world.

First published in The Age.

The love that dare not speak its name

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KEVIN and Hannah like going into town together to do the shops and have a bite to eat. He loves her very much and buys her flowers and chocolates and takes her away for romantic weekends. They have sex every Saturday night – he’d like it more often, but she’s often tired from work during the week – and they don’t have to worry about contraception because she’s had her uterus removed.

They sound like your average child-free suburban couple; well, perhaps a bit happier than the average. But Kevin and Hannah have intellectual disabilities, so they live in a special accommodation house. This meant their romance had a rocky start under the stern gaze of staff charged with their care.

The first time they tried to sleep together, Kevin told La Trobe University researchers, “A staff member knocked on the door and found us together. She said, `Get into your own bed’. I didn’t like her much doin’ that, because we’re two adults and she should have let us do it.” Kevin and Hannah forced the issue: “We left one night and we had sex somewhere. When we came back they had a talk to us and they said, `You can move into a room together’.”

From Kevin’s point of view, he and Hannah were a modern-day Romeo and Juliet, with public servants playing the obstructive Montagues and Capulets. But the situation for carers is not so simple; they must try to balance the human rights to sexual expression of their clients with intellectual disabilities with the duty to protect them from hurt or danger. What if Kevin was coercing Hannah? What if one gave the other a venereal disease? Would their families be horrified to learn that their adult children with disabilities were having sex, and if so, whose moral values should prevail?
Kevin and Hannah’s story is one of 25 detailed sexual and life histories recorded in a report launched this week by the Minister for Human Services, Christine Campbell. The report, People with Intellectual Disabilities Living Safer Sexual Lives, was designed to follow up overseas research that found people with disabilities had much higher rates of sexual abuse and sexually transmitted diseases than others.

It said people with disabilities were often wrongly stereotyped either as eternal children who did not develop sexual feelings, or as potential risks to the community because they were unable to control themselves. One of the authors is Dr Kelley Johnson, research fellow with the Centre in Sex, Health and Society at La Trobe University. Johnson argues that carers’ anxieties leave them either denying sexuality is an issue, and therefore providing no education about it, or practising strict surveillance to keep it from being expressed.

She says lack of privacy forces disabled people to hide their sexual activity, lack of information leaves them having unsafe sex, and lack of education about their rights and the power dynamics of sexual encounters leaves them vulnerable to abuse.

The report tells of Hussein, who didn’t use condoms because the men with whom he had sex didn’t like them. When Neville was institutionalised, he was often sexually abused by male staff, but when he tried to form a relationship with a woman living in the institution he was severely punished. “He learned that abusive sexual relationships were condoned but
that other relationships were forbidden,” the report said. (The names of all the people interviewed were changed.)

Jennifer Evans is president of the Health and Community Services Union, which represents the staff of community residential units. She says decisions about how to deal with sexual matters vary from one unit to another. “I think it’s a matter of (a), recognising your own values and morals, and (b), working out how not to inflict them on the people you are working with. Some carers believe it is their role to be a moral caretaker as well. I don’t see that.”

Evans says, for example, that she disagrees with the department’s ruling that staff are not to facilitate brothel visits by clients: “Other carers would strongly disagree with me, but I believe I am there to facilitate that person’s integration into
the community in whatever way that needs to be done, whether it’s as a visit to a massage parlor or to a local coffee shop.”

But even Evans has been confronted with situations that have made her uneasy. One unit’s residents were all young people in their teens and early 20s who had grown up together in an institution. When they moved to a community residential unit they began sexually experimenting with each other: “Their relationships were almost what I would term (emotionally) incestuous…because they were all like siblings to each other.” She still offered them sex education and condoms.

One of the girls was later found having sex with her boyfriend on an oval in a park: “She considered that more private than her bedroom. If she brought the boyfriend home, then everybody in the house would know about him, but in the park, she felt that nobody knew her.” Evans does not accept the notion that some carers fail to deal with sex because it is too confronting: “I don’t think it should be any more uncomfortable than helping people with other aspects of life that we’re not normally confronted with, like assisting them in the toilet or the bath…I think it’s more to do with the fear that if something happened, staff will be responsible for whatever goes wrong. I have worked with staff who have a very protectionist kind of attitude towards residents and don’t allow them to make mistakes they might learn from.”

A complicating factor in protecting them from abuse is that sometimes fellow residents are sexual offenders. “One chap in particular was very predatory,” Evans said. “He actually wanted to go back to living in institutions, where he had been abused himself and then became an abuser, because living in the community curbed his behavior. He used to say, `I’d get the ones who can’t speak because then they can’t do anything about it’.” Evans said it was decided he was never to be allowed out without a staff member, and other residents’ bedroom doors were alarmed at night to keep them safe.

For Johnson, the most striking thing to emerge from the research was that the yearnings of people with disabilities are just like everyone else’s, even if their chances of fulfilling them are lower. “Most of the people in the group we talked to desperately wanted close, intimate, loving relationships with somebody else. And that was really difficult for them to find because of the ways their lives were constrained and because of the kind of rejection they experienced from the community.”

Kevin is determined to hold on to his Hannah. “The only one I want to spend all my life with is Hannah. I love her that much. I don’t want to lose her,” he told researchers.

“I’m hoping to marry Hannah one day. Yeah. Hoping to.”

Also see: Marriage, Love, Sex … Not a Disability

First published in The Age.

Marriage, love, sex … not a disability

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Sarah has sworn off men since she became a single mother. Tom uses massage parlors because he doesn’t know how to meet women. Luigi, who prefers girls, believes that toilets are the place where sex happens because that’s where men ask him for it. Alicia has been happily married for five years.

All of these people have intellectual disabilities. Their stories are told in a report to be released today that concludes that community attitudes leave many intellectually disabled people vulnerable to rape, forced to lead secret sexual lives and practising unsafe sex.

The report, People with Disabilities Living Safer Sexual Lives, contains the detailed histories of 25people interviewed by La Trobe University’s Australian Research Centre in Sex, Health and Society.

Researcher Kelley Johnson said the project was partly in response to British findings that about 70per cent of women with an intellectual disability had experienced sexual abuse, and that both men and women in this group had a higher than average rate of sexually transmitted diseases, including HIV/AIDS.

Of the 25 people interviewed for this study, 18 (11men and seven women) reported sexual abuse. This occurred while they were in institutions, in independent or supported living in the community, or while they were living with their families.

Many still had active sexual lives and wanted a long-term relationship. Some had found partners and had children; one woman was lesbian and one man was gay.

Dr Johnson said the understandable anxieties of carers and families of disabled people often led them to deny sexuality was an issue or to try to prevent sexual activity. This violated human rights and drove the behavior underground.

“That doesn’t just happen to people with disabilities; it happens to the young and to the elderly, too,” she said. “People who have been married for 50years are often separated if they have to enter nursing homes.

“But for people with disabilities, the surveillance is life-long. Service providers and families are very concerned about safety and protection, which is of course legitimate. But the problem is the way it is often managed; people didn’t let them have information for fear it might lead to experimentation, or sometimes disabled people were just told, `This is not part of your life.”‘

Some disabled women were forbidden sex because of concerns about pregnancy, Dr Johnson said. “Some of them said, `Well, my mum didn’t want to have to raise another child and she thought she would (if I had sex),’ or `Mum thought if I had a child it would be like me.”‘

Janice Slattery and Amanda Hiscoe, who both have an intellectual disability, were members of the reference group advising researchers (they were not among those interviewed for the study). Mrs Slattery agreed that carers have to learn that “people do have their own freedom as well as being protected. There’s too much protection. They don’t get the correct information to protect them from sex, and they have to learn the hard way and that can be scary for them.”

Mrs Hiscoe said she hoped the project would force the rest of the community to take off “the horse’s glasses” (blinkers) they wear when looking at people with disabilities and realise “they deserve the same respect and same dignity and same rights
as being the very so-called normal people”.

The best outcome, said Mrs Slattery, who has been married for 15years, would be for a more open approach to “give other people with disabilities the opportunity to achieve what we’ve achieved; a happy marriage”.

The study recommended that services for disabled people develop policies in human relationships and sexuality, and that professional carers, families and people with disabilities be offered education about the issues.

The report was funded by the Victorian Health Promotion Foundation and will be launched today by the Minister for Human Services, Christine Campbell.

Also see: The Love That Dare Not Speak Its Name

Ending the affair WOMEN AND GAMBLING

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GABRIELA Byrne remembers first hearing about Jie Yu, the mother whose toddler died after being left in a hot car while she played the pokies. Byrne shivered to think that it could have been her. Even more painfully, “When my daughter heard it, she said, `It could have been me.”‘

Byrne used to be a problem gambler. For four years from 1992, nothing else mattered to her when the urge hit. “I picked up my kids one day; my son was at preschool and my daughter in the first year of school. It was a hot day. I had this voice saying to me, `Oh my God, today you can’t gamble,’ because my husband was interstate at work and I had the kids. And then this voice said, `But you need to go, just for five minutes.”‘

Byrne left her children in a car across the road while she played the pokies at a local hotel. She was gone only 20minutes, “probably because I ran out of money.

“But it doesn’t take 20minutes for a child to get out of the car and run across a busy street and get hit. (Another gambler I know) put her son to bed, he was three at the time, and she left him to play the pokies. When she came back at 11.30 or 12 a neighbor had him because he had been running out on the street screaming for his mum.”

News of the death of Jie Yu’s son, toddler Brian Yao, in February last year was splashed across newspapers and television reports. Even Prime Minister John Howard felt impelled to comment on the tragedy. A Supreme Court jury recently convicted Yu of manslaughter and she is awaiting sentence.

But while Brian Yao’s fate seemed extraordinary, the circumstances that led to it are frighteningly common. Researchers have known for years that women who become “hooked” on pokie machines lose their sense of time while they are playing and become oblivious to the demands of normal life.

“I think there’s the potential for it to occur again,” says Julie Nelson, coordinator of Gamblers Help Northern, of Brian’s death. Nelson says more than 50,000Victorian women are now “addicted” to poker machines, and women make up 52per cent of problem gamblers calling Gamblers Help. The Productivity Commission has estimated that 1.1per cent of the population has severe gambling problems, and 2.3per cent have serious problems.

Women who are compulsive pokie players commonly feel the sense of timelessness and tuning out from the normal world that Yu experienced during the two-and-a-half hours that proved fatal for her son, according to Victorian Government research.

Playing for Time, a study by the Department of Human Services into the impacts of gambling on women, says: “Many women have reasons to be attracted to the sense of timelessness, ritual or even distortion of thinking that may arise during long episodes of play. It gives an opportunity for respite, a chance to change `the present’ by replacing it with oblivion.”

Says Nelson: “The product has a very mind-deadening effect; you can switch off totally, you can absorb yourself in the flashing lights and the continuous play.”

The effect is so intense that in problem gamblers it can interfere with otherwise powerful parenting instincts, says Helen Carrig, manager of Relationship Australia’s South Australian problem gambling service. “Women, in particular, are programmed to look after children, so when a mother forgets her child or puts gambling ahead of her priorities in terms of purchasing for the household, that tells you something very serious is going on for her.”

This is not news that all politicians have been keen to disseminate. The Playing for Time report was gagged for two years by the previous Kennett government, according to one of its contributors, Ainslie Hannan. Hannan, who is also chairwoman of Women’s Health in the North, says: “They wouldn’t let the research be launched. It was completed in 1998 but was finally launched in March, 2000, by (Labor minister) Christine Campbell.” Playing for Time found that women gamble for many reasons: loneliness, boredom, anxiety, depression; to escape the relentless demands of family, or because they have financial or relationship problems. Many women who start as “normal” social gamblers develop a problem with it if there is a big change in their lives: if they lose a job or a partner, if children arrive or leave home, or if they experience some kind of tragedy. Psychiatry labels problem gambling an “impulse control disorder”.

There are similarities between men and women with gambling problems but they tend to gamble for different reasons, says Nelson. “We see more men gambling for a competitive edge, whereas women are more likely to be filling in time or to relieve their mind of pressure… using it for emotional pain relief.”

Once an obsession with poker machines develops, it has all the hallmarks of an affair, says Helen Carrig. “They no longer think about their partner; they think about the machine. The effect on relationships is exactly like having an affair: there is deceit, preoccupation, and time and money spent away from the partner and the relationship.”

Byrne, who now counsels problem gamblers, agrees. “I always refer to my time as a poker machine addict as my hot passionate love affair with George (as in Tattersall). It had a lot of characteristics of an affair; the lying, the cheating, the putting of a lot of your needs or wishes on to something or someone else. You lose all sense when you have an affair like this.”

For some women, the relationship with poker machines mirrors the dynamics of an empty or abusive relationship they have in real life, says Jeanette Wentzel, a counsellor with Gamblers Help Eastern. “It’s like another person they have to feed and cosset and give something to, another thing making demands on them.”
Byrne says problem players experience adrenalin highs while playing, followed by depressive lows that send them back to the pokies for another lift. Kate Earle, a psychologist and researcher, says tense people use the pokies as a tranquilliser and flat people use them as a stimulant. “It’s an avoidance mechanism for a lot of people. We can only stand so much reality,” she says.

This leads to the question raised by the gambling industry before a recent Productivity Commission inquiry. Industry representatives argued that problem gambling was the result of people with problems who gambled, rather than something that was caused by gambling.

But the commission concluded that, for many gamblers, pre-existing problems do not appear to trigger problem gambling. It also said scientists have been unable to identify an “addictive personality”. “While some factors may predispose a person to gambling, there is little evidence that problem gamblers share common personality traits, which suggests, in turn, that anyone can, in the right circumstances, become a problem gambler,” it found.

Women seem particularly vulnerable to poker machines. “Men certainly haven’t taken to poker machines in the same way or so rapidly,” says Alun Jackson, professor of social work at Melbourne University.

Research suggests this is partly because there are few recreational spaces in which lonely or isolated women feel as welcome, comfortable, anonymous and safe as they do at pokie venues – and such venues are now common in many suburbs, sharing the same areas women have always frequented for shopping. The gaming venue where Brian Yao died is next to a supermarket.

“Women describe (pokie playing) as one of the few times that people don’t ask them who they are. People who look different aren’t questioned,” Hannan says. “Women also feel that (gambling) is one of the few things in their life that’s just for them, and with that comes a sense of freedom and a sense of false control.”
Sometimes, there are few recreational alternatives. “Take Sunbury,” says Nelson. “It’s a commuter suburb. Partners are at work from 7am and don’t get home till 7pm, and that’s a big day for women to fill. But nearly every community venue, such as the bowling club, has gaming machines. There are five main community meeting places and they all have gaming machines.”

And sometimes women are directly targeted in marketing campaigns. Byrne says: “I know of a pub in Oakleigh that for a while, until we sent a TV crew there, was giving women vouchers for milk and ironing. If you go there and spend $20 you get half an hour’s ironing from somebody. They are especially targeting women and social security (recipients).”

Compulsive gamblers and their counsellors have suggested a range of measures to ease the problem. They include interruptions to play and reminders to players about how much time has passed and how much money has been lost; education programs, including warnings in venues about the possibility of “addiction”; and alternative avenues for play, recreation and creativity for women.

Byrne is now cured of her gambling obsession, to the point where she can go into pokies venues without feeling tempted to play. “It’s like it is with an old passionate love affair. If you run into an old flame, the one you thought you could not live without, you look at him and you think, `God, what on earth did I ever see in him.”‘ Her voice is suddenly joyous: “It’s not me any more. I don’t know what I ever saw in it.”

But she knows that she can never replace what she gambled away. Byrne lost a job and many friendships – and came close to losing her marriage – before she was able to break her addiction. “My daughter and my son are very educated about this; I think we have a very, very close relationship. But I missed four years of their growing up. And that’s something nobody can give you back, even God.”

The personal costs

* Problem gambling causes 29,000 divorces or separations each year.

* One in 10 problem gamblers contemplates suicide and up to 420 suicides a year can be attributed to gambling. Each year 49,000 people suffer depression “often to always” as a result of their problem gambling.

* Problem gamblers each lose an average of $12,000 a year; their total losses are $3 billion a year, making them one-third of the gambling industry’s market.

* For every problem gambler there is, on average, one associated child living in the same household.

* American research has found that children of problem gamblers are more likely to be depressed, drop out of school, smoke, drink, take drugs, and gamble.

Source: Productivity Commission

Also see Gambling with Life and Ending The Affair

First published in The Age.

A gamble with life

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Jie Hua Yu looked blank when the police first asked her about playing the pokies. “Pokies?” she asked, in her uncertain English. “What – what do you mean?” It seemed she had been in Australia long enough to have discovered this consolation of the lonely, but not long enough to know its name in the local lingo.

It was midnight in a homicide squad interview room. Yu hadn’t slept for 36 hours. She was there because her son, 19-month-old Brian Yao, was in intensive care. The previous day, February 16, 2000, she had left him in a hot car for two-and-a-half hours while she played poker machines at a local hotel.

On the police video tape of that interview, played in court last week, Yu looked weary but relaxed. She even laughed a couple of times. It was if she didn’t yet understand the gravity of the situation: her son’s, or her own.

On February 22 last year, five days after that interview, doctors at the Royal Children’s Hospital pronounced Brian dead. Yu was charged with having killed him.

It seemed to be a different woman who appeared on a charge of manslaughter in the Supreme Court dock last week. This woman wept; not noisily, but often. Whenever the events surrounding her child’s death were raised, she cried, her face crumpling like a child’s. Then she would rub at her eyes with a handkerchief, fiercely, as if trying to scour away the grief.

The gambling problem that was to take her son’s life began long before he was born, a psychiatrist told the court. Yu, now 40, arrived in Australia from China in 1988 and married her husband, waiter Benny Yao, the following year. The psychiatrist said her “very significant” gambling difficulties began after she left work to have children.

The eldest of her three children was seven when Brian died; the youngest, three months.

Ruth Vine, deputy chief psychiatrist for the state of Victoria, said: “There was certainly an element of loneliness and lack of socialisation in Mrs Yu’s life, in that she had very little contact with non-Chinese-speaking people, particularly following the birth of her children and her removal from the workforce … the setting in which this initiated.”

The doctor said Yu was an intelligent woman whose problem had reached the point where she was almost constantly preoccupied by the thought of poker machines: “Although she probably only actually attended such venues two or three times a week, nonetheless the thought and the preoccupation, and a sense of anxiety and guilt and apprehension, was with her on a far more frequent basis.”
Dr Vine said problem gambling was classified medically as an impulse-control disorder, such as shoplifting. People suffering from it used gambling “as self-treatment for depression, looking for excitement, to calm down – it has all sorts of different (causes)”.

(For legal reasons, Dr Vine’s evidence was ruled not relevant and was not presented to the jury. The comments reported here relate to a voir dire examination before the judge, the purpose of which was to help determine the legal relevance of her medical evidence as to Yu’s state of mind.)

Dr Vine said Yu’s husband had become concerned about her gambling to the point where he had got rid of her Visa card.

That fateful Wednesday morning, Benny Yao was asleep after having finished work at 2am. Jie Yu got up about seven, fed Brian and his school-aged brother, and pottered about until it was time to drop her older son at school.

Then she returned home to get money for shopping. She entered the house briefly and took $150. When she returned to the car, Brian was asleep. So she decided instead to go to the Ferntree Gully hotel, which has 90 gaming machines.

“I was going to go in there for 20 to 30 minutes,” she told police through an interpreter. “… I thought, `I will just play for a while and if I can win $8 or $10 or something, then I can shop for more things’.”

She parked her red Toyota Camry in an area of the car park that had no shade and wound up the windows so Brian would not be abducted. She left him asleep, in his polycotton pyjamas, strapped into his child harness.

Inside, she “did one round” to see which machine was “good”. “Then I played with one machine for some time and then I didn’t win and then … I go and do the same thing with the other one.” She sometimes looked through a window to check the car, “but I didn’t go into the car to check … I thought that I was lucky and he was still asleep”.

In fact, Brian was developing heatstroke, a condition to which children are far more vulnerable than adults. Children’s bodies are not as effective at regulating their temperature and they have a higher metabolic rate. And small children, as the prosecutor pointed out, cannot remove themselves from safety harnesses or locked cars.

Scientists later determined from tests that if the temperature outside is 24.7, the car’s interior will be 35.1 degrees; and if it is 28.8 outside, the inside can reach 59 degrees. But Yu was inside in air-conditioning, unaware of the rising temperature or even the passage of time. Dr Vine said: “Mrs Yu described a state of mind at that time that is very common in persons who have a preoccupation with gambling in that she was entirely – entirely – focused on the activity at hand … and I think it’s recognised that the (environment) in which many poker machines are kept tends to be one where there is an encouragement for that focus to develop …

“I am not going to say she had an altered state of consciousness, but an extremely focused attention that was only cognisant, really, of the machine in front of her.”
To that extent, the doctor said, she was “unaware of her son or the car or the day”.

Reality returned with the arrival some time after 11.30am of her husband. Hotel staff saw him talking to her angrily in the foyer. A gaming-room attendant, Val Miles, told the court Yu was “certainly cowering” as her husband upbraided her. Yu later told police through an interpreter: “He said that I was having fun by myself and leaving our son in the car.” Yu said she thought she had been in the gaming room for only 20 or 30 minutes.

Mrs Miles said she watched the couple leave. When they reached the car, “the gentleman hit the lady across the head. They seemed still to be arguing”.

When the parents found the child unconscious, they took him straight to the local Angliss Hospital. Doctors said he was cyanosed (blue) and convulsing, with a dangerously high temperature of 42.3 degrees (a normal temperature is between 36 and 37.5 degrees).

Pathologist Matthew Lynch, who performed the autopsy on Brian, said: “(Heatstroke) is the end stage of the temperature going up and the body losing the capacity to bring it down. When it gets to that end point, most of the important systems of the body start to malfunction.” Dr Lynch said this involved severe brain injury as well as problems with the heart, lungs and kidneys. “And these problems will compound each other. The situation often just gets worse and worse.”

In his summing up, the prosecutor, Paul Coghlan, QC, built a quiet but inexorable case against Yu. He pointed out that love and negligence are not mutually exclusive; that negligence arises because we have a duty of care to others; and that the duty of care of a parent for a small child is one of the greatest. He said that Brian’s death was an inevitable and foreseeable consequence of his mother’s conscious actions, and that two-and-half hours was an inexcusable length of time to have left him in the car. He asked the jury to set a community standard on the issue.

He spoke soberly, without aggression. “There’s no joy in this case. There’s no joy for me as a prosecutor, no joy to say that this is a case in relation to which a determination has to made about a mother in these circumstances. (But) it’s about the enforcement of law as we understand it in this community.”

The defence counsel, Brian Bourke, appealed for the jury’s sympathy with Rumpolesque eloquence. He quoted at length the British writer G.K. Chesterton on his experience as a juror, including his dismay at the way lawyers and judges and policemen lose perspective: “`This is the reason for the jury system. Strictly, they don’t see the prisoner in the dock … They only see their own workshop…”

Mr Bourke suggested it was the gambling industry that should be on trial. The jury should remember the accused as a good and caring mother, he said.

“Put yourself in her position for one minute. She will live with it to the end of her days. Regardless of what is said by this jury, what verdict you return, she will bear that, and she needs no verdict of yours to appreciate and realise the enormity of this sort of conduct.”

The jury took only two hours to find Yu guilty. She has yet to be sentenced. Justice Bernard Teague indicated that he would impose jail only if it were necessary to allow Yu to access the supportive supervision available to those on parole.

In the end, the law had viewed the child’s death with gravity and the mother’s life with compassion.

First published in The Age.

Also see The End of The Affair.