In the weeks before her death, Sadif Karimi made repeated calls to a domestic violence hotline. She was told she was no longer a client. By Martin McKenzie-Murray.

Exclusive: How our crisis hotline failed Sadif Karimi

Hazara woman Sadif Karimi.
Hazara woman Sadif Karimi.
Credit: Supplied

People on the street heard the screams. Running from his house, Daniel McCready entered his neighbour’s yard and saw a flaming jerry can. He could smell petrol and singed hair. Inside the house, he found Sadif Karimi – still alive, but suffering what would soon prove to be fatal, full-thickness burns. On that evening, February 3 this year, the house in Cranbourne, in Melbourne’s south-east, which Karimi shared with her husband and his parents, was also occupied by two nieces and Sadif’s sister-in-law. In another room lay Sadif’s six-month-old baby. Later, McCready would tell The Age that Sadif was eerily calm. “I don’t know if she was scared or distressed but she was just so calm.”

The family was weeping, coaxing Sadif to drink from a glass of milk. McCready yelled that she be placed in the shower, where she stood silently. McCready’s wife, a nurse, arrived shortly after. Then paramedics. Sadif was taken to intensive care at The Alfred Hospital. She died three days later.

The family told friends and neighbours – and later police – that Sadif had immolated herself in the backyard. A 22-year-old Hazara woman, she migrated to Melbourne in 2015. Through an arranged marriage, Sadif was culturally bound – and dependent – upon her in-laws. Sadif spoke no English, and some who knew her say she suffered extreme loneliness.

The Saturday Paper has learnt that in the months before her death Sadif Karimi repeatedly engaged the Victorian domestic violence service Safe Steps. In November she was placed in emergency accommodation. The Saturday Paper is not suggesting that anyone in her family is responsible for her death.

Sadif’s first contact with Safe Steps, in November, followed a referral from WAYSS, a homelessness service for women. Sadif was at a local police station when the call was made. For hours before she had been wandering the streets, cradling her child.

Sadif was assessed by Safe Steps as high priority. For approximately a week, she and her young child lived alone in emergency accommodation. During that week a family violence safety notice hearing was scheduled. It was listed for November 29. Unable to provide a translator, the court postponed the matter. Having come into Safe Steps’ service, usual protocol obliges a daily telephone call. Sources tell The Saturday Paper that this didn’t occur.

On December 4, Sadif decided to return to her Cranbourne home. “That’s all she knew,” a source said. “She knew nothing but being with this family. And what was culturally appropriate was staying there, no matter what.”

Sadif’s return home meant her official disengagement with Safe Steps. The organisation’s chief executive, Annette Gillespie, emphasised that Sadif’s death did not occur while she was a client of the service. But her death continues to haunt staff, who allege that it wasn’t properly handled, that there was inadequate attention paid to its effect on staff, and that the sorrowful case highlights the troubled culture in the sector.


The Saturday Paper is not suggesting Safe Steps is responsible for Sadif Karimi’s death. Even those most critical of the organisation know directly the extraordinary pressures of the job – the psychic tax, the sheer volume, the difficulty of parsing risk. Sadif’s death was likely the outcome of an exceptional and tragic confluence of factors.

However, one source said that procedural points were missed, that there was a lack of receptiveness to Sadif’s particular circumstance. “The case manager is meant to call the woman every day she’s in our service and help her work towards having a place to go after she leaves their accommodation. And that just very, very rarely happens. What normally happens – and what is often encouraged by managers – is to exit a woman to a homelessness service, no matter what her circumstance. No matter how many kids she has, no matter where she’s from, no matter how much English she speaks – they want to push her out and line her up at a homeless service.

“So Sadif was treated the exact same way that a rich white woman would have been treated if she called in for help. But Sadif couldn’t speak English. [She had] no support network, no system at all that could help her. She was put into emergency accommodation with her baby and left to rot.”

After Sadif returned home, she made repeated calls to Safe Steps in December and January. She was told – correctly – that she no longer had a case manager. The organisation couldn’t provide her with legal advice, she was told. One source disputes this. “We could have linked her with Victoria Legal Aid – we have an MOU [memorandum of understanding] with them that if we make a referral to them they’ll call a woman and give her free legal advice within 48 hours. That wasn’t done for her.”

Sadif’s final calls to Safe Steps were in late January, less than a fortnight before her death. The Saturday Paper understands that at this time Sadif was referred by Safe Steps to a homelessness service. She was not deemed to be at immediate risk. This assessment was made because Sadif herself responded to a question regarding her safety, saying she did not think she would be killed. One source tells The Saturday Paper that there was no understanding from Safe Steps of the implications of either the question or the response.

The following day, Sadif called again. This time it was to request emergency accommodation. Again, she was referred to a homelessness service. Gillespie told me that it was highly unusual to discuss details of individual cases – there are obvious bonds of confidentiality – and she would not be drawn on the details above. But Gillespie did tell me her workforce was “highly diverse” and responsive to cultural sensitivities. Gillespie also said that “we acknowledge women’s choices may not always be consistent with our own advice”. 


Critical sources express sympathy for the pressure under which the Safe Steps staff who answer the emergency hotline number – the so-called Rapid team – operate. Safe Steps is one of three Australian services that field calls to 1800Respect, the national domestic violence counselling hotline. The organisation was given the contract last year after the group that previously handled the calls refused to renew its subcontract with government. The previous provider was concerned by the quality of care possible under the new contract and would not comply with a request to turn over case records arbitrarily.

A KPMG report that looked at the service for the 2014–15 financial year found that of more than 50,000 calls, only 28 per cent were answered. The model needed to change. In the new model, however, there is a serious question about whether quantity is preferred to quality, or if a balance is even possible.

“I’m sympathetic to the Rapid team,” a source says. “They are so under the pump. They have a manager standing behind them clapping in their ears to get them off phone calls quicker. Management has made it that Rapid can only care about answering a phone call – it doesn’t matter what kind of service you give, as long as that call is answered, you’re doing your job. We had a new worker literally yelling at a woman, saying ‘I’m a Rapid phone operator – I cannot keep talking to you’ just a few minutes into a phone call. Yelled at the woman and then hung up on her. And then the manager started clapping and saying, ‘Well done.’ As if that was a good client process. It’s disgusting.

“There were more changes to Rapid a few months ago. People were pulled off case management and assessment to just sit on Rapid and answer calls. If you answered a phone call, and another came in, you’d have to put your first call on hold and answer the other one. You could have a weeping woman hiding in a bathroom, and you’d be meant to say, ‘Can you hold, please?’ It was 100 per cent to get phone calls answered so they could hit that KPI [key performance indicator].”

Sources say that the mental consequences of Sadif’s death for Safe Steps staff were not adequately considered. Multiple sources told The Saturday Paper that weakness would not be tolerated, that there was inadequate supervision and a near absence of empathy. There is, they said, a high turnover of staff. “I didn’t expect it to be this bad,” says one source. “People were really unhappy … They made me a target. They were showing you that you were being watched and that you’re expendable. But I know I did a good job.”

One source complained about her treatment when she asked for support after Sadif’s death. “It was straight up gaslighting what happened – being told that I hadn’t worked with the woman. It just wasn’t true. And she knew that, but thought she could talk me out of being interested in the death … There was no support.”

The Australian Services Union has received multiple complaints from staff. It met with current employees earlier this week.

In a statement to The Saturday Paper, Safe Steps strongly rejected allegations that it had a toxic workplace. “We reject the claim that the Safe Steps Family Violence Response Centre workplace is oppressive. Employee health and wellbeing is understood, valued and actively supported at all levels ... and the organisation is committed to providing a supportive working environment that maintains and promotes the health and wellbeing of all of its employees.

“It is false to say that bullying is common. The organisation adopts wholly a zero tolerance on bullying and harassment. As with many workplaces we have, on very rare occasions, received a bullying complaint. In the past six years, during the tenure of the current CEO, these have totalled two. Both of these complaints were independently investigated by external, impartial parties and found to be unsubstantiated.

“Safe Steps is also committed to maintaining an employee assistance program – a confidential counselling service for employees paid for by Safe Steps at no cost to the employee. Safe Steps actively promotes and encourages employees to participate.”

Safe Steps also defended its counselling system: “Our aim is to be efficient and highly responsive to ensure as many women as possible are helped, but to approach each call as if it is the most important call we will receive that day. Our goal is to ensure that each woman who calls feels that their concerns are heard and understood, but also that the advice and solutions they are offered is both comprehensive and specific to their particular needs. Women and children who are at risk are our priority and our focus. Callers to 1800Respect can be assured that, through Safe Steps, [they] will get the support they need, at the time they need it most from fully qualified staff.”

Professional services company EY, on behalf of the Victorian Department of Health and Human Services, is currently examining the organisation. Annette Gillespie told me that the allegations against the organisation all derive from one individual, greatly aggrieved after being fired for poor performance. “It’s all very difficult,” Gillespie told me. “But we will receive over 300 calls for assistance today, and tomorrow, and the day after – and that has to be my priority.” 

In their statement, Safe Steps said: “Written and verbal information provided to Safe Steps by the Department ... is that it is usual practice for them to undertake performance reviews of organisations that it funds if external parties have discussed with them any issues they feel may exist. In the interests of transparency and accountability, we welcome the current review.”

It’s understood that the report is close to completion. A government spokesperson would not comment, beyond saying, “we will be in a position to provide further detail at the conclusion of that review”.      

Sources for this story gravely considered whether sharing their concerns would discourage women from calling the service. They were adamant that Safe Steps continues to do important, often life-altering work. But, they argued, public attention may also have the consequence of improving their service – and the welfare of its employees. “What is happening there is not normal,” says one source. “Change needs to come.”

The police investigation into Sadif Karimi’s death continues.


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This article was first published in the print edition of The Saturday Paper on June 30, 2018 as "Exclusive: How our crisis hotline failed Sadif Karimi".

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