When we visited Nauru as paediatric specialists three years ago, we were asked to see 30 of the 100 children being detained on the island. Among them was a six-year-old girl who had tried to kill herself and a two-year-old boy with such severe behaviour problems a doctor had prescribed anti-psychotic medicines. Their parents were in despair. They had fled persecution, trying to save their children from harm, but had ended up imprisoned on a remote island, without hope. We left with the view that these were the most traumatised children we had ever consulted on, far worse than children we had seen in Australia, Africa, Asia or Europe.
Three years later, 43 of those children remain on the island. Officially they are now free to move around, but reports of attacks by locals show Nauru is not safe and so they remain in the "Regional Processing Centre". In 2014, the Australian Human Rights Commission reported that children at this centre were deeply traumatised psychologically, and had even been abused. Their detention was harming them. When Australia introduced mandatory detention in 1992, it took 10 weeks on average to process an application for refugee status. Now it takes years. As the numbers of children in detention fall, the length of time in detention rises. This is deliberate: wilfully damaging children's health to deter others from seeking asylum.
About 90 per cent of people who arrive by boat seeking asylum are classed as "genuine refugees". The United Nations Refugee Convention says countries shall not punish people for seeking asylum. It also says countries should never return refugees to their own country of origin. We signed that convention. So if those families on Nauru are not coming to Australia and not going home, what will happen to them?
Australia has forgotten those 43 children on Nauru whom we visited three years ago. They are hidden out of sight on a remote island. The media struggles to report on them because the Nauru government charges a journalist $8000 to apply for a visa, which can be refused without right of appeal, no money back. When Alanna talked about Nauru at The Women in the World summit in New York in April, the Americans were shocked: "Not even Donald locks up children indefinitely".
We are specialists in children's health. We know the evidence that immigration detention damages mental health. We know the longer you detain people, the worse the effect: 95 per cent of children who were assessed when in prolonged immigration detention at Wickham Point in Darwin met the criteria for post-traumatic stress disorder, with sleep disturbance, anxiety, bed-wetting and self-harm. We know some of these children will get better, but only if they are released from detention.
For those children still on Nauru, we are told efforts are being made to find a place for them but that families may need to be split up, even though we know children separated from their families do worse than those who can live with supportive parents. That is not good enough. We are appalled our country punishes children because their parents dared flee persecution. If those children are left with permanent mental health problems as a result of their prolonged detention, it should be on our conscience.
Professor David Isaacs is a consultant paediatrician and a clinical professor at the University of Sydney. Alanna Maycock is a paediatric clinical nurse consultant. They run a clinic for refugee children.
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