Ending the abuse of children on Nauru: We must be better than this

We didn’t need more evidence of the terrible harms of detention, but we received it last Wednesday. Yet again the Australian public was confronted with thousands of examples of the daily trauma of life in the Nauru detention centre - incidents of child abuse, assault, sexual abuse and self-harm.

The revelations in the incident reports leaked to The Guardian are horrifying, shocking, but not surprising. Not to the hundreds of doctors and other healthcare workers who have seen the evidence of the harms of immigration detention over and over again. Not to those of us who have repeatedly voiced our concerns about the extreme risk to physical and mental health posed by conditions in the Nauru detention centre.

“Bring them here.” The popular social media catchcry that all asylum seekers on Nauru and Manus Island be brought to Australia is an echo of what my College, the Royal Australasian College of Physicians (RACP), has been saying for years.
Why? Because immigration detention harms the health of every single person there – adult and child – in both the short and long term.

In two and a half years, there were seven reports of sexual assaults and 59 reports of physical assault against children in the Nauru centre. Threats of sexual violence and incidents of self-harm are even more common. The RACP understands from the UN Refugee Agency (UNHCR) that the Nauru centre sees rates of post-traumatic stress disorder and depression among the highest recorded in medical literature anywhere in the world.

My fellow paediatricians and other brave health professionals – risking jail time for speaking out on the impact of detention on the health of their patients – are once again asking the question: when will our warnings be heeded?

Paediatricians, physicians, psychiatrists, nurses – we all speak from an evidence-based perspective. Yes this is a highly emotive issue in a politically charged environment, but for us it is clear: children are suffering unspeakable abuse and harm in immigration detention, right now. Quite possibly, they will suffer the physical and mental health effects for the rest of their lives.

We have repeatedly warned that the conditions for children in the Nauru detention centre pose devastating health risks and we have offered the solution: bring them here. In Australia paediatricians can properly treat our young patients, we can discharge them from hospital knowing we will see them again, and we can fulfil our legal and ethical requirements to ensure we are not sending these children back into harm’s way.

The offshore detention of children prevents us from doing these things. The system that we have created in Australia will not allow paediatricians to fulfil our most basic function; to promote and protect the health and wellbeing of children. Paediatricians from across Australia have been contacting me to say we must do all in our power to ensure an end to this abuse of children.

This last fortnight has been a shameful one for Australia. First, the abuse of adolescents at the Don Dale detention centre in the Northern Territory, then the Amnesty International and Human Rights Watch report into conditions on Nauru, and now these latest revelations. It is hard not to see a pattern: as a country, we are failing the most vulnerable people in our care.

Are we really the kind of society that turns away when we hear of young children being hurt, assaulted and abused? Have we learned nothing from the Royal Commission into Institutional Responses to Child Sexual Abuse?

Or are we the kind of society that cares about these issues only when they make headlines and we can no longer pretend they don’t exist? There is now underway a second Royal Commission into how Australia treats its children.

How many Royal Commissions do we need before we finally say, “Enough!” We don’t need any more reports or horrifying news headlines to tell us what we already know. Children are being harmed, abused and traumatised, and it must stop. Now. We are better than this. We must be.

Dr Sarah Dalton
RACP Paediatrics & Child Health Division President