Pearls and Irritations

When it comes to children in need, most Australians feel compassion.

Most will applaud today’s announcement that ‘Boat Kids’ will be released into the community. However this decision does not go far enough. It includes only kids aged less than 10 years (excluding many vulnerable teens); only those detained on the Australian mainland (excluding kids on Nauru, Manus and Christmas Islands); and only kids who arrived before July 19^th 2013. Furthermore, the number to be released includes kids already living in community detention housing.  

Christmas Island is a remote tropical ‘paradise’ in the Indian Ocean, over 2600 km from Perth or Darwin. When I visited with the Australian Human Rights Commission in July 2014, as part of their Inquiry into Children in Detention, it was ‘home’ to 174 children, including 26 unaccompanied minors – all boys aged between 14 and 17 years.  Australia continues to detain kids, despite the United Nations Guidelines on the Detention of Refugees that ‘Children should not be placed in detention’ and that ‘Minors who are asylum-seekers should not be detained’.

Compassion, it seems, has gone missing on Christmas Island.

‘Home’ for families in these immigration detention centres consists of a small metal cabin, some 3 x 3 metres squared in one of two rows of similar cabins separated by a wooden walkway. Add a bunk bed and a cot to the rooms and there remains little space for a child to learn to crawl or walk, or for exploratory play. According to the father of a 2 year old boy “the housing is dirty, sub-standard, hard to be there. The child keeps hitting his head on items in the room – the bed, the shelf – because of the lack of space.”

Cramped conditions, a punishing climate and overcrowded living in close proximity to scores of families make for little privacy and dire health consequences. Childhood infections spread quickly. When we were there many children had a respiratory virus and there had been outbreaks of gastroenteritis. We repeatedly heard the refrain “my kids are always sick.”

The air-conditioned environment exacerbates symptoms in the many children with asthma. Others have medical conditions requiring assessment, medical or surgical treatment on the mainland – and for some the long wait for transfer had been intolerable.  A two and a half year old with no speech, a 6 year old with deafness requiring grommets for glue ear, a child with a facial abscess needing surgical drainage, a boy with an undescended testes, a child with rotten teeth, a girl with sleep apnoea….

Of greater concern than signs of physical ill-health, however, are the psychological symptoms we heard of from many children.

They reflect past and ongoing trauma, including the depression and self-harm many have witnessed in their own mothers. Stress in young children was manifest by onset, in detention, of bed-wetting, nightmares and defiant behaviour. In older children we heard of refusal to eat, separation anxiety, regression of speech, development of stutter, mutism and social withdrawal. Some expressed their stress through their art. A 10 year drew his ‘family home in jail’ and a six year old drew herself behind bars, with the caption ‘I want go out’ . Crying was ubiquitous in these images.

Conversations with teenagers, who could articulate their predicament, were particularly poignant.

They became distressed, describing flashbacks of trauma experienced at home, during harrowing boat trips to Australia, and during their time on Manus, where some were sent as a result of incorrect age determination. According to one boy who went to Manus, ‘I saw with my own eyes one boy hung himself in a cupboard – they were taken to hospital.’ They talked of their fear of being returned to Manus when they turned 18. 

All spoke of feelings of hopelessness, sadness and lack of a future. They talked of frequent crying, families missed, lost expectations, lack of education and feelings of guilt because they had not fulfilled their family’s hopes after more than a year in ‘Australia.’  One boy summed this up as ‘a horrible situation. I feel depressed, preoccupied with my misfortune. I have not smiled or laughed the last few months. There is nothing to make me happy or to tell my family to make them happy.’  Some talked of self-harm and some spoke of death. In the words of one 12 year old girl ’My life is really deth. I don’t know why I’m in the jail realy. I don’t kill any body.’

Detention of children for lengthy periods is in contravention to the UN Convention of the Rights of the Child. This states that ‘The arrest, detention or imprisonment of a child shall be in conformity with the law and used only as a measure of last resort and for the shortest appropriate period of time.’ The UN Human Rights Committee reiterates this: ‘Asylum seekers who unlawfully enter a State party’s territory may only be detained for a brief initial period in order to document their entry, record their claims, and determine their identity.’  Most people have now been detained on Christmas Island for over a year and the anniversary of their arrival came as a bitter blow for many.  One man asked ‘Is it the Australian government’s aim to make us all go mad?’

As victims of a policy that dictates that any arrival by boat after July 19^th 2013 will never be settled in Australia, many have accepted their fate of settlement offshore. But their arbitrary detention without assessment for refugee status has left them in an intolerable limbo. One father said ‘If they won’t have us in Australia, find somewhere else for us to go. We can’t go home.’ A mother expressed her anguish, ‘The criminals, at least they know their sentence – we don’t.’ Many felt guilty for placing their children in such a predicament. As one mother said, ‘Even if I did something wrong, coming here, why ruin the life of our kids?’

As a reflection of their increasing despair and frustration about the adverse conditions for their children, a group of young mothers with young infants resorted to self-harm.

When we visited 10 such women – deemed at future risk – were under 24-hour surveillance by guards, not nurses. Despite this mental health crisis the centre has no resident psychiatrist. ‘I swear the physical health is not so much a problem. It is the stress and the psychological impact of the detention that is getting to us,’ said one mother of two.

It is outrageous to keep asylum seekers in the limbo of uncertainty. It is unacceptable to keep children in detention on Christmas Island, and it is unjust to deny children optimal health care and education.  One mother said ‘one of the most important concerns for my baby is he has not received his BCG vaccine – when everyone in the world should receive it. They say ‘we don’t have it’ or ‘later’ – the story changes.’ In the words of one child, ‘I not want to sit in jail? I want to go school….in here no have school everyday. Please help me?’

Australians might well ask ‘Where is the compassion on Christmas Island?’

If we are to retain our international standing as a civilised society, we cannot continue to persecute children seeking asylum as a deterrent to others.

Elizabeth Elliott AM, is the Professor of Paediatrics and Child Health, Sydney Medical School and Consultant Paediatrician at the Children’s Hospital at Westmead.

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