A recent visit to Nauru revealed the effects of Australia’s offshore detention policy and its impact on mental health.
This article was published by The New York Times on the 5th of November 2018.
TOPSIDE, Nauru — She was 3 years old when she arrived on Nauru, a child fleeing war in Sri Lanka. Now, Sajeenthana is 8.
Her gaze is vacant. Sometimes she punches adults. And she talks about dying with ease.
“Yesterday I cut my hand,” she said in an interview here on the remote Pacific island where she was sent by the Australian government after being caught at sea. She pointed to a scar on her arm.
“One day I will kill myself,” she said. “Wait and see, when I find the knife. I don’t care about my body. ”
Her father tried to calm her, but she twisted away. “It is the same as if I was in war, or here,” he said.
Sajeenthana is one of more than 3,000 refugees and asylum seekerswho have been sent to Australia’s offshore detention centers since 2013. No other Australian policy has been so widely condemned by the world’s human rights activists nor so strongly defended by the country’s leaders, who have long argued it saves lives by deterring smugglers and migrants.
Now, though, the desperation has reached a new level — in part because of the United States.
Sajeenthana and her father are among the dozens of refugees on Nauru who had been expecting to be moved as part of an Obama-era deal that President Trump reluctantly agreed to honor, allowing resettlement for up to 1,250 refugees from Australia’s offshore camps.
So far, according to American officials, about 430 refugees from the camps have been resettled in the United States — but at least 70 people were rejected over the past few months.
That includes Sajeenthana and her father, Tamil refugees who fled violence at home after the Sri Lankan government crushed a Tamil insurgency.
A State Department spokeswoman did not respond to questions about the rejections, arguing the Nauru refugees are subject to the same vetting procedures as other refugees worldwide.
Australia’s Department of Home Affairs said in a statement that Nauru has “appropriate mental health assessment and treatment in place.”
But what’s clear, according to doctors and asylum seekers, is that the situation has been deteriorating for months. On Nauru, signs of suicidal children have been emerging since August. Dozens of organizations, including Doctors Without Borders (which was ejected from Nauru on Oct. 5) have been sounding the alarm. And with the hope of American resettlement diminishing, the Australian government has been forced to relent: Last week officials said they would work toward moving all children off Nauru for treatment by Christmas.
At least 92 children have been moved since August — Sajeenthana was evacuated soon after our interview — but as of Tuesday there were still 27 children on Nauru, hundreds of adults, and no long-term solution.
The families sent to Australia for care are waiting to hear if they will be sent back to Nauru. Some parents, left behind as their children are being treated, fear they will never see each other again if they apply for American resettlement, while asylum seekers from countries banned by the United States — like Iran, Syria and Somalia — lack even that possibility.
For all the asylum seekers who have called Nauru home, the psychological effects linger.
‘I Saw the Blood — It Was Everywhere’
Nauru is a small island nation of about 11,000 people that takes 30 minutes by car to loop. A line of dilapidated mansions along the coast signal the island’s wealthy past; in the 1970s, it was a phosphate-rich nation with per capita income second only to Saudi Arabia.
Now, those phosphate reserves are virtually exhausted, and the country relies heavily on Australian aid. It accounted for 25 percent of Nauru’s gross domestic product last year alone.
Mathew Batsiua, a former Nauruan lawmaker who helped orchestrate the offshore arrangement, said it was meant to be a short-term deal. But the habit has been hard to break.
“Our mainstay income is purely controlled by the foreign policy of another country,” he said.
In Topside, an area of old cars and dusty brush, sits one of the two processing centers that house about 160 detainees. Hundreds of others live in community camps of modular housing. They were moved from shared tents in August, ahead of the Pacific Islands Forum, an intergovernmental meeting that Nauru hosted this year.
Sukirtha Krishnalingam, 15, said the days are a boring loop as she and her family of five — certified refugees from Sri Lanka — wait to hear if the United States will accept them. She worries about her heart condition. And she has nightmares.
“At night, she screams,” said her brother Mahinthan, 14.
In the past year, talk of suicide on the island has become more common. Young men like Abdullah Khoder, a 24-year-old Lebanese refugee, says exhaustion and hopelessness have taken a toll. “I cut my hands with razors because I am tired,” he said.
Even more alarming: Children now allude to suicide as if it were just another thunderstorm. Since 2014, 12 people have died after being detained in Australia’s offshore detention centers on Nauru and Manus Island, part of Papua New Guinea.
Christina Sivalingam, a 10-year-old Tamil girl on Nauru spoke matter-of-factly in an interview about seeing the aftermath of one death — that of an Iranian man, Fariborz Karami, who killed himself in June.
“We came off the school bus and I saw the blood — it was everywhere,” she said calmly. It took two days to clean up. She said her father also attempted suicide after treatment for his thyroid condition was delayed.
Seeing some of her friends being settled in the United States while she waits on her third appeal for asylum has only made her lonelier. She said she doesn’t feel like eating anymore.
“Why am I the only one here?” she said. “I want to go somewhere else and be happy.”
Some observers, even on Nauru, wonder if the children are refusing to eat in a bid to leave. But medical professionals who have worked on the island said the rejections by the Americans have contributed to a rapid deterioration of people’s mental states.
Dr. Beth O’Connor, a psychiatrist working with Doctors Without Borders, said that when she arrived last year, people clung to the hope of resettlement in the United States. In May, a batch of rejections plunged the camp into despair.
Mr. Karami’s death further sapped morale.
“People that just had a bit of spark in their eye still just went dull,” Dr. O’Connor said. “They felt more abandoned and left behind.”
Many of the detainees no longer hope to settle in Australia. New Zealand has offered to take in 150 refugees annually from Nauru but Scott Morrison, the Australian prime minister, has said that he will only consider the proposal if a bill is passed banning those on Nauru from ever entering Australia. Opposition lawmakers say they are open to discussion.
In the meantime, Nauru continues to draw scrutiny.
‘I’m Not Going Back to Nauru’
For months, doctors say, many children on Nauru have been exhibiting symptoms of resignation syndrome — a mental condition in response to trauma that involves extreme withdrawal from reality. They stopped eating, drinking and talking.
“They’d look right through you when you tried to talk to them,” Dr. O’Connor said. “We watched their weights decline and we worried that one of them would die before they got out.”
Lawyers with the National Justice Project, a nonprofit legal service, have been mobilizing. They have successfully argued for the medical evacuation of around 127 people from Nauru this year, including 44 children.
In a quarter of the cases, the government has resisted these demands in court, said George Newhouse, the group’s principal lawyer.
“We’ve never lost,” he said. “It is gut-wrenching to see children’s lives destroyed for political gain.”
A broad coalition that includes doctors, clergy, lawyers and nonprofit organizations, working under the banner #kidsoffnauru, is now calling for all asylum seekers to be evacuated.
Public opinion in Australia is turning: In one recent poll, about 80 percent of respondents supported the removal of families and children from Nauru.
Australia’s conservative government, with an election looming, is starting to shift.
“We’ve been going about this quietly,” Mr. Morrison said last week. “We haven’t been showboating.”
But there are still questions about what happens next.
Last month, Sajeenthana stopped eating. After she had spent 10 days on a saline drip in a Nauruan hospital, her father was told he had two hours to pack for Australia.
Speaking by video from Brisbane last week (we are not using her full name because of her age and the severity of her condition), Sajeenthana beamed.
“I feel better now that I am in Australia,” she said. “I’m not going back to Nauru.”
But her father is less certain. The United States rejected his application for resettlement in September. There are security guards posted outside their Brisbane hotel room, he said, and though food arrives daily, they are not allowed to leave. He wonders if they have swapped one kind of limbo for another, or if they will be forced back to Nauru.
Australia’s Home Affairs minister has said the Nauru children will not be allowed to stay.
“Anyone who is brought here is still classified as a transitory person,” said Jana Favero, director of advocacy and campaigns at the Asylum Seeker Resource Center. “Life certainly isn’t completely rosy and cheery once they arrive in Australia.”
On Monday, 25 more people, including eight children, left the island in six family units, she said.
Those left behind on Nauru pass the days, worrying and waiting.
Christina often dreams of what life would be like somewhere else, where being 10 does not mean being trapped.
A single Iranian woman who asked not to be identified because she feared for her safety said that short of attempting suicide or changing nationality, there was no way off Nauru.
She has been waiting two years for an answer to her application for resettlement in the United States — one that now seems hopeless given the Trump administration’s policies.
Each night, often after the power goes out on Nauru, she and her sister talk about life and death, and whether to harm themselves to seek freedom.
If you or someone you know needs help, support can be found in your area by clicking here: the International Association for Suicide Prevention. In Australia, call Lifeline on 13 11 14.
Mridula Amin reported from Nauru, and Isabella Kwai from Sydney. Lachie Hinton contributed reporting from Nauru, and Damien Cave from Sydney.