18 Oct 2016

'Nobody believed in life any more'

3:19 pm on 18 October 2016

Six extracts from Amnesty International’s report on life in the Nauru island refugee camp.

This story contains discussion of sexual assault, self-harm, suicide, mental illness and child abuse, and may be triggering for some people.

Refugees are experiencing a "mental health epidemic" in Australia's offshore processing centres

Refugees are experiencing a "mental health epidemic" in Australia's offshore processing centres Photo: Amnesty International


A new report from undercover investigators on Nauru has revealed some of the horrors experienced by refugees stuck in Australia’s offshore processing system. Our antipodean neighbours continue to “process” refugees and asylum seekers trying to access Australia by sea on Nauru and Manus islands.


Technically, refugees and asylum-seekers are no longer detained on Nauru. In 2015, the Government of Nauru announced that the Australian Refugee Processing Centre was no longer a place of detention, but rather an open centre. The country has an area of just 21 sq km, much of which is uninhabitable.


The camps are notoriously difficult for both media and human rights workers to access, with Nauru charging journalists $8000 just to apply for visas which are routinely rejected. But workers for Amnesty International gained undercover access to Nauru and carried out dozens of interviews with refugees, camp workers, medical staff and volunteers. The team corroborated accounts from asylum seekers with medical reports, police records, and the Nauru files - a cache of 2000 incident reports leaked to The Guardian this year.


The report they produced is a litany of horrors: multiple accounts of self-harm, suicide attempts, sexual assault, child abuse, neglect and inadequate access to medical care.


Here are ten extracts that tell the story of life for the refugees and asylum seekers who try to reach the lucky country.




Most recently, a leaked UN report on Nauru found post-traumatic stress disorder and depression “have reached epidemic proportions. UNHCR anticipates that mental illness, distress and suicide will continue to escalate in the immediate and foreseeable future”.


There’s no denying that the detention environment is a causative factor to mental health distress


Amnesty spoke to a number of refugee families who had watched members decline sharply after reaching Nauru. They recounted how family members including children and pregnant women had attempted to end their lives by drinking washing liquid, hanging, overdose, and self-immolation. One man who escaped persecution in Iran with his wife Yasmin and young son provided her entire medical file. Nurses began by describing Yasmin as a “well cared [for]” “talkative,” assertive, actively engaged” woman. After two years in detention, she had attempted suicide three times, eventually setting fire to the family home while inside, before being hospitalised:


“Hourly reports from nurses observing Yasmin in the psychiatric ward describe a woman who bears little resemblance to her previous self.  Yasmin refuses food and medication; she does not shower, brush her teeth, or change her clothes. She spends days on end in bed, crying or almost motionless, and does not engage with medical staff. She still tries to end her life. A report from September 2016, describes Yasmin “suddenly and nimbly” jumping onto a washing machine and swinging herself “out from the steel beam in an attempt to get onto the water tank”.


“This action failed,” the report says, “and she dropped to the ground, landing on her feet.” The report continues: “She has previously indicated she wants to climb to a high place and jump off in order to break her bones.”


Devastated, [her husband] Amir said, “I have no hope. It’s end of time here. I can see my son and wife going down day by day.”


Even management at IHMS – the private health service provider contracted by the Australian government – admitted conditions on Nauru were “extreme” and told Amnesty International researchers:


“There’s no denying that the detention environment is a causative factor to mental health distress […] People’s bodies and their health is one of the only recourses left to them; […] this is people’s last resort, their only avenue of appeal.”


Nauru’s child protection framework is “virtually non-existent”. A 2016 joint study commissioned by the Ministry of Home Affairs and UNICEF found that “Nauru does not have a consistent reporting, data collection or monitoring system in relation to child maltreatment”.


The parents said that Nahal does not go to school, does not play, and is always scared


The study cited Nauru police officials as saying that they “do not keep data on reported cases of child abuse” - and as a result, both victims and predators fall through the gaps. In one particularly disturbing 2015 example, the Nauru Police Force hired as a reserve officer a man who had been convicted of raping a child just four years previously. Refugee children are particularly at risk of sexual assault, with some parents saying their complaints are not followed up by police and sexual predators remain in the community.


One family told Amnesty of how their six-year-old daughter was sexually assaulted and then re-traumatised in her questioning by police:


One night in December, Firuz said he couldn’t find Nahal and went looking for her: “I eventually found her behind the house, near the wall. She was with […] – a 23-year-old refugee, we know him. When I saw them, he was pulling down his pants. I started punching him but he got on his motorbike and ran away. He was about to rape her, I just scared him off. I called the police and screamed, “Why are you not catching him?!” and they said that the judge was off duty. But they took a statement from Nahal, forcing her to write what happened.” The next day, they wanted to get a statement from Nahal again. “I said, “Why? Where is the doctor? Where is the child psychologist?” ... In her statement, Nahal wrote, “There was this boy he took [me] somewhere. Then he took me there he started pulling my trousers first and then his trousers and I told him that is not the right thing to do to a child. Then that boy did something to me and my dad and mom came and became angry. […] He pull down my pants, he cuddle me, but I don’t know the name [of] the thing the person did to me.”


The parents said that Nahal does not go to school, does not play, and is always scared ...  that [in 2016] Nahal’s condition continued to deteriorate, including increasing anxiety and nightmares, and that she currently takes 25 mg of Endep (a strong antidepressant) every night.”




Researchers report the environment at the Refugee Processing Centre is highly militarised, and many of the staff are former military personnel.


Why am I in prison? Does that mean I am a bad person?

One Iranian man said that when he first caught sight of the security fence around the facilities, “I felt like someone punched me in my heart”. Ali Kharsa, a 19-year old Syrian refugee, described his three years on the island: “I felt like I was a slave. Being detained is like feeling you did something wrong – like you are a criminal.”


Similarly, a service-provider described a conversation she had with a seven-year-old boy from Iran: “He would ask me so many questions. He’d say ‘I don’t understand this place. Prisons are for bad people, right? Bad people are the men who hurt my father [in Iran]. Why am I in prison? Does that mean I am a bad person?’” All of the service-providers with whom Amnesty International spoke described practices that appear to serve no purpose but to break people’s spirits, such as forcibly expelling asylum-seekers from the showers after two minutes, with shampoo still in their hair, or making people wait weeks or months to get basic necessities like underwear or shoes.


Jalil and his wife fled Iran because they converted to Christianity and their lives and safety were at risk due to religious persecution. Jalil said their treatment was designed to dehumanise and erode their hope:


“Immigration has been playing mental games on us: one day they wouldn’t give enough water, other day would say, ‘You would never go to Australia’. We weren’t allowed to smoke for seven months- they said they were afraid we would set the camp on fire. We had to beg for slippers and clothes for our wives and children. Everything was so dirty—bathroom, shower. Healthcare was not available: every time you got sick, they would just give you Panadol and water. They would give us a few minutes to shower. They [the guards] said: ‘Our country – our water, so we decide when to turn it off.’ Everybody was on pills for mental health, crying every night, nobody believed in life anymore.”


Save the Children’s school on Nauru was shut down in mid-2015, but refugee children are technically allowed to attend local Nauruan schools. One worker interviewed by Amnesty estimated that there had been 90 percent attendance at Save the Children’s school - although about 60 percent of refugee children attended the local school during the initial transition, within six months that figure had dwindled to five percent.


“Service-providers expressed heartbreak at what they saw as the complete waste of these “brilliant minds.” Former teachers spoke of watching the slow, inexorable deterioration of their students. One teacher said “Over 15 months, I saw these children change to be unrecognizable. There was a 12-year old student on psychotropic medication – she had been one of the brightest, bubbliest students – by the end [she] would just cry silently.”




The report concludes the Australian government has deliberately allowed inhumane circumstances to try and deter future refugees from attempting to reach Australia. Amnesty argues that the “processing” of refugees and asylum-seekers on Nauru is “a deliberate and systematic regime of neglect and cruelty, and amounts to torture under international law.”


“Harm has indeed ensued – it has been devastating and, in some cases, irreparable,” they conclude.

Researchers interviewed service providers including the ex-director for mental health of IHMS, the health provider contracted to serve Nauru by the Australian government:


“The appalling harm that refugees and asylum-seekers have suffered is the inevitable and foreseeable consequence of transporting them there in the first place. Dr. Peter Young, former director for mental health at IHMS, said that the Australian Department of Immigration and Border Protection “allowed a system to persist that would guarantee that a lot of things would fall through the cracks.” One service-provider said: “Nauru is built to fail these people: how much can we break them so that they go back, and no boats will ever come again?”


As the Refugee Council of Australia expresses it: “The threat of being sent to an offshore processing centre can only ‘work’ as a deterrent if people seeking asylum believe that what they are seeking in Australia – safety, humane treatment – will not be available to them in Nauru and Papua New Guinea […] In essence, the success of offshore processing depends on human suffering.”




The researchers found “without exception, all of the people interviewed by Amnesty international on Nauru expressed concern about inadequate physical and mental health care”.


After two months, I was still in a lot of pain, painkillers didn’t work, but they sent me back to the camp, with crutches.


One woman told of how she fell and broke her tailbone around three years ago, when she first arrived on the island. She has lived in excruciating pain for the years since:


“First, IHMS gave me painkillers for a week, said it would be ok. I kept crying for 10 days, begging them to do something. Finally, they did an X-ray and found that my tailbone was broken. I begged them to move me to RPC-1 for two months (because conditions were a bit better there). After two months, I was still in a lot of pain, painkillers didn’t work, but they sent me back to the camp, with crutches. IHMS doctor just kept telling me I should walk. When another doctor saw me, he said if I continue walking with crutches, I will lose mobility in my legs. For eight months [I] walked with one stick. After one year I got my refugee status, and moved out of the camp. The pain in my legs continued. I was seeing a surgeon every week, but he said he couldn’t do anything because they didn’t have [magnetic resonance imaging equipment] here.”


The private health provider on the island, IHMS has “strongly refuted” the claim that refugees and asylum-seekers are denied treatment or receive poor quality treatment.


A harrowing new report out of Australia's offshore processing centres

A harrowing new report out of Australia's offshore processing centres Photo: Amnesty International


What the Australian government says:

The Australian government this morning denied claims that there are systematic human rights abuses occurring on Nauru.

Prime Minister Malcolm Turnbull said during an interview on Australia’s Radio National this morning that the Australian Government’s commitment to asylum seekers was “compassionate”.

“I reject that claim totally. It is absolutely false,” Turnbull said. “The Australian Government’s commitment is compassionate and it’s strong.”

“What we’ve been able to do is stop the boats — no deaths at sea. We’ve closed 17 detention centres ... we reduced children in detention from almost 2000 when we came in office to zero.”