Working With Refugee Children and Families: Update for Mental Health Professionals
A 12-year-old Iranian refugee girl, who had tried to ready herself on fire with petrol, rests in a bed in Nauru, where nearly 1,000 refugees and asylum seekers have been sent past the government of Australia. Mike Leyral/AFP/Getty Images hide caption
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Mike Leyral/AFP/Getty Images
A 12-year-former Iranian refugee girl, who had tried to ready herself on fire with petrol, rests in a bed in Nauru, where well-nigh 1,000 refugees and asylum seekers have been sent by the authorities of Australia.
Mike Leyral/AFP/Getty Images
The government of Nauru, a tiny island nation in the South Pacific, and the charity Doctors Without Borders are in a bitter dispute over mental health intendance for asylum seekers and refugees.
The controversy revolves around approximately 900 individuals sent to Nauru by the Australian government since 2013. They arrived in Australia by boat, coming from such countries as Iran, Somalia, Sri Lanka and Syria; the government sent them to Nauru and Papua New Republic of guinea. Virtually of them have been at that place four years.
"Let's be very, very clear. They're trapped on a rock in the middle of the Pacific," Paul McPhun, MSF Australia's executive manager, told NPR in a phone interview. These asylum seekers and refugees have no passports and few opportunities for education and piece of work, he said. McPhun has besides said there were instances of physical and sexual corruption among that population.
Eleven months ago, MSF (the acronym for Doctors Without Borders' French name) began providing gratis mental wellness care on Nauru. Despite MSF's efforts the mental wellness situation among asylum seekers and refugees on the island has reached a "critical level," said McPhun. At least 78 MSF patients on Nauru accept had suicidal thoughts or attempted suicide since the group began offer treatment, he said.
The dispute surfaced on October 5 when the government of Nauru told MSF their intendance was "no longer required" and asked its team of 7 health workers to cease providing psychological and psychiatric services inside 24 hours.
Nauru said that intendance is being provided by the 65 health professionals, including 33 mental health professionals, contracted by the Australian authorities to work with the asylum seekers and refugees on the island.
At consequence, according to the government, was the telescopic of MSF's work. On October 12, the government of Nauru issued a statement charging that MSF did not meet the commitment it had made to provide health services for the local population of some xiii,000 Nauruans and instead tried to farther its political advocacy agenda past focusing on refugees and asylum seekers.
MSF vehemently disagrees with the government'due south claims. In an email to NPR on October 12, MSF's humanitarian specialist on displacement, Aurelie Ponthieu, wrote, "Medecins Sans Frontieres' only calendar on Nauru was to provide the best medical and mental wellness intendance to Nauruans, aviary seekers and refugees on the island and alleviate their suffering. This was done in agreement with Nauruan authorities."
When MSF left the island on October 9, nearly 100 people were on its waiting listing for mental health services.
"Make no mistake MSF is extremely concerned for the ongoing mental health for all of our patients on the island," McPhun said during an MSF press conference in Sydney on October 11. He was joined at the printing conference by Christine Rufener, an American clinical psychologist who has worked with MSF in diverse locations, including Republic of nauru, and Dr. Beth O'Connor, a MSF psychiatrist who worked in Nauru for the 11 months that services were offered.
At the press conference, the two providers described the mental health conditions they witnessed on the isle.
According to O'Connor, when MSF arrived many of the refugees and asylum seekers were struggling with mental health issues and had not received mental health care for the prior ix to 10 months.
Adult asylum seekers and refugees were struggling with depression, feet and post-traumatic stress disorders. Many exhibited "significant levels of self-harm, suicidal ideation and suicide attempts," O'Connor said.
The providers noticed like mental health issues in children.
"We were seeing suicide attempts in children as immature as 9 years erstwhile," O'Connor said.
Over the 11 months she was in Republic of nauru, O'Connor noticed the mental health of the children she saw was deteriorating. Some children began to stay in their beds, no longer eating, drinking, or going to the bathroom on their ain. When she tried to talk to children she had previously conversed with, they would not answer.
"They would but stare correct through me. And seeing that level of deterioration in the children was actually quite horrific," O'Connor said.
Asylum seekers and refugees on Republic of nauru had lost all hope for a meaningful future, according to Rufener. Her voice quivering, she said, "I heard information technology in their words and I saw information technology in their eyes."
UNHCR, the U.N. refugee bureau, corroborates MSF's cess of the mental wellness of refugees and asylum seekers on Republic of nauru.
"Our assessments, including that of consultant medical experts, is that the mental health situation has now reached crunch betoken," Catherine Stubberfield told NPR. She is the spokesperson for the UNHCR Regional Representation in Canberra, Commonwealth of australia.
MSF and UNHCR are adamantly calling for the immediate evacuation of all aviary seekers and refugees from Republic of nauru equally well every bit an end to Commonwealth of australia'southward policy of indefinite offshore detention.
McPhun says it'southward of import to emphasize that if the aviary seekers and refugees in Nauru are removed but put in detention elsewhere, they will not exist able to recover.
"In terms of the fourth dimension frame in which people should now be moved, the situation could not be more urgent," Stubberfield said. "It has now reached a precipice."
The refugees and aviary seekers should be brought to Australia to prevent further tragedy and loss, Stubberfield told NPR. People who have sought Australia'due south protection remain the country's responsibility under international law, she said.
"Commonwealth of australia must be held accountable for this policy that it has established, financed and managed for more than than five years," Stubberfield said.
In its statement on October 11 through the Department of Home Affairs, the Australian government said MSF's removal from Republic of nauru is "a thing for the Government of Republic of nauru." The Australian authorities has not yet responded to the latest calls to move the asylum seekers and refugees off of Republic of nauru.
Rachel D. Cohen is an intern on NPR'due south Scientific discipline Desk.
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Source: https://www.npr.org/sections/goatsandsoda/2018/10/12/656957635/why-msf-had-to-stop-offering-mental-health-care-to-refugees-in-nauru