The United Nations called for the refugees on Nauru to be evacuated to Australia. While the Australians spin their wheels on the issue, the need for mental care is pressing.



Over the weekend, the UNHCR called on the Government of Nauru to evacuate the refugees in order to receive the adequate support unavailable on the island. This comes in the wake of the Nauru government expelling the medical and psychological personnel of NGO Médecins Sans Frontières (MSF) on the 7th of October.



The government gave no explanation for its actions, but relations with the NGO have been difficult in the eleven months that MSF has been working there. It is likely that the government feared international attention to the prison-like conditions in which refugees and asylum seekers were kept.



Of the 900 refugees on Nauru, 100 are children, often kept separately from their parents. Médecins Sans Frontières had been providing mental health care, as no independent psychological services are available on the island. This matters, as these individuals have suffered trauma prior to landing on Nauru.

Many refugees suffer from depression and a feeling of hopelessness. As president of an international child welfare NGO, I was responsible for mental health efforts for traumatised children and youth. In Cambodia and Croatia, we saw the impact of them losing their homes and families due to natural catastrophes or war.

Severe cases of childhood psychosis may require long-term psychotherapy. Often frequent and severe language disturbances are observed. In the absence of adequate care and psychotherapy, these children can become mentally deficient, unable to perform their duties as adults.

With early and adequate psychological care, some of the challenges can be met. Children display an extraordinary need for contact, and warmly react to therapists. If that is removed, the child has a deep sense of loss, magnified by the extreme load of having to flee what they already knew as familiar.



There is an urgent need for early psycho-social care. The term “psycho-social” underlines the close relationship between the psychological and social impact of refugee flight. By psychological effects we mean those experiences which affect emotions, thoughts, memory, learning and how a situation may be understood. By social effects, we mean how experiences alter people’s relationships to each other. The psycho-social impact must be assessed as soon as possible in order to develop effective programming.

The action of the Nauru Government in practice condemns the traumatised young to lifelong anguish and other disabilities. MSF has called for the immediate evacuation of all refugees from Nauru, but for the moment, the Australian officials refuse to accept the refugees, saying that evacuation would create a flow of new refugees.

Obviously, conditions of stability and economic opportunity need to be created in the nations from which the refugees have fled.

That may be a point of discussion, and debate – thusly, progress may come slow, or not at all – however, there in the meantime we should not lose sight of the primary objective, the return of Médecins Sans Frontières and the implementation of mental health programs on Nauru.





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