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12 Children in detention on Nauru

Nearly every first-hand account of Nauru makes reference to its overwhelming heat. The average temperature on Nauru is 31 degrees. Inside the detention centre tents, temperatures regularly reach 45-50 degrees.[496] One child living in detention reports that ‘the weather here is so hot that if you sit outside in the sun for a period of time you lose consciousness’.[497]

Nauruan climate is also distinctly tropical. Humidity ranges between 75-90 percent. Rainfall is irregular and annual figures vary from less than 300 mm to more than 4000 mm per year.[498] This means that for most of the year the environment is sparse, dusty and without grass or greenery. When it rains it pours, with flooding and leaking roofs common.[499]

Offshore Processing Centre 3 is the name of the camp where children and families are housed on Nauru. It is a gravel construction site. The tent accommodation is situated on loose and uneven rocks. Parents expressed concern that thongs wear out ‘almost immediately on the gravel’ and children described walking and running in the centre as ‘painful’.[500] A former doctor who worked at the Regional Processing Centre said she could barely walk from her car to the detention centre without risking a sprained ankle.[501] These rocks also reflect the harsh glare of the sun. According to a former employee of Save the Children, staff need to wear strong eye protection and hats. Neither of these are readily available for children on Nauru.[502]

The Island of Nauru is the site of heavy open-pit mining for phosphate. The United Nations High Commissioner for Refugees noted concern in 2013 over the camp’s ‘proximity to phosphate mining, which causes a high level of dust’.[503] Paediatrician, Professor Elizabeth Elliott, expressed concerns about the ‘causal effect of atmospheric phosphate’ on ‘recurrent asthma and irritation of the eyes and skin’.[504]

12.1 Accommodation

No child should be subject to arbitrary interference with his or her privacy, home or correspondence (Article 16 Convention on the Rights of the Child)

The United Nations High Commissioner for Refugees visited Nauru in October 2013 and described the detention centre tents as ‘large vinyl marquees with individual family areas separated by vinyl partitions’. The tents have ‘wooden flooring and ceiling fans. There was no air conditioning’.[505] The tents appear to contain very little furniture besides beds. The Commission was told at the Inquiry’s third public hearing that there are no chairs or tables and families cannot sit with their children to do homework or to eat with them.[506]

The harsh environment on Nauru has affected the condition of the tents. A child living in detention described their deterioration.

Our marquees are very dirty. Because of the weather, after sometime, there is mould in the marquees and because of the strong sun, the roof of the marquees has holes and when it rains, we get a lot of water inside the marquees. There is so much water that we have collected all our belongings and empty the water with buckets.[507]

Each of these tents houses 12 to 15 families.[508] Save the Children employees claim that as a result of these cramped conditions there is ‘little privacy [and] high noise levels at all times’.[509] A Child Protection and Support Worker on Nauru added, ‘[b]ecause they are only separated from other families by cloth, there is no ability to have private conversations’.[510] The lack of privacy appears to unsettle some children, with the noise and exposure preventing them from getting adequate rest. One 14 year old girl expressed her embarrassment about sharing a small space with her stepfather and stated that she was embarrassed having her underwear seen by him.[511]

Row of tents with fold out beds under them

Living arrangements on Nauru, 2012. Source: Department of Immigration and Border Protection, reproduced under a CC BY 2.0 license.

Top view showing rows of tents

Living arrangements on Nauru, 2012. Source: Department of Immigration and Border Protection, reproduced under a CC BY 2.0 license.

12.2 Facilities

Children within detention must be treated with humanity and respect (Article 37(c) Convention on the Rights of the Child).

Submissions to the Inquiry identified serious shortages of even the most basic needs on Nauru, especially water. Showers may be restricted to 30 seconds each day.[512] At other times water appears to run out altogether. According to employees of Save the Children, ‘[t]here have been multiple times that Offshore Processing Centre 3 has “run out” of water, resulting in overflowing and blocked toilets with faeces on the toilets or on the floor of the toilet’.[513]

Even when water supply is secure there are ubiquitous concerns with hygiene. The Inquiry heard evidence that the grounds of Offshore Processing Centre 3 are frequently littered with refuse and garbage bins were left overflowing.[514] According to one submission, the Health and Safety Manager of the centre suggested that Save the Children hold a ‘Clean-up Day’ during which children would be invited to pick up the trash.[515]

Problems of cleanliness and hygiene appear to be especially serious as they relate to toilets and showers. The Inquiry heard evidence that at times the Regional Processing Centre ran out of soap.[516]

One child in Offshore Processing Centre 3 claims that ‘the toilets are very dirty and unhygienic. Most of them do not work and are unusable. The bathroom floors are always covered in dirty water’ and the water shortages ‘[cause] filthiness and increase the number of flies’.[517] Another child writes:

Because of this situation, new diseases came out like skin rashes, mosquitoes discovered and new flys ... Disease got worse in the camp and still expanding. Sometimes because of the smell, our camp it’s like a sewer. The cleaners cleaning the toilets whenever they want. Around the toilets are mountain of toilet paper and pee and poo and water up to your ankle.[518]

At the third public hearing the Inquiry was told by a doctor who had worked on Nauru that the state of the toilets and the lack of water contributed to dehydration.

And the dehydration was often related to both the fact that they didn’t have access to water throughout the day on demand and the other reason was that a lot of them, particularly women and children, didn’t want to drink water during the day because they didn’t want to use the shared toileting facilities.[519]

12.3 Provision of clothing and footwear

The State is responsible for providing material assistance such as nutrition, clothing and housing where a child is in need (Article 27(3) Convention on the Rights of the Child)

The Inquiry heard evidence that the provision of clothing and footwear is inadequate for many children on Nauru. Employees of Save the Children report that there is a particular shortage of appropriate footwear:

Many children are wearing adult sized thongs with holes placing them at risk and resulting in numerous foot injuries... Staff are not allowed to enter OPC3 without closed toe shoes for workplace health and safety reasons. However, children and adults have been forced to ‘make do’ with thongs that are often broken, have holes or are not the appropriate size despite waiting months for replacement shoes.[520]

The same employees add that there is a lack of appropriate clothing for the climate, with children wearing ‘long sleeved flannel shirts ... in 45 degrees and 90 percent humidity’.[521]

There are also many accounts of shortages of underwear for children and a lack of bed sheets.

A 13 year old girl ‘had only two pairs of underwear and only one she could use while on her period. She felt shame because she was an adolescent girl and each day she had to wash her underwear and hang them to dry in front of her father which was not culturally appropriate. She went for months without additional underwear despite multiple written requests’.

A boy on Nauru had his genitals exposed because he was only given two pairs of shorts, one of which was badly torn, and no underwear.

One 13 year old boy who wets the bed did not receive new sheets and detergent, even after repeated requests from STTARS.[522]

12.4 Recreation and play

States have recognised the right of the child to rest and leisure, to engage in play and recreational activities appropriate to the age of the child and to participate freely in cultural life and the arts (Article 31 Convention on the Rights of the Child)

There has been some progress on building the infrastructure for play and meaningful activities on Nauru. The Department constructed a new playground in Offshore Processing Centre 3 in February 2014 and also opened a soccer field in Offshore Processing Centre 1 next to the school.[523] [524]

However, the Commission remains concerned that there are insufficient toys, books and play equipment. The Inquiry heard evidence from a former Save the Children employee that children played with rocks and stones.[525]

12.5 Education

States have expressly recognised the right of the child to education (Article 28(1) Convention on the Rights of the Child)

All school aged children on Nauru have access to school. Primary school consists of 4 hours of class time within Offshore Processing Centre 3. Secondary school is located in Offshore Processing Centre 1 and children are transported by bus to class. There is also a pilot program to integrate asylum seeker children into local Nauruan high schools. As of February 2014, four early high school students were attending Nauru College and 11 late high school students were studying at Nauru Secondary College.[526]

There are concerns that the schooling environment in detention is not conducive to learning on Nauru. Save the Children workers claim that the provision of education has been ‘largely inadequate due to the lack of appropriate facilities’. They cite ‘high noise levels, not enough chairs ... lack of air conditioning and temperatures that were 45 to 50 degrees Celsius.’[527] In addition, the detention centres are insufficiently equipped with ‘books, lesson plans, writing implements, paper’ to provide adequate education.[528]

Evidence suggests that the high school students studying in Nauruan schools are faring better and exhibiting improved mental health and wellbeing.[529] However, the average class size in Nauruan schools is 40 students and it is estimated that there are ‘no classrooms, furniture or resources at Nauruan schools to support additional children from the Regional Processing Centres’.[530] There are concerns that this program will not proceed beyond its pilot stage.

The Inquiry received evidence suggesting that Nauruan schools may soon face teacher shortages for their own students. As an Education Bill mandating teaching qualifications takes effect at the end of 2014, an estimated 60 percent of the current teaching staff in Nauruan high schools may be let go because they do not have the relevant qualifications.[531]

Classes in the detention centres have students of disparate ages and abilities, making them difficult to manage. One teacher on Nauru claims that ‘[b]ecause there is such a wide diversity of what level of education the students have enjoyed previously, it can at times be challenging to cater for everyone.... I teach a group of students aged 14 to 18, most of whom are beginners in English and may be illiterate’.[532] A former worker adds ‘we have teenage children in class with much younger kids and 11 year olds in classes with high school kids’.[533]

The biggest barrier to education remains the fact of detention itself. A former worker on Nauru concludes, ‘they feel very hopeless about their future and do not see the point of trying to learn in school because they will just “stay here forever”.[534]

12.6 Security measures

Every child deprived of his or her liberty should be treated with humanity and respect for the inherent dignity of the human person, in a manner which takes into account the needs of persons of his or her age (Article 37(c) Convention on the Rights of the Child)

The Inquiry received submissions that the security measures on Nauru create the feeling of imprisonment.[535] The Sub-Committee of the Joint Advisory Committee for Nauru highlights that ‘the perimeter is fenced and there are entry checkpoints’.[536] A former trauma counsellor for Save the Children concludes, the ‘centre is set up as a prison’.[537]

12.7 Policy guiding the transfer of children to Nauru

On 19 July 2013 the Australian Government announced a Regional Settlement Arrangement with the Government of Papua New Guinea.[538] Under the Regional Settlement Arrangement, asylum seekers arriving unauthorised by boat after 19 July 2013 will be transferred to Papua New Guinea for processing and resettlement (if found to be refugees). If found not to be refugees they will be returned to their country of origin or a country where they have a right of residence. On 3 August 2013 the Australian Government signed a similar Memorandum of Understanding with Nauru.[539]

Current government policy is that families and children will only be transferred to Nauru, not Papua New Guinea. Single adult men are transferred to both Papua New Guinea and Nauru.

At 31 July 2014 there were 695 men, 268 women and 183 children detained at the regional processing centre on Nauru.[540] At least 27 unaccompanied children have been transferred to Nauru since 31 March 2014.

12.8 Impact of detention on children

States have an obligation to take all appropriate measures to protect children from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation that includes sexual abuse (Article 19(1) Convention on the Rights of the Child)

Children are also entitled to enjoy the highest attainable standard of healthcare and facilities (Article 24(1) Convention on the Rights of the Child)

The Inquiry has received significant evidence regarding the deteriorating health of children in detention on Nauru.

A social worker employed by Save the Children described witnessing ‘a marked deterioration in children’s mental health as children began to realise that they would be in Nauru for a long time’.[541]

A doctor who worked in Nauru for six weeks between February and March 2014 stated that ‘every day ... there were teenagers and unaccompanied children who were either on suicide or self-harm watch’.[542]

On 27 September 2014 it was reported that a 15 year old girl was evacuated from Nauru to Australia after attempting self-harm.[543]

According to the Joint Advisory Committee on Nauru, over the 14 month period between September 2012 and November 2013 there were 102 incidents of self-harm in adult males.[544] The incidence of self-harm among adult detainees on Nauru is revealing in two important respects. First, it is a reflection of the damaging effect of the conditions on Nauru on the mental health of all detainees. Second, the incidents of self-harm by adults are an additional aspect of life in detention with which children must contend. As employees of Save the Children note:

each day the children are in detention exposes them to witnessing additional traumatic situations ... which serves as triggers to past traumatic events and delays their ability to recover from previous trauma.[545]

The impact of detention on mental health appears to be compounded by a number of conditions. The Inquiry received evidence that:

As children develop challenging behaviours due to their deteriorating mental health, increased anger, and helplessness regarding their detainment; they also begin to experience more stigmatisation from the community by peers and their adult caregivers.[546]

One 16 year old boy experiencing issues with aggression, anger and depression, was said to have received so much ‘taunting, ridiculing, threats, exclusion and aggression’ that he was temporarily removed to Offshore Processing Centre 1 – the adult centre.[547]

 

Family separation has a similarly damaging effect on mental health. A teacher on Nauru claims that ‘I know most of the residents in Offshore Processing Centre 3 are separated from at least one person in their immediate family’.[548] The same teacher adds:

Children suffer when they are separated from their families. This is especially noticeable in the many unaccompanied minors [children] that live here. Their behaviour indicates that they respond even more strongly when something happens that upsets them, e.g. when something changes in a class - new teacher, new room, new internet time, ... - they might play up in class, get angry, get upset, start misbehaving, refuse to follow instruction, or even have a complete meltdown, for some even on a daily basis. Having multiple incidents in one day in a class is not unusual.[549]

The Commission heard evidence of a 13 year old boy detained in Nauru who had experienced significant weight loss. The child expressed to the treating doctor ‘a complete loss of hope; despair’.[550] The doctor described how ‘[h]e had no appetite and no will to eat. He lost over 10 kilograms which would be about a quarter of his body weight’.[551]

The Inquiry has received evidence that the practice of referring to children by boat number is pervasive in some detention centres. Employees of Save the Children claim that Nauru is no exception.

This is a common practi[s]e that occurs among ALL service providers including Save the Children Australia, a child rights organisation which seeks to show that even the most fervent advocates of child’s rights begin [adapting] practises that are prevalent in the institution despite awareness of the detrimental impacts of these practises.[552]

Employees of Save the Children report that children have disclosed that they are ‘just a number’ and that they feel like ‘animals and not people’.[553] Children on Nauru have signed their artworks and have referred to themselves by their boat number rather than by their name.[554]

The detention environment and the limitations of healthcare on Nauru have also posed serious challenges to the physical health and development of children.

Conditions in detention are crowded and often unhygienic. As a result, even a minor incidence of communicable diseases is likely to result in a serious outbreak. Employees of Save the Children report ‘outbreaks of lice, gastroenteritis, and school sores that are difficult to contain due to the use of common toilets and showers, common eating areas and close living conditions’.[555]

The impact that long term detention has on the physical and mental health of asylum seekers detained offshore has been well-documented.[556] Previous reports about Nauru and Manus Island document the incidence of people with a range of mental illnesses, including depression, anxiety, post-traumatic stress disorder, adjustment disorder and acute stress reaction. High levels of actual and threatened self-harm have also been documented over past years.[557]

In 2005, Mr Paris Aristotle, as the Director of the Victorian Foundation for the Survivors of Torture, accompanied a former Immigration Minister John Hodges on a visit to Nauru. Mr Aristotle reported that ‘it had reached a point where none of those interventions were going to prevent a rapid decline in their mental health’.[558] Immigration Minister Amanda Vanstone agreed that 25 of the remaining 27 detainees on Nauru should be brought back to Australia ‘on the expert advice of health professionals because of serious mental health concerns’.[559]

Given the well documented evidence regarding the negative impacts of lengthy detention on Nauru, the Australian Government can be considered to be on notice as to the risk of serious harm to the children and families that are detained there.

12.9 Transfer of unaccompanied children

Children who are separated from their family environment shall be entitled to special protection and assistance provided by the state (Article 20(1) Convention on the Rights of the Child)

What is our fault? That we came to Australia after 19 July? We are not criminals. Already 10 months we are in detention centre. It will be great if we put in jail instead of detention centre. We are thirsty for freedom.

(Unaccompanied child in detention)

The Commission is aware of at least 27 unaccompanied children who have been transferred to Nauru and remain in detention.

The Nauruan Minister for Justice and Border Protection is the legal guardian of unaccompanied children who are transferred to Nauru. Some of the Minister’s powers have been delegated to Save the Children. The Director of Policy and Public Affairs at Save the Children told the Inquiry that unaccompanied children receive 24-hour care from his staff and that they are housed in a separate and secure compound with air-conditioning.[560]

Given the impacts of detention on unaccompanied children on Christmas Island the Commission holds grave concerns for the wellbeing of these children on Nauru.

12.10 Child protection and allegations of abuse

States have undertaken the obligation to take all appropriate measures to protect children from all forms of physical or mental violence (Article 19 Convention on the Rights of the Child)

Further States have undertaken the obligation to protect children from all forms of sexual exploitation and sexual abuse (Article 34 Convention on the Rights of the Child)

The Inquiry has received evidence from staff working in Nauru of incidents of harassment, bullying and abuse.

In November 2013 a 16 year old boy was allegedly sexually assaulted by a cleaner, in view of security staff. It is understood that the cleaner was removed from the centre indefinitely.[561]

An 8 year old boy was allegedly sexually assaulted by adult detainees in view of a security staff member.[562]

The Commission is concerned by reports that there is no child protection framework for children detained in the detention centres and that Nauru itself has no child protection framework.[563] The Commission is further troubled about claims by children’s welfare service providers that they are unable to remove children from situations of abuse except in extreme circumstances and then only for a limited period of time.[564]

12.11 Health services

States recognize the right to enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health (Article 24(1) Convention on the Rights of the Child).

International Health and Medical Services is the health provider to detainees on Nauru. It employs 48.5 full-time equivalent staff on site at the Nauru regional processing centres. On an average day, the International Health and Medical Services receives 50 to 60 written requests for healthcare and around the same number for mental health care.[565] In response to a written request, the International Health and Medical Services makes an appointment for the detainee and provides them with an appointment docket. In reality, International Health and Medical Services medical staff see a total of 50 patients in a day. There is a ‘fail to attend’ rate of approximately 25 to 30 percent.[566]

There are some limits to specialist health services on Nauru. The medical provider does not currently employ a paediatrician. There is noone on staff who has neonatal or early childhood resuscitation experience, advanced paediatric life support training or child protection experience.[567] According to the Subcommittee of the Joint Advisory Committee on Nauru, this places children at risk.

...children deteriorate quickly when they are unwell, and the 24-36 hour timeframe for medical evacuation will not allow support during the critical early period of severe illness.[568]

The Commission was also advised about inefficiencies in access to health care. Detainees told the Joint Advisory Committee that they ‘wait too long’ for care and that they had to submit four to five requests before they received an appointment.[569] Employees of Save the Children raised concerns over transport and response to emergencies. They cited the following case of one ‘limp and non-responsive child’:

The Save the Children worker found that although the parents believed they were waiting for an ambulance, as she liaised with Wilson's Security guards, she was informed that an ambulance was ‘not available’ and that the child and his parents would have to take a bus to IHMS which would not be available for at least 30 minutes. She noted that the Wilson’s Security guards were ‘casual’ in their approach to this child’s serious health concern.[570]

 

Many detainees reported that even once appointments were secured, the quality of the International Health and Medical Services care was inadequate. One 15 year old child claims:

They will give us panadol for any problem or they will tell us to drink water. Or they will send us to a terrible room / tent call isolation room / tent. This room is dirty, no air condition, really hot, smelly, not a place for sick person. So everybody hide their problems from IHMS.[571]

 

Evidence suggests that there are challenges in managing vaccination programs on Nauru. International Health and Medical Services reports that 80 percent of detainees had completed immunisation and that the remaining 20 percent had scheduled a follow-up.[572] However, the Joint Advisory Committee found a contrary situation.

... we asked people about immunisation in all compounds, on a brief history, no one (adults or their children) had completed three sets of vaccines, suggesting that no one was up to date.[573]

 

Even if detainees are fully vaccinated, the Nauru immunisation schedule does not include the mumps, varicella, rotavirus, human papilloma virus or pneumococcal vaccines contained in the Australian Immunisation Schedule. [574]

12.12 Republic of Nauru Hospital

There is one hospital on Nauru. The Republic of Nauru hospital services 42 to 50 beds. It includes a two bed emergency room, a two bed high dependency unit, 12 acute adult beds, four acute paediatric beds, 16 long stay beds, two delivery rooms, six maternity beds and a single operating theatre. It also has an additional renovated four bed ward for the use of International Health and Medical Services.[575] While there have been very few recent referrals of asylum seekers to the hospital, referrals are reserved for the acute clinical care of illnesses that cannot be treated at the detention centre.[576] This includes surgery, cardiology, paediatrics, optometry and dental services.

The Joint Advisory Committee has raised concerns that ‘conditions at the hospital are difficult, particularly following the 2013 fire’.[577] In particular, there appears to be a shortage of the most basic equipment. The Committee writes:

There is no bed linen (patients families usually provide this when they are admitted), there are limitations with infection control procedures, the medical incinerator has not been functioning for some time, and the buildings have structural issues, including the use of asbestos sheeting. Visiting medical specialists are asked to bring their own equipment and supplies, including drapes.[578]

Certain hospital services are not offered in Nauru, partly due to shortages in resources. As of February 2014, there was no obstetrician at the hospital and hospital maternity services were provided by midwives.[579] There is no blood bank on Nauru. In situations requiring a transfusion, relatives are needed to donate blood at the hospital. There is no facility for antibody testing or blood borne virus screening.[580]

12.13 Mental health services

Mental healthcare is provided by International Health and Medical Services and by the NSW Service for the Treatment and Rehabilitation of Torture. As of February 2014 the full-time equivalent staff on Nauru included three mental health team leaders, one psychologist, four mental health nurses and three counsellors. There was a sleep management program operating at the detention centres, including the short-term use of benzodiazepines where necessary. Approximately 60 adults in detention on Nauru were taking psychotropic medications. This constitutes 6.3 percent of all adults detained there.[581]

The Joint Advisory Committee reported in February 2014 that the child psychiatrist position had been vacant but claimed that a psychiatrist would start work a week after their visit.[582] They also raised uncertainty about whether the psychologists or mental health nurses had paediatric qualifications or experience.[583]

People requiring intensive mental health support are put on a Psychological Support Program. As of February, there were three people on the Psychological Support Program, with staff reporting that the numbers of people on the Program ranged from 0 to 15 at any given time.[584] In the 14 month period from September 2012 to November 2013, there were 102 incidents of self-harm among adult males.[585] The Commission has concerns therefore, with the low number of people on the Psychological Support Program.

12.14 Pre-transfer assessment processes for people being sent to Nauru

Prior to the transfer of asylum seekers and children to Nauru, the Department conducts a Pre-Transfer Assessment to ‘consider whether appropriate support and services are available at the [Offshore Processing Place] and to confirm that there are no barriers to the transfer’.[586]

As a part of the Pre-Transfer Assessment, an International Health and Medical Services clinician, usually a nurse, performs a medical assessment and informs the Departmental officer as to the individual’s fitness to travel and fitness for placement.

To assess fitness to travel, clinicians review individual health records and, in some circumstances, they perform a physical examination. This occurs if an individual makes significant medical complaints or has a known communicable disease. Clinicians then categorise individuals into one of four groups:[587]

Category 1: Fit to fly to an OPC site
Category 2: Short-term NOT Fit to fly (anywhere)
Category 3: Fit to fly, not recommended for OPC site medium term
Category 4: Fit to fly, not recommended for an OPC site long-term.

During this assessment, clinicians also evaluate an individual’s fitness for placement. According to internal guidelines, clinicians must review ‘ongoing healthcare needs’ and ‘escalate’ any ‘concerns as to the suitability of the receiving site’.[588]

The Commission is concerned about the adequacy of the medical assessments, particularly those conducted within a 48 hour time frame. For example, a doctor who worked on Christmas Island told the Inquiry that a woman understood to be pregnant with twins and a 4 year old boy with cerebral palsy were sent to Nauru.[589]

Health clinicians have expressed similar concerns about the haste of the assessments:

A number of healthcare clinicians were uncomfortable completing these assessments and there was a sense of pressure from the healthcare service and immigration department to complete assessments quickly and indicate a client is ‘fit to fly’ based on clinical history. This process sometimes made it feel like the healthcare service was there to protect and serve the needs of the immigration department.[590]

This view is supported by the Royal Australasian College of Physicians. They add:

an adequate medical assessment is not possible within 48 hours. Initial health assessments conducted on asylum-seeker arrivals involves taking a detailed history and conducting a thorough examination of the patient, identifying any chronic or acute conditions and ensuring immunisations are up to date. Conducting the health assessment once the person seeking asylum has arrived at the centre is just not acceptable.[591]

The Inquiry team also heard several concerns regarding the standard of the medical assessments. A professional working in immigration detention wrote that there is a lack of expertise among the clinicians conducting the assessment of children:

There appeared to be a lack of developmentally-appropriate pre-transfer mental health assessment for children. There was no specialised assessment protocol that responds to children and young people who are high risk to prevent them in being transferred [to] a RPC.[592]

The same professional adds that some assessments were ‘conducted in advance with a large window of time; anywhere from a few days to one month prior to transfer to other centres’.[593] Given the volatility of health conditions in detention, these alleged delays raise doubts as to the currency of the medical assessment.

An additional limitation of the Pre-Transfer Assessment is that it does not consider mental health illnesses or identify people who have suffered torture and trauma. Mental health screening appears to occur after transfer. This concern is shared by the United Nations High Commissioner for Refugees:

Post-transfer mental health screening by IHMS continues to identify mental health cases and survivors of torture and/or trauma. This raises concerns about the reliability and comprehensiveness of Australia’s pre-transfer assessments.[594]

Employees from Save the Children claim that a female unaccompanied child with a history of ‘anxiety attacks, depression, hopelessness and self-harming behaviour’ had been transferred to Nauru from Christmas Island.[595]

As part of the transfer process, Department officers review health recommendations, along with any special needs or logistical concerns that may affect the transfer. Officers consider family unity, individual protection claims against the Regional Processing Country and whether the transferee is someone who the Minister has exempted from the Migration Act.

Departmental officers conduct interviews with asylum seekers to make the final assessment of their fitness for transfer. During interviews with children, an adult family member or an independent observer must be present.

Officers complete a Best Interests Assessment for children before they are deemed fit for travel. As a part of this assessment, officers consider whether the education, accommodation, services, activities, care and welfare arrangements at the detention centre are appropriate for the child.[596]

Under current Australian Government policy, all families and children who arrive by boat on or after 19 July 2013 must be transferred to Nauru. There are no exceptions to this policy.[597] This means that there are only two possible outcomes to a Pre-Transfer Assessment - officers may clear the transfer or postpone it until such a time when a transfer is reasonably practicable. The Government has instructed that, where possible, the Department will complete the Pre-Transfer Assessment within 48 hours.[598]

12.15 Failure to consider the best interests of the child

Under Article 3 of the Convention on the Rights of the Child, Australia has an obligation to treat the best interests of the child as a primary consideration in all actions concerning children. This obligation is explicitly acknowledged in the Department’s Best Interests Assessment process for children.[599] However, the Department’s Best Interest Assessment appears to be irrelevant in the decision to transfer a child to Nauru. This is because the Australian Government has made a blanket decision that, in every case, the best interests of the child are outweighed by other primary considerations:

... the Australian Government’s view is that in making the transfer decision, the best interests of such children are outweighed by other primary considerations, including the need to preserve the integrity of Australia’s migration system and the need to discourage children taking, or being taken on, dangerous illegal boat journeys to Australia.

Accordingly, while this assessment considers a range of factors to ensure that care, services and support arrangements are available to meet the needs of the individual child, it does not consider whether the best interests of the child would be served by the individual child being transferred to an RPC.[600]

By the Department’s own explanation, the best interests of an individual child has no bearing on whether that child is to be transferred to Nauru. Given the very serious resource limitations and the poor living conditions on Nauru, it is the view of the Commission that the Best Interests Assessment for children, is in name only.

The Minister’s role as the guardian of unaccompanied children under the Immigration (Guardianship of Children) Act 1946 (Cth) requires him to act in the best interests of the child. Article 18(1) of the Convention on the Rights of the Child states that ‘the best interests of the child will be [the legal guardian’s] basic concern’. Article 18(1) makes clear that the best interests of an unaccompanied child must not only be a primary consideration (as suggested by article 3(1) of the Convention), but the primary consideration for the person acting as a child’s legal guardian.

The monitoring visit by the United Nations High Commissioner for Refugees to Nauru in October 2013 found that the ‘harsh and unsuitable environment at the Regional Processing Centre is inappropriate for the care and support of children seeking asylum’. It raised concerns that children did not have access to adequate education and recreational facilities and was of the view that no child should be transferred from Australia to Nauru.[601]

The Commission shares the view of the United Nations High Commissioner for Refugees. It is difficult to see how transferring children to Nauru for processing of their refugee claims could ever be in their best interests.

12.16 Lack of individual assessments of the needs of the child

All 27 unaccompanied children who were assessed under the Department’s Best Interest Assessment process between 1 January 2014 and 31 March 2014 were recommended for transfer to Nauru on the basis of almost identical generalised statements of reasons. These were expressed as follows:

Appropriate arrangements are in place in Nauru, therefore the child’s transfer was appropriate.

Department officers reached this conclusion by ticking a series of boxes in the Best Interest Assessment form which indicate that they have ‘considered advice from relevant areas in the Department of Immigration and Border Protection about the services available in the Regional Processing Centre and think that these services will be appropriate’.

It is unclear how Departmental officers made these findings as none of the Best Interest Assessments document any individualised assessment of the unaccompanied child’s educational, care, welfare and service related needs. There is also no information provided about the quality of the facilities and services on Nauru to support the findings that these facilities and services are appropriate to support that child’s needs.

In the many instances where children aged 16 to 17 years old were recorded as having little to no schooling, the Departmental officer declared that the educational services in Nauru would be appropriate for the child without providing any information about what remedial educational services are available in Nauru.

Similarly, there appeared to be no consideration of other interests affecting the child; for example, whether the child had adult relatives such as aunts, uncles and cousins residing in Australia (including in immigration detention).

The Best Interest Assessment form provides space for a Departmental officer to record specific considerations about the services that a child might need in the Regional Processing Country. In all of the Best Interest Assessment forms reviewed by the Commission, this space was left blank. This strongly suggests a lack of assessment of the individual needs of the child.

Case Study 13: Transfer of a single father with a hernia condition and his sick child to Nauru

In March 2014 the Inquiry spoke to a father who fled Syria with his five sons. At the time the family were detained at Aqua Detention Centre on Christmas Island.

The father was experiencing pain from a hernia and had difficulty walking to the communal bathrooms in the compound. The doctor had advised him to limit his walking as it could exacerbate his condition. In December 2013 the father fainted due to dehydration.

His eight year old son was seeing the mental health team every fortnight and was taking medication for bed-wetting. In December 2013 his son started to wet his pants during the day and needed to wear pads.

Despite these health problems, the family were transferred to Nauru.

The father claims that the health service on Nauru ran out of medication for bed-wetting leaving his child without medication for months.

The father does not eat meals regularly because he is required to walk 10 mins each way in the heat and then stand in a long line three times each day in order to receive food.

The father was offered surgery for his hernia twice at the local hospital in Nauru. The first time the operation was cancelled as a result of a power failure. The second time the surgeon refused to operate because the father had arrived 15 minutes late. He was unable to attend on time because he was reliant on the detention authorities to transfer him to the hospital. The father has lost confidence in the Nauruan hospital and remains in pain from his hernia.

12.17 The scope of the Commission to inquire into detention on Nauru

This Inquiry was commenced on the Commission’s own motion and the Commission drafted the Terms of Reference. The Terms of Reference indicated that the President would inquire into the impact of immigration detention on the health, wellbeing and development of children. In a discussion paper released at the same time as the Terms of Reference, the Commission confirmed that Inquiry staff would not travel to Nauru or Papua New Guinea, but that the Commission may nevertheless make observations on the transfer to and detention of children on Nauru and Manus Island.[602]

The Commission sought information and documents from the Department of Immigration and Border Protection pursuant to a number of compulsory notices issued under s 21 of the Australian Human Rights Commission Act 1986 (Cth). The Department provided responses to each of the notices issued by the Commission, but did not provide certain information or documents about the following issues:

  • the transfer of children to Nauru;
  • the arrangements between Australia and Nauru and between Australia and its contracted service providers in relation to the detention of children at the Regional Processing Centre on Nauru; and
  • the impact of detention at the Regional Processing Centre on Nauru on the health, wellbeing and development of the children detained there.

The reason given by the Department for not providing this information was that it considered the information ‘not relevant to the Inquiry, as it does not relate to the immigration detention of children in Australia and is, therefore, outside the scope of the Terms of Reference’.[603]

The Commission responded to the Department’s objection, confirming the scope of the Commission’s Terms of Reference and asking again for the production of the documents in relation to Nauru required by the compulsory notice.[604] The Department wrote back advising that it maintained its previously expressed position.[605]

Given the limited timeframe for the Inquiry, the Commission did not take any further steps in relation to the refusal by the Department to fully comply with the statutory notice.

As a result of the Commission’s inability to obtain information from the Department about the transfer of children to Nauru and the detention of children on Nauru, the material contained in this chapter is drawn from submissions from:

  • children and adults detained on Nauru;
  • eyewitness accounts of conditions on Nauru observed by the United Nations High Commissioner for Refugees during several site visits;
  • written submissions and oral evidence taken under oath from employees of Save the Children who worked as welfare officers with children detained on Nauru;
  • written evidence and oral evidence taken under oath from doctors providing medical services to children on Nauru; and
  • supporting material submitted to the Commission including incident reports created by organisations contracted to the Commonwealth to provide services to people detained at the Regional Processing Centre on Nauru.

12.18 Findings in relation to children on Nauru

Children on Nauru are suffering from extreme levels of physical, emotional, psychological and developmental distress. The Commission is concerned that detention on Nauru is mandatory for children and that there is no time limit on how long they will be detained.

The Commission finds that the inevitable and foreseeable consequence of Australia’s transfer of children to Nauru is that they would be detained in breach of article 37(b) of the Convention on the Rights of the Child.

The Commission finds that Australia transferred children to Nauru regardless of whether this was in their best interests, in breach of article 3(1) of the Convention on the Rights of the Child.

The Commission has serious concerns that the conditions in which children are detained on Nauru are in breach of the Convention on the Rights of the Child, articles 19(1), 20(1), 24(1), 27(1), 27(3), 28, 31 and:

16(1): No child shall be subjected to arbitrary or unlawful interference with his or her privacy, family, home or correspondence, nor to unlawful attacks on his or her honour and reputation.

34: States Parties undertake to protect the child from all forms of sexual exploitation and sexual abuse.

37(a): No child shall be subjected to torture or other cruel, inhuman or degrading treatment or punishment. Neither capital punishment nor life imprisonment without possibility of release shall be imposed for offences committed by persons below eighteen years of age.

[496]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 2. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 30 September 2014).
[497]Name withheld, 16 year old detained in Nauru OPC, Submission No 91 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2091%20-%20Name%20withheld%20-%2016%20year%20old%20detained%20in%20Nauru%20OPC.pdf (viewed 30 September 2014).
[498]Australian Bureau of Meteorology and Commonwealth Scientific and Industrial
Research Organisation (CSIRO), Climate Change in the Pacific: Scientific Assessment and New Research Vol 2: Country Reports (2011) p 134. At http://www.pacificclimatechangescience.org/wp-content/uploads/2013/09/Volume-2-country-reports.pdf (viewed 5 September 2014).
[499]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 3. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[500]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014) p 35.
[501]Dr A-L Chan, Third Public Hearing of the National Inquiry into Children in Immigration Detention 2014, Sydney, Thursday 31 July 2014, p 2. At https://www.humanrights.gov.au/sites/default/files/Dr%20Chan.pdf (viewed 30 September 2014).
[502]K Diallo, Third Public Hearing of the National Inquiry into Children in Immigration Detention 2014, Sydney, 31 July 2014, p4. At https://www.humanrights.gov.au/sites/default/files/Ms%20Diallo.pdf (Viewed 30 September 2014).
[503]Office of the United Nations High Commissioner for Refugees, UNHCR monitoring visit to the Republic of Nauru,7-9 October 2013, p16. At http://unhcr.org.au/unhcr/images/2013-11-26%20Report%20of%20UNHCR%20Visit%20to%20Nauru%20of%207-9%20October%202013.pdf (viewed October 2014).
[504]Australian Human Rights Commission, New Mothers on Suicide Watch at Christmas Island, Australian Human Rights Commission Latest News, 24 July 2014. At https://www.humanrights.gov.au/news/stories/new-mothers-suicide-watch-christmas-island (viewed 8 October 2014).
[505]Office of the United Nations High Commissioner for Refugees, UNHCR monitoring visit to the Republic of Nauru 7-9 October 2013, p16. At http://unhcr.org.au/unhcr/images/2013-11-26%20Report%20of%20UNHCR%20Visit%20to%20Nauru%20of%207-9%20October%202013.pdf (viewed 8 October 2014).
[506]K Diallo, Third Public Hearing of the National Inquiry into Children in Immigration Detention 2014, Sydney, 31 July 2014, p 6. At https://www.humanrights.gov.au/sites/default/files/Ms%20Diallo.pdf (Viewed 30 September 2014).
[507]Name withheld, 16 year old detained in Nauru OPC, Submission No 91 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2091%20-%20Name%20withheld%20-%2016%20year%20old%20detained%20in%20Nauru%20OPC.pdf (viewed 7 October 2014).
[508]Names withheld, employees of Save the Children Australia in Nauru, Submission No183 to the National Inquiry into Children in Immigration Detention 2014, p 3. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[509]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 3. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[510]Name withheld, Child Protection and Support Worker in Nauru, Submission No134 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20134%20-%20Name%20withheld%20-%20Child%20Protection%20and%20Support%20Worker%20in%20Nauru.pdf, (Viewed 30 September 2014).
[511]Name withheld, former professional working in Nauru OPC, Submission No 67 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2067%20-%20Name%20withheld%20-%20Former%20professional%20working%20in%20Nauru%20OPC.pdf (Viewed 30 September 2014).
[512]Name withheld, teacher in Nauru, Submission No156 to the National Inquiry into Children in Immigration Detention 2014, p 1. At http://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/national-inquiry-children-immigration-detention-2014-0 (Viewed 30 September 2014).
[513]Names withheld, employees of Save the Children Australia in Nauru, Submission 183 to the National Inquiry into Children in Immigration Detention 2014, p 4. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[514]Names withheld, employees of Save the Children Australia in Nauru, Submission 183 to the National Inquiry into Children in Immigration Detention 2014, p 5. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[515]Names withheld, employees of Save the Children Australia in Nauru, Submission 183 to the National Inquiry into Children in Immigration Detention 2014, p 5. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[516]K Diallo, Third Public Hearing of the National Inquiry into Children in Immigration Detention 2014, Sydney, 31 July 2014, p 6. At https://www.humanrights.gov.au/sites/default/files/Ms%20Diallo.pdf (Viewed 30 September 2014).
[517]Name withheld, 16 year old detained in Nauru OPC, Submission No 91 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2091%20-%20Name%20withheld%20-%2016%20year%20old%20detained%20in%20Nauru%20OPC.pdf (viewed 7 October 2014).
[518]Name withheld, child detained in Nauru OPC, Submission No 132 to the National Inquiry into Children in Immigration Detention 2014, p 2. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20132%20-%20Name%20withheld%20-%20Child%20detained%20in%20Nauru%20OPC.pdf (Viewed 30 September 2014).
[519]Dr A-L Chan, Third Public Hearing of the National Inquiry into Children in Immigration Detention, Sydney 31 July 2014, p 3. At https://www.humanrights.gov.au/sites/default/files/Dr%20Chan.pdf (viewed 30 September 2014).
[520]Names withheld, employees of Save the Children Australia in Nauru, Submission No183 to the National Inquiry into Children in Immigration Detention 2014, p 19. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014)
[521]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 19. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[522]Names withheld, employees of Save the Children Australia in Nauru, Submission No183 to the National Inquiry into Children in Immigration Detention 2014, pp 46-47. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[523]Name withheld, teacher in Nauru, Submission No 156 to the National Inquiry into Children in Immigration Detention 2014, p4. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20156%20-%20Name%20withheld%20-%20Teacher%20in%20Nauru_0.doc (viewed 7 October 2014)
[524]Name withheld, Child Protection and Support Worker in Nauru, Submission No 134 to the National Inquiry into Children in Immigration Detention 2014, p5. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20134%20-%20Name%20withheld%20-%20Child%20Protection%20and%20Support%20Worker%20in%20Nauru.pdf (Viewed 30 September 2014).
[525]K Diallo, Third Public Hearing of the National Inquiry into Children in Immigration Detention, Sydney, 31 July 2014, p 9. At https://www.humanrights.gov.au/sites/default/files/Ms%20Diallo.pdf (Viewed 30 September 2014).
[526]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 16.
[527]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 34. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[528]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 34. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[529]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 35.
[530]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 11.
[531]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014).
[532]Name withheld, teacher in Nauru, Submission No 156 to the National Inquiry into Children in Immigration Detention 2014, p 4. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20156%20-%20Name%20withheld%20-%20Teacher%20in%20Nauru_0.doc (viewed 7 October 2014)
[533]Name withheld, Child Protection and Support Worker in Nauru, Submission No134 to the National Inquiry into Children in Immigration Detention 2014, p 5. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20134%20-%20Name%20withheld%20-%20Child%20Protection%20and%20Support%20Worker%20in%20Nauru.pdf (Viewed 30 September 2014).
[534]Name withheld, Child Protection and Support Worker in Nauru, Submission No 134 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20134%20-%20Name%20withheld%20-%20Child%20Protection%20and%20Support%20Worker%20in%20Nauru.pdf (Viewed 30 September 2014).
[535]Name withheld, former professional working in Nauru OPC, Submission No 67 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2067%20-%20Name%20withheld%20-%20Former%20professional%20working%20in%20Nauru%20OPC.pdf (viewed 7 October 2014).
[536]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 14.
[537]Name withheld, former professional working in Nauru OPC, Submission No 67 to the National Inquiry into Children in Immigration Detention 2014, p 1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2067%20-%20Name%20withheld%20-%20Former%20professional%20working%20in%20Nauru%20OPC.pdf (viewed 7 October 2014).
[538]Regional Resettlement Arrangement between Australia and Papua New Guinea (19 July 2013). At http://www.refworld.org/docid/51f61a504.html (viewed 3 September 2014). See also Memorandum of Understanding between the Government of the Independent State of Papua New Guinea and the Government of Australia, relating to the transfer to, and assessment and settlement in, Papua New Guinea of certain persons, and related issues (6 August 2013). At http://www.dfat.gov.au/geo/png/joint-mou-20130806.html (viewed 3 September 2014).
[539]Memorandum of Understanding between the Republic of Nauru and the Commonwealth of Australia, relating to the transfer to and assessment of persons in Nauru, and related issues (3 August 2013). At http://www.dfat.gov.au/issues/people-smuggling-mou.html (viewed 3 September 2014).
[540]Department of Immigration and Border Protection, Immigration Detention and Community Detention Statistics Summary, (31 July 2014). At http://www.immi.gov.au/managing-australias-borders/detention/_pdf/immigration-detention-statistics-july2014.pdf (Viewed 30 September 2014).
[541]Name withheld, former professional working in Nauru OPC, Submission No 67 to the National Inquiry into Children in Immigration Detention, p 2. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2067%20-%20Name%20withheld%20-%20Former%20professional%20working%20in%20Nauru%20OPC.pdf (viewed 7 October 2014).
[542]Dr A-L Chan, Third Public Hearing of the National Inquiry into Children in Immigration Detention, Sydney 31 July 2014, p 4. At https://www.humanrights.gov.au/sites/default/files/Dr%20Chan.pdf (viewed 30 September 2014).
[543]J Maley, ‘Girl evacuated from Nauru after self-harm attempt’, Sydney Morning Herald, 27 September 2014. At http://www.smh.com.au/federal-politics/political-news/girl-evacuated-from-nauru-after-selfharm-attempt-20140927-10n023.html (viewed 29 September 2014).
[544]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements (16-19 February 2014), p 24.
[545]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 9. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[546]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014 p 50. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[547]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 17. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[548]Name withheld, teacher in Nauru, Submission No 156 to the National Inquiry into Children in Immigration Detention 2014, p 5. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20156%20-%20Name%20withheld%20-%20Teacher%20in%20Nauru_0.doc (viewed 7 October 2014)
[549]Name withheld, teacher in Nauru, Submission No156 to the National Inquiry into Children in Immigration Detention 2014, p5. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20156%20-%20Name%20withheld%20-%20Teacher%20in%20Nauru_0.doc (viewed 7 October 2014
[550]Dr A-L Chan, Third Public Hearing of the National Inquiry into Children in Immigration Detention, Sydney, 31 July 2014, p 3. At https://www.humanrights.gov.au/sites/default/files/Dr%20Chan.pdf (viewed 30 September 2014).
[551]Dr A-L Chan, Third Public Hearing of the National Inquiry into Children in Immigration Detention, Sydney, 31 July 2014, p 4. At https://www.humanrights.gov.au/sites/default/files/Dr%20Chan.pdf (viewed 30 September 2014).
[552]Names withheld, employees of Save the Children Australia in Nauru, Submission No183, p 44. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[553]Names withheld, employees of Save the Children Australia in Nauru, Submission No183, p45. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[554]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183, At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[555]Names withheld, employees of Save the Children Australia in Nauru, Submission No183, p.4. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[556]Australian Human Rights Commission, Submission to the Senate Standing Committees on Legal and Constitutional Affairs Inquiry into Australia’s agreement with Malaysia in relation to asylum seekers (September 2011), para 76. At http://humanrights.gov.au/legal/submissions/2011/20110914_asylum_seekers.html (viewed 3 September 2014).
[557]Australian Human Rights Commission, Submission to the Senate Standing Committees on Legal and Constitutional Affairs Inquiry into Australia’s agreement with Malaysia in relation to asylum seekers (September 2011), para 76. At http://humanrights.gov.au/legal/submissions/2011/20110914_asylum_seekers.html (viewed 3 September 2014).
[558]M Gordon, ‘Detainees to cast off from Nauru’, The Age, October 14 2005. At http://www.theage.com.au/news/immigration/detainees-to-cast-off-from-nauru/2005/10/13/1128796652052.html (Viewed 30 September 2014).
[559]K Bem, N Field, N Maclellan, S Meyer, T Morris, A Price Too High: The Cost of Australia’s Approach to Asylum Seekers, Oxfam Australia, (2007), p 3. At http://resources.oxfam.org.au/filestore/originals/OAus-PriceTooHighAsylumSeekers-0807.pdf (viewed 30 September 2014).
[560]M Tinkler, First Public Hearing of the National Inquiry into Children in Immigration and Detention, Sydney, 4 April 2014, p 12. At https://www.humanrights.gov.au/sites/default/files/Mr%20Tinkler_0.pdf (viewed 30 September 2014).
[561]K Diallo, Third Public Hearing of the National Inquiry into Children in Immigration Detention 2014, Sydney, 31 July 2014, pp 13-14. At http://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/national-inquiry-children-immigration-detention-2014-1 (viewed 16 October 2014)..
[562]Name withheld, Child Protection and Support Worker, Submission No 134 to the National Inquiry into Children in Immigration Detention 2014, p 4. At http://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/national-inquiry-children-immigration-detention-2014-0 (viewed 16 October 2014).
[563]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 35.
[564]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 10. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[565]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements,(16-19 February 2014), p 22.
[566]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 22
[567]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 19.
[568]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements,(16-19 February 2014), p 3.
[569]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements,(16-19 February 2014), p 38.
[570]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 28-29. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[571]Name withheld,16 year old detained in Nauru OPC, Submission No 96 to the National Inquiry into Children in Immigration Detention 201, p1. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2096%20-%20%20Name%20withheld%20-%2016%20year%20old%20detained%20in%20Nauru%20OPC.pdf (Viewed 30 September 2014).
[572]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 31.
[573]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 32.
[574]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014) p 32.
[575]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements (16-19 February 2014), p 10.
[576]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 22.
[577]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements (16-19 February 2014),p 11.
[578]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 11.
[579]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements,(16-19 February 2014), p 36.
[580]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements,(16-19 February 2014), p 10.
[581]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements,(16-19 February 2014),p 22.
[582]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014) p 34.
[583]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 20.
[584]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 27.
[585]N Procter, S Sundram, G Singleton, G Paxton, A Block, Nauru Site Visit Report, Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements, (16-19 February 2014), p 24.
[586]Department of Immigration and Border Protection, Submission No 45 to the National Inquiry into Children in Immigration Detention 2014, p 73. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2045%20-%20Department%20of%20Immigration%20and%20Border%20Protection.pdf, (Viewed 30 September 2014).
[587]Department of Immigration and Border Protection, International Health and Medical Service Practice Guideline: Transfer within the Detention Network or into the Community, Item 7, Document 7.3, Schedule 3, First Notice to Produce 31 March 2014.
[588]Department of Immigration and Border Protection, International Health and Medical Service Practice Guideline: Transfer within the Detention Network or into the Community, Item 7, Document 7.3, Schedule 3, First Notice to Produce 31 March 2014.
[589]Dr G Ferguson, Third Public Hearing of the National Inquiry into Children in Immigration Detention 2014, Sydney 31 July 2014, p 16. At https://www.humanrights.gov.au/sites/default/files/Dr%20Ferguson%20Dr%20Sanggaran.pdf (Viewed 30 September 2014).
[590]Name withheld, professional working in Immigration Detention, Submission No 209 to the National Inquiry into Children in Immigration Detention 2014, p 8. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%2020… (Viewed 30 September 2014).
[591]Royal Australian College of Physicians, Health of unaccompanied children at risk, 27 September 2013. At http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CB0QFjAA&url=http%3A%2F%2Fwww.racp.edu.au%2Fdownload.cfm%3FDownloadFile%3D5D55761B-FF93-DC8E-475C8CCC72BB46BA&ei=BBAqVJeTJs-A8gWnzYGgAQ&usg=AFQjCNH0KmvY5z9F_nsB3sYHk35CchHVnQ (Viewed 30 September 2014).
[592]Name withheld, professional working in Immigration Detention, Submission No 209 to the National Inquiry into Children in Immigration Detention 2014, p 8. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20209%20-%20Name%20withheld%20-%20Professional%20working%20in%20immigration%20detention.docx (viewed 7 October 2014).
[593]Name withheld, professional working in Immigration Detention, Submission No 209 to the National Inquiry into Children in Immigration Detention 2014, p 8. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20209%20-%20Name%20withheld%20-%20Professional%20working%20in%20immigration%20detention.docx (viewed 7 October 2014).
[594]United Nations High Commissioner for Refugees, UNHCR Mission to the Republic of Nauru 3-5 December 2012 Report, p15. At http://unhcr.org.au/unhcr/images/Amended%20footnote%202012-12-14%20nauru%20monitoring%20report%20final_2.pdf (viewed 7 October 2014)
[595]Names withheld, employees of Save the Children Australia in Nauru, Submission No 183 to the National Inquiry into Children in Immigration Detention 2014, p 42. At https://www.humanrights.gov.au/sites/default/files/Submission%20No%20183%20-%20Names%20withheld%20-%20Employees%20of%20Save%20the%20Children%20Australia%20in%20Nauru_0.pdf (viewed 7 October 2014).
[596]Department of Immigration and Border Protection, Best Interests Assessment for transferring minors to an RPC, Item 1, Document 1.2, Schedule 3, First Notice to Produce 31 March 2014.
[597]Department of Immigration and Border Protection, Operation Sovereign Borders, 2013. At http://www.customs.gov.au/site/Translations/Fact-Sheet-English.asp (Viewed 30 September 2014).
[598]Department of Immigration and Border Protection, Operation Sovereign Borders, 2013. At http://www.customs.gov.au/site/Translations/Fact-Sheet-English.asp (Viewed 30 September 2014).
[599]Department of Immigration and Border Protection, Notice to produce, Best interests Assessment for transferring minors to an RPC (forming part of Pre-Transfer Assessment), Schedule 3, First Notice to produce 31 May 2014, Document 1.2.
[600]Department of Immigration and Border Protection, Notice to produce, Best interests Assessment for transferring minors to an RPC (forming part of Pre-Transfer Assessment), Schedule 3, First Notice to produce 31 May 2014, Document 1.2.
[601]Office of the United Nations High Commissioner for Refugees, UNHCR Monitoring visit to the Republic of Nauru 7-9 October 2013 Report, p 13. At http://unhcr.org.au/unhcr/images/2013-11-26%20Report%20of%20UNHCR%20Visit%20to%20Nauru%20of%207-9%20October%202013.pdf
(viewed 7 October 2014).
[602]Australian Human Rights Commission, National Inquiry into Children in Immigration Detention 2014: Discussion Paper (2014), p 2. Available at http://www.humanrights.gov.au/publications/national-inquiry-children-immigration-detention-2014-discussion-paper (viewed 3 September 2014).
[603]M Bowles, Secretary, Department of Immigration and Border Protection, Correspondence to Professor G Triggs, President, Australian Human Rights Commission, 24 April 2014.
[604]Professor G Triggs, President, Australian Human Rights Commission, Correspondence to the Department of Immigration and Border Protection, 5 May 2014.
[605]M Bowles, Secretary, Department of Immigration and Border Protection, Correspondence to Professor G Triggs, President, Australian Human Rights Commission, 12 June 2014.