Médecins Sans Frontières (MSF) workers have been forcibly expelled from Nauru for the crime of caring about refugees. Dr Nicole Montana, senior medical officer for Australia’s health contractor IHMS, has also been arrested and ordered to leave the island for “a breach of regional processing rules”. Australian governments, both Liberal and Labor, have criminalised compassion and are persecuting those who respect the basic human rights of refugees.

Montana and the MSF workers have angered the government by calling for the evacuation of refugees from Nauru and describing their plight as “beyond desperate”.  They have spoken angrily about the shocking physical and mental health condition of refugees on the island. For this heinous transgression, they’ve been accused of being “political activists” by the Nauruan and Australian governments and of acting outside their remit. 

MSF workers have been on Nauru since September 2017, a period in which 78 people, including children, have attempted suicide or have self-harmed. Some of the 119 children incarcerated on the island have also started to exhibit symptoms of a very rare mental health condition called “resignation syndrome”. Resignation syndrome first presented in significant numbers amongst refugee children in Sweden several years ago. Dr Barry Phataford, the founder and president of Doctors for Refugees, has described the syndrome as a “rarely seen progression beyond profound depression”. 

It is a passive pathway to death in which the bodies and minds of refugee children begin to shut down in response to neglect, isolation and the hopelessness of a situation from which they cannot escape. Sufferers become catatonic and enter into a coma-like state, unable to eat, move or communicate. Their bodies waste away unless they are intravenously fed. 

MSF workers have publicly insisted that all children need to be evacuated from Nauru, with an MSF spokesperson explaining, “What MSF found while treating refugees and asylum seekers in Nauru, is that the very cause of their suffering is the indefinite nature of the offshore detention policy”.

MSF workers who have witnessed first-hand the desperation of adults and children in detention have come to the same conclusion as numerous other medical staff and more than 30 humanitarian and medical organisations: almost every refugee on Nauru now has some kind of serious mental health and/or physical health problem, and further deaths are guaranteed unless they are evacuated immediately.

The cure for resignation syndrome is intensive, high quality paediatric mental health care and the restoration of hope. Hope and a real change in the material circumstances of the refugee children and their families – enough to make them feel secure enough that the world is not going to harm them – is the only way to avoid a full blown humanitarian catastrophe on Nauru.  

Australia is one of the richest countries in the world and could easily offer these children hope. But instead it is more brutality, with the Australian government setting the benchmark for anti-refugee governments around the world. 

Yet thanks in part to the “political activism” of MSF workers, for the first time in many years cracks have emerged in the Liberal Party over the government’s treatment of refugees in offshore detention. Two Liberal parliamentarians have called for the immediate removal of all refugee children and their families from Nauru. Shamefully for the Labor Party, members of the government have proved more vocal critics of refugee cruelty than the official opposition. 

If lives are to be saved and the situation turned around, it will not be because of politicians whose privileged position depends heavily on vilifying refugees. It will be because of the heroic efforts of MSF workers and others like them, activists and refugees themselves who refuse to be silent in the face of gross injustice.