Feb 16, 2019

Five years on Nauru

Co-produced with

We unravel how refugee families destined for Australia ended up stuck in an immigrant detention camp more than a thousand miles away on the tiny island nation of Nauru. And why, after years of confinement, kids are succumbing to a surreal mental illness spreading through the camp like a contagion.

This episode is a collaboration with the Australian Broadcasting Corporation’s show “Background Briefing” and reporter Olivia Rousset.

Listen: Breaking point: Australia under pressure to evacuate sick children from Nauru

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Credits

Today's show was produced in collaboration with the Australian Broadcasting Corporation.

Reveal: Produced by Laura Starecheski. Edited by Brett Myers.

Partner Name: Reported by Olivia Rousset. Produced by Alice Brennan, Leila Shunnar and David Lawford.

Support for Reveal is provided by the Reva and David Logan Foundation, the Ford Foundation, the John D. and Catherine T. MacArthur Foundation, The John S. And James L. Knight Foundation, the Heising-Simons Foundation and the Ethics and Excellence in Journalism Foundation.

Transcript

Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal's radio stories is the audio.

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Al Letson:	From The Center of Investigative Reporting and PRX, this is Reveal. I'm Al Letson.
Maya:	I can see chickens because my dad gives them always food.
Al Letson:	That's Maya. She's a preteen girl from the Middle East.
Maya:	And I can see lots of fences and rocks like rocks right now. See everywhere you walk, there's rocks.
Al Letson:	Maya is one of hundreds of refugees mostly from Iran, Sri Lanka, Myanmar and, Pakistan who, for years, have been stuck in an immigrant detention camp on Nauru. That's a small island nation in the middle of the South Pacific.
Maya:	We don't have school. School is dangerous to go to school because ...
Al Letson:	Maya's not her real name and we can't tell you her age or what country she's from. We even changed her voice to protect her identity because her lawyers worry, speaking out could hurt her immigration case. What we can tell you, is that Maya and her family were trying to get to Australia to claim asylum. But Australia sent them here to this camp more than 1700 miles away.
Al Letson:	We got to talk to Maya because Australian reporter, Olivia Rousset managed to reach her on Nauru through a video chat.
Olivia Rousset:	Where are you?
Maya:	I'm behind my house.
Olivia Rousset:	Okay. Show me around.
Maya:	This is it. This is the houses. That one is my lemon tree.
Al Letson:	And Olivia, I understand that the day to day lives of the children stuck on Nauru have been very tough for any reporters and for the public to learn anything about.
Olivia Rousset:	That's right Al. I didn't even try to get a visa to travel to Nauru. Only a few journalists have even been allowed on the island to talk to the refugee families there. And the visa application alone costs nearly $6000 and most people get denied anyway.
Al Letson:	So, the only way you could talk to her was through this video connection. Take me through the video call with Maya.
Olivia Rousset:	Sure. When I first talked to her in August last year, Maya was living on Nauru with about 650 other refugees and asylum seekers.
Maya:	This is the fence and this is the rocks. Everywhere you go you'll see rocks and fence.
Olivia Rousset:	The ground is covered in bright, white rocks left over from an old phosphate mine. There's no grass in sight and hard, steel fences surround the whole area.
Maya:	Before I zoomed it but now I'm not zooming it so, you can see how high they are. Like, this high.
Olivia Rousset:	In the background I can see rows of small trailers where refugee families live. Maya pans to a little girl running over the rocky ground.
Maya:	She's chasing the chickens. We don't have anything to play with.
Olivia Rousset:	What's the little girl's name there?
Maya:	Monia.
Olivia Rousset:	She was born on Nauru huh?
Maya:	Yes, of course.
Olivia Rousset:	Life on Nauru is awful for these refugees. It's hot. The islands almost right on the equator and, for years they lived in plastic tents that just baked in the sun and families had to line up to get rationed food and toiletries. They don't get good medical care. There are dozens of documented accounts of assaults and sexual abuse of refugees including kids.
Olivia Rousset:	The whole place, the island, is just eight square miles and Australia won't let them leave. So, life there is like a dead end.
Maya:	It's not a place for kids to see this. It's like we're in a zoo. They have fences all around us and the fences they're so big.
Olivia Rousset:	Maya's been living like this for the last five years.
Maya:	Five years is too long and now we're nearly in six years.
Olivia Rousset:	At the peak there were hundreds of children like Maya living with their families in the camp on Nauru. The story I want to tell you Al is about how these children have dealt with essentially being trapped here for years.
Al Letson:	Olivia can you just back up and explain why these kids are stuck on Nauru?
Olivia Rousset:	Yes. All the refugees on Nauru tried to reach Australia by boat to claim asylum. But both Liberal and Conservative politicians in Australia wanted to stop them. What's really strange is that most asylum seekers come to Australia by plane and, those people aren't being targeted.
Olivia Rousset:	The fates of just a few thousand people who came by boat have taken over the whole immigration debate here in Australia.
Al Letson:	Kind of like the wall has here in the US?
Olivia Rousset:	Right. We can't have a wall here. We have 16,000 miles of coastline so, stopping the boats is how our politicians talk about securing our border. They also claim that they're trying to avoid people dying at sea if the boats sink. So, for the past five and a half years, Australia's had a hard line position. No asylum seekers coming by boat will ever be allowed to settle here. Even if they're found to be genuine refugees and most are. They're fleeing war and political persecution.
Olivia Rousset:	Instead, they're sent to two Pacific Islands, Nauru and Manus Island in Papuan New Guinea. Australia calls these sites offshore processing facilities.
Al Letson:	There was a moment where it seemed like many of these refugees might actually be resettled in the US?
Olivia Rousset:	Yes. That's right. In 2016, US President, Barrack Obama struck a deal with Australian Prime Minister, Malcolm Turnbull.
Reporter:	The Prime Minister, Malcolm Turnbull has announced a one off deal to resettle refugees from Manus Island and Nauru in the United States.
Malcolm Turnbul:	It is a one off agreement. It will not be repeated.
Olivia Rousset:	Up to 2,000 refugees were supposed to go to America. But the process hadn't even begun by the time President, Donald Trump took office.
Reporter:	The President is on a Twitter spree this morning and, he is not mincing words diplomacy in 140 characters or less.
Reporter:	Do you believe it, the Obama Administration agreed to take thousands of illegal immigrants from Australia? Why? I will study this dumb deal. That deal aiming to resettle refugees, not undocumented immigrants from two Pacific Islands into the US.
Olivia Rousset:	After just a week in office, Trump issued a broad Executive Order that had a huge impact on that deal.
Reporter:	Dozens of people remain in detention at airports across America this morning over how US President, Donald Trump's order ...
Crowd:	No hate, no fear, refugees are welcome here. No hate, no fear ...
Olivia Rousset:	Trump's 2017 travel ban targeted citizens of seven majority Muslim countries and, it changed everything for the people on Nauru. Around a third of the refugees there were from Iran and that door largely closed for them as it did for the Somalis, the Syrians, the Iraqis and Sudanese people on the island.
Al Letson:	Meaning Australia won't take them and now the US won't honor its deal so kids like Maya are stuck.
Olivia Rousset:	Exactly. In Nauru that final rejection was like a trigger that set off this contagion of despair. The children in the camp responded in a surreal way. I started to hear from advocates about kids not eating or drinking. Not even responding to voices and falling into this almost catatonic state.
Al Letson:	Olivia, your story's going to take us inside the lives of these kids and their families so, I want to let listeners know that parts of this story will be tough to hear. I also should say that Olivia originally reported this story with the Australian Broadcasting Corporation and, its show Background Briefing. They're our partners on this episode.
Al Letson:	So Olivia, can you start off telling us how you were able to connect with these kids on Nauru?
Olivia Rousset:	Sure. In August last year, I was put in touch with Maya by an advocate who's in regular contact with kids on Nauru and for weeks we talked on messaging apps.
Maya:	The mental health are in my house now.
Olivia Rousset:	Really? Mental health? Who are they seeing?
Maya:	They're seeing my sister.
Olivia Rousset:	Maya is outside in the sun. But she tells me her sister doesn't leave the house anymore.
Maya:	She said she doesn't like to eat. She don't like see anyone. She talks with the dolls or, she hits her head on the wall. She's eating but not very well. Like little, little bit and she's not drinking enough water and she talks by herself and, she cries every time. She's like getting worse and worse.
Olivia Rousset:	This is that contagion of despair I mentioned earlier.
Maya:	She tried to burn herself. Twelve year old girls have tried to do stuff that they're not meant to do to their self. Just, they're trying to hurt their selves.
Olivia Rousset:	It got so bad that more than 130 kids had to be evacuated to Australia. Many of them have attempted suicide or needed urgent medical treatment. The evacuations have had a profound impact on the kids left behind.
Maya:	You know we have all these kids. We're now like a family because all of us ... Like, I can't explain it. But we have seen each other for five years and now it's like everyone is going and everyone is suffering because of Nauru.
Olivia Rousset:	Maya's sick of talking about Nauru and politics and changes the subject. I tell her one of my sons is about her age.
Maya:	In Australia what time the school finish? Your sons going to come in 15 minutes from home, yes?
Olivia Rousset:	I should get him to talk to you one day to say hi.
Maya:	Yes. I was thinking in 15 more minutes he will come and I can talk with him.
Olivia Rousset:	When my son comes home, he and Maya quickly establish common ground.
Maya:	Who's your really close friend like really good friend?
Speaker 2:	I'm not sure. I have a few.
Maya:	What's your favorite subject? I love science.
Speaker 2:	I'm good at maths but I don't like it.
Maya:	There's no good schools where I live now.
Olivia Rousset:	On Nauru refugee kids attend school with kids who are born on the island and sometimes they're bullied. Like most refugee kids here, Maya stopped going to school some time ago because she said she didn't feel safe. Instead, she spends most of her days on her bed trying to distract herself from a traumatized sister.
Maya:	We're getting so sick and tired of staying here every single day of our life we wake up, it's the same day. Nothing is changed. Fence, rocks and tents. That's all there is.
Olivia Rousset:	Fence, rocks and tents. When I contact the family again a few weeks after this conversation, Maya's father tells me that now both his daughters are sick and that Maya's barely eaten for a week. She can't talk to me right now. "She is tired", he texts.
Olivia Rousset:	Recently a parcel arrived for me in the mail. When I open it, I find a bunch of documents about the mental health of refugee and asylum seeker children on Nauru. "Alright, God there's so many files on here. I'll just open one up". Someone with a connection to Nauru risked criminal prosecution to leak these files to me.
Olivia Rousset:	"Okay, so they're called the strengths and difficulties questionnaire, STQ and there's one, two, three, four, five, six different tabs to each summary. It gives their age, when it's been done, who's done it".
Olivia Rousset:	I realize what I'm looking at is a crucial chain of information. There's a spreadsheet with details about every refugee and asylum seeker child on the island between 2015 and 2017. There's also a set of mental health self assessment questionnaires along with their summarized results and, a document on how to interpret them.
Olivia Rousset:	A company called International Health and Medical Services or IHMS, conducted the questionnaires. The Australian government hired them to provide medical care on Nauru. What the files show me is that the Australian government knew four years ago that there were kids on Nauru who badly needed mental health care.
Olivia Rousset:	"So, this questionnaire is given to kids to assess their mental health and see how they're doing at home and at school and with friends socially and, in all sorts of different ways and it can either be done by parents on behalf of their children answering a questionnaire or, it's done by the kids or by both. And then, they take from these answers, results and put them on some kind of spectrum of where they're sitting. So there's whole lot of questions here. 1. Considerate of other people's feelings, 2. Restless, overactive, cannot stay still, 5. Often loses temper, 6. Would rather be alone than with other young people, 8. Many worries or often seems worried, 14. Generally liked by other young people, 21. Thinks things out before acting, 24. Has many fears, "I am easily scared", 27. How long have these difficulties been present? And then they've got a result's page with a clinical risk rating and then a risk over time".
Olivia Rousset:	In the data I've seen, only 4 out of the 41 kids were rated as normal and they're all 10 year's old or younger. The others, 37 children, showed what's termed, "A substantial risk of clinical mental health problems".
Olivia Rousset:	"Okay. Hold on. Here's one from Maya and there's a document that explains how to score these things. Where is it? Here we go. So, okay. So the total difficulties score which is what I'm looking at, it is high if it's between 17 and 40. Maya's score is 25 and it says, "This score is high. There's a substantial risk of clinically significant problems in this area", and this was done in ... Wow, nearly two and a half year's ago.
Olivia Rousset:	So way back then she was exhibiting pretty serious mental health concerns and her sister as well. Okay so, Maya's sister comes up as a 30 clinical risk".
Olivia Rousset:	Scores like this should trigger treatment including intensive therapy. The surveys should then be repeated three month's later to see if the children have improved. But what these documents show me is that, only 9 of the 37 kids were given any follow up surveys.
Dr. Peter Young:	It shows that there were measurable problems occurring way back at the start of 2015. There's clear evidence then that there were major problems occurring.
Olivia Rousset:	That's Dr. Peter Young. He supervised mental health services on Nauru for refugees and asylum seekers in detention from 2011 to mid 2014. That same year, he went public alleging the immigration department new child detainees were mentally unwell and had covered it up.
Dr. Peter Young:	And that lines up with the condition reported data that I was involved with collecting in 2014. So, looking at the problem from two different angles, we get the same result. That there is severe problems occurring and that they're getting worse. The department has had this information all along so, this thing should have been well known to everybody at every level since those early days.
Olivia Rousset:	Dr. Young says the leaked questionnaires I got in the mail confirm his allegations that the Australian government ignored the early warning signs.
Dr. Peter Young:	It's really significant to see this data because it's exactly the sort of data that the government and the department doesn't want to see in the public domain. Every piece of data like this that becomes public, just reinforces that the regime of keeping people in Nauru and offshore places like this and in detention generally, causes harm to their mental health. And particularly the children in this case. And that the government has known about this for many years.
Olivia Rousset:	Dr. Young says he tried to put data about how badly the kids were doing on Nauru into a government report but the immigration department stopped him.
Dr. Peter Young:	I was told we should not present data in such a way as it can be analyzed over time. Because when you did that, of course you could see deterioration over time. It made it very obvious when you put it into graphs. So, those were the sorts of things that they didn't want to be presented in such a way as the results could be easily interpreted.
Olivia Rousset:	The Australian Minister for Immigration, David Coleman declined my requests for an interview. I asked the Department of Home Affairs, which is like the Department of Homeland Security in the US whether the Australian government knew four year's ago that there were children on Nauru assessed as being, at severe risk of mental disorders. But officials didn't respond to that question. The department does say there are 65 contracted health professionals on Nauru including 33 mental health professionals. But my sources tell me those providers are not always on the island. The fly to Nauru for a few weeks at a time.
Olivia Rousset:	The Australia government has paid close to 30 million dollars to upgrade the island's hospital and medical services. They now say, refugees living on Nauru are the responsibility of the Nauruan government so they need to use the local health care system. I tried several times to contact representatives of the Nauruan government for comment. But I got no response.
Olivia Rousset:	Dr. Vernon Reynolds was one of the longest serving child psychiatrists on Nauru. During his two years on the island, he asked the Australian government to evacuate 15 critically ill children. He says only two were taken to Australia.
Dr. Vernon Reyn:	There was no action happening so I would come back three month's later and these incredibly sick kids would be just rotting in their rooms. Then I'm saying to the same people again, "I'm incredibly seriously worried about this person. We need to move them", and writing more reports saying that, in bold font and trying to push whatever I can.
Olivia Rousset:	Dr. Reynolds says the health care company he worked for warned him after he wrote those strongly worded reports. They said the reports had upset government officials and could cause legal problems for them in the future. Then when Dr. Reynolds tried returning to Nauru last April to keep taking care of the kids there, he says the Australian government blocked him from going.
Olivia Rousset:	A spokesperson for the Department of Home Affairs provided a statement. It said in part, "The Australian government takes seriously its role in supporting the government of Nauru to ensure that transferees are provided with a range of health, welfare and support service arrangements".
Al Letson:	But when it comes to the health and welfare of kids on the island, the situation keeps getting more dire.
Speaker 3:	She all the time in bed not moving, not talking. Like right now she is not eating at all. Nothing.
Olivia Rousset:	How long since she's had any food?
Speaker 3:	Long time really. I don't remember how long. Very long time.
Al Letson:	What exactly is wrong with the kids on Nauru? That's ahead on Reveal from the Center for Investigative Reporting and PRX.
Al Letson:	Our newest episode out this week looks at concussions in high school sports. We know many of you will have questions for your local school district. Like, what are they doing to protect student athletes? Are there concussion policies in place? If so, what are they? We want to help you get answers to those questions so we've put together a really simple form to start you digging. To get it just text the word football to 63735. Again, just text football to 63735. We'll take care of the rest. You can text stop at any time. Standard data rates apply.
Al Letson:	From The Center for Investigative Reporting and PRX this is Reveal. I'm Al Letson. We've been hearing about the children stuck on Nauru. A tiny island nation in the South Pacific. They're refugees and asylum seekers who tried to reach Australia by boat. But that country didn't want them and instead, sent them to an immigrant detention camp on Nauru.
Al Letson:	Olivia Rousset originally reported this story for the Australian Broadcasting Corporation show Background Briefing. They're our partners on today's episode.
Al Letson:	Olivia, Nauru is an independent country? So why did it take on all of these refugees from Australia?
Olivia Rousset:	Well, what's amazing is that Nauru was once one of the world's richest countries in terms of GDP per capita but all that money came from one resource, phosphate. From thousands of years of accumulated guano. Basically bird poo from sea birds. But guess what happened there?
Al Letson:	All the bird poop ran out?
Olivia Rousset:	Yes, pretty much. Strip mining left their whole island environmentally ravaged and broke.
Al Letson:	Okay, so now this island has no resources and needs some way to bring in money?
Olivia Rousset:	That's exactly right. And Australia pays Nauru about $1,500 per person per month in visa fees alone. That's more than 10 million dollars just in the last financial year. Which is close to 10% of the country's GDP.
Al Letson:	So Australia's been paying Nauru to keep hundreds of families in this detention camp for five years? And Olivia, you've been reporting on how the kids who have almost nothing to do and no clear future, can start to just shut down.
Olivia Rousset:	Yes. They do. A number of children stopped eating and drinking and talking. As one of the doctors on the island wrote, "They curled up in a fetal position hidden under blankets in dark rooms, unresponsive to anyone". They weren't in a coma but they may as well of being. It's called resignation syndrome.
Al Letson:	That is a really horrible name. Just the idea of kids giving up. Being resigned to their fates.
Olivia Rousset:	It is and it's one of the most persistent mental health conditions for children on Nauru. Because their situation offers the perfect storm of conditions for it to take hold. They've got histories that are marked by trauma and now, they're suffering from inescapable stress and they have a sense of hopelessness for their future.
Al Letson:	You've seen it so, what does this syndrome look like?
Olivia Rousset:	It's a psychological syndrome but it has physical effects. And on Nauru it's swept through the community almost like it's contagious.
Al Letson:	Like it's contagious? Wow.
Olivia Rousset:	Let me tell you about a family. It's not Maya's family, the girl we heard from earlier but, it's another family. A single mom and three daughters who have been on the island for about five years. We've changed their names and altered the kid's voices because their immigration cases are still pending and, their lawyers worry that they could be punished for talking.
Olivia Rousset:	Their story starts in a hospital on Nauru in the middle of 2018. I got this audio recording from an advocate in Australia who was trying to help them get medical care.
Hospital staff:	Think of other people they are coming.
Speaker 4:	We are thinking of other people but I have to think about my sister too.
Hospital staff:	You are occupying my bed. This is not a war. Understand?
Olivia Rousset:	You can hear the family arguing with hospital staff. They're trying to get treatment for the youngest girl Alia.
Hospital staff:	That's for you to sort it, not me. I'm not a mental health nurse.
Speaker 4:	Yes and we are not a mental health nurses too.
Hospital staff:	But I want my place here.
Olivia Rousset:	The day before this was recorded Alia started self harming, cutting her arms and legs with a razor blade. She'd also stopped eating and drinking. Then she hurt herself again. So, her mother Mona brought her here to the ER where she's begging them to treat Alia.
Olivia Rousset:	What happens next is disturbing. Some listeners may want to skip this part. Hospital staff tell them the only place Alia can stay is in the old hospital with nursing home patients and Alia loses control.
Alia:	I don't want to go there. Do you want me to kill myself now? You want me to kill myself?
Mona:	You happy now? You happy?
Olivia Rousset:	Alia is then put on an IV drip. But according to her mom despite cutting herself again while she's in hospital, Alia receives no psychiatric care and is later discharged.
Mona:	Doctor tell after finish this drip, go back home. I tell but my daughter not very good. How can send her at home?
Olivia Rousset:	Alia's mom says her daughter is completely shutting down but there's nothing she can do. She has to take Alia back to the hospital every few days where she's rehydrated with a drip.
Mona:	Stop eating. Stop talking. Don't think food. Don't like go to toilet. Three day at hospital, don't like anything and after doctor coming, I tell "Please help my daughter". Waiting for [inaudible 00:27:15], waiting for doctor mental health. Waiting for someone write complaint. Waiting, waiting and this time I am very angry. Waiting for what. For my daughter die. I don't like my daughter die.
Olivia Rousset:	Back home Alia's mom also finds this note. That her daughter has written which we asked an actor to read.
Actor:	"I want to tell you I am sick and nobody is helping me. We're here in hell for five years. I just feel like I'm in the deep, deep ocean screaming and shouting and nobody can hear me. I don't want to be living in this hell anymore. I really want to get out of here. Please help me. Please, I want to study. I want to become an air hostess. Please help me and help my family. Please help us. Please."
Mona:	Because if any mom look her children die, mom die. Because don't have any power. Help my children.
Olivia Rousset:	In the two weeks since her first hospital visit, medical staff from the health care contractor, IHMS, and a child psychiatrist from Doctors Without Borders assess Alia several times. On their final visit, they note her blood pressure is difficult to measure. She has no knee jerk reflex and her body is limp. She's barely eaten or drunk any water in that time.
Olivia Rousset:	The next day lawyers in Australia bring Alia's case before the Federal Court. The lawyers are asking that Alia be brought to Australia with her entire family for specialist treatment. The court rules Alia be brought to Australia for urgent medical treatment. A relief for her mom. But that relief is temporary because as she learns, only one family member is allowed to accompany Alia. Her mother must now leave Alia's two sisters on Nauru with no parent.
Olivia Rousset:	"I'm on my way to a house in the outer suburbs of a major city where the mother and her daughter are living in community detention. They've been there for over two months since they were evacuated from Nauru."
Olivia Rousset:	Alia and Mona live in government housing in a row of identical units. There's junk mail all over the lawn. It doesn't look like anyone's living here.
Olivia Rousset:	"Hello, How are you. Good to see you."
Olivia Rousset:	This small two bedroom unit has one living and kitchen area. It's pretty simple with a tiled floor. And even though they have two bedrooms, Alia and her mom sleep in the same room. Their tubular metal, single beds side by side.
Olivia Rousset:	"Do you think she'll talk to me?"
Mona:	I ask her.
Olivia Rousset:	"I just want to see her and say hello."
Mona:	I tell her.
Olivia Rousset:	Alia lays inert but awake under a synthetic lilac blanket. "Is there anything you can tell me?"
Olivia Rousset:	She doesn't respond to my questions. It's about 11 am and Alia lies in the dark bedroom with gloves on.
Olivia Rousset:	"Are your hands cold?"
Mona:	Stiff for now. I tell doctor hand and legs and face sometimes very, very cold and all her body very hot.
Olivia Rousset:	Since coming to Australia Alia has improved physically but she's still psychologically withdrawn.
Mona:	Don't like go school. Don't like make anything. Tell me, "I don't like see anyone". If we see anyone together quickly I think where my sisters" You know?
Olivia Rousset:	Before she left the island, a psychiatrist from Doctors Without Borders diagnosed Alia with resignation syndrome. In amongst the documents leaked to me, I found Alia's mental health questionnaire from two year's ago. Her clinical risk rating was 27. I asked Dr. Vernon Reynolds, the contracted doctor who worked on Nauru, what this means?
Dr. Reynolds:	So, this young person from that questionnaire it suggests they were really, really quite mentally distressed and disturbed and it was impacting on their daily functioning in a severe way. This young person needs, serious assessment and input from mental health services and they need it fast.
Olivia Rousset:	So it wouldn't be a surprise to you that just over a year and a half later she was self harming and then got resignation syndrome?
Dr. Reynolds:	Not at all. I mean I think if you have a young person expressing distress of that degree and very little is offered to them then, the distress increases and the dysfunction increases. And I guess that's what we're seeing numerous times in Nauru is that, people just continue to deteriorate and eventually it emerges into this depressive withdrawal syndrome that goes on to become what's known as resignation syndrome.
Mona:	How are you? [inaudible]
Olivia Rousset:	Alia closes her eyes as her mother and I sit on her bed chatting on the phone to her older sister Lena. She's in her early 20's and is still on Nauru.
Lena:	Now my mom and my sister's in Australia. I really want to be with them. Five years we've been going around this island and we can't go outside. We can't do anything. There is nothing.
Olivia Rousset:	In a carbon copy of Alia's decline, her middle sister, Haneen has also developed resignation syndrome. It began two month's ago soon after her mom and Alia left.
Lena:	She all the time in bed. Not moving, not talking. Now she's not eating at all. Nothing.
Olivia Rousset:	How long since she's had any food?
Lena:	It's a long time really. I don't remember how long. It's been very long time.
Olivia Rousset:	Dr. Reynolds is shocked that families like Alia's are still being separated with the help of the ABF, the Australian Border Force.
Dr. Reynolds:	I find this so disturbing and it tears my heart to hear of another situation like this.
Olivia Rousset:	What impact does family separation have on children with this syndrome?
Dr. Reynolds:	I mean there is so much research out there about how damaging family separation is to families and to children. The science is really clear on this. And common sense is clear on this. You do not separate families. It's the most damaging thing you could do to them. And so, for me, I've voiced my anger and frustration about this to ABF staff on the island a number of times saying, "This policy of separation is absolutely inhumane and it is traumatizing and damaging".
Dr. Reynolds:	It's so disturbing to hear that it's still happening.
Olivia Rousset:	Initially only the person who needed treatment was sent to Australia. Kids were accompanied by just one parent. No siblings, no complete families. It's not clear why families were separated in this way. Many think it was meant to discourage refugees from staying in Australia. That, if their family's are still in Nauru, they'll be more likely to return once the medical emergency is over.
Olivia Rousset:	Lawyers usually seek to have families reunited if it can be proven that separation is causing a medical emergency. Like it did for Haneen on Nauru without her mom and sister there.
Olivia Rousset:	I went to this cluttered Sydney office to meet a team of lawyers who are working seven days a week to reunite families like theirs. The National Justice Project has so far managed to bring more than 48 sick kids and their families from Nauru to Australia for urgent medical treatment. "I just got a message from Anna saying that she's walking up from Central. Can we talk and walk. I think she's too busy to give me an update so I'm going to go and find her".
Olivia Rousset:	Anna Tolbert is the lawyer working to bring Alia's sick sister Haneen to Australia. She's wearing a casual summer dress and she doesn't break her stride as she approaches me.
Anna Tolbert:	Is that on?
Olivia Rousset:	Yes.
Anna Tolbert:	Okay, yes. It's completely urgent. She desperately needs help. Her life is at risk. She's at risk of permanent organ damage and yet I can't work on her case because I've got other urgent cases and there actually taking up all of my time. So everything else is ground to a halt as a result of that.
Olivia Rousset:	These delays are distressing for Alia and Haneen's mom Mona. As we sit on the bed next to her daughter she keeps repeating a refrain over and over again.
Mona:	I am single mom. I need someone help me.
Olivia Rousset:	She needs help. She's a single mom.
Mona:	I don't like take anyone from my children.
Olivia Rousset:	She just needs her family to be back together again. "And did the lawyers tell you ... When did they say that the case will come?"
Mona:	I don't know. This week maybe. I hope because I want my children. Enough.
Olivia Rousset:	Before I leave, I ask Alia one last question and she finally responds to me.
Olivia Rousset:	"Can you tell me what you want?"
Alia:	I just want my family.
Al Letson:	But reuniting Alia and her sisters well that's a complicated legal battle which takes time.
Lena:	She's getting skinny. Now she's not doing anything. She's not responding to me.
Al Letson:	That's ahead on Reveal from The Center for Investigative Reporting and PRX.
Al Letson:	From The Center for Investigative Reporting and PRX this is Reveal. I'm Al Letson. Today we're bringing you the story of refugees and asylum seekers being detained by Australia on the island of Nauru in the middle of the South Pacific. After being stuck here for five years families watch their children succumb to a mental illness, spreading through the detention camp almost like a virus.
Al Letson:	Children refuse to eat or drink and sometimes, became suicidal. It's an awful condition called resignation syndrome. Reporter Olivia Rousset from the Australian Broadcasting Corporation show Background Briefing helped expose the truth about Nauru. She picks up the story with a family. A mom and three sisters who've been separated by the crisis.
Al Letson:	Mona, the mother was evacuated with her teenage daughter Alia after Alia got sick. But things are getting dangerous for Lena and Haneen, the two sisters left behind on Nauru. Here's Olivia.
Olivia Rousset:	Haneen is deteriorating fast. I get in touch with her older sister Lena who's in her early 20's. Both were left behind when their mother and sister flew to Australia.
Lena:	Hello Olivia. She's always in bed and I don't see her opening her eyes. Always ...
Olivia Rousset:	Lena began sending me voice messages with updates on Haneen's condition.
Lena:	It's still like more than three weeks she didn't eat anything.
Olivia Rousset:	Lena is now caring full time for Haneen just trying to keep her alive even though she's not eating and is barely drinking water.
Lena:	I took her to the hospital on Tuesday night. Tuesday night around 7 o'clock. I went inside. I just told them I want to put for her a drip.
Olivia Rousset:	The only place Lena can get Haneen on an IV drip is at the local Republic of Nauru Hospital.
Lena:	I have somewhere voices. I got some. I send it to you.
Hospital staff:	How many days she no eat? How many days? You know? Don't know? Okay. Can you hear me? Hello. Hello. Open your eyes please.
Olivia Rousset:	This nurse is trying to insert a drip into Haneen's arm.
Hospital staff:	It will be hard because she's not making a fist.
Olivia Rousset:	She's unresponsive and her severe dehydration makes it difficult for nurses to find a vein.
Hospital staff:	Be strong okay. I need to put another one. You need to make a fist. Make a fist for me please.
Olivia Rousset:	After Haneen's given the drip at the hospital, Lena is told to take her unresponsive sister back home.
Lena:	So this is my third time I take her to the hospital. But this time they don't want to keep her at the hospital because they say that mental health even the one lady from the government, she came to the hospital and she told me that, "You guys are not allowed to stay here for long. The doctor tell you that you have to leave. You have to leave because this is not mental health hospital".
Olivia Rousset:	Lena's worried this treatment isn't enough to keep her sister alive and she keeps saying to me, "Are they waiting for my sister to die?" The Nauruan government never got back to me about any of my questions for this story. And the Australian government says there is adequate medical treatment for refugees on Nauru.
Olivia Rousset:	But Haneen has been sick for around two months and has got no mental health treatment. Doctors Without Borders says that Haneen needs to be evacuated to Australia for medical care and to be with her mother. They say it's her only chance of recovering. Lena says her sister is only getting worse.
Lena:	Yes. I'm scared because it's really awful what happened. When we was in the hospital they say that she is getting only better because of this treatment. They had the drip that she will ... Blood pressure will go lower again and her sugar. And I don't know if also only the drip and the stuff will help her body.
Lena:	And now even around her eyes it's getting black and she's getting skinny. Now she's not doing anything. She's not responding to me. Three times like her eyes go like shaking. I really don't like to see my sisters like this, my family like this. I never imagine these things might happen to my family. But now it's happening.
Anna Tolbert:	The Federal Court at Phillip Street.
Olivia Rousset:	Five days after Lena sent me her last message, her lawyer, Anna Tolbert is finally on her way to court to try and get Haneen transferred to Australia for emergency medical care.
Anna Tolbert:	The thing that really gets me is, it was actually predicted in the medical records of the younger sister that the one we're going to court for today, would develop the same symptoms. So, it's not like this is a surprise to the government that we're heading back to court again. And yet we are.
Olivia Rousset:	In Australia, she'd be able to get the treatment she needs for resignation syndrome.
Anna Tolbert:	The evidence that we have is that she won't actually get better if she's not joined with her complete family. It's basically PTSD. A lot of people liken it to PTSD and the treatment for that is feeling safe and secure and not having worries about family members and those sorts of things.
Anna Tolbert:	Can I get a receipt please. Thank you.
Olivia Rousset:	Anna and another National Justice Project lawyer, Emma Hearne take their case before the judge. We can't follow them in to record. It's against the law. But I get the latest from Anna as soon as she leaves the courtroom.
Olivia Rousset:	"So what happened?"
Anna Tolbert:	They agreed to bring them to Australia which is a big relief.
Olivia Rousset:	Anna says there were no objections from the government's lawyers. The judge ruled Haneen and Lena can be reunited with their mother and sister.
Olivia Rousset:	"Does that mean they'll come soon?"
Anna Tolbert:	We don't know. We don't know where they're going, we don't know when they're traveling. But we know that there's court orders to get them here.
Olivia Rousset:	I ask if she's gotten a chance to tell Lena the news.
Anna Tolbert:	I've just texted her to tell her that she's coming to Australia.
Olivia Rousset:	"What did she say?"
Anna Tolbert:	Sorry. I'm quite tired.
Olivia Rousset:	Anna pulls up a text message on her phone from Lena.
Anna Tolbert:	"It's great news really. Thank you a lot. Really thank you a lot."
Anna Tolbert:	After the last time we went to court for this family, I cried a lot as well. So at least this is good crying.
Olivia Rousset:	There's no way of knowing what kind of long term effects her kids might suffer. But at least Mona's nightmare of separation from them will soon be over.
Olivia Rousset:	In October last year, the day after this story first aired in Australia, Home Affair's Minister, Peter Dutton announced the Australian government's new position on refugee and asylum seeker children on Nauru.
Peter Dutton:	We want to get kids off Nauru. That's the stated intention. I don't want anyone in detention. We're working through the arrangement that we've got. We've got down to 50 children. Our intention is to get it down to zero but to do it in a way that doesn't restart boats.
Olivia Rousset:	He means boats full of people seeking asylum. Boat trips he claims could ramp up if people are no longer scared of getting stuck on Nauru. The Department of Home Affairs sent me a statement. It said, "It's now removing children from Nauru quietly and sensibly in accordance with our policies".
Al Letson:	Olivia, your reporting first aired in October. How are Lena, Haneen, Alia and their mother doing now?
Olivia Rousset:	Lena and Haneen spent some time locked in detention once they got to Australia but they've been finely reunited with their mom and Alia. And Haneen is eating and she's talking but they say she's still very skinny and weak. And Alia is seeing a psychologist but she's started going to school in their new temporary home. And all of them are living in this kind of insecure legal limbo because they could be removed from Australia at any time.
Al Letson:	Have you heard anything about what happened to Maya, the girl in the video chat at the beginning of the story?
Olivia Rousset:	A couple of months after I first spoke to her, she and her family were moved to Australia. And she's in what's called, Community Detention which means she has a curfew and she can't travel out of the city. But she lives in a regular house in the suburbs with her family. Just this month Maya's finally back at school and her sister's no longer bedridden and is starting to socialize with other kids again.
Al Letson:	How many kids are left on Nauru?
Olivia Rousset:	There are only four kids left on the island and they've been accepted for resettlement in the US. So finally, thanks to the Herculean efforts of lawyers, doctors and advocates, there will soon be no kids on Nauru. Also, I should point out that the Australian government hasn't confirmed or denied whether it will detain children there in the future.
Al Letson:	It sounds like for now at least, the crisis for kids on Nauru is almost resolved?
Olivia Rousset:	It is but you know Al, even though the kids are off, this is far from over. There are hundreds of adults in the same situation. Many of them are suicidal without enough medical care even suffering from resignation syndrome. Some of them arrived on Nauru as children without their parents. But they've now turned 18 so the policy doesn't apply to them. These people tell me that with the kids gone, they fear that they will be forgotten.
Al Letson:	That's reporter Olivia Rousset. We also want to thank Alice Brennan host and Executive Producer of the Australian Broadcasting Corporation show Background Briefing. They were our partners on today's episode.
Al Letson:	You can find Background Briefing's podcast on iTunes or wherever you get your podcasts. And there are other shows of the same name so, be sure to look out for the Australian Broadcasting Corporation or ABC along with a picture of an iceberg lurking mostly beneath the surface. It is definitely worth a download. I love it.
Al Letson:	And one more update. Just this week, law makers in Australia voted to make it easier for doctors to evacuate sick refugees from the islands without having to go to court. With elections coming up, the people stuck on Nauru and Manus Island are once again front and center in Australia's immigration debate.
Al Letson:	Our lead producer for this week's show is Laura Starechesky. Brett Myers edited the show. We had a lot of help today from our partners at the Australian Broadcasting Corporation. Lilah Schunar and David Lawford helped produce the show. Anne Worthington and Alexandra Fisher did fact checking. Janine Colic helped with translations and we had production help from David Lewis, Alex Mann and James Brandis. Background Briefing's Supervising Producer is Alli Russell. Thanks also to HYY in Philadelphia for production help. Our Production Manager is Najib Aminy . Original score and sound design by the Dynamic Duo. J Breezy, Mr Jim Briggs and Fernando my man yo Arruda. Help from Clare Mullen and Caitlin Benz. Our CEO is Krissa Sharfenburg. Our Senior Supervising editor is Taki Telenidas. Our Executive Producer is Kevin Sullivan and our theme music is by Karmarado. Lightning. Support for Reveal is provided by the Reeve and David Logan Foundation, the John D. And Katherine D. McArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising Simons Foundation, and the Ethics and Excellence in Journalism Foundation. Reveal is a co production of The Center for Investigative Reporting and PRX.
Al Letson:	I'm Al Letson and remember there is always more to the story.
Speaker 1:	From PRX.

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