About 100 children live on Nauru, one of the remote islands where Australia operates offshore processing centers for migrants. They’ve been there for so long that “several children have lost all hope to the point that they are no longer speaking or eating,” Daniel Webb, director of legal advocacy at the Human Rights Law Center in Melbourne, told The Washington Post this week.

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“Even some of the government’s most senior medical advisers are warning that children may die,” he said. “It’s a miracle one hasn’t died already.”

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When they left home, their families were hoping to reach Australia, where many planned to apply for asylum. But in 2013, Australian authorities changed their migration policy, authorizing the detention of migrants and asylum seekers who try to reach Australia by boat. Instead of being allowed into Australia, they are placed, apparently indefinitely, on Nauru, or Manus Island, which is part of Papua New Guinea.

Once sent offshore, asylum seekers have little hope of ever reaching Australia. They don’t want to return to where they came from, but they often don’t have anywhere else to go. Devastated by extensive phosphate strip mining, about 80 percent of the island is uninhabitable with much of the marine life killed by mining runoff. The weather is hot and humid year around.

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Medical and human rights professionals have said publicly that in the face of this uncertainty, a number of asylum-seeking children on Nauru have developed health problems, including a condition known as “resignation syndrome.” This dangerous medical condition has been recorded in other asylum-seeking populations, notably in Sweden. It can be brought on by trauma and stress. Those who develop the syndrome essentially stop communicating with the outside world. They struggle to eat, drink and speak. They have trouble opening their eyes, and in extreme cases, lose consciousness and can require a feeding tube. Last week, the Guardian reported that about a dozen children on Nauru are refusing food and drink.

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In the past year, Webb said, more than 30 critically ill children were evacuated from detention on Nauru and taken to Australia for “urgent medical care.” But he said the Australian government has resisted such evacuations unless it is legally forced to comply. “Many of these cases have involved children who have repeatedly attempted suicide or who have become withdrawn and stopped eating or drinking,” Webb said.

Recently, a 12-year-old girl on Nauru attempted to set herself on fire, and a court ordered that a 10-year-old boy, who had tried several times to kill himself, receive treatment in Australia.

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In an email, a spokesman for the Australian Department of Home Affairs said the Australian government has provided “significant support” to Nauru for health and welfare services.

“A range of care, welfare and support arrangements are in place to provide for the needs of refugee children and young people,” the spokesman said. “Service providers are contracted to provide age-appropriate health, education, recreational and cultural services.”

But there have been increasing calls for Australia to reassess its offshore processing policy, which Australian officials have said is necessary to curb migration. On Thursday, The Guardian reported that the president of the Australian Medical Association wrote to Australia’s new prime minister, Scott Morrison, calling the physical and mental health conditions for families on Nauru “a humanitarian emergency requiring urgent intervention.”

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In the letter, Tony Bartone urged the prime minister to change the country’s policy. “There are now too many credible reports concerning the effects of long-term detention and uncertainty on the physical and mental health of asylum seekers,” he wrote.

But Morrison, who previously served as immigration minister, has historically taken a tough line on migration. As the New York Times reported this month, he keeps a small model of a boat in his office. The words “I stopped these” are engraved on its side. It was a gift from a constituent.

In June, Home Affairs Minister Peter Dutton warned that “a single act of compassion,” such as bringing people out of the island detention centers would fuel more migrants to board boats and try to reach Australia. “The boats haven’t gone away, and if there is a success defined by an arrival of a boat in Australia, then the word will spread like wildfire,” he told the Weekend Australian.

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In Nauru, the government has suggested that children who have fallen ill are doing so at the encouragement of their parents and other adults coaching them on how to get to Australia. In an interview with Sky News in August, Nauru President Baron Waqa said children are “working the system, probably short-circuiting it, just to get to Australia.”

Medical professionals publicly pushed back against those claims. Webb insists that the scale of human suffering on Nauru is severe.

“They’ve been surrounded by misery for the last five years,” Webb said. Some of the children “have never known a day of freedom in their lives.”