Last week, three children held in Australia’s offshore immigration regime on the island of Nauru were moved to Australia following court order or threat of legal action.

In six months, eight cases have been brought before the Australian courts of children suffering life-threatening psychological or physical illness that cannot be properly treated on Nauru.



Every one of those cases has been won. Children have been moved to safety. And more cases will follow, this week and the week after, and the week after that.

Slowly, literally one by one, through Australia’s legal system, the children on Nauru are finding a path to the care their doctors have been insisting – in some cases for months – that they need.

But the impact on those left behind on the island is profound.

On Nauru they refer to the “contagion”. It is a small place, and the refugee and asylum seeker communities are tight-knit. Everyone knows everyone, and knows how they are faring: who is “doing well”, who is struggling, who is close to breaking.

A child attempts suicide or commits self-harm, and soon, it is seen, they are moved with their families to Australia where they can access appropriate care. For the next child, the example is starkly apparent. Some workers in that place have even talked about a “saviour complex” developing, where children believe they can, indeed must, save their family through drastic and dangerous action.

The regime the Australian government has put in place, where children must be allowed to become life-threateningly unwell before a move can be contemplated is exceedingly dangerous.

The contagion is not so strong that it will affect those who are coping on Nauru, but it is immensely powerful on the vulnerable, those for whom five indefinite years in detention has worn at their resilience, whose family support structure has been eroded by the impotence of life in detention, for whom another day, week, month, of uncertainty cannot be countenanced.

The risk that a child will die is real.

There are some, at very senior ranks, within the Department of Home Affairs, who appear happy to see each of these cases go all the way to the federal court.

That way, they can tell their superiors – those demanding the policy of offshore detention be defended regardless of the human cost – that they fought the cases all the way to the doors of the courthouse or beyond: that it is “activist lawyers” or “lefty judges” who are undermining the government’s policy.

But there are others in the department who recognise that the price to pay for that political cover is massive, and the risk catastrophic.

It requires children to grow so physically ill, or so acutely psychologically unwell, that their lives are at stake, and that recovery is thwarted or made near impossible.

Even when doctors repeatedly insist sick children be moved urgently, their transfer will be resisted, refused or rerouted.

After a 14-year-old girl doused herself in petrol and shakily attempted to set herself on fire, the Australia government refused to concede she required the level of psychiatric care it admits is not available on Nauru.

A two-year-old girl was close to death from encephalitis when she was taken from Nauru. Over days she had grown steadily sicker, so sick there were real fears she would die in transit. No treatment on the island had arrested her decline. Finally, she was put on to a plane and sent … not to Australia, where doctors had recommended she go, but to Papua New Guinea, despite the hospital in Port Moresby insisting it did not have the equipment to adequately treat her.

It took a judge in the federal court to order her brought to Australia, where she is now being treated.

There are more of these cases coming. The government will likely reject doctors’ recommendations, and fight the cases all the way to the doors of the federal court – where it will either accede at the very last minute or lose in the face of overwhelming evidence before a judge.

And one by one, children will finally be moved to the care they need. But each time, the contagion will only be strengthened. There are 130 children under Australian care remaining on Nauru. Australia’s current policy insists each one deteriorates to a critical state before there is the necessary intervention.

As ever in this arena, the politics poisons the policy.

The political calculation will override the humanitarian consideration of a child’s life: a reckoning will be made between the risk of a child dying by their own hand in Australia’s offshore regime, and the undermining of government policy by moving a single child to safety.

• Comments are premoderated to ensure the discussion is about topic addressed in this article