Nauru Doctors Slam Expulsion Amid Fears For Refugee Kids

Refugee children on Nauru as young as nine have attempted suicide, and there are fears some will die after mental health workers were expelled from the island.

Staff from Médecins Sans Frontières, also known as Doctors Without Borders, were left outraged and dismayed after being given just 24 hours notice from the Nauruan government that their services were no longer required.

MSF has been providing mental health support on the island, to both local Nauruan people and the refugees and asylum seekers sent to the former Australian detention centre there, since November 2017.

A team of around ten psychologists and psychiatrists have been assisting dozens of refugees on the island who have been experiencing severe mental issues including depression, anxiety, self-harm, suicidal ideations and the rare 'withdrawal syndrome', where people withdraw from eating, drinking, going outside or even using the toilet.

This week, MSF was told they would no longer be needed, and staff visas were cancelled as they left Nauru in recent days.

Dr Christine Rufener, Dr Beth O'Connor and Dr Paul McPhun from MSF address the media in Sydney on Thursday (AAP Image/Danny Casey)

MSF Australia's executive director Paul McPhun said the charity had been given little reason why their "desperately needed healthcare" services were terminated, and claimed the 24-hour notice was in breach of their contract which provided for a three-month wind-down period.

He said it was "very unusual" for MSF to be so quickly ejected from a country.

"Five years of indefinite limbo has led to a radical deterioration of their mental health and wellbeing," McPhun said.

"Separating families, holding men, women and children on a remote island indefinitely with no hope of protection except in the case of a medical emergency, is cruel and inhumane. Australia's policy of indefinite detention should be immediately stopped."

Some of the refugee children on Nauru

MSF claimed just two or three mental health professionals remain on Nauru, including a psychiatrist who does not speak English, and a nurse. The charity also said Australian home affairs minister Peter Dutton was incorrect in his claim on Wednesday that MSF only provided support to Nauruans.

"Quite clearly he was ill-informed. The first page of our memorandum of understanding... specifically includes refugees and asylum seekers,"McPhun said.

The MSF ejection comes as a crowdfunding campaign to display the message 'Kids Off Nauru' on the Sydney Opera House has raised nearly $50,000 in a matter of days.

MSF has raised the alarm over the "beyond desperate" situation of refugees and asylum seekers on Nauru, who have no prospect of being brought to Australia and have not yet -- and may never be -- accepted for resettlement in third countries like the USA.

The charity called out the "vicious cycle of deep despair" many are experiencing, with no idea when or if they will ever leave Nauru.

"Children were presenting with depression and anxiety, post-traumatic stress disorder and we were seeing suicide attempts in children as young as nine years old," said psychiatrist Dr Beth O'Connor, who worked on Nauru for almost the entirety of MSF's tenure there.

O'Connor also detailed the 'withdrawal syndrome', which has been documented in many young people on Nauru.

Nauru is an island the size of Melbourne airport. (Getty Images)

"There were no they were no longer eating or drinking sufficient amounts to keep themselves alive. Many were not able to toilet themselves. They were incontinent of urine and faeces," she said.

"Seeing that level of deterioration in the children was really quite horrific."

In a statement, O'Connor added "I fear the withdrawal of MSF's psychiatric and psychological health care from Nauru will claim lives."

Dr Christine Rufener, a clinical psychologist who also spent several months on Nauru, fought back tears as she spoke of her experiences on the island.

"Virtually every patient I met expressed current intense suicidal ideation and many had recent self-harm or suicide attempts," she said.

"The word I heard most often in my own therapy sessions with patients was 'destroyed'. People feeling that their sense of self and any hope that they have about living a meaningful future has been irrevocably destroyed."

Dr Christine Rufener, Dr Beth O'Connor and Dr Paul McPhun from MSF address the media in Sydney on Thursday (AAP Image/Danny Casey)

The Australian government has continually stated that care and welfare of refugees and asylum seekers, which has included several deaths and many suicide attempts, is a matter for the Nauruan government.

However, MSF has called for all to be evacuated from Nauru and for the Australian government to act to rectify the "beyond desperate" situation.

"Separating families and forcibly holding men, women and children on a remote island definitely with no hope or protection except in the case of a medical emergency is cruel, inhumane and degrading," McPhun said.

"This policy should be stopped immediately and should not be replicated by any government."