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Submission to the National
Inquiry into Children in Immigration Detention from
into Children in Immigration Detention
Human Rights and Equal Opportunity Commission
GPO Box 5218
I am writing to express my serious concerns about the health and well-being
of children, pregnant and lactating women and women of child bearing age
in the groups of asylum seekers presently locked up in detention centres.
I am also concerned about the men.
The human right to
adequate food and nutrition is a well established concept across
the world (see "Nutrition rights: The Human Right to Adequate Food
and Nutrition" by George Kent on behalf of the World Alliance on
Nutrition and Human Rights, 2000-http://www2.hawaii.edu/~kent/tutorial2000/titlepage.htm).
Whilst food and human
rights is not mentioned in the Australian constitution, Australia is a
signatory to international standards of the United Nations including the
UN Committee on Economic, Social and Cultural Rights on the right to health
under Article 12, ICESCR.
I am sure that most
Australians agree with the Universal Declaration of Human Rights, which
states "Everyone has the right to a decent life, including enough
food, clothing, housing, medical care and social services. Society should
help those that are unable to work because they are unemployed, sick,
disabled, or too old to work. Mothers and babies are entitled to special
care and assistance."
Women of child bearing
age, pregnant and lactating women and children have particularly important
food and nutrition needs related to particular stages of the life cycle.
If these needs are not met at the appropriate physiological age/stage,
there are health effects at the time or later in life.
When children are
deprived of adequate food and nutrition at important stages of growth,
there are long lasting and often permanently damaging consequences. Some
examples are stunting (growth failure) and marasmus (severe underweight)
or both together, together with the devastating effects of particular
micronutrient deficiencies. There can also be effects on psychological
and social well-being and behavioural and mental problems.
When pregnant and
lactating women are deprived of adequate nourishment, the health of the
mother suffers and adds to her burden of disease and morbidity and reduced
longevity later in life.
We are limited in
our review of the health and well-being of such vulnerable people in detention
centres-for the reason that the centres are not open to examination by
professional experts and others.
My serious concerns
are presented here on the basis of current knowledge and long experience
in the field of food, nutrition and dietetics. These concerns are now
expressed in a food insecurity framework.
In the first instance,
asylum seekers come from third world countries and then refugee camps
where the food supply and living conditions are problematic (even under
the better of situations). Food insecurity has often been a long standing
factor in their original and transit communities. I expect that a proportion
of the children and the women, in particular, will have been poorly nourished
either intermittently or constantly for at least several years before
arriving in Australia.
Add to this, the
exposure to high ambient temperature and lack of food security in smugglers
boats for perhaps several weeks of transit to Australia.
On arrival in Australia,
we understand that asylum seekers are not screened (let alone assessed)
for nutritional status. The children and pregnant and lactating women
are not reviewed for nutritional problems, which are expected to exist
in a proportion of them. There are no services provided in detention camps
for food and nutritional monitoring and support, particularly of those
most in need.
In remote detention
centres in remote communities and the Pacific, we do not know if food
insecurity exists. But food insecurity is expected to exist because of
the way in which families are communally fed, with no flexibility as to
eating hours, or availability of food and nourishing snacks between meals
for anyone, and little opportunity for the use of family meals to foster
good behaviour and child development.
If children need
feeding between meals, as most children do, I understand that there is
a limited choice of junk food snacks for sale but if families (and particularly
single mothers or single children) have to spend what little money they
have in this way, it leads to further impoverishment.
It would also be
interesting to know if families have any choice of foods, and whether
they are culturally acceptable to all of them. I would not expect that
this exists, leading to further food insecurity. All of these important
factors, which have enormous implications for health and well being in
the groups in question, are of course of increasing concern when detention
extends from weeks to months and years.
Those who protest
about their detention by fasting or sewing their lips together can be
expected to suffer greatly from a nutritional and health viewpoint. The
negative nitrogen balance and catabolism of body protein and fat stores
develops in four days or less, depending on initial body weight, and age.
Add the compounding effects of dehydration in high ambient temperatures
and the serious and perhaps life threatening decrease in body thiamin
reserves. Permanent brain damage and perhaps death is likely after four
to six weeks from thiamin deficiency in a healthy adult with good body
thiamin reserves to start with. There has been no work on how long this
takes in children or pregnant or lactating women-for obvious reasons-but
theoretically it could possibly be days in an undernourished child, and
certainly would be a much shorter period than four to six weeks.
On release from remote
detention centres, asylum seekers are again highly likely to be confronted
by food insecurity. Their inability to work or get a health card and their
own depleted resources and health means that they gravitate to the areas
of Australia which are already the most disadvantaged (the lowest socio-economic
index of geographical area, known as the first quintile of SEIFA).
Here asylum seekers
are observed and known by us to often be unable to access sufficient food,
and they are presenting in increasing numbers for emergency food relief.
There are many occasions when even this sort of charity cannot meet their
In summary, food
insecurity is a negative and often continuous factor in the lives of asylum
seekers - from their often impoverished lives in their original homeland
through mandatory detention centres and perhaps for years in their lives
in the Australian community. This is potentially serious and most disadvantageous
for the development of children and the health and well-being of them,
and of pregnant and lactating women.
We must also be cognisant
of the effect of the potentially increased burden of disease and physical
and mental and behavioural problems which asylum seekers potentially bring
to Australian communities - particularly communities which are already
disadvantaged, which have low levels of infrastructure and resources,
and where community and individual food insecurity already exist.
There are more humane
and cost-effective ways of coping with the asylum seekers who reach our
shores. It will be highly advantageous to them and to Australian residents
if they are screened and assessed for nutritional problems on arrival.
This should be followed by the provision of food and beverages which ensures
their food security and promotes their health and well-being-with continued
monitoring. On discharge to the community (as soon as possible, preferably
weeks) it would be wiser to provide them with sufficient entitlements
to prevent further food security and its associated high burden of ill-health
and other problems.
I will be pleased
to provide the Inquiry with further detail and information on the consequences
of food insecurity and its prevention in asylum seekers, as required.
Beverley Wood PhD, FAHIA, MDAA, APD
Consultant in Food, Nutrition and Dietetics
Updated 14 July 2003.