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An 11-month-old girl is brought into the Paediatric Ward at Tungaru Central Hospital, Kiribati. She is suffering from malnutrition, severely dehydrated. The doctors decide an intravenous drip is the best course of action but the parents refuse the treatment, wishing instead to pursue traditional medicine. A doctor visiting from overseas tries to find out why. The reason is lost in translation, leaving the question unanswered and frustration at being unable to speak the Kiribati language. Later a nurse explains that the parents are fearful of the drip and injections. They have seen children die after receiving such treatment and are scared that, if they allow their daughter to be prodded, she too will die. The doctors try another course of treatment. The parents discharge the child, against the advice of the medical staff, taking her back to the village.
The central issue is a child’s right to health and health services, combined with the state’s duty of care and medical negligence. Should the child be compelled to stay? This question has never been debated in Kiribati. Like so many other issues central to achieving every child’s right to education, equality and protection, the questions have not been asked, let alone answered.
In Kiribati, there is no specific legislation that comprehensively protects children, despite the government ratifying the Convention on the Rights of the Child in 1995. There are serious gaps in the law governing the sexual exploitation of children, in particular pornography and illicit transfer. There is no alternative care system, only vague and defunct provisions in the Penal Code which attempt to cover abuse and neglect of children, but they are insufficient and ineffective. Corporal punishment in schools is not sanctioned, nor is it prohibited. There is a lack of understanding by medical staff, law enforcement agencies and the general public of the operation of duty of care laws. The difficulties in enforcing the rights of the child on this central Pacific nation of atolls are vivid, and the consequences can be dire.
Despite a growing number of children being left alone while parents go drinking and partying after payday, there is only one known case of parental neglect leading to a prosecution in the past decade. The hospital regularly sees children so severely malnourished that their lives hang in the balance, even though food and medical treatment are readily available, particularly on the main atoll, Tarawa. Family violence is endemic. It exists as a trigger and response to the symptoms of other social ills, such as increasing rates of HIV/AIDS and other sexually transmitted diseases, commercial sex work with foreign fishermen as well as locals, alcohol abuse, and the perpetuation of the cycle of violence over generations.
Kiribati is recognised by the United Nations as a Least Developed Country. Life here is tough. On each of the atolls, and in particular the outer ones, subsistence living supplements a limited monetary income. Many families are reliant on remittances from family members overseas to cover the cost of living. Families debate about children being needed at home to work rather than being placed in school.
At the beginning of the year, in an attempt to enforce basic education, the government of Kiribati introduced a Compulsory Education Order determining that every child between the ages of six and 14 must attend school. With some 16 250 children between these ages, in a country of 90 000, this is no trivial declaration. The social discussion which surrounded the proclamation of the order reminded parents that they would be liable for prosecution and fined on conviction for not sending their child to school. Perhaps this was not the most appropriate method to encourage compulsory education, but it certainly sparked a debate about the right of each child to a basic education. Of course the difficulty will be, as always, actual enforcement. How realistic is it that local authorities will seek out parents who either do not care whether their children attend school or do not see the value of education over daily survival? Many parents may simply register a child at a school yet the child will never attend or may only attend sporadically. With principals and head teachers not wanting to admit poor attendance, it is unlikely they will report a child who repeatedly fails to come to school.
Local authorities face many practical difficulties in enforcing compulsory education. One is finding ways of checking that each child who is entitled to an education is enrolled at a school. The acute shortage and confusion over data collection, and the maintenance of records, makes cross-checking near impossible. Kiribati faces the juxtaposed difficulties of overcrowding, rapid urbanisation on Tarawa, with extreme remoteness and isolation on the outer atolls that are scattered across the Pacific Ocean. The lack of financial and human resources increases the difficulty of providing basic services. In urban areas the rate of birth registration, the right of every child, is 60 per cent while in rural areas registration rates fall to 40 per cent.
At the crux of all these dilemmas, complexities and intricacies lies the simple fact that in Kiribati, though it is ‘modernising’ with cars, DVD players, computers and solar panels popping up everywhere, two important public debates are yet to be had. The debates over state interference/intervention in the home and family affairs, and cultural relativism and human rights have not been front and centre issues. Sometimes the question is implied, sometimes discussions occur on the peripheries, but there is no broad social dialogue for all to comment on. In a society where conflict is generally avoided, these are debates which must be had in order to provide a mandate for action and secure change.
There are issues of exploitation and abuse such as child pornography, compounded by technology with which Kiribati is presently struggling to come to terms.
Also there are issues common to every culture: abuse of the voiceless, disempowerment of the disadvantaged and avoidance of the central issue by politicians. This year two of our rightly culture-proud Pacific neighbours, Kiribati and Samoa, appeared before the United Nations Committee on the Rights of the Child. In January 2007 the Marshall Islands will be reporting.
These are interesting times across the Pacific where there are over 2 million children under 18. Increased tourism or, in the case of the Solomon Islands, a rapid increase in the expatriate community are helping fuel the commercial sexual exploitation of children. The underlying notion of children as property needs to be confronted. Family violence, a social scourge throughout our globe, is emerging as an issue that sparks the social conscience in Pacific Island countries. Fiji has recently established a Family Court and in Kiribati the Police Service’s Family Affairs and Sexual Offences Unit has been expanded from one serving officer to seven. Pacific governments are actively engaged in addressing violence in the home, but more needs to be done, in particular, to protect and assist children. It also needs to be done faster. This is one area where Pacific time just won’t cut it.
Despite all the dire predictions the 11-month-old girl lived. Others, however, have not been so lucky. The children’s ward at Tungaru Central Hospital faces the problem of parents refusing lifesaving treatment each and every week. As yet no parent has been charged with manslaughter for refusing lifesaving medical treatment for their child. Recently, however, the Office of the Attorney General and Hospital Services investigated steps to address the issue. Poor enforcement and lack of understanding over the rights of the child are neither problems faced only by Kiribati nor the result of purely cultural conflicts, but are challenges faced everywhere that must be repeatedly overcome.
The government, along with the wonderful people working to ensure children’s rights in Kiribati, will eventually correct these misunderstandings. How many children must pay the price between now and then? Advocating rights of the child is easy. No-one wants to see children suffer so instead of simply advocating and ratifying the Convention on the Rights of the Child — the most ratified international human rights document in the world and the only UN human rights convention signed by all Pacific nations — let’s secure change. Why is it that, in the end, rights are viewed as a usurpation of authority? Empowerment of children should not be viewed as the disempowerment of adults. Empowering children should not be feared; it should be seen as the best investment we can possibly make in our collective future.
SARAH BASSIUONI is an advocate for children's rights in Kiribati.
© 2006 Sarah Bassiuoni
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URL: http://www.austlii.edu.au/au/journals/AltLawJl/2006/56.html