Education And Debate

Children on hunger strike: child abuse or legitimate protest?

BMJ 1996; 312 doi: (Published 24 February 1996) Cite this as: BMJ 1996;312:501
  1. A Mok, medical officera,
  2. E A S Nelson, lecturer in paediatricsa
  1. a Department of Paediatrics, Chinese University of Hong Kong, 6/F Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
  1. Correspondence to: Dr Nelson.

    The issue of children on hunger strike (voluntary total fasting) has not been reported before. The World Medical Association Declaration of Tokyo 1975 and the Declaration of Malta 1991 (revised 1992) provide clinicians with guidelines for the management of adult patients on hunger strike1 2 but do not mention children. We report the management of 14 Vietnamese children, aged 1 to 12 years, who took part in a hunger strike at a refugee detention centre in Hong Kong.

    The influx of Vietnamese boat people to Hong Kong and other South East Asian countries began in the 1970s. Initially all were deemed to be political refugees who would be resettled in a third country. This policy was then revised and over 20000 refugees were reclassified as “economic migrants” for repatriation to Vietnam. Some returned under a voluntary repatriation programme, but most resisted. Earlier attempts at forced repatriation were opposed by the United States Administration. A resumption of forced repatriation, together with a possible reversal of United States policy, was reported in the local media in September 1994.3 This resulted in the north section of the High Island Detention Centre (population 1500) embarking on a hunger strike. Everyone in this section, including children, fasted or were fasted, for up to five days. Only water was taken orally. Breast feeding …

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