This article contains references to suicide/self-harm.
Asylum seekers and refugees transferred to Australia under the Medevac legislation have been waiting more than two years to receive medical treatment for multiple chronic and serious health conditions, according to a .
The report titled 'Healthcare denied: Medevac and the long wait for essential medical treatment in Australian immigration detention' found the federal government had not provided members of the Medevac cohort with timely or adequate health care, with indefinite detention causing their health to deteriorate further.
Now repealed, the Medevac legislation allowed refugees and asylum seekers to be transferred from offshore detention centres to Australia for medical treatment. This transferral needed to be approved by two independent doctors and the Home Affairs minister, who could refuse if they deemed it unnecessary or a security risk.
The research was published by the Public Interest Advocacy Centre (PIAC) and drew upon evidence uncovered through the organisation’s casework with 13 Medevac asylum seekers.
PIAC interviewed asylum seekers suffering from a suite of mental health issues, dental problems, heart conditions, knee issues, haemorrhoids and gastric and urological conditions.
Sadiq*, who was interviewed by PIAC as part of the report, came to Australia by boat in 2013 and was detained on Manus Island and Nauru for six years.
While in detention, Sadiq developed a serious knee injury, for which he waited three years to receive surgery in Port Moresby.
Upon inspection, doctors discovered that years without medical treatment had led to the cartilage in his knee almost completely wearing away.
Post-operation, he suffered a series of serious seizures over a period of eight months.
Refugees and asylum seekers in Melbourne's Park Hotel on Sunday said they are concerned about the response of Serco and the ABF. Source: Refugee Action Collective
Two Australian doctors later found Sadiq could not be safely treated in Papua New Guinea and that he’d been prescribed multiple medications with harmful and potentially life-threatening drug interactions.
Under the Medevac legislation, Sadiq was transported to Australia for medical treatment in June 2019.
Once in Australia, Sadiq underwent an electroencephalogram medical test for his seizures and was placed on the waiting list to see an orthopaedic specialist.
Despite requiring urgent medical attention, Sadiq waited over nine months for a specialist appointment. When he finally saw a specialist, they determined his knee was inoperable due to the severe damage and prolonged lack of treatment.
Another man interviewed by PIAC, Pakistani refugee Rashid* has been in detention for eight years and was detained on Christmas Island in July 2013 before his transfer to Manus Island.
Despite a longstanding history of severe gum disease and dental issues, Rashid has been waiting 21 months for dental treatment since his transfer to Australia.
Currently held in a Brisbane detention centre, Rashid remains in pain with a deteriorating dental condition.
PIAC says Rashid has been told that the dental treatment he requires may not be provided in the public system or by International Health and Medical Services (IHMS), who are contracted by the Department of Home Affairs.
Delays in treatment and the impact of indefinite detention
About 190 refugees and asylum seekers were transferred to Australia under the Medevac scheme, which operated for eight months - from 1 March 2019 until 4 December 2019.
The legislation required two independent doctors to determine that the temporary transfer was necessary, with the Minister of Home Affairs given 72 hours to approve or refuse the transfer.
“The Medevac regime was intended to ensure that people detained in offshore facilities with serious health conditions could access essential medical services,” said Lucy Geddes, PIAC senior solicitor and the report’s lead author.
Protesters have rallied outside the Park Hotel in Melbourne where asylum seekers are being held. Source: AAP
“It is absolutely appalling that two years later, people are still waiting for treatment for painful and debilitating conditions including severe gum disease, chest pain and heart palpitations.”
Ms Geddes said sustained periods of detention and looming uncertainty had contributed to the declining physical and mental health of Medevac asylum seekers and refugees.
“The combination of delayed treatment and long-term confinement to a hotel room has also exacerbated some existing medical conditions,” she said.
“Since being transferred to Australia, the conditions of onshore detention have resulted in our clients’ mental health deteriorating to the point they have been at risk of suicide.”
Ismail Hussein, a former Medevac transferee detained at the Mantra Hotel in Melbourne, said the conditions were “more difficult than what we experienced in Manus Island”, with people spending up to 23 hours a day in their rooms.
“Maybe one hour of gym – that’s the only time that I am not in my room,” he said in the report, adding, “The rest of the day, I’m lying on my bed or sitting on the chair.”
Another man complained that mental health support in immigration detention was grossly inadequate. He told PIAC "you need to be extreme or threatening self-harm for any action to be taken. People are given tablets and sent away".
PIAC’s report sets out a range of recommendations for the government to follow, including the immediate release of Medevac refugees and asylum seekers into the community.
The report also calls for the government to prioritise and expedite medical treatment for the Medevac cohort through the public health system and suggests a comprehensive review of the mental health care provided in immigration detention led by health experts.
In 2013, the Commonwealth Ombudsman delivered a report on suicides and self-harm in immigration detention.
Detainees at the Kangaroo Point centre in Brisbane Source: SBS Radio
The Ombudsman found that “because the Department [of Immigration and Citizenship] has a high level of control over particularly vulnerable people, its duty of care to detainees is, therefore, a high one”.
“It is not enough for the department to avoid acting in ways that directly cause harm to detainees,” said Colin Neave, the Commonwealth Ombudsman.
“It also has a positive duty to take action to prevent harm from occurring.”
*Names changed to protect individuals' privacy
SBS News has contacted the Australian Border Force and Department of Home Affairs for comment.
Readers seeking support with mental health can contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636. More information is available at Beyondblue.org.au. supports people from culturally and linguistically diverse backgrounds.
