Martin says he raised these concerns with ABF officials. He says the responses were, at best, unhelpful. Sometimes, there was no response.

“If you are a doctor your primary role is to do the best for your patients,” he said. “You should be striving to do that all the time, it is what we do. That is what you sign up for. That is widely understood. When I did see what I felt were huge delays in these patients getting the care they needed, I felt obliged from a medical, ethical, social, moral responsibility to flag this up and the responses I got were dismissive at best.”

BuzzFeed News and the ABC have obtained several medical request forms that disclose shocking conditions for patients in urgent need of medical transfers. They include female asylum seekers with breast lumps being denied required biopsies. They also show patients with nerve, back and kidney conditions unable to be properly diagnosed.

The delays in their treatment appeared to make their ailments worse. In one case, medical removal documents reveal a delay of a full year for a patient suffering from kidney stones, an extremely painful condition that gets worse over time and can eventually cause death.

“If [redacted] is not treated, he is at risk of developing permanent damage to his kidneys and renal failure due to progressive obstructive uropathy," his treating medical doctor wrote in 2017. The patient "is also at risk of increased urinary tract infections which can cause general sepsis, acute renal impairment and chronic kidney damage. The client is also at significant risk of his mental health further deteriorating.”

Martin had several patients with obstructing kidney stones on high doses of painkillers waiting for treatment.



“There were patients there who were undoubtedly suffering long term irreparable renal damage because of the intransigence of [the ABF],” he said.

The allegations Martin raises are at considerable odds with the Australian government’s recent representations that it has improved medical care for asylum seekers.



In 2014 an asylum seeker on Manus Island died from a foot infection. His death is subject to an ongoing coronial inquiry.

Paul Douglas, who was previously the Australian immigration department’s chief medical officer, told a February 2017 inquest hearing that his report into the case found that “ambiguous and deficient” policies for emergency evacuations contributed to the events. “I think the fact that we’ve made some clear changes in process showed that they could be improved,” he said.

And in April 2017, a cross party parliamentary inquiry recommended that Australia review medical transfer procedures “as a matter of urgency”.

BuzzFeed News asked the Australian immigration department whether such a review had occurred, and how processes had changed since 2014. It also put detailed questions about Martin's allegations medical delays to the department.

The department did not respond to specific questions, but a spokesman said in a statement: "Health care in regional processing countries is the responsibility of the governments of PNG and Nauru.

"All transferees in regional processing countries have access to clinically recommended care. Refugees settled in the community have access to local health care services.

"Where required health services cannot be provided to transferees and refugees on Manus or Nauru they will be temporarily transferred to Port Moresby, PNG, for the required services."

"Decisions about medical transfers are made on a case by case basis according to clinical need, in consultation with the contracted health services provider and the government of Nauru or PNG."