The immigration department has defended the level of healthcare and medication available to refugees on Manus Island amid reports some who are severely ill are too scared to leave its detention centre.

Iraqi man Mohammad Albederee, who was granted refugee status this week, faces intense pressure to leave the centre where he has access to healthcare through the International Health and Medical Services clinic.

Albederee, 31, has survived for 10 months on fluid injections, sweet tea and salt because he is unable to keep food down after being on hunger strike in protest against the lack of medical treatment for kidney and shoulder problems after an alleged assault by guards.

He can walk a few steps only on crutches and his weight has dropped from 74kg to 48kg, refugee advocate Jeanie Walker says.

The father of three fears his access to free healthcare and medication will dry up if he leaves the detention centre.

Papua New Guinean authorities want to move him to a temporary accommodation centre for refugees at nearby Lorengau.

“He won’t get any help there, currently he has people carrying him to the bathroom, shaving him and washing him,” Walker said. “The [authorities] just want him to die elsewhere, not at the detention centre.”

Walker claims refugees at Lorengau are forced to buy their own medication and many were relying on the generosity of private Australians to fund their prescriptions.

Albederee had a broken hand and lumps on his other hand that need surgery, she said.

He also had a shoulder injury and kidney problems after an alleged assault by guards at the detention centre last year.

A spokeswoman from the immigration department said refugees were given 28 days of medication when they left the detention centre and that a health services provider had a weekly clinic at the Lorengau transit centre staffed by a doctor and registered nurse.

The spokeswoman said refugees had access to the PNG public health system and were provided with free medication when treated at the Lorengau hospital.

“If the medication is not available at the Lorengau hospital, refugees are able to purchase it from the local chemist using their allowance,” she said.

The spokeswoman pointed out there were people with positive refugee status still living at the detention centre.