A mental health crisis among refugees and asylum seekers on Manus Island has continued over the Christmas period, with at least three men medically evacuated to Port Moresby for hospitalisation after suicide attempts or acts of self-harm.

At least one of the men was among dozens moved by Papua New Guinea authorities from Port Moresby back to Manus Island as part of “security preparations” ahead of the Apec conference in November, including those who were yet to receive or complete medical treatment.

One man was found at his Lorengau accommodation on Wednesday morning after what was described as an act of self-harm. He was found by a friend who had gone to wake him for breakfast.

“But he didn’t open the door [so] they got security but couldn’t open it,” said Benham Satah, a Kurdish refugee currently in Lorengau. “We had to smash the door really hard and use a screwdriver … We went inside and found him shaking and with foam coming out of his mouth.”

He was transported to the Pacific International hospital (PIH) clinic in Lorengau by friends and security officers, before he was transferred to the main hospital in Port Moresby that afternoon.

“He was in very bad shape and the doctor told me he might have injured his kidney or liver,” Satah said. “He’s awake [now] and his friend says he repeats things a couple of times, he is forgetting things … There are about 23 people in PIH in Port Moresby at the moment. Mostly they are there because of suicide or mental health issues.”

Satah said the man had previously been in Port Moresby for 14 months to get treatment for a hernia but doctors were unable to perform surgery.

Behrouz Boochani, a Kurdish Iranian refugee and journalist on Manus Island, said sick refugees and asylum seekers were victims of politics, particularly those who were brought back to Manus from Port Moresby.

“They transferred them while they were still needing medical treatment,” he said. “They told them that we will send back to Port Moresby later but still they did not send them to Port Moresby. Many of these people need medical treatment and should be sent to Port Moresby but the system keeps them in a hard situation.”

Health services available to refugees and asylum seekers at the Lorengau accommodation and facilities have been beset with complaints about poor quality of care, alleged refusals to treat some patients and alleged demands for payment.

The PIH in Port Moresby has also been criticised in the past, notably for its treatment of Hamid Kehazaei, who died of a treatable sepsis infection in 2015.

Papua New Guinea itself has extremely low health outcomes and quality of care, and has experienced a nationwide medication shortage.

Earlier this month at least eight men voluntarily moved from Manus Island to the Australian government’s other offshore processing centre on Nauru.

Boochani estimated as many as 50 incidents of self-harm or attempted suicide among the cohort on Manus Island in the past month. He said another Iranian man attempted to take his own life on Thursday afternoon and would likely be sent to Port Moresby.

Boochani said three men were transferred to Port Moresby on Sunday.

“I can not say how many people exactly did attempt suicide or harm themselves but these days self-harm or a suicide attempt is a common thing on Manus,” he said.

A spokesman for the Australian Department of Home Affairs said the government did not comment on individual cases.

“In addition to the healthcare provided to transferees at the East Lorengau refugee transit centre and the Lorengau hospital, arrangements are in place for transferees to receive specialist treatment in Port Moresby where clinically recommended,” he said.

• In Australia, the crisis support service Lifeline is on 13 11 14. In the UK Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. Other international suicide helplines can be found at www.befrienders.org