A female refugee on Nauru who according to the Amnesty report has been self-harming. Credit:Amnesty The report concluded: "The government of Australia's 'processing' of refugees and asylum-seekers on Nauru is a deliberate and systematic regime of neglect and cruelty, and amounts to torture under international law." Furthermore, Amnesty warned Australia's policies had shifted the goalposts on what other countries considered to be acceptable treatment of refugees, and had "already harmed global standards on refugee protection". The global human rights group visited Nauru for five days in July, and corroborated testimony from interviews using thousands of pages of medical reports and statements to police, and other data on the public record. It painted a picture of a dysfunctional system where Australia exercised strict control but publicly passed the buck to Nauru, and where on-the-ground authorities lacked the power to make decisions without Canberra's permission.

Children playing near the Refugee Processing Centre on Nauru. Credit:Amnesty International "They can't authorise anything, they can't do anything, unless Canberra said 'jump'," one service provision manager told Amnesty. Even the contracted healthcare operator, International Health and Medical Services, was hamstrung when it came to medical evacuations. "IHMS can't do anything unless Canberra authorises it," the manager said. Anna Neistat, Amnesty's senior director of research who travelled to Nauru, said the report provided direct evidence of Australia's responsibility for day-to-day decision-making, and that Australia should be held accountable for breaching the Convention Against Torture - with a remote possibility that individual government officials could be prosecuted under international law. Children play near the detention centre. Credit:Amnesty "It's the intentional nature of it," she told Fairfax Media. "The Australian government is not even hiding the fact that the key purpose of this policy is deterrence. When you set up a system that inflicts deliberate harm as a deterrence, it's really hard to find another name for it other than torture."

Dr Neistat, a 15-year veteran of crisis work in Syria, Yemen and Chechnya, said the Nauruan regime was particularly galling because people's suffering was "absolutely unnecessary" and shrouded in "shocking" secrecy. "I was not prepared for what I saw, and definitely not prepared for what I heard," she said. Tents at the centre. Credit:Amnesty I was not prepared for what I saw, and definitely not prepared for what I heard Among the asylum seekers she interviewed were a Pakistani man who tried to kill himself twice in 10 weeks by dousing himself in petrol and drinking dishwashing liquid, an Iranian man who found his pregnant wife in the bathroom with rope marks on her neck, and a 13-year-old Afghan boy who attempted suicide multiple times using a knife, petrol and by drowning. An IHMS manager who spoke to Amnesty anonymously conceded conditions at the processing centre were "extreme". "There's no denying that the detention environment is a causative factor to mental health distress," they said. "People's bodies and their health is one of the only recourses left to them. This is people's last resort, their only avenue of appeal."

The Department of Immigration and Border Protection responded to the report late on Monday, saying Amnesty had repeated claims that had already been refuted by the Department and its contractors. It accused Amnesty of failing to consult with the Department before publication and said "in many cases the report references unsubstantiated claims made by individuals or advocacy groups as fact in the absence of evidence". Meanwhile, DIBP secretary Michael Pezzullo told a Senate estimates hearing he found the report's claims of deliberate torture "offensive" and "objectively, in our view, not true". "I refute categorically, both on behalf of my own department, and by way of explaining government policy in this regard, that it Is not the Australian government's position ... that we flout any laws, international or otherwise," he said. Prime Minister Malcolm Turnbull said he "totally" rejected Amnesty's claim of torture as "absolutely false". "The Australian government's commitment is compassionate and it's strong," he told ABC radio on Tuesday. He recognised there were sad stories on Nauru but said "there are 1200 people … from whom we can never hear because they drowned at sea [under Labor's policy settings]". In further criticism of Nauru, Amnesty concluded that medical problems, including serious heart conditions, improperly healed broken bones and infections "do not appear to have been treated in a timely way" by IHMS, and that a majority of interviewees were denied access to their medical records. IHMS said it "strongly refuted" those claims in a statement sent to Fairfax Media. In a finding that mirrors a damning United Nations report released two weeks ago, Amnesty warned Nauru was structurally incapable of protecting children's human rights. In one chilling example, the Nauruan Police Force hired as a reservist a man who had been convicted of raping a child just four years previously. One service provider said refugee children attending Nauruan schools were being hit by teachers and even threatened with machetes by their peers.

"Over 15 months, I saw these children change to be unrecognisable," a dismayed teacher said. "There was a 12-year-old student on psychotropic medication – she had been one of the brightest, bubbliest students – by the end [she] would just cry silently." Nauru's child protection framework was "virtually non-existent" and the human potential of asylum seeker children was being "senselessly squandered", the report concluded. Further systemic failures included arbitrary arrests and intimidation of refugees and asylum seekers, and a failure to investigate crimes against them. In one case, Iranian refugee and father Sam Nemati was jailed for two weeks after attempting to kill himself. Dr Neistat said the UN Committee Against Torture should investigate Australia's complicity in the treatment of asylum seekers on the island, and "questions should be asked" about Australia's bid for a seat on the UN Human Rights Council. "We definitely think the Australian government is violating international law," she said. "This needs to be stopped. It's unlawful, it's harmful, it amounts to torture."

The Australian government is expected to respond to the report once it has been formally released on Monday night.