Group criticises counselling services cut when Manus refugees have one of highest mental illness rates in world

This article is more than 2 years old

This article is more than 2 years old

The Australian government is trying to walk away from the human rights crisis it created on Manus Island, winding back health services while refugees and asylum seekers are still in its care, Amnesty International has said.

A report by the organisation, released on Friday, criticised the termination of mental health services despite the 700-strong refugee population on Manus having one of the highest rates of mental illness in the world, according to the UN.

“Last year two refugees committed suicide in Manus Island, illustrating the terrible price of confining vulnerable people to remote detention centres,” said Graham Thom, refugee coordinator at Amnesty International Australia.

“In the wake of these tragedies Australia has inexplicably cut counselling and trauma services, just one of a raft of changes which will make it even harder for refugees and asylum seekers in Papua New Guinea to access healthcare.”

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The report is based on an Amnesty investigation conducted in November last year, one month after detainees were moved out of the processing centre and into other accommodation centres in Lorengau.



The Manus Island detention centre was closed on 31 October and services – including healthcare – withdrawn. However hundreds of men refused to leave due to fears for their safety in the community following a number of violent incidents. The three-week standoff ended when PNG authorities cleared the centre out with force.

Counselling services that were previously available have not been replaced.

International Health & Medical Services (IHMS) has operated a smaller-scale clinic at one of the three new accommodation centres for the refugees and asylum seekers, but it was not open after hours and did not provide critical care or outreach services for patients unable to leave their beds.

Those who could not be adequately treated in Lorengau are transferred to Port Moresby for treatment, and if appropriate care was not available there they were earmarked for international transfer, but with lengthy waiting periods.

“While PIH [Pacific International hospital] is better equipped than public health services in PNG, it remains limited by the availability of specialists and medical equipment,” Amnesty said.

“PNG does not have the ability to provide the type of specialist medical care that refugees and asylum seekers require, especially in relation to mental health issues, within the country.”

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Amnesty toured facilities at the same time as the UNHCR, which found the Lorengau hospital operating at 33% over capacity, with no refugee expertise and an intermittent ambulance service. It also found half of all doctors and 43% of all nurses positions unfilled.

“Amnesty International’s own findings were consistent with those of UNHCR – that healthcare for refugees has largely been inadequate and declining because of limitations imposed by the Australian government, and that unless some of the most urgent cases are transferred to Australia, they will not be able to receive necessary treatment, with potentially life-threatening results,” Amnesty said.

Thom told Guardian Australia while the situation was less chaotic now than in November, there were still “gaping holes” in health services.

Among the case studies presented, one man had a stent inserted in his stomach during an operation and was told it would be removed in six weeks. Eight months later it remained and was pressing against his bladder, causing bleeding.

Another man had a broken wrist that was left untreated for more than four years.

At the end of last month the Australian government ended its contract with health provider IHMS and engaged the PNG Pacific International hospital.

“By shifting healthcare responsibilities to local contractors and the public health system, the Australian government has limited the availability, accessibility and quality of healthcare for refugees and asylum seekers,” Amnesty said.

“Refugees and asylum seekers live in accommodation, with security, meals, medication, healthcare all currently provided by the Australian government or its contractors.”

Amnesty said the government needs to be transparent about its contract with PIH, and ensure at least the same level of care is available, including reinstating mental healthcare, interpreters and medical evacuations to Australia when necessary.