The only single woman denied an interview has a litany of health problems and alleges sexual harassment by officers

This article is more than 2 years old

This article is more than 2 years old

Ellie* is in limbo. One of just a few single female refugees on Nauru, she is the only one who has not been granted an interview for US resettlement. She is also in pain, suffering a litany of health complaints including urinary incontinence that has lasted more than four years.

She is among a significant number of women on Nauru with gynaecological issues and other female-specific illnesses which doctors say the health providers are particularly ill-equipped to treat.

“I have many medical issues,” Ellie says. “I’m suffering from incontinence, kidney stone, haemorrhoids, herpes, back and knee pain.

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“During this period I’ve tried hard through [Australian authorities] to follow up on my treatments and once I was transferred to PNG.”

She also alleges sexual harassment by unnamed officers.

Dr Barri Phatarfod, a GP and president of Doctors4Refugees, says Ellie’s case is indicative of the “traumatising” extra health issues faced by female detainees on Nauru, on top of widespread physical and mental illnesses.



“The main concern with gynaecological issues on Nauru is a recommendation by [International Health and Medical Services] that no gynaecological surgeries be done on Nauru,” Phatarfod tells Guardian Australia.

“We reviewed all the medical recommendations in which doctors have advised short-term gynaecological surgery be done … and on each occasion IHMS has said that the operating facilities in the Royal Nauru hospital are not considered adequate.”

IHMS is contracted by the Australian government to provide healthcare on Nauru and on Manus Island.

In April Australian Border Force responded to a number of complaints from Ellie about her medical care and her wish to be transferred from Nauru.

“Please make an appointment with IHMS as they will be able to assist with any health concerns you may have,” it said.

The average time for terminations on Nauru is at 20 weeks gestation, which is absolutely brutal by any measure Barri Phatarfod, Doctors4Refugees

Documents seen by Guardian Australia reveal Ellie has experienced urinary incontinence since she was held on Christmas Island in 2014. She has had little relief except for a short reduction in symptoms after a 2015 visit to a Port Moresby specialist.



The specialist recommended that Ellie’s sleeping quarters be near a bathroom. “Psycho-socially it is prudent that this facility be provided … to ensure no exacerbated conditions,” the specialist’s report said.

Ellie says her bed is about two tents away from the toilet – far enough that she often can’t make it in time. Instead she urinates into a mug and then walks to the toilets to pour it out.

The Papua New Guinea doctor recommended a follow-up appointment after three months but it never happened.

One document written by an IHMS medical officer noted the “logical” request from Ellie to see the only doctor who had “been able to have any positive effect on decreasing her symptoms”.



At least one trip back to PNG – in 2016 – was prevented by government immigration issues “beyond IHMS’s control”, one document said.

Ellie’s case suggests that medical transfers continue to be blocked or delayed, against the advice of doctors.

The Department of Home Affairs says 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”.

Ellie has been found to be a refugee in need of protection. After attempting to reach Australia by boat she was detained on Christmas Island and Nauru.

So far 262 of the 939 refugees and asylum seekers on Nauru have been accepted for resettlement in the US, as part of the deal struck between the Australian government and Obama administration. Of those, 165, including 17 single women, have left the island.

Ellie says she has requested an interview but she is the only single woman not to get one. She remains in the tents of the Nauru detention centre.

She is fully aware that transfer to Australia is not an option. A doctor has determined she has no reason to be feigning illness and she should be allowed to be treated in PNG.

“The fact you can have medical advice routinely overridden by a departmental bureaucrat or someone without medical training just speaks volumes as to how the Australian government and Department of Home Affairs do not see these individuals as people,” Phatarfod says.

Q&A: Ged Kearney refuses to say whether detainees should be brought to Australia Read more

“Many of the patients we advocate for have doctors on Nauru advocating their urgent healthcare and it’s delayed two, three, four years. It’s a situation unthinkable anywhere else. These doctors on Nauru are not refugee advocates. They are there to do a job.”

There have been women on Nauru with untreated fistulas, rectoceles and cystoceles, as well as about seven or eight women who have had breast lumps for several years.

Doctors4Refugees is trying to obtain IHMS records for a woman who Phatarfod says was raped two years ago and has been bleeding every day since. They suspect that appropriate tests were not conducted.

The wait for refugee women on Nauru who want or need a termination has ballooned, Phatarfod says.

“Doctors would refer a termination, typically around seven weeks, but the average time for terminations on Nauru is at 20 weeks gestation, which is absolutely brutal by any measure,” she says. “You can feel the baby move.



“Women who have been raped, who have severe psychiatric conditions, making them wait until around 20 weeks, we wouldn’t see this anywhere else in the world.”

• Real name has been withheld