An Afghan man detained on Nauru requires urgent medical evacuation for a heart condition, according to doctors, but his case has not been classed as an emergency.

The man was asked to write a will and has requested that if he dies, the Australian government care for his children and provide them with an education.

A cardiologist said the man was suffering from acute coronary syndrome and probably suffered a heart attack more than two weeks ago.

Dr Clare Arnott, a member of the asylum seeker advocacy group Doctors for Refugees, said the 42-year-old man first presented to hospital on Nauru two weeks ago suffering from severe chest pain.

Arnott reviewed the man’s medical files following his admission and said the results from his electrocardiogram and cardiac enzyme test revealed his condition was “clearly very serious”.

“He definitely has acute and unstable coronary syndrome,” Arnott said. “His results are also consistent with having suffered a myocardial infarction [heart attack]. In any Australian tertiary hospital he would be taken to emergency and admitted immediately, and would receive a cardiac angiogram within 24 hours.”

The angiogram, an X-ray of the heart to determine if the coronary arteries are blocked or narrowed, and which helps a doctor to determine whether angioplasty, a stent or coronary artery bypass surgery is required, is not available on the island. His medical files show that Nauru doctors advised “urgent overseas referral”.

He said two weeks ago he signed two documents to say he would be willing to be medevacked to Papua New Guinea or Australia for treatment. He also claims he was told his sons could go with him. But he has not heard anything more since then.

A spokeswoman from the Department of Immigration and Border Protection said the reports on Saturday that a man was unwell and had been referred to or required medevac were “untrue” and said no further comment would be made.

But a department spokesman later told Guardian Australia the man had been identified. When asked if the department would be retracting its comments that the reports were untrue, the spokesman said it stood by its original comments because Guardian Australia had inquired about a man requiring a medevac, an emergency transfer, rather than a medical transfer.

“There is a significant distinction between a ‘medevac’ and a ‘medical transfer’,” the spokesman said.

“A medevac is a medical emergency, requiring urgent transport by air ambulance, where a medical transfer is undertaken where the required treatment is not of an urgent nature,” he said.

“The reports relating to a man requiring medevac from Nauru are false.”

Arnott said the man’s situation was an emergency and that in Australia he would have received emergency treatment.

She understood the man discharged himself from the hospital on Nauru because he was the sole carer to two sons in their early teens, one of whom has acute mental health issues and who has previously self-harmed and attempted suicide. The medical equipment and urgent treatment the asylum seeker requires was also unavailable in the Nauru hospital, Arnott added.

“It’s not that he has refused medical treatment, it’s that he is very worried about his children and needs to care for them,” Arnott said.

“My understanding is that he has also been asked to write a will.”

The man wrote a will asking the Australian government care for his children if he dies, and ensure that his children receive a good education. It is unclear if the will would stand up legally, but the man said he was scared of his children coming into the care of the government of Nauru.

He continues to suffer from severe chest pain, she said.

Guardian Australia understands a medical transfer for the man has been approved, but it is unclear when this will occur or where the man will be sent for treatment.

According to the Darwin Asylum Seeker Support and Advocacy Network the man fled Afghanistan after his wife had died. He went to hospital for the first time two weeks ago, for approximately five days, and checked out due to concerns over his children’s wellbeing, a spokesman for the network confirmed.

The man said when he and his family first arrived on Christmas Island, “I thought it was a chance to start a new life”.

“I told my kids: ‘We have come from darkness to light and we have left ignorance. We can get educated’,” he said.

“I have hopes and wishes for a nice future. I wish that my sons can get a good education, live in a good house and live like humans, just like others live. I wish my children could live like other children. Good food, good clothes. I want a bright future.”



The man’s advocate, Darwin Asylum Seeker Support and Advocacy Network’s Natasha Blucher, said the man was in serious danger and terrified about the future for his children.

“He needs to be evacuated as soon as possible, preferably to Australia but to anywhere that can meet his serious medical needs,” she said.

“Talking to him, it’s evident his only concern is being alive to protect and care for his boys.”

A 26-year-old Bangladeshi refugee died in Nauru hospital in May from suspected heart failure after suffering a series of heart attacks. Plans were made to take him to Australia by air ambulance but he could not be moved.