A refugee on Manus Island sought medical help 13 times in two months before he collapsed and died, the Senate heard this week.

In other cases detailed to a Senate committee inquiry into abuse, self-harm and neglect in offshore detention – established after the publication of the Nauru files by Guardian Australia – a 70-year-old refugee with a heart condition waited 20 days for a doctor’s appointment, and a child refugee on Nauru possibly suffering from sexually transmitted disease was refused a medical transfer recommended by a specialist.

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The committee heard evidence this week from senior immigration department officials about the standard of healthcare on the Australian-run offshore detention islands of Manus and Nauru, including details of the treatment and death of the Sudanese refugee Faysal Ishak Ahmed last December.

International Health and Medical Services, the department’s healthcare provider, is contracted to provide, in offshore centres, “primary and mental healthcare services broadly comparable to Australian community standards”.

Under questioning from the Greens senator Nick McKim, officials including the department’s chief medical officer, Dr John Brayley, told the Senate that IHMS was meeting that obligation.

But the committee has heard evidence in submissions that for offshore patients the clinical opinion of doctors is regularly overruled, and that refugees and asylum seekers sometimes wait weeks or even months to see specialists.

Doctors for Refugees detailed the case of a child held on Nauru suffering suspected extra-pulmonary tuberculosis – or possibly yaws or syphilis, a sexually transmitted disease – who was recommended by a clinical professor in paediatric infectious diseases for transfer to Australia for further specialist investigation. The child was not transferred.

Another child was assessed by an IHMS psychiatrist on Nauru as having significantly impaired speech, fine motor skills and “global developmental delay”. Doctors for Refugees strongly recommended an immediate transfer to Australia for specialist services but the child remains on the island and has not received specialist paediatric care.

The Australian Medical Association submission detailed the case of a 70-year-old Rohingya refugee who was sent to Port Moresby hospital for seven months, with “very little treatment availble to him”. He was then removed from the hospital without warning and taken back to the Manus detention centre, where he waited 20 days for a doctor’s appointment.

He was diagnosed with a heart condition and high blood pressure. “His symptoms included extremely swollen feet and legs, and being unable to walk or stand for longer than a few minutes.”

McKim cited a submission from the president of the Australasian College for Emergency Medicine, Prof Anthony Lawler: “ACEM considers there is no evidence that the healthcare provided in regional processing centres is at a standard which would be acceptable or expected for any patient in Australia.”

On 22 December 2016, 27-year-old Faysal Ishak Ahmed suffered a seizure inside the Manus Island detention centre and fell, hitting his head. He was flown to Brisbane the next day but died on 24 December.

Ahmed saw a doctor the day before he collapsed but it is alleged he was told he was not unwell. He had sought medical attention in the detention centre 13 times in the two months before he died, the Senate heard.

The Labor senator Patrick Dodson told department bureaucrats it was deeply concerning that Ahmed could have presented to the Manus detention centre medical clinic so many times – “up to 20 times” in the six months before he died – “and no one’s come to a view that there’s something seriously wrong”.

Brayley said: “This case raises questions about diagnosis and decisions.”

A witness to Ahmed’s collapse said he had been removed to the voluntary supported rest area – usually used to protect people experiencing mental health episodes – complaining of chest pains.

“Another patient heard him saying, ‘I cannot breathe, my heart has stopped,’ and shortly afterwards he fell down on his forehead with thick liquid and water came out through his nose and mouth,” the witness said.

The Queensland coroner is conducting an inquiry into Ahmed’s death.

Before he died, fellow Sudanese refugees inside the detention centre were so concerned by his repeated seizures and collapses that they wrote a letter outlining months of escalating health complaints which, they said, had been ignored by medical staff.

On 15 December, exactly a week before he collapsed, Ahmed himself had written to IHMS, complaining his health concerns were being ignored. In broken English, Ahmed said he had chest and heart problems, and high blood pressure.

Faysal Ishak Ahmed complains about his treatment

The day after Ahmed collapsed, while he was still alive, his compatriot refugees wrote a four-page letter to IHMS pleading with doctors to “give him the kind of treatment his problem need[s] … before its too late … instead of hiding the facts from him”.

They detailed seizures and breathing difficulties Ahmed had suffered since September. The letter alleged:

He saw a GP on the 21st of December 2016, and he was told by the GP there was nothing wrong was told that he was not going to be seen by any doctor again in the future and IHMS cannot help him anymore with that problem. When he came back from his appointment he was very much affected by the reply of the IHMS that they would not be assisting him in the future. He kept saying ‘I swear, I am not pretending that this disease would kill me’. His condition got worse and worse on that day.

The letter writers asked that Ahmed be treated immediately. “We have got nothing in our power to help him, but we are kindly and humbly giving you this piece of advice so as to take it into consideration immediately before it’s too late,” they wrote.

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Brayley confirmed to the committee that Ahmed had repeatedly sought medical attention. He said he was restrained from publicly discussing details of Ahmed’s treatment and death because of the coronial inquiry.

“He had presented to the health services at Manus Island on a number of occasions, and on the day of the critical incident, he collapsed suffering a head injury that we would believe to the be the cause of his death. He was then transferred to Brisbane for medical treatment.”

“The situation is one of a man who had presented 13 times for medical care from October 1, with some specific symptoms, had those symptoms assessed and then investigated, had this critical event with the head injury, and is now a matter that we need to internally review as part of our own quality processes, as well as the usual processes that occur with the coroner.”