Detainees are being deprived of basic medical care and clothing, former staff member says

Medical care at the Manus Island detention centre was so bad one detainee ripped out his severely infected tooth after months of vain attempts to get treatment, a former caseworker says.



The caseworker told Guardian Australia her clients showed “extreme resilience” despite the conditions. She said the man had been unable to eat properly for months before taking the drastic action in early June.

“He attempted to access medical treatment many, many times, but after continuous delays and being told to write a request [for treatment], and being given just Panadol and water, he made the decision to literally rip his own tooth out.” An abscess hole was left where his tooth had been, she said.

Another client made many requests for more clothing and a pair of thongs because his attire was in tatters, she said.

“I went down into his living block and saw for myself that he had no other clothes other than the ones he was wearing, and he walked around barefoot because he had no shoes or thongs,” she said.

“The thongs they gave him were soon ripped because the ground as Manus is very sharp with rocks. He was told they had run out of stock for more.”

As his caseworker, she visited the supply storage area and saw there was plenty of stock in his size. The store worker asked her for receipts of the man’s requests for shoes.

“[He] handed me seven receipts,” she said. “I took these to the store worker, and just as I was handing them over, my team leader walked in and saw me, asked me what I was doing, and when I told her, she grabbed the receipts out of my hand, informing me that I should have asked her permission first.

“I was prevented from giving my client the basics that he needed, despite the items being available in stock, and they were never issued to him.”

The operator of the detention centre, Transfield, declined to comment on the claims that basic supplies had been withheld.

The immigration minister, Scott Morrison, denied clothing supplies were withheld from detainees.

“My department rejects the claim that at any time, clothing or shoes have been withheld from a transferee,”he said.

The caseworker said she saw raw sewage outside the tent where men in the Foxtrot compound ate their food. “Men literally had to walk through open sewerage to get into the tent to eat, and the smell is consuming, constantly,” she said.

Every transferee was instructed to write a request if they needed to see a doctor or a nurse, she said, but many did not know how to do so. “As a caseworker, we are very, very clearly instructed that we are not allowed to assist them in writing, even if it is our client,” she said.

“Whether they even know how to read or write, whether they understand the forms, whether they know how to express what their medical concern is, we as their caseworkers are not allowed to assist them in any way, shape or form.”

Asylum seekers were given only paracetamol and water for most ailments, she said. “I still carry emotional scars and simply cannot put this behind me until that place is shut down,” she said.

“I have ID numbers, names and faces of these men etched into my soul and I cannot rest until it is closed and they are brought back to onshore detention. I no longer work in any part of the immigration system.”

A letter written by an asylum seeker on the island and forwarded to Guardian Australia tells a similar story.

A young man wrote that he had written more than 40 times to International Health and Medical Services, which is contracted to provide health services on the island, to complain about a lack of medical treatment for severe stomach pains, which he described as being “in my intestines”.

“All the feedback I received is meaningless and I am still suffering,” he wrote. “When you ask for better treatment simply they request for you to go back to you [sic] country.”

He said some detainees were so sick they could not walk. “Sometimes when they [the authorities] hear a visitor is coming [to the Island] they have to hide sick people in a place called the green zone,” the letter said.

“When the ombudsman [staff] came they couldn’t find anyone because they had hided [sic] them in [a] different place. They are able to do many things which no one will see.”

The Foxtrot compound was surrounded by sewage pipes, he wrote, and wastewater spilled onto the ground around the buildings, placing detainees at risk of illness and infections.

International Health and Medical Services told Guardian Australia about 50 health staff were employed to work there. They provided medical care “broadly comparable” to the standard in Australia, IHMS said.

On Nauru, five asylum seekers and refugees have contracted tuberculosis. Guardian Australia understands from several sources that the first confirmed case was detected in an unaccompanied minor on the island.

In addition to the five confirmed cases, several other asylum seekers and refugees have been tested for the disease. It is not known where the outbreak originated.

TB, which is prevalent in south and south-east Asia and the western Pacific, killed 1.5 million people in 2013, more than any other infectious disease except HIV.

Under international law, Australia is legally responsible for the detainees on Nauru and Manus Island, because it has “effective control” of their detention and resettlement, according to the UN and international legal consensus.

Australia contests this, saying the welfare of detainees in its offshore detention regime is the responsibility of the host state.