INSIDE MANUS: no first-world picnic

The documents, which paint a picture of frustration and suffering, include minutes of managerial meetings and operational reports, as well as lists of requests by asylum seekers for everyday items.

They reveal a series of health alerts at the detention centre including vaccine shortages, outbreaks of disease and myriad infections, as well as psychiatric trauma, including cases of asylum seekers self-harming.

Despite the graphic detail, people who have worked at the refugee processing centre say the documents cannot convey adequately the stench of faeces, urine and mould that pervade the living quarters nor the despair in the cries of asylum seekers as they rattle fences and shout “f— PNG” and “we are human”.

The documented and verbal accounts of life on Manus Island add to a litany of evidence about Australia’s treatment of asylum seekers, confirming further the tense and unhappy environment that existed in the lead-up to February’s riot that left 23-year-old Iranian Reza Berati dead and dozens more asylum seekers injured.

But they also shed light on the burden placed on those agencies and service providers trying to care for the detainees in cramped barracks in a remote location in the Pacific Ocean, 800 kilometres north of Port Moresby.

The documents, which span 2013 through this year, show:

► Self-harming and attempted suicide by asylum seekers were frequent occurrences, with workers at times only able “to do the basics” in caring for those suffering acute psychological distress;

► Management concerns that security officers and other workers did not have the skills necessary to deal with asylum seekers who were in a highly agitated mental state;

► Requests from asylum seekers to visit the healthcare clinic could go days without eliciting a formal response, with managers “inundated when entering a compound” and some detainees threatening self-harm in order to see a doctor sooner;

► Outbreaks of gastro-enteritis were common among detainees and staff and, in December 2013, ‘Oscar’ compound had to be quarantined because of scabies;

► Detainees were also suffering skin infections and rashes, toothache and infected wounds;

► Asylum seekers, a number of whom claimed to be minors, reported numerous incidents of sexual assault and intimidation among the detainee community, with some saying they were too frightened to use the communal bathrooms for fear of attack;

► A manager for G4S, the firm that oversaw security at the detention centre, conceded that it was difficult “to police” the detainees to ensure their personal safety;

► Education sessions prepared for asylum seekers described Papua New Guinea as dangerous and impoverished and PNG police as violent and corrupt and who “may ask for money or sexual favours in return for not imprisoning or beating you”.

The documents seen by The Citizen contain incident reports and management plans outlining the breadth of the challenges and tasks undertaken by those groups that partner with the Department of Immigration and Border Protection to manage the facility. These have variously included the Salvation Army, Save the Children, Transfield Services, the security firms G4S and Wilson Security, and International Health and Medical Services.

The Salvation Army and G4S are no longer involved in the running of the facility. Instead, a number of responsibilities at the processing centre have been bundled together and are overseen by Transfield.

A spokesman for G4S declined to discuss matters raised by the documents, saying the company did not wish “to pre-empt or compromise the investigations and reviews of the Australian and Papua New Guinea governments”.

Both Australia and PNG are investigating February’s violence at the detention facility that embroiled local guards and police. An independent review by a former secretary of the Attorney General’s Department, Robert Cornall, reported this week a witness account which put the blame for Mr Berati’s death on a local Salvation Army worker along with local security guards.

According to the witness, the Salvation Army PNG local “hit him twice with a very long stick at the door of his room’’. “When he fell down, more than 10 PNG locals, guards and Australian expats … all of them kicked him in his head. One PNG local put a very big stone at his head.”

PNG police are conducting further investigations into the incident, while the result of a separate Senate inquiry is due soon.

The documents, specifically the minutes of regular Client Placement and Preventative Meetings, point to a range of mental health issues among asylum seekers and summarise discussions about how best to manage them.

Authors of the documents repeatedly describe asylum seekers as appearing to be on the brink: one is reported to be “fed up with his life”, while another found his friend trying to “hang himself in the bathroom”. Many are suffering “acute stress and detention fatigue”, while the lives and wellbeing of many are said to be “unraveling” in detention.

Meanwhile, the minutes of an operations meeting reveal that concerns were raised about the ability of security guards to handle asylum seekers who were psychologically distressed.

Asylum seekers also were wary of the local PNG community. According to the notes, an asylum seeker told staff he feared being resettled in PNG after being “told by a member of G4S, who he believes to be from PNG, that people from PNG did not like Muslims or white people”.

Concerns about the healthcare facilities at Manus Island were first raised in April 2013 after a former IHMS doctor told the ABC’s Four Corners the medical situation on Manus was a “disaster”.

A heads of agreement struck with the Federal Government commits the IHMS to providing on Manus Island “a level of care that is sufficient to maintain optimal health, broadly comparable to what is available in Australia and the best available in the circumstances”.

However, a report for the Federal Parliamentary Library has noted that “there is limited publicly available information on which to base an assessment of whether these objectives are being achieved”.

Part of the contract also stipulates that the IHMS create partnerships with local PNG health services in order to provide a full range of healthcare to the asylum seekers, but last year the chief executive of the island’s Longerau Hospital, Dr Otto Numan, conceded that such services needed to be improved.

This, in fact, was undertaken with investment from the Salvation Army after it found the local hospital having “showers that we wouldn’t shower in, with mould stains all over them, mould all over the walls of rooms where premature babies lay, power points that hung out of the walls, holes in the walls behind sinks and many other things that would be an [Occupational Health and Safety] nightmare”.

Responding to a series of written questions from The Citizen, an IHMS spokesman said this week: “IHMS provides health care that is broadly comparable to Australian standards, taking into account the needs of patients, and circumstances at [detention sites].

“Similar to community standards, urgent health needs are attended to in priority over less urgent and routine needs and therefore there may be at times, a waiting period.

“IHMS’ health team is able to respond to acute situations 24 hours a day. The number of staff is designed to cater for the population and health requirements at site and is regularly reviewed.”

More than 1100 men are currently detained on Manus Island – nearly half of whom are Iranian.