More than 2,000 doctors have petitioned for an Afghan refugee on Nauru to be transferred to Australia

This article is more than 2 years old

This article is more than 2 years old

A dying Afghan refugee currently held in offshore processing on Nauru must be brought to Australia for palliative care, doctors groups have told the government.

The Australian Medical Association and the Royal Australasian College of Physicians have both told the government 63-year-old Ali*, who has lung cancer, should be moved to Australia to “be allowed dignity and respect at the end of his life”.



The medical groups’ statements follow an open letter signed by more than 2,000 doctors calling for Ali’s transfer, and a public petition to the prime minister that has garnered more than 22,000 signatures.

Last month, Guardian Australia revealed the details of 63-year-old Ali, an Afghan Hazara man suffering advanced lung cancer. Sources on Nauru and doctors familiar with his case say the palliative care he is receiving inside the Australian-run regional processing centre is “totally inadequate”. His prognosis is “dire” and he has only weeks or months to live.



The Australian Border Force has told Ali he can go to Taiwan to die – an option he has rejected because he does not know anybody there, is concerned there would be no translator from his language, Hazaraghi, and that there would be no one to perform the Shia Muslim rituals and ceremonies on his body when he died.

The ABF has also offered him $25,000 to return to Afghanistan, the country he fled after facing threats on his life. Ali is a member of the persecuted Hazara minority and has been formally recognised as a refugee – he faces a well-founded fear of persecution in Afghanistan and cannot be forcibly returned there. Australia is legally obliged to protect him.

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Ali should be immediately brought to Australia for palliative care, the AMA said.

“He has advanced lung cancer. He needs significant palliative care services that he cannot receive on the island. This is not in dispute,” AMA president Dr Tony Bartone said.

Moving Ali to Taiwan was neither medically nor ethically appropriate, Bartone said.

“The AMA has always held that all people who are under the protection of the Australian Government have the right to receive appropriate medical care without discrimination, regardless of citizenship or visa status.

“They should be treated with compassion, respect and dignity. On any score – international obligations, conventions, respect, standards of clinical and ethical care – we must not fail to provide the requisite medical care on Australia’s watch.”

The AMA has consistently called for an independent statutory body of clinical experts with the power to investigate and report to parliament on the health and welfare of asylum seekers and refugees in Australia’s care.

The Royal Australasian College of Physicians said people suffering terminal illnesses should not be subjected to indefinite detention at the end of their lives.

“Someone who is suffering from a terminal illness and where treatment is out of the question, should not be held in detention,” RACP president, associate professor Mark Lane, said.

“This man should be brought to Australia for palliative care and be allowed dignity and respect at the end of his life.”

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An open letter from Sydney GP Dr Sara Townend has now attracted more than 2,000 doctors’ signatures, including former heads of the AMA and doctors who have worked on Nauru.

“If he goes to Taiwan, where there are no Hazara, he will die isolated and without community. This is no way to die,” the letter says.

“If he remains on Nauru, he faces a potentially catastrophic death, without medical expertise to ease his pain and symptoms. This is no way to die.

“His only chance of a good death is to come to Australia so that he can have both community and medical expertise. Our international reputation depends on it. Our humanity demands it.”

Townend told Guardian Australia: “it hurt so much to read of this man’s situation because I work so hard for my own patients to make their deaths the best they can be.

“I work with adults who are dying, and with children who are dying. Even here in Australia with excellent palliative care available, a good death is challenging to achieve. I could not bear to think of this man dying alone in a room without family or community or appropriate medical expertise. I could not believe this was a deliberate act of exclusion by my government.”

A change.org petition, calling for Ali’s transfer to Australia, has now been signed by more than 22,000 people.



“He has one incredibly simple request: to come to Australia and receive some relief from the pain and die with some dignity and comfort,” the petition says.

On Nauru, several sources have told Guardian Australia that ABF staff have made repeated requests to Canberra for intervention in his case.

High-profile or politically-sensitive medical cases are decided not by the ABF but by executive-level officials of the Department of Home Affairs: in some cases as high as the secretary of the department or the minister for home affairs.

ABF recommendations from Nauru are often overruled at executive level inside the department. The decision to offer Taiwan as a medical transfer can only be made by senior department staff.

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IHMS, the Australian government’s contracted health provider on Nauru, has refused to answer questions about when it had become aware of Ali’s critical health needs, when it first requested he be moved, or how many transfer requests it had made.

The department said it would not comment on individual cases, but that medical transfer decisions “occur on a case-by-case basis according to clinical need, in consultation with the contracted health services provider and the government of Nauru … [and] with the permission of the individual”.

“Australia has provided significant funding and support over a number of years to improve health infrastructure in Nauru.”

Friends on Nauru say that Ali – who had previously worked in construction while being held on Nauru – has deteriorated badly in recent weeks. He is finding it increasingly difficult to speak, has lost most of the use of his right arm, and can no longer dress himself.

“He [Ali] is very angry, he is very upset as well,” a friend on the island said. “He said these people do not have a human heart.”

*Ali is a patronym, his full name is withheld to protect his family.