The passing of the fifth anniversary of offshore detention on Manus has seen those incarcerated on the island sink further into mental despair and physical surrender. By Behrouz Boochani.

Five years in Manus purgatory

Pacific International Hospital staff and security guards attend to a detainee following a suicide attempt, at the East Lorengau centre, Manus Island.
Pacific International Hospital staff and security guards attend to a detainee following a suicide attempt, at the East Lorengau centre, Manus Island.

Two months ago, the refugees on Manus Island and Nauru experienced the fifth anniversary of exile and incarceration. It was like a sledgehammer, reminding them of the painfully long and tortuous period they have had to endure.

It seems this anniversary reminded everyone how many opportunities they have lost, the extent to which they have lost their freedom, how many dreams and hopes have been crushed. The people who have been separated from their children all these years suddenly realised how much their children must have grown. The milestone conjured up a profound longing that can tip anyone over the edge, and the younger people among us realised how far away they really were from their hopes and dreams.

It was for these reasons that during the past two months the mental health situation has become dire on Manus Island.

It is perhaps hard for people who have not spent time in prison to fathom how a prisoner’s sense of time is different from other people’s. Sometimes prisoners forget how long they have been locked up. The reality of being forced to live in a tightly confined space with a large number of humans for a long period of time, being forced to see the same people every day, every night… This harsh reality disrupts and distorts one’s sense of time. This reality propels you into the realm of the surreal. It only takes one event to remind you how long you have been forced to live in purgatory.

It is not my intention to discuss the private lives of refugees here on Manus – it is enough to know that every single person’s life here is a tragedy. But my aim in this article is to provide a report of the past two months, during which a number of terrible incidents have taken place on the island. This report only applies to Manus Island. The refugees on Nauru are experiencing a different humanitarian crisis, which involves more than 100 incarcerated children.


Shahed is a young man who fled Iraq to escape the dangers of war. I have known him for more than five years. He is a brave man who arrived on the same boat as me. The bond created by travelling together on that boat carries the same meaning as the connection some have with those from the same city or neighbourhood. You can empathise with one another’s pain and trauma on a profound level.

The presence of strong individuals such as Shahed on Manus is always a source of solace for those around them. Engaging with people such as him evokes a feeling of strength regardless of the affliction and torment.

But the prison is ever so merciless.

On many occasions the prison debilitates people like Shahed, leaving them utterly hopeless. It crushes and drives them to collapse. He was pushed to this point all of a sudden; he did not leave his room for a month and suffered from severe depression. He did not eat for a 10-day period. It was not as if he was on a hunger strike. No. He could not bring himself to eat. At the end of August, he poured petrol over himself, so he could self-immolate. But the other refugees held him back. Shahed is a person who has been totally destroyed. He is totally depressed. He is not the same strong Shahed we once knew, the one who retained his hopes and dreams.

Rasil is an Iranian refugee who also suddenly experienced a rapid psychological decline. He harmed himself and for more than a month now he has not been able to move his arm properly. With the current situation the way it is he will be disabled from now on. The court ordered immigration to transfer him to Port Moresby, and he was there for a few weeks, but he was returned to Manus without receiving treatment. For the past week, he has been held in a tiny room in the police station for quarantine reasons. He is suffering alone.

At time of writing, another refugee from Hillside Camp who tried to take his own life was taken to a quarantine cell in the police station by the guards. Both he and Rasil are now held in isolation.

These problems came after yet another incident last week, which involved a young Iranian refugee named Ben. Early in the morning, as the refugees were getting up to have breakfast, they were confronted by a terrifying sight. A noose and rope were set up in the middle of West Haus Camp. The noose was around Ben’s neck. The other refugees immediately brought him down. After being hospitalised for a few days, Ben was transferred to Port Moresby.


What is interesting here on Manus is that Immigration and others in charge of the system do not spend one second interacting with the patients. Some refugees end up becoming prisoners right there in the isolation cells, others are set free to leave on their own, others are transferred to Port Moresby. The system is always opaque, riddled with selective treatment and games for which no one can ever work out the rules.

Hussein is a 25-year-old refugee. He was exiled to Manus when he was just 19 years old. During all these years he has been grappling with mental health issues and trying to cope by taking all kinds of psychiatric pills. He says that from 2015 he has been using them every day in order to tolerate this situation in detention, and to get some sleep at night. In the first week of September, Hussein harmed himself. He was taken to hospital where he received some dressings for the wounds. The next day he wounded himself again, only deeper this time. He is just one example of a young guy here who is in the prime of his life but feels that he has lost everything.

Perhaps the most distressing incident in the past two months involved a man, about 45 years old, who swallowed material to injure himself. After a few hours, he swallowed more. The day after this incident he was in the bathroom of the hospital and cut his head in a number of places. For some hours he refused to allow the nurses to stitch up his wounds. I have known this man for years – he is a stateless Kurd, meaning that he is not recognised as a citizen of any nation. For years he has been suffering from various physical ailments. For years he has been refused proper treatment and has been a captive of the tortuous bureaucratic systems designed by International Health and Medical Services, the Department of Home Affairs and PIH (the Pacific International Hospital in Port Moresby). He has two sons, aged eight and 12.

In the second half of September, Dr Nilanthi Kanapathipillai from Central Gippsland Health in Victoria visited Manus for one week and met with many of the refugees. I asked her about the current situation and she explained: “Mental health is a significant, if not the largest, health concern here amongst previously well men aged 22–54 … Problems range from major [reactive] depression, depression with psychotic features, significant and untreated PTSD and outright psychosis … The escalation in the rates of self-harm and suicide attempts over the past few months is reflective of not only the desperate need for a voice, but the total inadequacy of psychiatric care provided to the vulnerable … It’s disgraceful.”

The situation for the refugees on Manus has become extremely dangerous. If this continues in the same way there is no doubt more people will die. Over the past years, four people have died from suicide alone – all clear examples of men who were isolated and left alone to deal with the pain and suffering of purgatory. Clearly, there are still men here with deteriorating mental health and on the verge of collapse, and they are affecting everyone else around them who are also battling to cope.

Lifeline 13 11 14

Translated by Omid Tofighian, University of Sydney.


This article was first published in the print edition of The Saturday Paper on September 29, 2018 as "Five years in purgatory".

A free press is one you pay for. Now is the time to subscribe.

Behrouz Boochani is a senior adjunct research fellow with the Ngāi Tahu Research Centre, University of Canterbury, and is an associate professor at the University of NSW.

Sharing credit ×

Share this article, without restrictions.

You’ve shared all of your credits for this month. They will refresh on June 1. If you would like to share more, you can buy a gift subscription for a friend.