Refugees on Manus and Nauru were given hope by the passing of the medivac bill, but the reality is just another layer of bureaucracy added to their lives. By Behrouz Boochani.

Medivac missteps rack sick refugees

A refugee on Manus Island is prepared for transportation to Pacific International Hospital, Port Moresby.
A refugee on Manus Island is prepared for transportation to Pacific International Hospital, Port Moresby.

After a lot of political tumult the medivac bill was eventually passed on February 12. According to this law, all sick refugees on Manus and Nauru now have the opportunity to be transferred to Australia for medical assistance. Although there was opposition, in the end it was a success for those refugees. In fact, this was the first time in six years that the Australian parliament passed a law that could be considered somewhat humane.

This law could have been passed two months earlier but the Liberal Party delayed it. Finally it was made law. This bill was a sign of hope for dozens of refugees who have been struggling for years with numerous mental health and physical conditions. But two-and-a-half months after the bill was passed it is clear that it is being used as an instrument of grief and torture.

On the day that the bill was passed, more than 20 sick refugees were lying on Pacific International Hospital (PIH) beds in Port Moresby. They were hopeful that they would soon be transferred to Australian hospitals. Not only have they not been transferred, many of them have been discharged from the hospital in Port Moresby without adequate treatment and put in the Granville Motel. They have been replaced in PIH by others from Manus.

During this time I have had the opportunity to visit this hospital. I was transferred to Port Moresby for an interview with United States authorities, so I had the chance to go to the hospital. I must admit that after all these years, after experiencing so many terrible incidents, and after visiting many sick refugees, I was still shocked by what I saw.

There were many young men there, some of whom were in wheelchairs. Some of them were extremely skinny and malnourished, unable to speak, lying in bed. Some had harmed themselves to such an extent that their arms and legs were covered in wounds and scars. Some of them had been in that state for a period of more than six months – simply lying in bed and receiving very basic care, totally inadequate to their needs.

While I was shaken by their situation I was not surprised. In this medical system the main objective is not to cure anyone; the aim is to leverage the sick refugee’s illness to torture him into submission.

Now they have discharged many of these same people. Over the past few days, one of these sick patients was extremely worried and called me. He said he was starving, thirsty and roaming around homeless. I asked what had happened and he said the hospital managers wanted to discharge him and threatened to report him to the police unless he signed discharge papers. He ran away because he refused to sign.

This is one of the bizarre aspects of the system: sick refugees have no option but to surrender to the medical system, which itself tortures them. On the one hand, they know they will not receive adequate medical services; on the other hand, without this system they are completely on their own.


I have written many times before of how the medical system seduces refugees and makes them dependent. The problem that sick refugees face is not limited to this hospital – the problems are just like those experienced on Manus Island. Self-harm, attempted suicide, chronic depression and paranoia are all rampant, and in a place with almost no medical facilities or resources. The system just documents the sick people by placing them on waiting lists with the hope of them being transferred to the Pacific International Hospital in Port Moresby.

On Manus there are dozens of individuals who have been on the waiting list for months. During this time they
are given nothing but basic medicine such as painkillers. In Manus there is no option for a sick refugee – they have to receive treatment from the local hospital, which has practically no resources to treat the sick.

Just today, as I am writing this article, a 45-year-old man was taken to the local hospital on Manus with heart pain. But immigration and the other refugees know too well that it is impossible for this hospital to help him. Like many others, this man needs immediate assistance from a place with proper medical facilities; however, he must remain there in Manus hospital under the shadow of death.

The same problem applies to local people – despite the best intentions of the hospital’s limited medical staff, the facility remains dangerously underequipped.

So what has changed over the past two-and-a-half months? I can say for certain that practically nothing has changed. During this time only two people have been transferred to an Australian hospital as a result of the bill. One question comes to mind: why is it that the law has not been implemented after this period?

According to the bill, if two doctors confirm that a sick refugee needs to be transferred to Australia then the government must comply with their advice. However, a big problem with this bill is that a clear mechanism has not been designed so that a refugee can access two doctors. In fact, dozens of sick refugees either do not know how or have no way to apply for a transfer.

During this time a group of refugee supporters called the Medivac Group has been formed to help refugees enter this process. The Refugee Council of Australia, Asylum Seeker Resource Centre, Amnesty, National Justice Project and Human Rights Law Centre are all planning to assist refugees in relation to this. They have access to two doctors and have a list of sick refugees provided by refugees and advocates.

However, after practically two-and-a-half months no more than two individuals have been transferred to Australia.

The thing that has made this process excruciating is that these human rights organisations are following the same path the government has been carving out all these years regarding the treatment of sick refugees. This is nothing more than subjecting refugees to a bureaucratic game – a very drawn-out administrative process and complex structure.

At this point in time, a refugee has to sign many forms and send his documents and information to these groups. Then he has to wait for them to act on his behalf. But this is an extremely tortuous process. Many people signed papers months and months ago and are still waiting for attention.

If we were to calculate the length of time necessary for all the sick refugees to leave this island, based on the rate of two people every two-and-a-half months, we can conclude that it would take about 128 years. You are right to laugh. You would be right, also, to conclude that the government has tried to exploit this bill for its own political purposes.

They reopened the Christmas Island detention centre at a massive cost and then closed it again after a short period. Home Affairs Minister Peter Dutton announced that hundreds of refugees would be transferred to Australia and would fill up hospital beds. Of course, that didn’t happen. With all the political ruckus and propaganda this bill is a failure.

Just like the US refugee swap deal, it has absorbed refugees into another long and exhausting game. While all this takes place there are dozens who need to urgently be taken to Australia. It seems the point that is always forgotten is that we who are in Manus and Nauru are human beings. We have been held captive here for six years, stuck in an inhumane system. I ask that we all contemplate a man, someone who has no one and is alone, lying on a rotting bed, struggling to stay alive, longing for his children.  

Translation: Omid Tofighian, American University in Cairo / University of Sydney.

This article was first published in the print edition of The Saturday Paper on April 27, 2019 as "Medivac missteps".

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