‘The system here is broken’: Secret recording reveals failures of offshore detention regime – The Sydney Morning Herald

Two refugees under Australia's care in Nauru are desperately seeking medical evacuations to Australia to escape a health regime thata government-contracted doctor on the island has admitted is "broken".

The men, respectively suffering debilitating headaches and a severeanal fistula, have been unable to secure medical transfers and are being told their fate is in the hands of the government of Nauru.

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A secret audio recording captures a doctor in Nauru stating the system there is broken.

Nawaf*, a refugee,has had the advanced fistula for more than two years and has refused surgery in Nauru because of concerns about infection during recovery, which requires the wound be left open to drain.

"It has become so bad that I have constant bleeding from the affected area, especially when I showerand use the toilet, and I am in severe pain," he wrote in a complaint lodged last year.

Another man, Afghani refugee Khan*, has been advised he requires an MRI not available in Nauru to treat severe occipital headaches, which leave him liable to lose consciousness and collapse.

In a secret recording given to Fairfax Media, a senior medical officer with contractor International Health and Medical Services concedesthe system is failing to provide adequate care for refugees on the island.

"This system here is broken," the doctor tells Khan. The doctor admits he has been unable to attain approval for a medical transfer.

"I've got to be careful, I've got to promise youwhat Ican deliver," he says in the recording. "Iasked all the questions last time: why is this man still here, why hasn't it been done? He's been waiting for sevenmonths at least.

"It's not working, thesystemis not working."

Khan agrees: "The system is broken, but we are suffering."

Asylum seeker advocates gave the patients' medical records to Melbourne GP Susan Ditchfield, who said the two men should be brought toAustralia urgently.

"[Khan]needs more than an MRI ... he needs a neurologist and he needs a cardiologist," she said.

Of Nawaf's fistula, Dr Ditchfield said: "The management of that is really specialised.Unless you get it exactly right, the patient can end up with permanent fecal incontinence.

"There are surgeons who specialise in this sort of surgery, and even in the best of hands it can go badly.It's very unlikely that such a surgeon is working on Nauru.

"These people need assessment in Australia.They are suffering needlessly."

Sandra Bartlett, a former case manager on Nauru, said "Fly Camp" whereNawafis living has "the least facilities and worst conditions" of any settlement on the island, with about 120 men sharing bathrooms.

A spokesperson for the Department of Immigration and Border Protection told Fairfax Media the process for medical referrals in Nauru was under the management of the Republic of Nauru.

In an emailto the Asylum Seeker Resource Centre sent on Friday, the department says Australian Border Force chief medical officer John Brayley acknowledges concerns about Khan's case, butconsideration of medical transfers isa matter for the government of Nauru.

Refugeesseeking offshore transfers for medical purposes must first approach staff at IHMS, which in turn negotiates with Nauru or Papua New Guinea, before a final decision is made by the DIBP.

Peter Rudolph, area medical director at IHMS, told a Senate inquiry in Marchthat while the department acted "rapidly" on very urgent matters, "with regard to semi-urgent cases, yes, there are delays".

Immigration Minister Peter Dutton is only informed of the matter after a decision has been made by thedepartment, the inquiry heard.

* Names have been changed

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'The system here is broken': Secret recording reveals failures of offshore detention regime - The Sydney Morning Herald