Refugee Council of Australia
Jetty on Manus Island

Until when: The forgotten men of Manus Island

Breaking the men

Breaking the men

This section will explore the worsening of health care since the closure of the RPC and the ending of the IHMS contract. The Australian Government has cut back the health care offered to people, and attempted to shift the responsibility to local contractors and PNG’s strained public health system. Torture and trauma counselling has stopped, and the numbers of mental health staff have halved. As the situation of refugees and people seeking asylum drags on in limbo, there have been more suicide attempts and self-harm.

Access to physical health care has also become more difficult. The larger clinic at the RPC has closed, leaving a smaller clinic at ELTC. People are often transferred from Manus Island to Port Moresby, as there is no treatment available for them on the Island. Yet very few receive proper treatment in Port Moresby, according to the refugees RCOA spoke to. Many wait for months to get an appointment. Others have been told they need medical treatment that is not available in PNG, but are not being transferred to Australia to receive that treatment.

UNHCR has called for immediate action by the Australian Government to “address a collapsing health situation among refugees and asylum-seekers at off-shore facilities in Papua New Guinea and Nauru” and for them to brought to Australia.As this section details, the men sent to PNG are being broken, as their physical and mental health rapidly decline. Some have died.

Others have become permanently disabled and one man has become blind. Many are suffering from chronic illnesses. Two years ago, they already had the worst mental health rates for any surveyed population.

For a long time, there have been serious concerns about the availability of health care for people sent to PNG. Until 30 April 2018, that care was provided under contract by International Health and Medical Services (IHMS), the service provider contracted by the Australian government to provide health care to refugees and people seeking asylum. While the RPC was open, IHMS operated a large clinic there, with an on-site pharmacy, and another clinic at ELTC for one day a week.

When the RPC was closed, those who remained inside the RPC during November 2017 had no access to health care and very limited access to medication. After the closure, refugees were instead told to access the much smaller clinic at the ELTC or the local hospital. There is no clinic at the other two centres. Since 1 May 2018, health care services have been provided by Pacific International Hospital (PIH), a local PNG contractor, under arrangements with the Australian Government.

Right to highest attainable standard of physical and mental health

Both Australia and PNG have ratified the International Covenant on Economic, Social and Cultural Rights, which requires them to respect and protect the right to the enjoyment of the highest attainable standard of physical and mental health for everyone (Art 12).

Where centres for refugees and people seeking asylum are located in places that are geographically and socially isolated, people may be unable to access health services, education, or legal assistance. States must ensure that the use of such centres, directed residence or other restrictions does not obstruct individuals from enjoying their rights, including to health.

The Australian government has implemented policies which make it difficult for refugees and people seeking asylum to access health care, including by sending them to countries (PNG and Nauru) with poor medical facilities, that are geographically isolated, and restricting their freedom of movement. These policies in combination deny them their right to health. The Australian government has an obligation to ensure their health care needs – both physical and mental are met to the highest attainable standard.

The deliberate obstruction of medical care or other humanitarian assistance to refugees and people seeking asylum as occurred between 31 October and 24 November 2017, may also amount to torture or other cruel, inhuman or degrading treatment.

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