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Seriously ill asylum seekers denied adequate care: AMA

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Photo: AMA Council for General Practitioners Chair Dr Richard Kidd addresses a Doctors for Refugees rally in Brisbane late last month

The AMA has raised concerns that many asylum seekers and refugees detained on Nauru and Manus Island are being denied appropriate and timely health care for serious health problems.

The peak medical profession organisation has told a Senate inquiry that asylum seekers reportedly suffering serious illnesses or injuries including heart problems, head trauma, post-traumatic stress disorder and possible bowel cancer are receiving care below-standard care, putting their health at risk.

In a lengthy submission to the Senate Legal and Constitutional Affairs Committee, the AMA said it had been contacted by numerous asylum seekers and their advocates seeking help in ensuring they received adequate health care.

It provided details of the treatment of eight asylum seekers, including an elderly man hospitalised for seven months in Port Moresby with a heart condition and high blood pressure before being abruptly returned to Manus with his condition unresolved; a deeply traumatised woman exhibiting self-harm and at heightened suicide risk; a man hit over the head with a machete subsequently diagnosed with a mental illness and a man who suffered a head injury, the extent of which was undiagnosed.

Upon investigating their circumstances, the Association said it was “concerned that many asylum seekers are not receiving appropriate, timely and quality medical care”.

“The AMA does not believe those detained on Manus and Nauru, either within detention facilities or within the community, are able to access a health care service of the same standard that a person in the Australian mainland would receive,” it concluded.

Highlighting the secrecy and lack of transparency surrounding the operation of the detention centres, the AMA reported that in each instance it was told by the Department of Immigration and Border Protection it needed to obtain the written consent of asylum seekers for the release of their medical records before any information was provided.

It said the process of obtaining consent was “difficult and frustrating”. In many cases, asylum seekers did not have access to computers and scanners and had to take a photo of a hand written consent form which was then sent by text to the AMA. In other instances, the Association reported it was unable to obtain the required consent and the wellbeing of the asylum seeker in question was unknown.

Related: Children on Nauru deserve Royal Commission

The AMA acknowledged that the information it obtained could not be independently verified, a fact that underlined its call for independent oversight of the health care provide to asylum seekers.

Ever since the Coalition abolished the Immigration Health Advisory Group in late 2013, the AMA has called for the establishment of an independent statutory body of clinical experts to investigate and report to Parliament on the health and welfare of asylum seekers.

AMA Vice President Dr Tony Bartone told Radio New Zealand that the appointment of such a body was vital to ensure cases of the kind investigated by the AMA were not allowed to continue.

“It’s not the job of the AMA to advocate on behalf of detainees who are patients in the various offshore facilities,” Dr Bartone said. “There should be an appropriate pathway which by there can be a review of the care that’s being given and the outcomes that are being achieved.”

The AMA Vice President said the problem did not lie with the health service provider, but the strictures within which they were required to work.

“They are operating under extremely difficult circumstances, often without enough detail or enough information to ensure the appropriate management,” he said. “They’re working towards a set of agreed requirements and they’re probably hamstrung to deviate from that, we don’t know whether a request has been made and not attended to or whether it is a failing at a much earlier level.”

He said such uncertainty and lack of transparency reinforced the case for a statutory body of experts to oversee the treatment asylum seekers received.

In addition to this, the AMA has called for a moratorium on asylum seeker children who had been transferred to the Australian mainland for medical treatment to be return to offshore detention, and for all children being held in offshore and onshore centres to be immediately released.

The AMA’s submission to the Senate inquiry can be downloaded at: file:///C:/Users/arollins/Downloads/Sub01.pdf

In Australia’s name

What AMA investigations have revealed about the medical care provide to some asylum seekers being held in offshore detention

Patient A

A 70-year-old Rohingya asylum seeker being held on Manus Island was hospitalised in Port Moresby for seven months, where he received little treatment. He was abruptly transferred back to Manus, where he waited 20 days to see a doctor. He was diagnosed with a heart condition and high blood pressure. At a meeting on 4 February, the-then AMA President Professor Brian Owler advised Australian Boarder Force Chief Medical Officer Dr John Brayley the man was likely to die without immediate treatment. Six days later Dr Brayley advised that a transfer to Australia should have been put in train the previous week.  No further details about his location or treatment are available.

Patient B

A 37-year-old Iranian engineer living in the community on Nauru was attacked and hit on the head with a machete. He subsequently suffered headaches, vomiting, nausea, dizziness and weakness. A CT scan conducted a month later identified a broken bone in the centre of his skull, a diagnosis subsequently changed to one of mental illness. His condition has continued to deteriorate. At last report he was on 16 medications and had lost 24 kilograms since the attack. No more information is available.

Patient C

A man being held at Manus sustained a head injury on 11 February. Twenty hours later he collapsed and lost consciousness. About 18 hours after this, he lost consciousness again. A neurosurgeon advised he needed a brain scan, MRI or at least a CT scan. The Department subsequently told the AMA the man had not been prescribed medication and “no recent health issues have arisen”. The AMA said this was at odds with what it had been advised.

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