Médecins Sans Frontières (MSF, Doctors Without Borders) Australia has disputed home affairs minister Peter Dutton’s version of events which led to the organisation being told by the Nauruan government to leave on October 5.
MSF executive director Paul McPhun said on October 11 that MSF had signed a Memorandum of Understanding with the Republic of Nauru that its doctors were able to treat everyone on the island — Nauruans, expatriates, asylum seekers and refugees.
Dutton said that MSF was not contracted to provide medical services to asylum seekers.
Prior to the MSF team arriving in Nauru in November 2017, McPhun said there was one resident, one mental health nurse and one psychiatrist. MSF was the only organisation, not contracted by the Australian government, which was assisting asylum seekers.
The international humanitarian medical organisation has condemned the Nauru government for stopping it providing desperately needed mental health care. MSF described the mental health of asylum seekers and refugees on the island as “beyond desperate”, and said they should be evacuated immediately. It also added its voice to the call for the Morrison government to end its offshore detention policy.
While the Australian government has retorted that staff from International Health and Medical Services (IHMS) visit Nauru, McPhun said that the refugees do not trust them given they are being paid by a government that prevents them from leaving or indefinitely imprisons them. Initially, the refugees were slow to make use of MSF’s services but this soon changed.
As well as providing free mental health services for everyone on Nauru, MSF has trained and supported Nauruans as well as performing numerous outreach activities.
Dr Beth O’Connor, a psychiatrist, said that all the asylum seekers MSF saw were already suffering trauma from having to flee their country of origin, and many are suffering as a result of five years of indefinite detention.
She said that sexual assaults and other acts of violence against asylum seekers are common. Children as young as 9 have attempted suicide. Others are unwilling to eat or drink, suffering from what is known as “resignation syndrome”.
Dr Chris Rufener, another MSF psychiatrist, compared the psychological wellbeing of the refugees on Manus with those on Lesbos in Greece where she has also worked. The refugees on Lesbos had hope that they would find a new home in Europe. But those on Nauru feel destroyed, she said. Fathers lose hope that they will ever see their children again. Rufener said that as Nauru regards attempted suicide as a crime, instead of being taken to hospital survivors are taken to jail.
All three referred to the gradual decline in the physical and mental health of asylum seekers, a result of the hopelessness they feel.
Seventy eight refugees have attempted suicide since MSF arrived. Many more have attempted to self harm. Moderate to severe mental disorders are faced by all refugees. When MSF left, more than 100 people were on the waiting list to obtain medical assistance.
The Australian government claims that no one on Nauru is in detention. The MSF doctors say that Nauru is a detention island.
There are no work or study opportunities available for refugees and family members remain separated.
After 70 asylum seekers received negative responses to their asylum applications in May, the doctors said that there was a rapid deterioration in those people’s physical and mental health.
“Separating families and forcibly holding men, women and children on a remote island indefinitely with no hope or protection except in the case of a medical emergency is cruel, inhumane and degrading,” said McPhun.
“This policy should be stopped immediately and should not be replicated by any government.
“It’s not MSF’s psychiatrists and psychologists that should be leaving Nauru; it’s the hundreds of asylum seekers and refugees that Australia has trapped on the island for the past five years that should be leaving.”