A lack of specialist care is to blame for deaths and health crises on Manus Island, say insiders.
Detainees on Manus Island have to wait five to seven days to see a doctor unless it is deemed an “absolute emergency”, a Manus Island whistleblower has told Crikey.
Martin Appleby, a former guard at the Manus Island detention centre, says it would also be impossible for doctors to test for the septicaemia that has left Hamid Kehazaei brain-dead in Brisbane’s Mater Hospital. “There’s no way you can take blood and get it tested. There was no ice to pack the blood in to get it Port Moresby for testing.”
Kehazaei was transferred to the hospital last Tuesday after he contracted cellulitis, which then turned into septacaemia. Concerns have been raised over delays to treatment for the 24-year-old after he cut his foot at the centre.
Doctors at Manus Island are “under the pump”, says Appleby, and are rotated fortnightly, making it unlikely that patients see the same doctor twice. According to Appleby, there are two doctors and four nurses on duty at any time for the 1200 people there.
“I had a knee infection and I was treated by a gyneacologist — great fella, did everything he possibly could. You couldn’t question his commitment, but the fact was he’s a gynecologist,” Appleby said. “There’s no specialised treatment — that’s what probably caused the issue [with Kehazaei].”
Rod St George, who was the Occupational Health and Safety Officer on Manus between March and April last year, says all staff at Manus, including medical staff, were “swamped” by the number of cases, and doctors would see 30 patients a day out of the 300 people who were there at the time.
“I had a knee infection and I was treated by a gyneacologist … You couldn’t question his commitment, but the fact was he’s a gynecologist …”
It could take hours to attend to an emergency, according to St George. Appleby told Crikey that he had seen guards berated for calling an emergency code black for a detainee who was showing signs of heart attack. The deainee was eventually diagnosed with angina.
As OH&S officer, St George says he encouraged staff and detainees to wear proper footwear. “Most people just knew, but you frequently saw detainees with just thongs on. Everybody knew that if you had an open wound in those condition it was a disaster.”
While both St George and Appleby say medical staff were doing the best they could, the conditions on the island made it difficult for patients to get proper treatment and be able to recover. St George says that for detainees on Manus Island, “the cards are stacked against them at the beginning”.
“When I was there what we would find is that people had certain ailments that here in Melbourne, for instance, you know if a doctor were to say, ‘just go home and rest’, that would be enough. But when resting means going back to a facility where you’re just going to sweat buckets, you’ll be lying on your bed, resting doesn’t have the same effect. It’s strenuous living. Just to simply stay alive is hard work because of all the elements, and on top of the physical problems there’s mental problems.”
St George points the finger at the government and the lack of resources and funding at the centre, saying “it’s proven to be a disaster”.
Both Appleby and St George were highly critical of the Immigration Department. “The government has just not afforded them the same rights as humans,” said St George.
Kehazaei’s case also raises questions of the government’s responsibilities as guardian of asylum seekers when decisions about life support need to be made. It has been reported that the government has now made contact with Kehazaei’s family in Tehran.
If a similar situation were to arise where an asylum seeker’s family could not be contacted it is clear who would make decisions regarding life support, according to experts Crikey spoke to. Professor Lindy Willmott, director at the Australian Centre for Health Law Research, says that in general if a person’s next of kin can not be contacted the decision is up to a “public guardian”, who is independent from the government and when making decisions, “they have to take into account the best interests of the person. That’s not particularly complicated or controversial.” Willmott says that hospitals are required to make reasonable attempts to contact the next of kin, but if that isn’t possible, the public advocate is contacted.