The death of asylum seeker Hamid Kehazaei reveals it is not possible to provide adequate health services in offshore detention centres and that the Department of Immigration should no longer be tasked with the job, according to a leading refugee health expert.
Professor Louise Newman, a former member of the Immigration Health Advisory Group (IHAG), has added her voice to calls for an independent investigation into the death of Kehazaei, the 24-year-old Iranian who died in a Brisbane hospital earlier this month after a foot infection spread through his body.
“This case is certainly very important and it raises several issues that need proper investigation – and by that I mean investigation that is not conducted by any doctors employed by the department of immigration,” Newman told New Matilda.
Kehazaei is believed to have developed sepsis from a cut on his foot, which then triggered cardiac arrest and left the young man brain-dead.
“[Sepsis is] a very serious case because it is a condition that’s treatable and what we need to understand is what medical investigations or assessments were actually conducted on the Island, what the recommendations made actually were, and how decision making processes are made in a situation like that,” Newman said.
The Minister for Immigration Scott Morrison has confirmed his Department will conduct a ‘clinical review’ into Kehazaei’s death, to be overseen by the Department’s chief medical officer. The Queensland Coroner will also deliver a report.
But Newman says the Coronial inquiry could take months, and that the conditions on Manus, which other doctors have described as ‘woeful’, need urgent attention.
“We know that a lot of the reports coming out of Manus indicate it’s a very high risk environment. More recent reports are that it’s actually a bit of a health hazard in that it’s unhygienic and there are inappropriate facilities,” Newman said.
“We know that there are limitations of what medical staff and clinicians can actually do there.”
In December 2013 the Abbott government dissolved the IHAG. The group included representatives from the medical peak bodies and came into being in 2006, after the Howard government was advised to establish independent health advisory bodies to oversee the detention of asylum seekers.
After the group was disbanded another former member, Dr Gillian Singleton, lamented its demise.
“The disbanding saddens me, as it is clear that there remains much work to be done,” she wrote at the time.
Prime Minister Tony Abbott hit back, saying the group had not been disbanded but simply streamlined to make it more effectual. All independent members were dismissed except for former defence figure Dr Paul Alexander, who had previously chaired the group.
Newman said that in her capacity as a psychiatrist she continued to work with patients in detention but that her recommendations for treatment were often ignored.
“We know that attempted suicides and self-harms are endemic in these [environments]. I have a lot of concerns, particularly about children and the babies who are currently in detention and are really quite compromised,” she said.
“I think there is enough high level concern to actually need a think or rethink of the provision and governance of health services.”
In the face of growing criticism about the state of the Manus facilities, Immigration Minister Scott Morrison has defended the quality of care provided to those interned.
At hearings conducted by the Australian Human Rights Commission, Morrison and outgoing Department Secretary Martin Bowles both complained that those questioning the services provided in offshore facilities were attacking the diligence of medical staff in the centres.
But the Commission also heard testimony from doctors working in offshore centres who said the Department ignored their recommendations, and that they were asked to change reports showing the high levels of psychological distress being suffered by those held in the facilities.
Newman said that working for private contractors and the Department had put doctors in a precarious moral position and that discussions about the performance of health professionals were a distraction from the bigger issue.
“The issue is should they and can they [health services]be provided by the Department of Immigration contracting out to private companies,” she said.