The plight of a dying Hazara refugee, brought from Nauru to Australia for palliative care, has shone a rare light on conditions in Australia’s offshore detention centres.
Doctors joined the campaign to give 63-year-old “Ali” a dignified death, after Home Affairs Minister Peter Dutton initially turned a deaf ear to his request.
Nearly 2300 doctors signed an open letter to Mr Dutton and his department asking for compassion for the terminal lung cancer patient.
“If he remains on Nauru, he faces a potentially catastrophic death, without medical expertise to ease his pain and symptoms. This is no way to die,” Sydney GP Dr Sara Townend said in the letter.
Separately, a public petition supporting the move drew 24,000 supporters, and the AMA and the Royal Australian College of Physicians added their weight to the cause.
AMA President Dr Tony Bartone said an offer by the government to send Ali to Taiwan was not appropriate, because he did not want to die without anyone who spoke his language or who could perform Shia religious rites.
In the week after Dr Townend’s letter went out on social media, we learned the father of six was the oldest detainee on the equatorial Pacific island.
The Afghani man had been there for five years and worked for a time as a builder earning $4 a hour, sending money to a son studying medicine.
Despite being recognised as a legitimate refugee who had fled persecution, Ali had been told he could never enter Australia, where he had family, because he had arrived initially by boat.
Meanwhile, public vigils were held around the Australia on June 14, in honour of Ali, and for Fariborz Kameer, a 26-year-old Iranian Kurd and former dentistry student, who had committed suicide in his tent on Nauru a week before.
At the Sydney vigil, Dr Vida Shahamat, who fled Iran as a refugee in 1983, said people held indefinitely in detention would succumb to mental illness, if not physical sickness.
“They will die, one by one, or they will end up in mental institutions under Australia’s care,” she told The Medical Republic.
Now living in Australia as a clinical researcher developing new cancer drugs, Dr Shahamat escaped with false papers after being expelled from medical school and jailed for her pro-democracy activities.
“I became deeply depressed and suicidal,” she said, recalling her loneliness and desperation after arriving in the US via Germany.
“The only thing that kept me going was hope that I could slowly rebuild my life.”
Most of the some 1700 refugees on Manus Island and Nauru, including many children, are Iranians and Somalis who have no chance of being accepted under a resettlement deal with the United States, according to advocates.
During the campaign for Ali, Dr Nick Martin, who worked as a senior doctor on Nauru in 2016-17, published an essay in the Australian literary journal, Meanjin, recounting his experience.
The GP, now doing locum work in NSW, said Border Force officials had obstructed his efforts to send seriously ill detainees off the island for hospital treatment.
“There were many cases where it seemed inexplicable that they were not being transferred off Nauru to get the treatment they needed. The roadblocks put up in my way were unbelievable.”
Patients in pain and suffering from conditions such as obstructive kidney stones and angina were victims of neglect in this way, Dr Martin said.
“That is quite apart from a huge mental health burden, which only goes up day by day as people remain stuck on Nauru,” he told TMR.
The rise in incidents of self-harm and suicide attempts by children as young as eight was “a vile situation”, he said.
“There can be no medical argument – there can be no disagreement – that prolonged indefinite detention is incredibly harmful to all detainees, particularly children, and the fact that it is still going on is a criminal act,” Dr Martin said.
The day after the vigils, the government quietly transferred Ali from Nauru to a Gold Coast hospital.