Asylum seekers detained offshore are being denied access to urgent medical care in Australia because immigration officials fear they will access legal assistance otherwise unavailable to them, an alliance of health workers says.
The allegation comes from the group Doctors 4 Refugees that reviews medical cases at the request of refugees detained in offshore prisons on Nauru, Manus, and Christmas Island.
Despite a lack of medical equipment and expertise available locally, it is increasingly rare for detainees to be sent to Australia for treatment.
"There's a push to keep them away from Australia," said Dr Barri Phatarfod, cofounder of the medical alliance. "The fear is that in Australia they may have access to legal assistance and the courts."
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The claim is backed by documents shown to Al Jazeera by the the Melbourne-based Human Rights Law Centre (HRLC).
In an email referring to an ongoing legal case before the High Court that challenges the legality of offshore detentions, an official at the Department of Immigration stated: "This is likely to cause problems with being able to return transitory persons, as more and more plaintiffs join the litigation.
"It is therefore important to return as many transitory persons as well [sic] can, as soon as possible."
More than 200 offshore detainees who travelled to Australia for medical treatment are currently able to stay in Australia awaiting the judgement in the High Court case.
They could be returned to Manus and Nauru if the court declares the legal challenge invalid.
"These 240 people are the most vulnerable members of an inherently vulnerable class," Daniel Webb, a lawyer with the HRLC told Al Jazeera.
"They're people the government itself has identified as having suffered serious harm in offshore detention and needing urgent treatment in Australia."
Running a 'racket'
However, Peter Dutton, the minister for immigration, told ABC radio last month that asylum seekers are running a "racket" by coming to Australia for medical care, and then seeking legal assistance to avoid being returned.
"The racket that's been going on here is that people at the margins come to Australia from Nauru. The government's then injuncted," he said. "We can't send them back to Nauru and there are more than 200 people in that category."
In an email to Al Jazeera, Dutton's office said: "All people at the regional processing centres in Manus, PNG [Papua New Guinea], and Nauru receive appropriate healthcare."
Phatarfod said it is hard to gauge just what medical facilities are available in the offshore processing centres.
"There's so much secrecy. But we know they don't have a lot of equipment. There is a lack of antibiotics and a lack of diagnostic equipment as well as a lack of pathology services," she said.
The refugee prisons, owing to their location in remote tropical locations, can present specific health problems, as can overcrowding, said Phatarfod. "With so many people crammed together infections are passed on. Diarrhoea is a constant problem, particularly among children."
Phatarfod's group reviewed the medical file of a young asylum seeker who died after a skin infection turned into fatal septicaemia.
Hamid Kehazaei died after a raft of treatment failures, according to Doctors 4 Refugees. They say Kehazaei should have been sent to Australia for early medical treatment that could have saved his life.
The bacteria responsible for Kehazaei's infection, while associated with a high mortality rate, is not intrinsically lethal if treated promptly.
Last month, a Somali detainee who claimed she was raped on Nauru, was flown to Australia for an abortion and then secretly repatriated to the prison on a charter flight to evade a court injunction.
Phatarfod told Al Jazeera there are other pregnant women held offshore.
"There's one woman who will probably need to have a caesarean," she said. "No provision has so far been made for her. We don't know what will happen to her."
In the latest case involving critical medical care for offshore refugees, it was reported on Friday that the company providing medical care on Nauru had reached out to a neo-natal specialist via the networking site LinkedIn.
The company asked him to travel to Nauru ahead of an imminent and clinically difficult birth.
The woman concerned, a Kurdish asylum seeker, is due to give birth any day but diabetes and a difficult medical history mean there are fears for her health - and for the health of her baby.
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It is an issue emphasised by Dr Peter Young, the former director of mental health services for the private contractor hired by the Australian government. In 2014, he resigned in frustration over his inability to provide effective psychiatric treatment to patients.
Young has strongly criticised the Department of Immigration and Border Protection for delays in bringing patients in need of specialist care to Australia.
Incarceration is itself a health risk, he said. "We know that people in detention have a range of medical disorders directly related to the time spent in detention," he told Al Jazeera.
"There's a concern that if people arrive onshore they may have access to legal counsel and other assistance."
For doctors such as Young, who have worked in detention centres, raising concerns about the healthcare available to refugees now comes with an added risk.
A new law, the Border Force Act, could see doctors, nurses, and other humanitarian workers with experience working in Australia's offshore prisons facing up to two years in jail for speaking out about conditions there.
"Doctors are not people who tend to be politically active," said Phatarfod. "But this new law has upset many people and now many of us feel like we need to get organised and speak up."
"Decisions affecting these individuals should be made based on their health, well-being and safety, nothing else. They are people in our care," Webb told Al Jazeera.
"You have to wonder why the government is so afraid of vulnerable people having access to lawyers and to the Australian justice system."
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Source: Al Jazeera