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MSF: Medevac repeal entrenches dangerous precedents on denial of medical care

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Republic of Nauru Hospital and local community houses. Nauru school in the background. © MSF

4 December 2019 – The decision to repeal Australia’s ‘Medevac’ legislation endangers patients in need and ignores the ethical framework of the entire medical profession, said international medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) today.

The Medevac referral process provided for in the Migration Amendment (Medical Transfers) legislation had been one of the most effective pathways for patients held under offshore processing to access the care they need in Australia.

“Asylum seekers and refugees who remain indefinitely contained on Nauru and PNG have been blocked again from accessing treatment for critical health conditions where adequate care is not available locally,” said Paul McPhun, Executive Director of Médecins Sans Frontières Australia.

Moreover, as noted by MSF in 2018 after 11 months working on Nauru, and in 2019 by the Independent Health Advisory Panel (IHAP), there is as yet no access to essential inpatient psychiatric care on Nauru.

McPhun added: “During our time working with patients on Nauru, MSF psychiatrists and psychologists determined that the majority had their lives impaired by mental illness.“

To now deny medical professionals from taking decisions in patients’ best interests – and to effectively hand that power back to unqualified officials – entrenches dangerous precedents set in the last years and puts those most sick and vulnerable at risk

“Preventing access to medical care as a policy tool is unethical and harmful to vulnerable people and the entire medical profession.”

“So the repeal of Medevac flies in the face of patient’s best interests. A lifeline has been ripped from the hands of people whose only crime may have been seeking safety from persecution.”

“Make no mistake, this repeal comes against the medical advice of many individual doctors and Australian professional bodies as well as MSF – an internationally-recognised independent medical humanitarian organisation that worked with asylum seekers and refugees on Nauru.

“All eyes will be on Nauru and PNG as vulnerable populations seeking medical assistance that they cannot secure locally face the consequences.”

MSF reiterates its call to immediately evacuate all asylum seekers and refugees on Nauru and PNG to be resettled in a safe place where they can have fast access to permanent resettlement, alongside their families, so they can begin rebuilding their lives.

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In October 2018 MSF was abruptly forced to leave Nauru after 11 months providing mental healthcare to Nauruan nationals, asylum seekers and refugees.

Of the 208 refugees and asylum seekers treated by MSF, 30% had attempted suicide and 60% had considered it. Furthermore, on initial assessment, almost 30% of MSF’s Nauruan patients appeared to have been neglected in terms of medical care, mainly due to a lack of available mental healthcare prior to MSF’s arrival.

Following on from this, MSF’s report ‘Indefinite Despair’ highlighted the mental health crisis present on Nauru. The mental health services available on the island including the Republic of Nauru Hospital, IHMS, and MSF were not able to deal with this level of mental health crisis, nor offer the specialised care required.

MSF data and medical experience with patients on Nauru demonstrates that dangerous mental health impacts are a predictable consequence of the reality of Australia’s border protection policies in so far as they continue to keep people indefinitely contained.