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‘A vulnerable population abandoned’: UNHCR doctors condemn Manus

The UNHCR’s Senior Mental Health Officer and an Australian doctor who has spent time on Manus Island have penned a damning letter on the PNG facility’s “corrosive” conditions and condemned the Australian government for abandoning the asylum seekers there in breach of their basic rights.

Australian psychiatrist Suresh Sundram and Peter Ventevogel, senior mental health officer at the UNHCR in Geneva, co-authored a searing editorial for The Lancet published this week, warning of “regrettable but foreseeable and preventable” outcomes from Australia’s abandonment of the Manus Island centre and abrupt withdrawal of psychiatric services, including self-harm, suicide and violence:

The authorities of Papua New Guinea, one of the poorest countries in the region with a Human Development Index ranking of 154 out of 188, do not have the means and infrastructure to implement such guidance without support.

In these circumstances, Australia’s abrupt withdrawal from Manus Island Regional Processing Centre leaves a vulnerable population abandoned.

It adds to mounting calls from Australia’s medical fraternity for urgent assistance to the men on Manus and a protest by Christian leaders this week who chained themselves to the fence of the Prime Minister’s Sydney residence.

The authors said the physical and mental health of the 379 refugees and asylum-seekers left at the facility when it was forcibly evacuated this week was “precarious”, and said their lengthy, arbitrary and indefinite detention had “corroded the resilience of detainees and made them vulnerable to mental illness.”

During a UNHCR monitoring visit to Manus in 2016, Sundram and Ventevogel said they deemed that 90% of the men met the criteria for severe mental health conditions including major anxiety and depression and post-traumatic stress disorder, with 71% experiencing torture or trauma prior to seeking asylum:

At the former detention facilities people had been placed for indefinite periods without external freedom of movement and no prospects for resettlement in Australia or family reunification.

Such an environment is wholly inappropriate for the housing of refugees and asylum seekers, violates their basic rights, and has associated social and health costs.

The punitive conditions and absence of realistic long-term solutions cause harm to asylum seekers, particularly related to their mental health.

The authors described the fears of the men about leaving the centre as “well-founded” in concern they would not be welcomed by locals, who had stormed the compound in 2014, killing one person and severely injuring others, with another altercation earlier this year resulting in police firing into the centre.

Writing about the new accommodation where the men would now be housed, they noted that there would be a smaller mental health team without trauma and torture counselling. In the interim, they had to seek help at the Lorengau General Hospital, without interpreters, a surgeon or anaesthetist, or extra resources to cope with the surge in demand.

They described mental health services at Lorengau as “rudimentary and unable to cater for the mental health needs of refugees and asylum seekers with diverse cultural backgrounds and specific experiences of torture and adversity.”

“It remains the Australian Government’s responsibility to seek durable solutions for the people who seek protection in their land,” they concluded.

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