On 4 December 2019, Paul McPhun, Executive Director of MSF Australia spoke to ABC TV’s Karina Carvalho about the government’s decision to repeal the Medevac legislation.
Karina Carvalho: I'm joined now by Paul McPhun who is the Executive Director of Médecins Sans Frontières Australia. Thank you so much for your time tonight, your response to the repeal of these Medevac laws in the senate.
Paul McPhun: I mean it's appalling news and I think it will have a traumatic impact on those that will now find themselves stuck, again, with very few options to seek the level of medical assistance that they need that is not available, where they're being indefinitely contained.
Karina Carvalho: Do you know the numbers of people who have been transferred from Manus Island and Nauru to Australia for treatment?
Paul McPhun: Yes, in the last year around 200 people were independently assessed by medical professionals, determined to be critically ill and requiring a level of assistance that wasn't available for them where they were being detained. And as a result, they've been transferred here to Australia.
Karina Carvalho: The government says that it's about 184 people and that none of them are currently in hospital, rather they're living in hotel rooms and apartments because the government can't send them back to Nauru or Papua New Guinea – or to a third country. That's problematic for the Australian government, isn't it?
Paul McPhun: Well what I could say is it's very hard to know exactly what is going on because there's not a lot of visibility and certainly no visibility to an independent organisation like ours. What I can say is we spent 11 months working with asylum seekers and refugees on Nauru. Our patient cohort was suffering severe mental illness. It was a mental health crisis, one of the worst we've ever experienced. We had 60 per cent of our patients thinking about suicide, 30 per cent had tried to commit suicide, including patients as young as nine years old. We know that there are fundamental mental health traumas and we know that offshore processing of this indefinite nature causes predictable mental harm. There is no question that people are severely ill, and I don't doubt for a minute that the medical professionals that made those assessments and called for those referrals did so legitimately. What has happened to those patients since and what they're condition is, is something that we have, like I said, no real visibility on.
Karina Carvalho: Why was Médecins Sans Frontières forced off Nauru last year?
Paul McPhun: The Government of Nauru made a unilateral decision that our services were “no longer required”. That was the official position, and I think the fact that we were becoming so heavily involved in what was clearly a mental health crisis was a concern. At the end of the day, I think it was no longer expedient for them, politically, to have an independent organisation fully aware of what was taking place and what the impact of these offshore policies of indefinite containment resulting in, in terms of severe mental condition, of people who've endured now more than six years in this indefinite despair.
Karina Carvalho: Why can't those mental health services be provided on Manus Island and Nauru?
Paul McPhun: Well actually the kind of mental health services we're talking about are really specialised, and we're talking about referring to secondary level care that's simply not available. It's largely absent there. When we were working on Nauru, there really was not, Nauru was not equipped with the level of psychiatric support and inpatient care that's required. They simply do not have the facility for that, whereas that's readily available in Australia. This is comprehensive care, it's not something that's simply delivered lightly or easily, and it's care that's required over quite a long continuum.
Karina Carvalho: This is obviously a highly political issue, what do you make of the deal that's been done to secure Jacqui Lambie's support? The government of course denies that a deal has been done.
Paul McPhun: The bottom line here is not about the Medevac Bill, it's not about Senator Lambie. The fundamental issue here is that policy makers have chosen to continue to support a policy of offshore indefinite detention that causes predictable, known harm on people. The medical evacuation bill was simply an instrument put in place, a lifeline to alleviate that, to allow people to have an independent assessment and a vehicle through which they could be transferred to get the care they need. The fundamental issue here is not that the Medevac Bill is no longer in place, it’s that these people will continue to become sicker. We know that, everybody knows that, but there's no political will to address that situation.
Karina Carvalho: The speculation is that Jacqui Lambie demanded a resettlement agreement with New Zealand; you would welcome that?
Paul McPhun: MSF continues as it always has to call for the complete removal of everybody from offshore detention. It causes mental, physical harm, it's predictable, it's known, we've documented it in Nauru, we've documented it elsewhere in the world. There's a body of medical evidence behind this, it was presented to the Senate enquiry. It simply has to happen, whether it's to New Zealand, to Australia or other safe locations. People need a safe environment so that they can rebuild their lives, they can be reunited with their families, and they can overcome the severe trauma they've been under for the past six years.
Karina Carvalho: So, then you don't need these Medevac laws then do you, if the refugees in these two places can be resettled in a third country?
Paul McPhun: The Medevac Bill was a band-aid to try and address an emergency - a crisis in which people were suffering. They were not getting the care they needed, it wasn't available where they were, it was simply a lifeline to enable them to get that care elsewhere, namely here. The fundamental problem is that we're causing people physical and mental harm by keeping them indefinitely detained in offshore processing.
Karina Carvalho: Médecins Sans Frontières’ Paul McPhun.