Nauru: blocking Medevac is against humanitarian ethics

26 Aug 2019

CANBERRA, 26 August 2019 - MSF told the Senate, Legal and Constitutional Affairs Legislation Committee today that the Nauruan Government’s unwillingness to authorise timely medical transfers or even tele-health consultations from Australia handicapped the Home Affairs Legislation Amendment (Miscellaneous Measures) Bill 2018, also known the ‘MedEvac Bill’.


MSF Australia Head of Advocacy Jon Edwards, speaks in a press conference on Monday 26 August. © Maya Zahran / MSF

“It should shock Australians,” said Médecins Sans Frontières/Doctors Without Borders (MSF) today, “that MSF, a medical humanitarian charity more used to working in warzones, had to intervene to treat asylum seekers and refugees who were under Australia’s care on the island of Nauru.”

“It should further shock the people of Australia that MSF was in Canberra today to advocate to the Parliament of Australia to maintain basic medical ethics and professionalism in the matter of medical referrals,” the organisation remarked.

During the hearing, Dr Beth O’Connor, former MSF psychiatrist on Nauru; Paul McPhun, Executive Director of MSF Australia; and Jon Edwards, Interim Focal Point for Pacific Operations, explained to the Committee how:

  • The mental health crisis seen on Nauru, one of the most severe MSF has witnessed anywhere in the world, was a predictable consequence of indefinite detention;
  • MSF’s ejection from Nauru with 24 hours notice left no opportunity “to fulfil even the minimum level of medical services to patients”;
  • The figures relating to suicide attempts and suicidal ideation on Nauru were similar now to when before MedEvac legislation was introduced. 


“As long as the circumstances driving the mental health problems on Nauru remain the same, mental health will get worse,” noted Mr. McPhun. 

MSF psychiatrists and psychologists were among the only independent medical professionals to work directly with patients on Nauru until being forced out in October 2018. MSF’s findings after 11 months of operating an independent mental health treatment service on Nauru was that curative treatment for the overwhelming majority of cases was not possible whilst the key stressors of uncertainty, isolation and family separation on Nauru remained.

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

“Our December 2018 report 'Indefinite Despair', was submitted to the Senate Inquiry along with key recommendations, detailing how existing psychiatric care facilities on Nauru were inadequate for the level of need we saw. Médecins Sans Frontières continues to call for the immediate evacuation of all refugees and asylum seekers contained on Nauru and Manus Island to a place of safety where they can rebuild their lives,” says Dr Stewart Condon, President, MSF Australia.

“Until then, patients should have unfettered access to consult with medical doctors, and medical doctors should remain at liberty to offer medical advice and opinion, including recommending medical evacuation to Australia when necessary.”