Why The Medevac Bill Is Important

19 Jul 2019

This week, the Australian Parliament is set to debate repealing the MedEvac Bill. Formally known as the ‘Migration Amendment (Urgent Medical Treatment) Bill 2018’, the Medical Evacuation Bill simply allows two doctors to decide whether sick refugees and asylum seekers held on Nauru and Manus Island should be transferred to Australia for medical treatment.

In an ideal world we would not need the MedEvac Bill, but right now it is crucial to keep it in place. Because decisions around how patients should be treated must always be made by independent medical professionals, not politicians.

Independent medical assessments help ensure the health and safety of asylum seekers and refugees detained on Nauru and Manus Island, and medical professionals need to be able to recommend medical transfers when they are needed.

If this Bill is repealed, and they are prevented from doing so, it will put lives at risk.

In an ideal world we would not even need this legislation, but right now it is crucial to keep MedEvac in place

Our work on Nauru

Médecins Sans Frontières has first-hand experience witnessing the conditions of immigration detention in Nauru. For 11 months, we worked on the island providing medical care to locals, asylum seekers and refugees.

As our report ‘Indefinite Despair’ details, the level of mental health suffering was among the worst MSF had ever seen.

More than 60 per cent of our refugee and asylum seeker patients had suicidal thoughts, and 30 per cent had actually attempted suicide. Among these were children as young as nine years old. 


Inside the refugee settlements on Nauru, September 2017. © MSF

Any situation that causes such elevated psychological risks must be taken seriously. MSF remains deeply concerned about the health of all asylum seekers and refugees. Reports of self-harm on Nauru and also Manus Island continue to reach us.

Our health promotion assessment found that the local Nauruan health system was under-resourced, particularly in how it treats and manages mental illnesses. Similarly, the healthcare provided by the Australian government had serious limitations, with – among other issues – insufficient psychiatric inpatient beds and frequent staff turnover.

The current level of health care is not adequate to treat the severe cases of mental illness we observed during our time on Nauru.

Our recommendations

Médecins Sans Frontières is working in many similar situations around the world, including at detention centres in Greece, Libya and Mexico.

The effects of indefinite detention are well documented by mental health research. As long as refugees and asylum seekers remain in indefinite detention, their mental health is likely to deteriorate, and lead to self-harm and thoughts of suicide.

Ultimately, everyone currently in indefinite detention on Nauru and Manus Island needs to be taken to a safe place where they can begin to recover and rebuild their lives.

In the meantime, it is crucial that the MedEvac Bill remains in place, to help prevent desperate people self-harming. It is a desperate measure for a desperate situation, but it may save lives.

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Your monthly gifts will help provide the independent funding we need to respond rapidly when emergencies strike – and the flexibility to adapt our response as circumstances change, so we can go where the medical needs are greatest. We will keep you informed about our work with special updates from the field and stories from our medical projects in over 70 countries. 

An ongoing donation from just $10 per month over one year could purchase a surgeon’s tool kit. 

Please consider joining us as a Field Partner with a monthly donation today.