A dying Afghan refugee held on will not be allowed to come to Australia for palliative care.
The Australian Border Force has told 63-year-old Ali*, who is suffering advanced lung cancer, he is deemed to have “refused treatment” because he declined to be moved to to die.
He told the ABF he did not want to go to Taiwan because he did not know anybody there, was concerned there would be no translator from his language, Hazaraghi, and that there would be no one to perform the Shia Muslim rituals and ceremonies on his body when he died.
The ABF has told Ali he will not be moved to Australia to die. The ABF has also offered Ali $25,000 to return home to Afghanistan. Ali is a member of the persecuted Hazara minority and has been formally recognised as a refugee – he faces a well-founded fear of persecution in and cannot be forcibly returned there. Australia is legally obliged to protect him.
Ali will stay on Nauru, where he is currently being held in the regional processing centre. Doctors have described the situation there as “totally inadequate” for a person requiring advanced palliative care.
Doctors familiar with his case say his prognosis is “dire”, and his life expectancy is “a matter of months”.
An on-island report seen by the ABF says: “He states that he is very scared and feels alone and isolated and that this will be made worse if he goes to Taiwan as he will have no supports other than the IHMS and ABF liaison with whom he is not able to communicate with. He feels that his case is hopeless and he is giving up.”
Ali, who has a wife and children in Afghanistan, previously worked in construction during his five years held on Nauru but his illness has left him requiring around-the-clock care.
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“His health condition is getting worse, very dangerous every day,” a member of the Afghan Hazara community held on Nauru told Guardian Australia.
“He is losing weight, it seems like he is going to die very soon.”
Another community member said friends had pleaded with Australian officials for assistance.
“But the ABF totally rejected his request: they said go to Taiwan for medical help; second option, go back to Afghanistan; third option is to stay here for as long as you are alive.
“He is very angry, he is very upset as well. He said these people do not have a human heart.”
Nauru sources say ABF staff on the island are concerned about the reaction of the refugee and asylum seeker community if Ali dies on the island. On-island ABF staff have made repeated requests to Canberra for intervention in his case.
Sources inside the regional processing centre confirmed that high-profile or politically-sensitive medical cases were decided not by the ABF but by executive-level officials of the Department of Home Affairs: in some cases as high as the secretary of the department or the minister for home affairs.
ABF recommendations from Nauru were often overruled at executive level inside the Department of Home Affairs.
The decision to offer Taiwan as a medical transfer can only be made by senior home affairs department staff.
IHMS, the Australian government’s contracted health provider on Nauru, refused to answer questions about when it had become aware of Ali’s critical health needs, when it first requested he be moved, or how many transfer requests it had made.
The Department of Home Affairs, which oversees the ABF, said it would not comment on individual cases, but that medical transfer decisions “occur on a case-by-case basis according to clinical need, in consultation with the contracted health services provider and the government of Nauru … [and] with the permission of the individual”.
“Australia has provided significant funding and support over a number of years to improve health infrastructure in Nauru.”
On Nauru, the situation among the refugee population is already tense. The large cohort of Iranian refugees has been effectively excluded from the US resettlement deal by the presidential travel ban.
There is also an acute and growing issue around child mental health. Australian courts have ordered acutely unwell children – some of whom are as young as 10 and who have attempted suicide repeatedly – to be moved to Australia.
The deaths of refugees and asylum seekers who die in Australia from injuries and illnesses sustained in offshore detention are routinely investigated by the coroner.
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The death of , who died from sepsis after his medical transfer was refused and then delayed by bureaucrats in Canberra, has been before a Brisbane coroner, due to report later this year.
The inquest into the death of , who died on Christmas Island after escaping from the detention centre there, will begin later this year.
An inquest into the death of , who died in Brisbane after publicly self-immolating on Nauru, has not yet been scheduled.
* Ali is a patronym, his full name is withheld to protect his family.
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