MSF con­firms forced exit from Nauru as refugee men­tal health 'be­yond des­per­ate'

The Guardian Australia - - Politics - He­len David­son

Médecins Sans Fron­tières has con­firmed it has of­fi­cially been forced to end its men­tal health work on Nauru, leav­ing lo­cal and refugee pa­tients be­hind in a sit­u­a­tion it said was “be­yond des­per­ate”.

MSF was given its march­ing or­ders on Fri­day and told to cease its ser­vices on Satur­day. Sev­eral days of at­tempted ne­go­ti­a­tions failed to sway the Nau­ruan govern­ment.

The or­gan­i­sa­tion said: “MSF is deeply con­cerned for the health and well­be­ing of its pa­tients and de­scribes the men­tal health sit­u­a­tion of asy­lum seek­ers and refugees on the is­land as ‘be­yond des­per­ate’,” it said in a state­ment on Wed­nes­day.

MSF, which plans to hold a me­dia con­fer­ence on Thurs­day, con­firmed it had “of­fi­cially been forced to ter­mi­nate its pro­vi­sion of men­tal health­care ser­vices on Nauru and all its in­ter­na­tional staff have now left the is­land”.

There is a grow­ing men­tal health cri­sis among adults and chil­dren on the is­land, and dozens have been flown to Aus­tralia for treat­ment be­cause of a lack of ad­e­quate avail­able treat­ment on Nauru.

De­spite this the Nau­ruan health min­is­ter last Fri­day told MSF its psy­cho­log­i­cal and psy­chi­atric ser­vices were “no longer re­quired on the is­land”.

MSF had been treat­ing both refugees and lo­cals since Novem­ber 2017. Asy­lum seek­ers are treated by the Aus­tralian govern­ment con­trac­tor, In­ter­na­tional Health and Med­i­cal Ser­vices (IHMS), but they have lit­tle trust among their pa­tients. IHMS and MSF didn’t share med­i­cal notes, is­land health sources said, risk­ing over­med­i­ca­tion and in­con­sis­tent treat­ment.

MSF gave pa­tients their files, which of­ten made their way into le­gal ap­pli­ca­tions to Aus­tralia’s fed­eral court for ur­gent med­i­cal trans­fers, some of which Nauru of­fi­cials had op­posed.

There has been spec­u­la­tion that this in­formed Nauru’s de­ci­sion (they lose money ev­ery time a refugee is flown out) but no spe­cific rea­son has been given.

Ac­cord­ing to MSF’s web­site, it has pro­vided “one door for all” psy­cho­log­i­cal and psy­chi­atric ser­vices as part of an agree­ment with Nauru’s health min­istry.

It has pointed to a lack of men­tal health sup­port for both “the Nau­ruan pop­u­la­tion and the asy­lum seek­ers and refugees liv­ing on the is­land as part of the Aus­tralian govern­ment’s pol­icy of off­shore pro­cess­ing”.

MSF staff were also train­ing and sup­port­ing lo­cal au­thor­i­ties in an ef­fort to in­crease Nauru’s ca­pac­ity to pro­vide psy­cho­log­i­cal and psy­chi­atric treat­ment.

“At this stage MSF wishes to re­it­er­ate our strong com­mit­ment to pro­vid­ing qual­ity men­tal health care to all those in need on the is­land,” a MSF spokes­woman had said on Satur­day.

“We are ex­tremely con­cerned that the health of our pa­tients may be af­fected by this de­ci­sion and urge the au­thor­i­ties to grant us per­mis­sion to con­tinue our life­sav­ing work.”

The Aus­tralian govern­ment, which reg­u­larly dis­tances it­self from in­volve­ment in its off­shore pro­cess­ing cen­tre when ques­tioned on var­i­ous al­le­ga­tions, fail­ures, and deaths, said the is­sue was a mat­ter for Nauru and MSF.

Pho­to­graph: Jusn Car­los Car­de­nas/EPA

All Médecins Sans Fron­tières’ in­ter­na­tional staff have left Nauru. The or­gan­i­sa­tion said it is ‘deeply con­cerned’ for its pa­tients on the is­land.

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