Nick Martin, a doctor who worked at the Australian-run refugee camp on the small Pacific island of Nauru, has revealed the inhumane and dangerous conditions forced upon the nearly 400 asylum seekers, including 43 children, who have been detained for more than four years.

“To treat these refugees and asylum seekers with absolute contempt and medical neglect—that is just shameful,” the doctor told the Australian Broadcasting Corporation (ABC), which conducted a joint investigation with BuzzFeed News.

“The trauma being experienced daily by the kids in particular was just unbelievable, I had never seen anything like it,” he said.

Martin spent 10 months, from November 2016 to August 2017, working as a senior medical officer for the International Medical and Health Services (IHMS), a private company contracted by the Australian government to oversee the medical facilities for detainees.

He is the most senior official who worked at Nauru to publicly speak out against the medical consequences of the Australian “border protection” regime, in which thousands of asylum seekers have been incarcerated on Nauru or Papua New Guinea’s Manus Island.

The detainees on Nauru, Martin said, have “been put at harm and knowingly, wilfully are coming to medical harm because of the policies put in place by the Australians.”

He added: “[T]here are people that are in pain every day, they have huge psychiatric issues and psychological troubles, and this is solely because of this hideous policy of keeping people in offshore detention for unbelievable lengths of time.”

These punitive policies were re-launched by the Greens-backed Gillard Labor government in 2012. It reopened the camps that had been originally established by the Howard Liberal-Coalition government in 2002 as the centrepiece of a “Pacific solution” to stop refugees reaching Australia.

The current Turnbull Coalition government has continued to imprison asylum seekers indefinitely in squalid camps, subjecting them to physical and psychological torture and extreme medical neglect.

Martin took the job in Nauru after a career in the UK’s Royal Navy as a surgeon lieutenant commander for 16 years, during which he served in the Persian Gulf, Afghanistan and Kosovo. He said part of the reason he chose to go to Nauru was that he served in wars that created asylum seekers.

Nauru was worse than a war zone, Martin said. He told BuzzFeed “the state they [the asylum seekers] were in after being locked up for three or four years to me was, in a way, more traumatic then anything I’d seen in Afghanistan.”

In Afghanistan, Martin saw the civilian victims as “casualties of war” and felt there was “always an option to do something about it.” In Nauru, however, he felt a “level of helplessness” because he could not get the best for his patients due to the “set-up being put in place by the Australians.”

Martin’s first impression of the Nauru camp was that it was run down and in horrible condition. Then he saw that it was “run on essentially military lines” with “lots of people in various uniforms around” and “lots of rules and regulation you had to abide by.”

Martin reported inadequate medical services, including severe delays on diagnostic treatments for possibly life-threatening symptoms, such as breast lumps, kidney stones, neurological damage and diabetes.

“If you are a brittle diabetic then you run the risk of going blind, kidney failure—you have massive cardiovascular complications…your life span is significantly shortened,” the doctor said. Recalling one patient who failed to get treatment, he said the man’s “eyesight was deteriorating, his health was suffering immensely.”

Martin said he was told “don’t contact the press, don’t talk out of turn, don’t be an advocate. Just look after the patients and don’t complain too much.” He described a “paranoid” environment. “Normally as a doctor you’re an advocate for your patients. But the word or term advocate became a real no-no.”

The doctor condemned Australian governments for trying to wipe their hands of the medical disaster. “They would hide behind Nauru and they would put in statements saying, ‘These are refugees and they’re the responsibility of the Nauru government.’ But that’s just not true and it’s a bare-faced lie.”

BuzzFeed News reported that Martin’s allegations were backed by a cache of leaked documents and emails it obtained, in which other medical practitioners detailed similar cruelties.

A central feature of Australia’s “stop the boats” policy is that no asylum seeker who tries to reach Australia by boat will be permitted ever to enter the country. Thus, according to the Australian government, the medical care of those deemed “genuine” refugees is acceptable because it is up to the standard in Nauru—an impoverished former British, Australian and New Zealand colony with a population of just over 14,000.

Any requested transfer of patients to Australia must go through an “Overseas Medical Referral” panel. Martin recalled one refugee who had a scooter accident and desperately needed to be transferred to Australia to avoid becoming a paraplegic. Martin made a request to the Australian Border Force (ABF) for a transfer and was told “nope, he is a refugee and he is under the care of the government of Nauru, therefore leave him there at the hospital.”

Because abortion is illegal in Nauru, transfers to Australia for abortions were regularly denied. One whistle-blower told BuzzFeed News that four women seeking termination, with gestation periods of 6 to 15 weeks, had their requests denied, despite health workers raising concerns about suicide or attempted “home abortions.”

These testimonies are the latest of many damning accounts. Numbers of United Nations and Amnesty International reports and a cache of over 2,000 incident reports leaked last year have detailed the trauma inflicted on children.

On Manus Island, the other offshore detention centre, the Australian government is currently starving hundreds of detainees imprisoned there, while closing the centre around them and giving the green light for the use of violence to evict them.

Martin and the other medical practitioners and case workers who have defied the Australian government’s censorship to lay bare the horrors of the detention camps reflect a broad sentiment among workers and young people against the brutal assault on refugees around the globe.