Inquest shows Australian governments directly responsible for refugee’s death

Nearly four years after the terrible death of 24-year-old Iranian asylum seeker, Hamid Khazaei, who was detained indefinitely by Australia, a coroner ruled that the outcome was “preventable.” The verdict is a damning, but belated, indictment of the brutal anti-refugee regime maintained by successive Labor and Liberal-National governments.

Khazaei died on September 5, 2014 after being imprisoned in Australia’s offshore immigration prison camps on Papua New Guinea’s (PNG) Manus Island, when severe septicaemia spread from a cut in his leg. His death was the direct result of the “border protection” regime continued by the Turnbull government.

In his findings, delivered on July 30, Queensland state coroner Terry Ryan detailed sub-standard medical facilities, “a series of clinical errors” and “failures in communication” that led to Khazaei’s death.

The coroner pointedly noted that despite the inquest not focusing “on the policy of offshore processing,” Khazaei’s death occurred in the context of “Australia’s immigration policy framework” that required he be “relocated to a small remote country.”

Ryan added: “Although Mr Khazaei was not sent to PNG to be punished, he had been detained on Manus Island for almost 12 months at the time of his death.”

To prevent future deaths in similar circumstances, Ryan said the best solution was to bring asylum seekers to Australia or New Zealand to ensure they received the quality of healthcare to which they were entitled. However, he admitted that would be “highly unlikely” to happen.

After being discharged from the Iranian military, Khazaei fled from Tehran in 2013 because he feared torture and imprisonment after a conflict with a cleric. In August that year, he arrived on a boat at Christmas Island, an Australian territory in the Indian Ocean, after a voyage from Indonesia.

Khazaei reached Australia a month after Kevin Rudd, the then Labor prime minister, announced that “any asylum seeker who arrives in Australia by boat will have no chance of being settled in Australia as refugees.” Instead, they would be detained indefinitely on Manus Island or the small island of Nauru unless they returned to their country of origin or “resettled” in PNG, Nauru or a third country.

Khazaei was transported to Manus Island in September 2013, where he remained incarcerated until his death. According to interviews delivered to the inquest, Khazaei was well known at the camp and was “considered polite and respectful to all.”

Throughout the first half of October 2013, Khazaei suffered from persistent bacterial infections, which many detainees endure due to the tropical climate on Manus Island. Rafael Cruz, one of the paramedics who monitored Khazaei, said in the coronial report that presentations with fever were “very common” on the island and the risk of infection was “quite great.”

On August 23, 2014, Khazaei again presented to the camp’s medical clinic, run by the International Health and Medical Services (IHMS), a private company contracted by the Australian government. He reported a two-day history of fever, body aches, chills, a sore throat and runny nose. At the time his temperature was 38.3 degrees Celsius. He was not provided with an interpreter and his leg, where his infection began, was not observed properly until the next day

Khazaei was provided with intravenous antibiotics, but his blood pressure started dropping and his heart rate rose. Around midnight of August 24/25, his temperature reached 39.6 degrees. By 8am on August 25, Khazaei’s treating doctor, Leslie King, decided he needed a transfer to the highest level of care.

The coronial report described the medical clinic as “basic.” What was revealed is a thoroughly understaffed and overrun clinic incapable of providing adequate healthcare to detainees. Antibiotics to treat a range of tropical infections were not stocked at the clinic, there was insufficient recording equipment to monitor Khazaei’s deteriorating condition and no protocols were in place to deal with septicaemia.

By 12:32pm on August 25, an urgent request was made for Khazaei’s medical transfer to Port Moresby, the PNG capital, on a commercial flight at 5:30pm that day. It was evident through the hearing that all patient transfers had to be approved by the Department of Immigration and Border Protection (DIBP), now the Department of Home Affairs. There was no response by the department until after the flight had left.

Dr Yliana Dennett, a coordinating doctor who worked for International SOS, the IHMS parent company, testified: “We usually do not recommend transfers to Port Moresby. However, experience has shown that the department was very reluctant to bring patients to Australia, and we knew that … if we recommend transferring to Australia, it would not be approved.”

No authorisation for a transfer was given until 8:41am the next day, by which time Khazaei’s conditions had worsened and a medevac was now required. Dr Stewart Condon had concluded that Khazaei should be immediately taken to Brisbane, Australia, rather than to the inferior facilities at Port Moresby. However, permission was not granted. Instead, Khazaei flown to Port Moresby’s Pacific International Hospital (PIH).

After Khazaei arrived at PIH on August 26, he was not seen for two hours, mainly waiting behind a curtain. It then took another two hours to transfer him to the PIH’s Intensive Care Unit (ICU). The report said the ICU was equivalent to a lower-level High Dependency Unit in Australia.

That night Khazaei suffered a number of catastrophic heart attacks and organ failures. The next day at 10am he was flown to the Mater Hospital, Brisbane, where he was unconscious and barely alive. He never regained consciousness before his family gave authorisation for his life support to be unplugged on September 5.

The coroner commented: “It appeared that the medical staff were working primarily to clinical imperatives, while the DIBP officers were working primarily to bureaucratic and political imperatives to keep transferees on Manus Island, or in PNG.”

Protestors outside the coroner’s court expressed frustration that no single party had been held responsible for Khazaei’s death. Doctors for Refugees convenor Dr Barri Phatarfod warned that similar deaths could easily occur again because health services in the detention camps “have actually become worse,” since the tragedy.

The Manus Island centre closed in late 2017 after PNG’s Supreme Court ruled it unconstitutional. The 600 male prisoners were forced to shift into even more primitive “transition” centres. More than 500 remain there, and, as of May 31, 245 detainees are still on Nauru, 22 of them children.

All the major political parties are responsible for Khazaei’s death. The Labor Party, whose minority government was kept in office by the Greens, reopened the Manus camp in 2012. The Liberal-National government, which was in office when Khazaei died, has continued the policy of indefinite detention of all asylum seekers.

Khazaei is one of 12 casualties since Labor reopened the camps in 2012. Hundreds more may have drowned at sea after being turned back by the Australian navy or died languishing in impoverished conditions in Indonesia or other south-east Asian countries.

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Inquest evidence shows Australian government was responsible for asylum seeker’s death
[8 December 2016]