A senior emergency doctor from Melbourne has self-funded a trip to Papua New Guinea's Manus Island to assess the health of refugees.
Protesting refugees on Manus Island. Photo: Supplied
Not satisfied with protesting against offshore detention, Nilanthi Kanapathipillai decided to try to make a difference on the ground.
Dr Kanapathipillai said hundreds of refugees queued to see her in a makeshift consulting room.
"Literally a park bench under the shade of a couple of trees. There was a barbecue area under cover. If I had to examine anyone, I had to put them behind the barbecue if I had to do any sort of personal examinations. But that was fine. We made do, it wasn't too bad," Dr Kanapathipillai said.
Nilanthi Kanapathipillai. Photo: Supplied
The most serious conditions she encountered amoung the refugees were mental health related.
"One of the gentlemen is in solitary confinement with active psychosis. [He had] no previous history of anything psychiatric and then he deteriorated over the last couple of years. He set fire to Hillside, one of the camps, was getting increasingly paranoid and now he's put in solitary confinement and has 24 hour armed guard with him," she said.
"He was psychotic, very delusional, was worried people were trying to rape him and he was probably one of the worst case scenarios, and probably also one of the examples of total mismanagement of somebody who was vulnerable, already traumatised from war, now incarcerated and then put into solitary confinement and taken away from Kurdish speaking colleagues."
Amoung the other serious complaints were untreated orthopaedic issues.
"There was a young guy who had a fracture dislocation of his wrist back in his home country. He'd had a plate and screws put in and then removed. Then during the riot one of the guards had re-broken his wrist and dislocated it three years ago," Dr Kanapathipillai said.
"So he has had an untreated, displaced fracture... and complete loss of the ability to extend his wrist. The actual dislocation has not been reduced for three years and it's still incredibly painful. That was the worst orthopaedic injury I've seen."
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Another refugee had what the doctor described as "a fixed claw hand" caused by what she believed was a "botched" procedure at a Port Moresby hospital.
Infections and complications from untreated diabetes were also prevalent in the men she examined.
"Lots of sepsis. People with untreated diabetes never having had diabetes before, probably due to stress and anxiety. Uncontrolled blood sugar levels and hyper tension. These are all in guys in their mid-twenties and thirties, it's what you'd expect from someone in their fifties.
"And not managed either. If you are a diabetic you check your sugars three times a day at first. These guys aren't checking their sugars for three months because there is one glucometer accessible to all of them."
Abscesses from poorly controlled diabetes and rampant sepsis. Manus Island refugee, 2018. Photo: Nilanthi Kanapathipillai
Initially, the doctor was surprised to find the men suffering health problems that had been left untreated but as her examinations progressed she came to expect the lack of medical intervention.
The volume of suffering amoung the men and the number seeking her attention were overwhelming, Dr Kanapathipillai said.
"I only saw 30 and there were hundreds lined up. I had to say 'I'm sorry I can't see you. I've got to do reports now, I just cannot expend anymore time because I'm exhausted'."
The doctor said she was able to carry out a full assessment of the men she examined, diagnose what treatment they required and write a report for each patient.
"I've tried to send them to every medical organisation I can and some of the legal organisations to see if they would advocate to expedite getting these guys to the mainland for treatment. It's painfully slow."
She is now trying to find orthopaedic surgeons and other health professionals able to donate their expertise but is struggling to find people willing to work pro-bono.
While Australia's doctors and medical associations have stated their opposition to offshore detention and reported health crises amoung refugees exiled to Manus and Nauru, Dr Kanapathipillai said she hoped some would do more.
"A lot of the colleges have stepped up... they've all put their hands up to say we don't advocate for this so I can see medicos are standing together but they need to do more than that. They need to go there whilst waiting for any legislation to change."
