Manus refugee's death followed inadequate care - nurse

8:27 pm on 8 August 2017

A refugee found dead yesterday on Papua New Guinea's Manus Island was not given adequate care, according to mental health nurse who worked there.

The Manus Island detention centre.

The Manus Island detention centre. Photo: Behrouz Boochani

Hamed Shamshiripour, an Iranian refugee who had a history of mental illness, took his own life, according to police, although the cause of death has been disputed.

The 31-year-old was the fifth refugee to die on Manus Island since 2013.

The nurse, who chose to remain anonymous, said Mr Shamshiripour should have been moved to Australia for treatment.

"What should have happened was that he should have been independently assessed by a psychiatrist ... and he should have been transferred to Australia for specialist, inpatient mental health treatment," she said.

Refugees protesting against attempts to evict them from an Australian run detention  centre on Manus Island.

Refugees protesting against attempts to evict them from an Australian run detention centre on Manus Island. Photo: Supplied/Refugee Action Coalition

"[Given] what we know about people with chronic trauma who present with impulsive, dysregulated, bizarre behaviour, I think it's fair to say that he probably ticked all the risk factors in terms of his risk to himself being dynamic."

The nurse, who did not work directly with Mr Shamshiripour, said he was well known amoung staff of International Health and Medical Services (IHMS), the company contracted to provide health care at the Australian-run detention centre.

"He was a patient who was quite widely discussed within the team so you could say he was relatively high profile," she said.

"Despite being given accommodation at the East Lorengau Transit Centre he was reported to be living almost homelessly and getting into confrontations with the locals."

Such conflict resulted in Mr Shamshiripour being briefly jailed in Lorengau last year.

The Kurdish journalist and Manus detainee Behrouz Boochani collaborated with the Guardian newspaper in 2016 to highlight Mr Shamshiripour's plight.

"I did my best but they didn't care," said Mr Boochani.

The Manus Island detention centre.

The Manus Island detention centre. Photo: Behrouz Boochani

"Today we canceled our protest because refugees were very angry and sad, and we were scared that maybe someone makes some violence."

The ongoing protest against power and water restrictions would resume on Tuesday, according to Iranian refugee Amir Taghinia.

Mr Taghinia said instead of Monday's protest, a vigil was planned for Mr Shamshiripour.

"We have prepared some photos of him. We are going to light some candles," he said.

"He unfortunately went through a very, very harsh time in here. He was mentally very ill and unfortunately he was not looked after at all."

The nurse said Mr Shamshiripour's lack of treatment was due to the culture within IHMS on Manus Island.

"People with high needs were seen as problematic rather than being in need of care," she said.

"Health provision was becoming less and less independent and increasing aligned with the custodial model of immigration.

"I didn't feel ethically they were providing the service which they sould have done, which should have been impartial and independent."

The nurse said a culture of "questioning and doubting" the men rather than observing them objectively was prevalent in the "nurse-lead" service, in which the oversight of a psychiatrists was "limited and fragmented".

Detention centre guards on Manus Island.

Detention centre guards on Manus Island. Photo: Behrouz Boochani

"You have intermittent visiting psychiatrists, but it's the nurses consistently that are making decisions even if their speciality was not in mental health. In my view that is where things fell down.

"The culture that has grown in that environment is not one of protecting or caring for people. They're judged as people who are not deserving any longer."

Condolences to Mr Shamshiripour's family and friends were extended by an IHMS spokeperson, who said they were saddened by his death.

But they also raised concerns with "inaccuracies and misinformation" surrounding the reporting of the health care provided to refugees on Manus.

"IHMS is contracted to provide health and mental health services to asylum seekers and refugees residing at the Regional Processing Centre. We are also contracted to provide some primary health and mental health services to the refugees living at the East Lorengau Refugee Transit Centre," they said.

"IHMS conducts welfare checks on refugees, however, like any patient, they cannot be forced to attend all scheduled appointments.

"IHMS is extremely proud of the work of its highly qualified and professional clinicians who operate within a very robust clinical governance system with a mission to deliver high quality, medically appropriate healthcare with humanity and cultural sensitivity.

"IHMS staff are highly committed and dedicated to the provision of high quality healthcare services to asylum seekers and refugees in what is a very complex and challenging environment.

"This commitment is demonstrated on a daily basis."

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