FEARING the forced closure of the Manus Island detention centre will lead to a humanitarian emergency, two Armidale-based whistleblowers are speaking out.
Phil Donnan was a humanitarian worker and Nick Martin was a medical officer at the facility.
Contracted by the Australian government to manage welfare operations on both Nauru and Manus Island - what Mr Donnan saw shocked him.
He alleges incidents of unrest unfolded daily, after three months on the island, detainees would grow agitated - within six months they would riot.
Frictions between the Manus Island population and asylum seekers have grown so precarious that refugees have barricaded themselves inside the camp that closed on Tuesday.
Without running water, electricity, sewage or access to medical services, the situation is deteriorating fast.
“We’re going to see a crisis on Manus Island only just starting,” Mr Donnan said.
“Most of them want to work, they have trade skills, there’s professionals there.
“They want to earn an income and there’s just no opportunity for them there on Manus Island - no opportunity whatsoever.”
The Papua New Guinea army is preparing to enter the Manus Island detention centre, where 600 men remain.
Mr Donnan said discord between the locals and asylum seekers was palpable when he was there.
“They [Manus Island residents] were dismantling the plant, there was a riot in February 2014 where there was a death - that was a clash between locals and the asylum seekers,” he said.
“Chances of that happening again are very high.”
Working seven separate deployments between the two detention centres, the Armidale resident said day-to-day life was a grim groundhog day ritual of playing games of chess and soccer to distract detainees from taking their own lives.
He alleges suicide attempts were made on a weekly basis and self-harm by the asylum seekers was routine during his deployments from October 2012 to March 2014.
When Mr Donnan first arrived on Manus Island, the asylum seekers seemed grateful to leave behind the destruction in their home countries.
It wasn’t long before they discovered they had left a lack of freedom in one country for another.
“After a month they started to realise that it was a prison and they weren’t getting out - no one was talking to them,” Mr Donnan said.
“When they realised they were incarcerated for an indefinite period of time for no crime they became really agitated.
“Their walls were pretty small, they could die of boredom if they weren’t trying to commit suicide.”
Hot, humid conditions, cramped bunks and a lack of water were the conditions Mr Donnan describes on both islands.
On Nauru, desalination plants provided a limited supply of clean drinking water to asylum seekers.
A short dry spell was all it took on Manus Island to leave water at a critical shortage.
A friend of Mr Donnan, Dr Martin resides in Armidale and worked as a senior medical officer on Nauru from November 2016 to August 2017.
When he first arrived at the island, smaller than Melbourne Airport, he said he felt it was an opportunity to give something back.
Having worked as a doctor for more than 16 years in the British Royal Navy, he felt personally responsible for creating some of the refugees he would soon attempt to treat.
“I thought I was pretty well placed to work there because it’s a fairly austere environment,” Dr Martin said.
“I knew they’d be desperate, I knew they’d be hopeless and I thought I’m probably a decent enough doctor to push for them to get the treatment they need.”
What he didn’t know is that he would feel just as hopeless as his patients.
He alleges lives were put at risk as refugees were consistently sent away from emergency departments on Nauru with no imaging, no medication and no proper investigations.
Challenged by circumstances to fulfil his duty of care, Dr Martin said he sent multiple emails to the Australian Border Force, most of the time to no response.
“It’s incredibly difficult because you just want to do your job as a doctor, you make a recommendation and you expect it to be carried out,” he said.
“They did not want people to leave the island, that was incredibly frustrating.Dr Martin
“Suddenly you have all of your clinical decisions being questioned by a non-medical person saying “No, that’s not going to happen,” on purely political grounds.
“They did not want people to leave the island, that was incredibly frustrating.”
The hospital in Nauru routinely ran out of basic supplies, Dr Martin alleges.
“The Australian government trumpeted that they spent $26 million on an upgrade, but they didn’t have the staff to work there,” he said.
“We were forever giving them fluids and dressings, Dengue testing kits - god knows what else because they just didn’t have it.”
Similar to Manus Island, Nauruan asylum seekers were avoiding refugee status because of poor medical care offerings outside the detention centre.
“They knew they wouldn’t receive any medical care once they became refugees because they were at the mercy of the Nauruan system,” Dr Martin said.
His decision to speak out is the same reason he can’t return.
Told the noise he made about healthcare standards meant his safety could not be guaranteed on Nauru, Dr Martin said the best he could do was tell people about it.
“In the end you have to make a call, I kept thinking the duties of a doctor are pretty well set out and have been since The Hippocratic Oath,” he said.
“In the end it became a tipping point.”
A Department of Immigration and Border Protection spokeswoman said health care in regional processing countries is the responsibility of the governments in Papua New Guinea and Nauru.
"All transferees in regional processing countries have access to clinically recommended care," the spokeswoman said.
"International Health and Medical Services delivers health services to transferees and refugees.
"Where required health services cannot be provided to transferees and refugees on Manus or Nauru they will be temporarily transferred to Port Moresby, PNG, for the required services."
Decisions about medical transfers are made on a case by case basis according to clinical need in consultation with contracted health services providers in Nauru and Papua Guinea, the spokeswoman said.