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Hamid Kehazaei

The dying of Hamid Kehazaei

By the time he was urgently medivacced to Brisbane, Hamid Kehazaei was already 'brain dead'

Not just 'the death', but also 'the dying' of Iranian asylum seeker Hamid Kehazaei should be remembered and never forgotten. Because it's 'the dying' of Hamid which tells us something about the brazen brutality of the then Prime Minister Tony Abbott and his 'henchman' Immigration Minister Scott Morrison.

We didn't learn about this beautiful young man's death from the Prime Minister; we didn't hear about it from Immigration Minister Scott Morrison. We learnt the facts first from one of the most seasoned refugee advocates Ian Rintoul. It was his press release that forced media responses and eventually confirmation from the Immigration Department and its Minister.

The silence from Canberra until forcibly obliged to 'confirm' facts - and only doing so on a minimal level - was now well and truly part of he hardline Tony Abbott administration. Immigration Minister Scott Morrison had already shown ample evidence of his underlying positioning, that reporters and journalists, especially if they're not connected to his favourite - and usually right-wing - media outlet, are scum and detritus and inferior humans who ought to be left bleeding, berated, and ignored wherever possible with arrogant disdain.

'Brain dead': Manus Island claims another victim

Media Release
Wednesday 27 August 2014
Refugee Action Coalition
Ian Rintoul
mobile 0417 275 713

A 24 year-old Iranian asylum seeker, Hamid Kehazaei, who was urgently medivacced from Manus Island to Brisbane on Wednesday 27 August has been declared to be 'brain dead'.

By the time Hamid was medivacced to Brisbane, he was suffering septicaemia, from an infection spreading from a cut foot, and went directly into intensive care in the Mater hospital. He had sought medical attention for days on Manus Island for the pain and the infection.

A couple of days ago, he suffered a heart attack and yesterday (Tuesday, 2 September), the Immigration Department and the hospital told the family that Hamid was confirmed as 'brain dead'. He remains on life support.

The hospital has told the family that a 'guardian' will be appointed at 'some stage' to decide on the withdrawal of life support. The family has indicated that they are willing for Hamid's organs to be donated if that is possible.

Hamid was among the first of the asylum seekers transferred to Manus Island by the then Rudd Labor government in September 2013.

On Sunday or Monday, P block in Foxtrot compound, where Hamid and 140 others had been living, was evacuated and closed.

"Hamid is a victim of the shocking conditions and medical neglect on Manus Island. It is inexcusable that he developed septicaemia on Manus Island," said Ian Rintoul, spokesperson for the Refugee Action Coalition.

"Once again, Scott Morrison is responsible for a death on Manus Island. There are scores of infections on Manus Island, and many complaints of the lack of medical attention. Asylum seekers on Manus Island are often forced to walk through raw sewage

"Nothing more obviously reveals Manus Island as a unhygienic hell-hole that must be closed."

Attached is a letter signed by Manus Island detainees accusing IHMS as responsible for the death of Hamid.

A vigil has been called for Thursday 4 September, 12 noon at Mater Hospital, South Brisbane.

For more information contact Ian Rintoul 0417 275 713

Related pages

21 October 2016: The Wilful Killing of Reza Berati - On a fateful evening in February 2014, Iranian asylum seeker Reza Berati was brutally kicked and bashed to death. This page stores hundreds of items published following his death, covering the period between February and June 2014.

Quick links:

Click the links below to jump down to the articles and items on this page with the same title.

Iranian asylum seeker Hamid Kehazaei brain dead in Brisbane hospital

Iranian asylum seeker Hamid Kehazaei brain dead in Brisbane hospital: Refugee Action Coalition

ABC News Online
By Emma Pollard and Lindy Kerin
Wednesday 27 August 2014

An asylum seeker who developed septicaemia after cutting his foot at the Manus Island offshore processing centre has been declared brain dead in a Brisbane hospital, a refugee advocacy group says.

Refugee Action Coalition spokesman Ian Rintoul said Iranian asylum seeker Hamid Kehazaei sought medical attention for days on Manus Island for the pain and infection.

It was believed he cut his foot three weeks ago.

Last Wednesday, Mr Kehazaei was flown to Port Moresby, then into intensive care in Brisbane's Mater Hospital.

Mr Rintoul said authorities took too long to act, and the 24-year-old had a heart attack before being declared brain dead on Tuesday.

He remains on life support.

The Immigration Department said the chief medical officer was reviewing the background to Mr Kehazaei's condition and the medical care he received while on Manus Island.

Mr Rintoul said Mr Kehazaei was a victim of "the shocking conditions and medical neglect on Manus Island".

"It is inexcusable that he developed septicaemia on Manus Island," Mr Rintoul said.

"Nothing else to describe it, but it is just sheer negligence."

"There are scores of infections on Manus Island, and many complaints of the lack of medical attention. Asylum seekers on Manus Island are often forced to walk through raw sewage."

Mr Rintoul said a guardian would be appointed to decide whether treatment should be withdrawn.

He said the family had indicated Mr Kehazaei's organs should be donated if possible.

A spokeswoman for the Immigration Minister said the Government was following normal processes for the transferee.

"The individual has not died. In respect to the family of the individual further details are not able to be provided," the spokeswoman said.

"The Government is following normal processes for the adult male transferee.

"The family has been engaged."

The International Health and Medical Services (IHMS), which provides health care at the Manus Island detention centre, has declined to respond to the claim, saying it would be a breach of patient confidentiality.

Manus Island detainees have signed a letter holding IHMS to blame.

Lack of information on health

The Royal Australian College of Physicians' national president Professor Nick Talley said since the Federal Government disbanded the Immigration Health Advisory Group there had been a worrying lack on information about the health of asylum seekers.

"We are concerned too that access is being restricted for independent health experts and refugee advocates to check out these conditions and provide all of us more information," he said.

"While the Australian Government might have a particular approach to the processing of asylum seekers - that's an Immigration decision - it's also critical that the Government ensure their health. That's a rights issue and the two positions mustn't be mutually exclusive."

Professor Tully said he would be concerned if the infection was not treated straight away.

"If a patient gets a serious infection it needs to be dealt with promptly," he said.

"Now I don't have any details about this case. So I cannot comment, specifically on this case.

"But if there are significant delays in appropriate medical attention being given on Manus Island, that needs to be addressed.

"The problem we have is the lack of information about whether that's occurring or not."

www.abc.net.au/../asylum-seeker-hamid-kehazaei-brain-dead-in-brisbane-hospital/5716292

24-year-old asylum seeker on life support

ABC Radio CAF - The World Today
Lindy Kerin
Wednesday, September 3, 2014 12:54:00

ELEANOR HALL: The young Iranian asylum seeker who was airlifted out of the Manus Island detention centre last week with severe septicaemia is now on life support.

The Royal Australian College of Physicians say his case raises serious concerns about medical treatment at the detention centre.

As Lindy Kerin reports.

LINDY KERIN: Twenty-four-year-old Hamid Kehazaei has been held at the Manus Island detention centre for the past year.

About three weeks ago he cut his foot. It became severely infected and last Wednesday he was airlifted to the intensive care unit at the Mater Hospital in Brisbane.

Ian Rintoul from the Refugee Action Coalition says he's now on life support.

IAN RINTOUL: The Immigration Department and the hospital have been in touch with the family about how long he will remain on life support. There's some discussions happening at the moment about that.

LINDY KERIN: Ian Rintoul says a family friend has been by the young man's side and has been trying to keep the family informed as much as possible.

IAN RINTOUL: Well, they're very distressed and he said he was very worried and, in the end, wasn't surprised when he was declared to be brain dead.

I think like everybody who's associated with this, he finds it's just, you know, unbelievable.

Just finds the situation where someone could have a cut on their leg on Manus Island and end up brain dead in Brisbane, he really can't, just can't come to grips with that.

LINDY KERIN: Ian Rintoul has alleged there was a delay of about a week in getting the asylum seeker's cut treated.

International Health and Medical Services, which provides health care at the Manus Island detention centre, has declined to respond to the claim, saying it would be a breach patient confidentiality.

Ian Rintoul again.

IAN RINTOUL: We get constant information from Manus Island about the lack of medical attention and this isn't the first time, and Hamid's not the first person who's complained about the infections.

It's very clear that there is a fairly blasé attitude to the cuts and infections, they're a constant feature of conditions inside Manus Island.

LINDY KERIN: The Royal Australian College of Physicians national president Professor Nick Talley says he'd be concerned if the infection wasn't treated straight away.

NICK TALLEY: If a patient gets a serious infection it needs to be dealt with promptly.

Now I don't have any details of this case so I cannot comment specifically on this case. But if there are significant delays in appropriate medical attention being given on Manus Island, that needs to be addressed.

The problem we have is the lack of information about whether that's occurring or not.

LINDY KERIN: Professor Talley says since the Federal Government disbanded the Immigration Health Advisory Group, there's been a worrying lack on information about the health of asylum seekers.

NICK TALLEY: We are concerned too that access is being restricted for independent health experts and refugee advocates to check out these conditions and provide all of us more information.

While the Government may have a particular approach to the processing of asylum seekers, that's an immigration decision, it's also critical that the Government ensure their health.

That's a rights issue and the two positions mustn't be mutually exclusive.

LINDY KERIN: The Immigration Minister was unavailable to speak to The World Today.

In a statement a spokesperson said:

EXCERPT FROM STATEMENT: In respect to the family of the individual, further details are not able to be provided. The Government is following normal processes for the adult male transferee. The family has been engaged.

LINDY KERIN: The Immigration Department says the chief medical officer is reviewing the background to the asylum seeker's condition and the medical care he received while on Manus Island.

ELEANOR HALL: Lindy Kerin with that report.

http://www.abc.net.au/worldtoday/content/2014/s4080045.htm

Asylum seeker reportedly declared 'brain dead' after leaving Manus Island

Immigration department says it has contacted Iranian asylum seeker's family and it will review his care

Oliver Laughland
Guardian Australia
Tuesday 2 September 2014 23.58 EDT

A 24 year-old Iranian asylum seeker has been declared brain dead, following his emergency medical evacuation from the Manus island detention centre last week, refugee advocates have said.

The man - named by the Refugee Action Coalition (RAC) as Hamid Kehazaei - contracted cellulitis, which developed into septicemia on Manus. RAC say the infection was contracted after Kehazaei cut his foot in the detention centre.

Guardian Australia reported last week there were concerns over delays to Kehazaei's treatment on Manus. The immigration minister, Scott Morrison, confirmed that the immigration department's chief medical officer, Paul Douglas, would conduct a review of the background to the man's medical condition and treatment on Manus.

A group of asylum seekers on Manus have signed a complaint form addressed to detention centre medical providers IHMS about the handling of Kehazaei's case.

A copy of the form sent to Guardian Australia and to the RAC reads: "To: The management of IHMS. Those who have signed this paper consider you are responsible for any consequence of not treating the illness of our dear friend Hamid Khazay."

The form appears to be signed by around 50 asylum seekers.

A spokeswoman for IHMS said they would not be commenting on any aspect of the case. A spokeswoman for the Mater hospital also said they could not comment.

RAC spokesman Ian Rintoul said he had been in direct contact with Kehazaei's family in Iran. They told the RAC Mater hospital representatives would appoint a guardian for Kehazaei who would manage withdrawal of life support.

Guardian Australia has contacted Kehazaei's family.

On Wednesday morning a spokeswoman Morrison said: "The individual has not died. In respect to the family of the individual, further details are not able to be provided.

"The government is following normal processes for the adult male transferee.

"The family has been engaged."

theguardian.com/../asylum-seeker-declared-brain-dead-medical-evacuation-manus-island

Asylum seeker 'brain dead' after delay in treatment for infection

Brisbane Times
Wednesday 3 September 2014
Sarah Whyte

An asylum seeker who contracted a skin disease on Manus Island, has been announced brain dead by doctors in Brisbane's Mater Hospital.

The 24-year-old man, Hamid Kehazaei, was medically evacuated to the mainland last Thursday and was pronounced brain dead last night, according to refugee advocates.

Greens immigration spokeswoman Sarah Hanson-Young said Mr Kehazaei's family were in the process of deciding whether to turn the life support machines off.

She also claimed there was a delay in transferring the man from Manus Island to the Australian mainland because a request from the medical service provider, the International Health and Medical Service, was denied.

"After being denied a timely transfer, this young man is now lying brain dead in a Brisbane hospital," Senator Hanson-Young said.

"This young man cut his foot, it got infected and he wans't given the right medical help and it has developed into this severe septicaemia.

"This is a disgraceful lack of care given to this young Iranian man and a lack of duty of care being given by the Immigration Department."

Refugee advocate Ian Rintoul claimed the compound on Manus Island where the man had cut his foot had been evacuated.

A spokeswoman for Immigration Minister Scott Morrison said: "This is simply not true."

On Wednesday morning, Mr Morrison also confirmed the man had not died.

"In respect to the family of the individual further details are not able to be provided," he said.

"The government is following normal processes for the adult male transferee. The family has been engaged."

On Friday, as the man was reportedly fighting for his life, the department said its chief medical officer was reviewing the background to the transferee's condition and medical care while at the Manus detention centre.

The standard of care provided by IHMS was called into question during the Australian Human Rights Commission inquiry into children in detention last month where evidence given to the inquiry showed the levels of medical care in immigration detention were often below Australian standards.

In May, a former Salvation Army staff member on Manus Island, Simon Taylor, claimed IHMS were giving asylum seekers a type of anti-malaria medication by staff that detention centre staff had been warned not to take.

brisbanetimes.com.au/../..delay-in-treatment-for-infection-20140903-10bwb0.html

Hamid Kehazaei: The Australian government must explain why he received inadequate care

Processing asylum seekers is an immigration decision, but ensuring their health is an issue of human rights. The two positions are not, and must not be, mutually exclusive

Nick Talley
Guardian Australia
Wednesday 3 September 2014

We should all be deeply concerned about reports of a 24-year-old Iranian, Hamid Kehazaei, recently flown to the Australian mainland from Manus Island after a cut on his foot developed into septicaemia. He is now on life support and the most recent reports are saying he is brain dead.

This case raises a whole host of questions. Was there a delay in diagnosis? Was there a delay in transferring him for medical treatment? While the facts of this case are still to be determined, what is becoming clear is the inadequate care being provided to people seeking asylum.

The standard of medical facilities in offshore detention must be questioned, as well as the timeliness of medical care. Delays in accessing necessary treatment mean that simple and easily treatable health conditions can deteriorate rapidly and become life threatening. The inadequate medical care received by people seeking asylum is having devastating consequences.

The Australian government says that they are providing health care services that are "broadly comparable with health services available within the Australian community". I don't believe this standard is being met. Had the Manus Island detention facility been adequately equipped to provide this young man with the healthcare he needed when he needed it, the outcome may have been very different.

The government has a lot of questions to answer. We need to know why this man did not receive adequate medical care in the first place. We need to know why there was a delay in transferring him once his condition deteriorated.

It is critical that the government is guided by independent expert medical advice, and that services are able to address complex health matters quickly and appropriately. Without this, it will be increasingly difficult for the government to respond to the growing concerns over conditions in offshore detention centres and the negative impact on asylum seeker health.

The government's approach to processing asylum seekers is an immigration decision, but ensuring their health is an issue of human rights. The two positions are not, and must not be, mutually exclusive.

Professor Nick Talley is the president of the Royal Australasian College of Physicians.

www.theguardian.com/../australian-government-must-explain-why-he-received-inadequate-care

The Pacific Solution is reaching its endgame. Scott Morrison will soon run out of options

Nauru and Manus Island are untenable. The new Indonesian president, Joko Widowo, may be less compliant on turn-backs. And Morrison isn't savvy enough to see what's coming

Richard Ackland
Guardian Australia
Tuesday 2 September 2014

The silver cup for stopping the boats takes takes pride of place in the Coalition trophy cabinet. The other chrome-plated election promise bauble is for the abolition of the carbon tax. There are only two, sitting there side by side, and both are hailed as political triumphs - although not necessarily policy successes.

The execution of the Coalition's boats policy, Operation Sovereign Borders, is dependant on variables that are outside the control of the government, and are not manageable by a minister singularly devoid of nuance and deftness.

Already there are signs that the Pacific Solution is fast approaching its endgame. Last month a departmental official told a parliamentary committee that no asylum seekers have been sent to Manus Island since February, and this reflected a request from the Papua New Guinean government.

The customs boat Ocean Protector kept 157 asylum seekers imprisoned at sea for nearly a month. The fact that they were not immediately dispatched to Nauru is as clear an indication as any that the "solution" of dumping people on the guano outcrop is fast approaching its finite point.

There would have been frantic amounts of pressure and bribes brought to bear on the Nauruan government to take this contingent of Tamils, who had refused to cooperate with Indian authorities dispatched to the Curtin detention centre in Western Australia.

Letting people rot in Australian funded regional detention centres is a key component of stopping the boats. The other plank in the policy is is turning back boats to Indonesian waters, with the Indonesian government, so far, being amazingly compliant.

We don't know how many turn-backs there have been. But it's entirely possible that the incoming Indonesian president Joko Widowo and his government will not be as tolerant of the turn-back policy as the current administration.

One thing is certain. The Indonesian authorities have largely turned a blind eye to the people smuggling trade and there has been evidence that local police are involved with it directly and indirectly.

It is evident that a majority of Australians have been prepared to accept the dreadful humanitarian consequences of our policy, grotesquely dressed up as as a necessity to save lives at sea. According to polling this is around 60% of the electorate. About 40% are puzzled that what were once sound national humanitarian ideals have been so easily sold for political expediency.

There are a couple of explanations for that. Australians don't like people smugglers profiting from the misery of asylum seekers and have come to accept that a proportion of those in the smuggling business are criminals. There is also the notion that an orderly queue for a humanitarian immigration program has somehow been jumped.

Implicitly Australians have decided that they don't want immigrants who self-select. We want the government to do the selecting. Bob Carr fuelled this state of affairs by insisting that most asylum seekers coming on boats are economic refugees, even though most are escaping from conflict zones.

Both the Coalition and Labor have fed into the same well of distrust and resentment. But if we accept that the Pacific Solution is almost played out and turn-backs are something that Indonesia will not accept indefinitely, where to next for our asylum policy?

Last month there was a big roundtable conference in Canberra trying to develop proposals for a better way to handle this divisive issue. It was organised by the Andrew and Renata Kaldor Centre for International Refugee Law, the Centre for Policy Development and a non-partisan research organisation, Australia21.

The discussion took place around a document called "Beyond Operation Sovereign Borders: A long-Term Asylum Policy for Australia" prepared by two former senior people from the Immigration Department, Peter Hughes and Arja Keska-Nummi.

Participants included politicians, a former Indonesian ambassador to Australia, a strategist from Malaysia, lawyers, academics and former military people. A full report is coming later in the year.

There are also several influential backers of the Liberal party who have taken an interest in the development of a better policy framework. The thinking end of the governing party is aware that the current "success" of the boats policy is not guaranteed to hold and that Morrison will soon run out of options.

One logical approach would be to sit down with Indonesia and Malaysia and negotiate an agreement that we take a fixed number of asylum seekers that are in their camps at the moment.

At the moment refugees from Indonesia account for less than 4% of our humanitarian program.

Australia's current humanitarian intake of more than 13,000 a year could be renegotiated so that we shift a significant proportion away from Africa and South America and put that component in Indonesia and Malaysia. In this way we could take 10,000 a year from our nearest neighbours to whom we owe a more direct and immediate obligation.

The processing would still be done offshore by recognised agencies, including the UNHCR, and at the same time Australia's recently discovered respect for orderly queues would be fully realised.

For relieving our immediate neighbours of the growing pressures of displaced people in their own camps we could extract undertakings that in return they crack down on people smugglers and intercept boats of "queue jumpers" bound for Australia.

In this way immigration self-selection would be cauterised, we fulfil our humanitarian obligations and salvage something of our reputation as a caring nation and, just maybe, it would stop the refugee debate descending into xenophobia.

All of this would require a savvy immigration minister, and there doesn't appear to be one on the horizon.

A natural consequence of such a new, post-Operation Sovereign Borders framework is that more asylum seekers would inevitably turn up in Malaysia and the Indonesian archipelago. This in turn would force a review of the current lax visa requirements in those places, which have traditionally been much more open to arrivals from other Muslim countries.

By no means would shifting the humanitarian intake closer to home be a comprehensive solution, but it would be a start of something more enduring and fairer, while at the same time being palatable to most Australians.

There's something else that could work to our benefit. The government has given the go-ahead for visas to foreign workers who are prepared to do skilled and semi-skilled jobs at discount rates. Yet, we already have a supply of these workers sitting in wretched camps waiting to be processed on Christmas Island, Nauru, Manus Island and elsewhere.

A large proportion of them have useful skills. Those who aren't so skilled are not "job snobs" and would be quite prepared to do work that Australians don't like doing, such as working in hospitals, nursing homes, stacking shelves in supermarkets, working in mines and cleaning office blocks - sectors of the economy where there are labour shortages.

One of the reasons the Coalition has embraced a higher level of "legal" immigration is because it has a pro-business economic booster effect. More people, more demand, more production, more consumption, and ultimately more jobs.

Australia has at its disposal many people who are desperate to contribute to this country. Instead, the official policy is to deprive them of that opportunity, because successive governments haven't had the intelligence or the courage to think beyond the catch-cry of "sovereign borders".

theguardian.com/../-is-reaching-its-endgame-scott-morrison-will-soon-run-out-of-options

No way to test for septicaemia on Manus, with doctors 'swamped'

A lack of specialist care is to blame for deaths and health crises on Manus Island, say insiders.

Crikey
Sally Whyte
Thursday 4 September 2014

Detainees on Manus Island have to wait five to seven days to see a doctor unless it is deemed an "absolute emergency", a Manus Island whistleblower has told Crikey.

Martin Appleby, a former guard at the Manus Island detention centre, says it would also be impossible for doctors to test for the septicaemia that has left Hamid Kehazaei brain-dead in Brisbane's Mater Hospital. "There's no way you can take blood and get it tested. There was no ice to pack the blood in to get it Port Moresby for testing."

Kehazaei was transferred to the hospital last Tuesday after he contracted cellulitis, which then turned into septacaemia. Concerns have been raised over delays to treatment for the 24-year-old after he cut his foot at the centre.

Doctors at Manus Island are "under the pump", says Appleby, and are rotated fortnightly, making it unlikely that patients see the same doctor twice. According to Appleby, there are two doctors and four nurses on duty at any time for the 1200 people there.

"I had a knee infection and I was treated by a gyneacologist -- great fella, did everything he possibly could. You couldn't question his commitment, but the fact was he's a gynecologist," Appleby said. "There's no specialised treatment -- that's what probably caused the issue [with Kehazaei]."

Rod St George, who was the Occupational Health and Safety Officer on Manus between March and April last year, says all staff at Manus, including medical staff, were "swamped" by the number of cases, and doctors would see 30 patients a day out of the 300 people who were there at the time.

It could take hours to attend to an emergency, according to St George. Appleby told Crikey that he had seen guards berated for calling an emergency code black for a detainee who was showing signs of heart attack. The deainee was eventually diagnosed with angina.

As OH&S officer, St George says he encouraged staff and detainees to wear proper footwear. "Most people just knew, but you frequently saw detainees with just thongs on. Everybody knew that if you had an open wound in those condition it was a disaster."

While both St George and Appleby say medical staff were doing the best they could, the conditions on the island made it difficult for patients to get proper treatment and be able to recover. St George says that for detainees on Manus Island, "the cards are stacked against them at the beginning".

"When I was there what we would find is that people had certain ailments that here in Melbourne, for instance, you know if a doctor were to say, 'just go home and rest', that would be enough. But when resting means going back to a facility where you're just going to sweat buckets, you'll be lying on your bed, resting doesn't have the same effect. It's strenuous living. Just to simply stay alive is hard work because of all the elements, and on top of the physical problems there's mental problems."

St George points the finger at the government and the lack of resources and funding at the centre, saying "it's proven to be a disaster".

Both Appleby and St George were highly critical of the Immigration Department. "The government has just not afforded them the same rights as humans," said St George.

Kehazaei's case also raises questions of the government's responsibilities as guardian of asylum seekers when decisions about life support need to be made. It has been reported that the government has now made contact with Kehazaei's family in Tehran.

If a similar situation were to arise where an asylum seeker's family could not be contacted it is clear who would make decisions regarding life support, according to experts Crikey spoke to. Professor Lindy Willmott, director at the Australian Centre for Health Law Research, says that in general if a person's next of kin can not be contacted the decision is up to a "public guardian", who is independent from the government and when making decisions, "they have to take into account the best interests of the person. That's not particularly complicated or controversial." Willmott says that hospitals are required to make reasonable attempts to contact the next of kin, but if that isn't possible, the public advocate is contacted.

http://www.crikey.com.au/?p=456038

Asylum seeker's family mourn 'sensitive, lovable' son declared brain dead

Hamid Kehazaei's family say the fit, 'gentle' 24-year-old should have been better looked after

Oliver Laughland and Donya Nissi
Guardian Australia
Wednesday 3 September 2014

The mother of the 24-year-old Iranian asylum seeker Hamid Kehazaei, declared 'brain dead' after being evacuated from the Manus Island detention centre has spoken of her anguish at the plight of her "sensitive, harmless, lovable" son and her inability to be at his side.

Kehazaei is understood to be on life support at Brisbane's Mater Hospital after a cellulitis infection sustained through a foot injury on Manus developed into septicaemia.

Kehazaei was flown from Manus last Wednesday. Speaking in Farsi from the family home in Tehran, Goldone Kehazaei told Guardian Australia she had not heard her son's voice since his diagnosis.

"Not even before he boarded the plane," she said, "They didn't allow anyone to go with him on the plane, they said he had to give written permission, but he was too ill and unaware of his surroundings at that point. I was very upset because if I was there I would have held his hand and given him some comfort.

"On the plane his heart stopped and by the time he got to hospital the infection had spread and blood wasn't getting to his brain. Only his heart and lungs were functioning. His brain and kidneys had failed."

"No one called us [from the hospital] because it was the weekend, so we called ourselves and they said: 'We don't know who you're talking about'.

"I later found out he was on life support."

Goldone, 48, said her son was a "very sensitive, harmless lovable person".

"Of all my three boys, he was the most gentle and loving," she said. Her voice cracking on occasion, she continued: "When all his friends found out what had happened they were devastated. No one can believe this happened to such a gentle soul."

Kehazaei's brother Mehei described Hamid as "a very healthy, athletic and a regular gym goer who played soccer". The family expressed shock that a young, fit man could contract such a devastating illness.

Asylum seekers detained in Kehazaei's compound have written to the medical provider International Health and Medical Services (IHMS) blaming it for his condition. It is understood there were delays to treating Kehazaei's infection, which can often be cured with antibiotics.

The former medical director of mental health services at IHMS Dr Peter Young said on Wednesday he would not be surprised at such delays as they were a "characteristic of being in a remote location". Young said the department had regularly told IHMS to take more medical risks in the care of asylum seekers detained offshore.

Goldone said Hamid regularly complained of the conditions on Manus and lack of treatment from medical staff.

"He said: 'the doctors don't care about us, we wash with rain water'. He said: 'I had a toothache for two or three days and they didn't give me anything for it.' He said the conditions were dirty and unhygienic."

Kehazaei spoke of pain in his legs for months before the cut - an unrelated injury - which is understood to have led to the infection. He told his mother doctors had advised the pain was due to humidity inside the centre.

Goldone said she had been told by doctors that the unhygienic conditions on Manus were responsible for the infection. She said she had been advised while Kehazaei was still in PNG that doctors were considering amputating his leg.

Kehazaei was detained in Foxtrot compound on Manus, where recently leaked intelligence reports show that about 280 asylum seekers are currently detained.

Following a visit to Manus last year Amnesty International described one dormitory in Foxtrot "P-dorm" as highly unsanitary and said the conditions there were tantamount to cruel, inhuman and degrading treatment.

"The mixture of stifling heat, sweat and moisture leaves a permanent, overwhelming stench. Asylum seekers reported finding snakes in the room and flooding when it rained," said Graeme McGregor, Amnesty's refugee campaign coordinator at the time. Guardian Australia understands Kehazaei was not detained in P-dorm.

Kehazaei, who had served in the Iranian military, left Iran in April 2013. "He said he wanted to be independent, stand on his own two feet and make a life for himself," Goldone recalled.

He arrived by boat on Christmas Island in August, just after the Rudd government introduced the policy of mandatory offshore processing and resettlement of asylum seekers who arrive by boat.

He was transferred to Manus a month later. Kehazaei was present during the violent unrest at the Manus centre in February 2014, which left his fellow Iranian asylum seeker Reza Barati dead after suffering multiple head injuries.

"He tried to steer clear of any trouble and separate himself - to not get involved," Goldone said, "but he was there when Reza died."

Did she worry for her son?

"Of course I did. He was living in unhygienic conditions, in high humidity, up to 55 degrees with no ventilation or air conditioning. They told him they were going to fix the conditions after Reza's death, but he said nothing has changed - the food improved a little bit, but that's it."

Mehei, a 30 year-old labourer, said the entire family was overcome with grief.

"We're devastated. The pressures we've faced since we found out have caused all of us heartache. My mum and dad are both taking medication to deal with it and so am I."

"They [the immigration department] said if he does pass away they will send his body back to Iran. But we are very angry at the Australian government, and we are prepared to sue for compensation."

The immigration minister, Scott Morrison, and IHMS have been contacted for comment.

www.theguardian.com/../asylum-seekers-family-mourn-son-declared-brain-dea

Asylum seeker's 'brain death' shows failure of care and of democracy

Ian Kerridge and David Isaacs
The Conversation
Thursday 4 September 2014, 11.13am AEST

The news that Hamid Kehazaei, a 24-year-old Iranian asylum seeker detained on Manus Island, has been diagnosed as brain dead following his transfer to the Mater Hospital in Brisbane is a tragedy. That it is a tragedy for this young man and his family is unquestionable - but the extent of this tragedy may be much more pervasive than we realise.

If the emerging details of his case are correct, Kehazaei developed septicaemia as a complication of cellulitis (skin and soft-tissue infection) arising from a cut in his foot. This, in itself, is disturbing.

Severe infection can result in brain death - either from infection of the brain itself (meningitis, encephalitis or brain abscess), or from brain injury due to a lack of oxygen resulting from cardiac arrest (as appears to be the case here), or from reduced blood supply to the brain. Yet it is very uncommon, especially in a young, previously healthy man.

Such a case could occur in Australia and has been described in 2012 in young Indigenous adults in Central Australia. Nevertheless, severe sepsis resulting from a foot infection is preventable. And a case like this occurring in an Australian national would raise serious questions about the appropriateness of the antibiotics used and the timeliness of care.

Most cases of brain death result from traumatic brain injury, stroke or lack of oxygen to the brain following asphyxia, near-drowning, or prolonged cardiopulmonary resuscitation.

What happened to Hamid Kehazaei raises concerns about the adequacy of care provided to him during initial treatment, including wound care and antibiotics, and how soon he was transferred to expert medical care, first to Port Moresby and subsequently to Brisbane.

If this young man became ill and had his brain die while seeking asylum in Australia and while in our care, then we must examine the details of his case and ask ourselves not only whether it was preventable but whether our policies and processes actually contributed to his death.

But how can we even begin to ask these types of questions when we know so little about the circumstances in which he became ill, and his subsequent care?

Protestations that this is due to the necessity of respecting privacy and confidentiality, ethical principles that are core to the health professional-patient relationship, are to some extent correct. But they also obscure important features of this case.

The government is simply wrong to claim that this issue should not be "politicised". What is ultimately at issue here is the way in which domestic politics and border policy impose norms (rules of behaviour) that are antithetical to medicine and health care and, fundamentally, to democracy.

Medicine, like biomedical science, requires transparency and honesty to be clinically and ethically sound. Peer review, clinical audit, root-cause analysis, family conferences, conflict-resolution strategies, case consultation, multidisciplinary team meetings, mortality and morbidity meetings, open disclosure policies: all rest on the importance of transparency and respect.

In contrast, we know very little about the people who seek asylum in Australia. Everything is secret - their arrival, their situation, their medical need, their illnesses, and their death.

This requirement for secrecy has largely overwhelmed efforts by many good people - legislators, human rights lawyers, refugee advocates, health workers, politicians and ordinary citizens - to shine a light on what is happening to people in detention.

The Immigration Health Advisory Group has been disbanded, restricting the degree to which the health professions can critique the care available to asylum seekers. And even those tasked with providing medical care to asylum-seekers struggle to advocate for the people under their care.

Policies restrict the degree to which they can care for their patients or refer them for specialist care not available in the detention centres. Contracts bind them to secrecy and many, often shocked by what they have seen, are prevented from speaking out by legal threats and intimidation long after they've returned to the mainland.

The language of "border control" has been used to excuse political secrecy. But such secrecy is what we usually associate with autocratic governments and is the antithesis of democratic ideals.

What this case illustrates, yet again, is that the asylum seekers detained on Manus and Christmas Islands and Nauru have been excised not only from the laws that determine access to Australia but from the care we should provide any vulnerable person for whom we are responsible. And from the ethical principles upon which medicine and our health system are based.

If we care about these people, and if we truly believe in the humane values that ground medicine and the moral principles that ground democracy, then we need to do two things. The first is to hold a truly independent inquiry into the care of people in detention. And the second is to end off-shore processing.

theconversation.com/..brain-death-shows-failure-of-care-and-of-democracy-31274

Inquiry sought into brain death of asylum seeker

The Age
Thursday 4 September 2014 - 6:48AM
Sarah Whyte and Michael Gordon

The former director of mental health services at Manus Island has called for an independent investigation into the brain death of an asylum seeker who remains on life support in Brisbane.

Peter Young from International Health and Mental Services (IHMS) said he was not aware of the circumstances in this case but logistical and bureaucratic delays in providing care were "part and parcel" of holding people in such remote locations.

Dr Young said he did not consider the chief medical officer of the department, Paul Douglas, to be independent as Mr Douglas had previously accused health service providers of being risk-averse.

The 24-year-old man, Hamid Kehazaei, was evacuated to the mainland last Thursday and was pronounced brain dead on Wednesday night at Brisbane's Mater Hospital, refugee advocates said.

Greens immigration spokeswoman Sarah Hanson-Young said Mr Kehazaei's family were in the process of deciding whether to turn off the life-support machines.

She said there was a delay in transferring the man from Manus Island to the Australian mainland because a request from the medical service provider, IHMS, was denied.

"After being denied a timely transfer, this young man is now lying brain dead in a Brisbane hospital," Senator Hanson-Young said.

"This young man cut his foot, it got infected and he wasn't given the right medical help and it has developed into this severe septicaemia.

"This is a disgraceful lack of care given to this young Iranian man and a lack of duty of care being given by the Immigration Department."

Refugee advocate Ian Rintoul claimed the compound on Manus Island where the man had cut his foot had been evacuated.

A spokeswoman for Immigration Minister Scott Morrison said: "This is simply not true."

The spokeswoman did not comment on the allegations of a delay, instead saying: "The government has consistently focused on the care of this young man and his family, as well as respecting their privacy.

"These are our primary concerns. It is disappointing that the Greens have sought to politicise this very sensitive and serious matter in this way."

On Wednesday morning, Mr Morrison confirmed the man had not died.

"In respect to the family of the individual, further details are not able to be provided," he said.

"The government is following normal processes for the adult male transferee. The family has been engaged."

Last Friday, as the man was reportedly fighting for his life, the department said its chief medical officer was reviewing the background to the transferee's condition and medical care while at the Manus detention centre.

The standard of care provided by IHMS was called into question last month during the Australian Human Rights Commission inquiry into children in detention, where evidence given to the inquiry showed the levels of medical care in immigration detention were often below Australian standards.

In May, a former Salvation Army staff member on Manus Island, Simon Taylor, claimed IHMS was giving asylum seekers a type of anti-malaria medication that detention centre staff had been warned not to take.

theage.com.au/../inquiry-sought-into-brain-death-of-asylum-seeker-20140903-10c0eb.html

Chris Rau: Detention healthcare tossed overboard

The plight of an asylum seeker who died from preventable septicaemia is so moving because it is so blithely routine in a surreal system, writes Chris Rau.

ABC The Drum
By Chris Rau
First posted Fri 5 Sep 2014, 3:20pm
Updated Fri 5 Sep 2014, 4:02pm

The story of Hamid Kehazaei - who is brain dead in Brisbane's Mater Hospital after a cut to the foot at Manus Island detention centre was left untreated - was both utterly avoidable and utterly inevitable.

The 24-year-old Iranian asylum seeker is the most recent, tragic face of the "collateral damage" in a bipartisan policy which has culminated this past year in fatal riots, medical malfeasance, at least two dead babies, alleged rapes in detention centres, and skyrocketing mental health conditions.

Successive governments have repeatedly cried crocodile tears about people-smuggler-driven deaths at sea while cynically denying asylum seekers who do make it into their care the very basics of human existence which governments can control. All in the name of deterrence.

These responsibilities include a duty of care to those under their jurisdiction, particularly those locked in remote, inhospitable state-sanctioned "facilities" - semantic quibbles about "detention centres" vs "prisons" aside.

Their rights include freedom from hunger, assault, solitary confinement; a basic standard of accommodation and health care; access to reading, writing, and drawing material at the very least; sanitation, clean air and water; and an independent complaints mechanism.

Mr Kehazaei's plight is so moving because it was so blithely routine in a surreal system. It becomes even more shocking when you realise that successive immigration ministers have been wilfully deaf to warnings about woeful standards of detention health care.

One can only assume it's not a lack of ministerial and public service intelligence, information, or even compassion: it is pure realpolitik. The marginal-seat black hole into which political humanity sinks. Or, as former Labor Immigration Minister Mick Young told former Federal Court judge, Ron Merkel, in 1987:

"There are no votes in my electorate (Port Adelaide) for keeping blacks in the community."

In January this year, I researched a feature for the GP subscription magazine Australian Doctor, following the December 2013 axing of the Immigration Health Advisory Group (IHAG).

IHAG was first set up in 2006 following Mick Palmer's and Neil Comrie's administrative reviews into then minister Amanda Vanstone's Immigration Department.

Then, as now, governments outsourced their obligations to asylum seekers locked up in mandatory detention to a multi-tiered array of contractors. The primary contractor would run the centres, which were then mainly onshore: Australasian Correctional Management (ACM; a subsidiary of Wakenhut); Global Solutions Limited; G4S; Serco; and now also Transfield.

Then, as now, these umbrella conglomerates subcontracted various chunks of responsibility to other corporations: for instance, International Health and Medical Services (IHMS) took on general health care, subcontracting further chunks off to GP services and to consultant psychiatrists, often on a FIFO basis. There then there was catering; cleaning; transport; tents; construction; tech support; welfare ... a long list.

Now there are the added, complex logistics for remote, hard-to-access tropical islands. Also, the delicacy of negotiating slices of Australian jurisdiction within sovereign countries like PNG (Manus) and Nauru. There, many staffers live on floating hotels, campervans and other hastily-arranged infrastructure.

All up, you get an accounting and accountability shemozzle: literally and figuratively a quagmire.

Even the most battle-hardened Senate Estimates Committees, the most mathematically-agile Financial Review journalists, and the most persistent archive rats have run weeping from their caves while trying to untangle it all.

The latest in the line of intrepid delvers has been Guardian Australia Australia's Nick Evershed, who ransacked an array of databases to crunch the numbers on August 25, estimating the figure for the contractual rewards of mandatory detention at $10 billion since mid-2007.

Guardian Australia gives a qualified estimate of 1,770 contracts awarded to 522 entities. And says it costs nearly $860,000 a year to house an asylum seeker offshore.

This can only be a guesstimate, because the Immigration Department shields its finances behind a kaleidoscope of "corporate-in-confidence" walls, just as it shields the stories of individual asylum seekers behind spurious "privacy" barriers.

What is less easy to hide, however, is the growing rebellion of some internal whistleblowers who are leaking documents and who are willing to risk breaching confidentiality clauses in their contracts to speak out about what they have described as substandard, often dangerous detention conditions.

Plus, the porous nature of social media devices - now available, with some ingenuity, even in remote locations - means stories like those of Mr Kehazaei's will no longer stay in previously impervious information bunkers.

Here is what an IHMS whistleblower, GP Dr John Vallentine, told Australian Doctor about Manus Island in April 2013 (he had been flown in from Christmas Island to help establish the clinic on Manus):

"There was a sense of unseemly haste about it all but I fell in with the spirit of things. As time passed, however, I found my requests to IHMS for equipment and drugs were receiving no action."

"Simple things - oxygen, Foley's catheters, yankeur suckers, paediatric antimalarials, parenteral antibiotics, fentanyl, vecuronium, morphine, corneal burrs, portable haemaccues to name but a few - just didn't turn up. IHMS sent boots and uniforms but the important stuff was not arriving."

"During that time, I was becoming increasingly concerned about our ability to manage children in this remote and quite unforgiving environment. We had no blood transfusion (capabilities), no paediatric-trained staff, no X-ray equipment, no paediatric emergency facilities. And for paediatric emergency cases, a 24-hour air transfer delay was unacceptable."

Since then, children have been removed from Manus, notorious for its waterborne diseases, just like Christmas Island is for its lung-damaging phosphate dust.

During my own research, I heard of mothers near Darwin who were denied access to midwives and later lost their babies; island compounds where three toilets were deemed sufficient for 200-300 detainees (on the days all loos were working and the floors weren't awash in faeces); repeated allegations of rape, both male-on-male and male-on-female; and delays in obtaining even the most basic of medicines like aspirin (which then had to be signed off with elaborate paperwork).

Given this litany of neglect, one has to wonder where IHMS spends its $1 billion (or thereabouts) in taxpayer largesse, while it or its subcontractors can't diagnose the onset of septicaemia.

If Hamid Kehazaei's case could be brought under standard medical negligence litigation in an Australian court, no medical insurer would even dare try to defend the case in court, given the sheer blatancy of medical neglect. It would be quietly settled for a large sum.

Given the implacable electoral hostility in marginal seats against "boat people", another theme is clear: it won't be the politicians of either major party who rediscover some basic humanitarian scruples.

This will only come via the courts, which have doggedly - via a lot of bono legal work - put the false pieties of so many of our politicians to shame. The next High Court case is set down for October 14 and 15.

Chris Rau has worked as a print journalist for 30 years. She has written about asylum seeker issues since 2005 for various outlets.

http://www.abc.net.au/news/2014-09-05/rau-detention-healthcare-tossed-overboard/5722036

Andrew Street: So we've killed another asylum seeker

Andrew Street
The Vine
Thursday 4 September 2014

There's been a lot of talk about the state of care in our offshore detention centres, usually involving the phrase "disgusting disease-ridden hellholes".

After all, when you're reading reports on how there have been 128 case of self harm among children on Christmas Island, for example, you can assume that things are pretty ghastly. That's at the best of the offshore processing centres, by the way.

However, Hamid Kehazaei was not on Christmas Island.

The 24 year old Iranian man was being held on Manus Island when he got a cut on his foot - a not uncommon occurrence, given that there are a shortage of shoes and the detention camp is little more than rocks and dirt.

The cut became infected. The facilities in the camp were inadequate to treat him, once they decided to give him treatment.

The healthcare providers on Manus Island, the International Health and Medical Service, asked the Department of Immigration and Border Protection for permission to send him to the mainland for treatment. The request was denied.

Last week he was finally evacuated to Brisbane to be treated at Mater Hospital, where he was found to have severe septicaemia. At some point in the next little while, the machines keeping the now brain-dead Hamid will be turned off.

A man who asked Australia for help, and who was supposedly under our protection, will die because he got a cut on his foot.

And let's not dick around: this is an explicit strategy of Scott "let them eat death" Morrison, who wants asylum seekers to know that we'll leave them to die. That's not a bug, it's a feature.

And we're doing it at a time when our government is ramping up its anti-Islam rhetoric, almost as though the PM is actively daring them to make us a target, and then punishing those that are fleeing the regimes we're prepared to go to war against. They're actively begging to join Team Australia, and we can't be fucked giving them a bandaid, much less some shoes.

First published at http://www.thevine.com.au/ [page no longer exists]

Asylum-seeker's family wants organs gifted as aid 'botched'

Sonia Kohlbacher
The Australian
September 04, 2014 12:00PM

THE Tehran family of 24-year-old Iranian asylum-seeker Hamid Keha­zaei was last night trying to come to terms with the news that he is brain dead in a Brisbane hospital, apparently about a fortnight after cutting his foot in a Manus Island compound described by refugee advocates as filthy.

Lawyers who had been representing Mr Kehazaei in a court challenge against the Australian government were in talks yesterday with lawyers from the Mater Hospital in South Brisbane, where it is understood he remains on life support.

His fellow inmates at the notor­ious immigration detention centre where Reza Berati was murdered in February accused government health contractor IHMS yesterday of botching its response to Mr Kehazaei's illness, first sending him to a hospital in Port Moresby rather than to Brisbane, where he was eventually transferred.

Immigration Minister Scott Morrison refused to answer questions about the chronology of events or to say whether Mr Keha­zaei had received appropriate care. "The individual has not died," he said in a statement.

"In respect to the family of the individual, further details are not able to be provided. The government is following normal pro­cess­es for the adult male transferee. The family has been engaged."

Last week, before news emerged that Mr Kehazaei was brain dead, a spokeswoman for Mr Morrison confirmed that he had been transferred in need of "urgent medical care" from the Manus detention centre to Port Moresby last Tuesday. There, he reportedly had a heart attack.

Mr Morrison's office had confirmed Mr Kehazaei was transferred from Papua New Guinea to Brisbane last Wednesday.

"On the advice of the clinical team, including the department's health-service provider IHMS, it was recommended that he be transferred to the Australian mainland to receive further specialised care," the statement said.

"The family of the man has been informed and is in regular contact with the hospital.

"The department's chief medical officer is reviewing the background to the transferee's condition and medical care while at Manus OPC."

Refugee Action Coalition spokesman Ian Rintoul said Mr Kehazaei had made numerous requests to guards at the centre for medical attention and was suffering septicemia by the time he was medivaced to Brisbane.

"A couple of days ago, he suffered a heart attack, and yesterday (Tuesday), the Immigration Department and the hospital told the family Hamid was confirmed as brain dead," Mr Rintoul said yesterday. "The hospital has told the family a 'guardian' will be appointed at 'some stage' to decide on the withdrawal of life support.

"The family has indicated that they are willing for Hamid's ­organs to be donated."

A Refugee Rights Advocacy Network spokeswoman said "poor sanitation" in the detention centre's ablution blocks, where detainees were often exposed to sewage, had caused the infection because there was a "lack of closed-in footwear".

She said Mr Kehazaei's infection had worsened and detainees had told her he was in pain.

theaustralian.com.au/../..wants-organs-gifted-as-aid-botched/story-e6frg6nf-1227046890262

Scott Morrison confirms 'parlous state' of asylum seeker on life support

Sydney Morning Herald
September 5, 2014 - 12:22PM
Sarah Whyte

The immigration system will sometimes experience "incidents", Immigration Minister Scott Morrison has said, while confirming that the 24-year-old asylum seeker who is fighting for his life in Brisbane is in a "very, very parlous state".

Hamid Kehazaei, who was being held in the Manus Island detention centre, was evacuated to the mainland last Thursday after his condition had reportedly deteriorated when a cut foot became infected, which led to severe septicaemia. He was pronounced brain dead this week.

"I should stress that on occasion we have incidents that occur in our detention facilities and outside our detention facilities," Mr Morrison told reporters in Brisbane on Friday morning.

"I think last year there were some 23 persons who passed away in the immigration system. The vast majority were in bridging care."

Mr Morrison denied reports that Mr Kehazaei had been mistreated in the system.

Greens senator Sarah Hanson-Young has made claims there was a delay in treating the man for the cut to his foot, resulting in severe deterioration of the man's health while he was on Manus Island.

"When someone becomes ill they receive outstanding care from the people who work as part of our mainland detention network," Mr Morrison said.

"[In offshore detention centres International Health and Mental Services] do an outstanding job."

Mr Morrison said would be asking the immigration department's chief medical officer to review the clinical treatment of the asylum seeker whilst he was on Manus Island and now in Brisbane's Mater hospital.

"I will base my assessment on the treatment on the facts and not Facebook."

Mr Morrison suggested that the man may have his life support turned off soon.

"There are decisions here that need to be taken in relation to this young man that are matters for the family and frankly the local authorities in Brisbane," he said.

Mr Morrison was also asked about claims made by former defence force chief Admiral Chris Barrie, who on Thursday described the detention centres as "jails".

Mr Morrison said: "On the issue of border protection policies, Admiral Barrie and I are in disagreement and I think the government's policy success strongly supports my argument."

Admiral Barrie, who was the defence force chief responsible for border protection under the Howard government, slammed the government's asylum seeker policy, saying the Coalition had robbed asylum seekers of their rights within the detention facilities.

"Australians are doing their utmost to extinguish hope, the most powerful of human emotions," Admiral Barrie said.

smh.com.au/../-parlous-state-of-asylum-seeker-on-life-support-20140905-10ctpc.html

Asylum seeker on life support was given 'outstanding' care, says Scott Morrison

Hamid Kehazaei's mother says she had to contact the hospital to find out her son was in a life-threatening condition

Oliver Laughland
Guardian Australia
Thursday 4 September 2014 23.13 EDT

The immigration minister, Scott Morrison, has said that asylum seeker Hamid Kehazaei received "outstanding" medical treatment on Manus Island, following his family's confirmation to Guardian Australia that the 24-year-old has been declared brain dead.

Kehazaei contracted an infection in the detention centre that developed into septicaemia and was evacuated from the centre last week. His family told Guardian Australia that during the evacuation Kehazaei suffered heart failure and lost brain functions.

Guardian Australia reported last week there were concerns that there were delays in Kehazaei's treatment on Manus Island, with the immigration minister instructing the department's chief medical officer to review the care offered.

"When someone becomes ill they receive outstanding care from the people who work as part of our mainland detention network, and in the offshore processing centres that are under the management of the governments of Papua New Guinea and Nauru," Morrison said in response to a question about the standard of Kehazaei's care.

Morrison said those criticising the standard of care were using the situation to "make political points". "I think that's unfortunate," he added.

"I'll base my assessment of the facts on that [review] assessment - not Facebook," the minister said.

Manus Island whistleblower Martin Appleby told Crikey on Thursday the detention centre had no facilities to test for septicaemia and that doctors were constantly under-resourced.

Morrison said the immigration department had been in "constant contact" with Kehazaei's family and he would not disclose any more detail on the case in order to "respect the wishes and the privacy of the family".

On Thursday Kehazaei's mother, Goldone Kehazaei, told Guardian Australia the family only found out that Hamid was being kept on life support after they called the hospital themselves.

"No one called us [from the hospital] because it was the weekend, so we called ourselves and they said: 'We don't know who you're talking about'," she said.

"I later found out he was on life support."

Goldone said of her son: "Of all my three boys, he was the most gentle and loving," describing him as a "very sensitive, harmless lovable person".

Peter Young, the former medical director of mental health services at International Health and Medical Services (IHMS) - the private medical company working on Manus Island - said delays to treatment on Manus Island were "characteristic of being in a remote location", adding that the immigration department had regularly told IHMS to take more medical risks in the care of asylum seekers detained offshore.

IHMS issued a statement on Kehazaei's case. It stated: "We are proud of the efforts and commitment shown by those of our team who provide healthcare services to people on Manus Island.

"In line with our normal procedures for serious cases, we have initiated a thorough review of the clinical care for this case and will also fully support the review which is being carried out by the Department of Immigration and Border Protection."

Speaking at a media conference at Brisbane airport on Friday morning to launch the use of new automated departures eGates, Morrison also dismissed comments made by Admiral Chris Barrie, a former defence chief responsible for border protection under the Howard government.

At a book launch event in Sydney on Thursday, Barrie - a longtime critic of the Coalition's border policies - described immigration detention centres as akin to jail.

Morrison also declined to go into detail on a report that an alleged people smuggler had their passport confiscated by the Australian Security Intelligence Organisation (Asio) after being deemed a threat to national security.

Speaking in general terms, the minister said: "We make no apologies for cancelling the passports of people we suspect might be a national security threat or involved in that type of criminal behaviour."

theguardian.com/../asylum-seeker...was-given-outstanding-care-says-scott-morrison

Scott Morrison rejects negligence claim over brain dead asylum seeker Hamid Kehazaei

ABC News Online
First posted Fri 5 Sep 2014, 1:41pm
Updated Fri 5 Sep 2014, 4:05pm

Immigration Minister Scott Morrison has rejected claims that an Iranian asylum seeker, who was declared brain dead after being transferred to Brisbane from Manus Island detention centre, was not given proper medical care.

Hamid Kehazaei, 24, cut his foot three weeks ago and developed septicaemia before being moved to the mainland for treatment.

He had a heart attack before being declared brain dead on Tuesday.

Refugee Action Coalition spokesman Ian Rintoul has accused authorities of taking too long to act.

Speaking today, the Minister said: "A lot of the reports and accusations that you have seen made have not been based on any primary knowledge of this case.

"Our focus and care has been on this young man from the moment he presented to medical officers at Manus Island and on focussing on the interests and engaging with the family."

Mr Morrison said he had also asked his department's Chief Medical Officer to review the case.

"I would base my assessment of that treatment on the facts not Facebook," he said.

Mr Rintoul said Mr Kehazaei sought medical attention for days before being flown to Port Moresby, then into intensive care in Brisbane's Mater Hospital last week.

He said Mr Kehazaei was a victim of "the shocking conditions and medical neglect on Manus Island".

"It is inexcusable that he developed septicaemia on Manus Island," he said.

"Nothing else to describe it, but it is just sheer negligence."

The Greens have also called for an urgent investigation into medical care on Manus Island.

The Minister said Mr Kehazaei remained in an "extremely parlous" condition.

"I think it's very unfortunate that some advocates and the Greens and others have sought to seek to use this event to make political points," he added.

In a written statement, Labor's immigration spokesman Richard Marles said the Government had taken the right step in asking the Department's Chief Medical Officer to review the clinical treatment of the man.

"Mr Morrison needs to ensure that review is made public as soon as possible," he said.

"Labor has strong concerns about the lack of transparency surrounding the treatment of asylum seekers under the Abbott Government.

"Every single Australian-funded facility must be run in a manner that is safe, humane, dignified and allows for proper oversight."

abc.net.au/../scott-morrison-reject-negligence--hamid-kehazaei-manus-island/5721848

Family of asylum seeker Hamid Kehazaei decide to switch off life support

The Age
September 5, 2014 - 3:03PM
Sarah Whyte

The family of asylum seeker Hamid Kehazaei have made the decision to switch off the 24-year-old's life support in Brisbane.

The Iranian asylum seeker has been on life support in Brisbane's Mater Hospital since last week when he was evacuated to the mainland from Papua New Guinea, where he was being held in the Manus Island detention centre .

Fairfax Media understands the decision was made by his family on Friday afternoon, who have also asked for Mr Kehazaei's organs to be donated.

Mr Kehazaei will not be pronounced dead until his organs have been removed for donation.

Mr Kehazaei was evacuated to the mainland last Thursday after his condition had reportedly deteriorated when a cut foot became infected, which led to severe septicaemia. He was pronounced brain dead this week.

His death will be the second death of an asylum seeker who has been held in the Manus Island detention centre.

In February, another asylum seeker Reza Barati was killed during violent clashes in the centre. Sixty-nine asylum seekers were also injured in the clashes.

The decision by Mr Kehazaei's family comes as Immigration Minister Scott Morrison told reporters in Brisbane that the immigration system will sometimes experience "incidents".

"I should stress that on occasion we have incidents that occur in our detention facilities and outside our detention facilities," Mr Morrison said on Friday morning.

Mr Morrison denied reports that Mr Kehazaei had been mistreated in the system.

Greens senator Sarah Hanson-Young has made claims there was a delay in treating the man for the cut to his foot, resulting in severe deterioration of the man's health while he was on Manus Island.

"When someone becomes ill they receive outstanding care from the people who work as part of our mainland detention network," Mr Morrison said.

"[In offshore detention centres International Health and Mental Services] do an outstanding job."

Mr Morrison said would be asking the immigration department's chief medical officer to review the clinical treatment of the asylum seeker whilst he was on Manus Island and now in Brisbane.

"I will base my assessment on the treatment on the facts and not Facebook."

theage.com.au/../family-of-asylum-seeker..switch-off-life-support-20140905-10czak.html

Iranian asylum seeker Hamid Kehazaei dies in Brisbane hospital after life support switched off

ABC News Online
First posted Fri 5 Sep 2014, 8:29pm
Updated Fri 5 Sep 2014, 10:01pm

An Iranian asylum seeker has died in a Brisbane hospital after being transferred from Manus Island detention centre with septicaemia.

Hamid Kehazaei, 24, cut his foot three weeks ago and developed septicaemia before being moved to the mainland for treatment.

He had a heart attack before being declared brain dead on Tuesday.

Immigration Minister Scott Morrison has confirmed Mr Kehazaei died after his family provided consent for withdrawal of his life support.

"An imam was present at the time of death and the government of Iran will be informed," Mr Morrison said in a statement.

"I am very saddened by this man's passing and on behalf of the Australian Government I extend our deepest sympathy to the man's family and friends.

"My department has and will continue to provide support to the family and has been in contact with family members during the course of the man's treatment.

"The Queensland coroner will be advised of the death and my department will cooperate fully."

The Immigration Department's chief medical officer will also conduct an in-depth clinical review of Mr Kehazaei's case.

"This will be in addition to any medical review that will also be undertaken by the medical services provider, International Health and Medical Services, conducted as part of their normal clinical governance arrangements," Mr Morrison said.

"I will await the outcomes of this report before making any further comment on the medical treatment provided in this case.

Medical care 'not good enough'

Refugee Action Coalition spokesman Ian Rintoul earlier accused authorities of taking too long to act.

Mr Rintoul said Mr Kehazaei sought medical attention for days before being flown to Port Moresby, then into intensive care at Brisbane's Mater Hospital last week.

He said Mr Kehazaei was a victim of "the shocking conditions and medical neglect on Manus Island".

"It is inexcusable that he developed septicaemia on Manus Island," he said.

"Nothing else to describe it, but it is just sheer negligence."

The Greens have also called for an urgent investigation into medical care on Manus Island.

In a written statement, Labor's immigration spokesman Richard Marles said the Government had taken the right step in asking the chief medical officer to review the case.

"Mr Morrison needs to ensure that review is made public as soon as possible," he said.

"Labor has strong concerns about the lack of transparency surrounding the treatment of asylum seekers under the Abbott Government.

"Every single Australian-funded facility must be run in a manner that is safe, humane, dignified and allows for proper oversight."

www.abc.net.au/../iranian-asylum-seeker-dies-in-brisbane-hospital/5724050

Hamid Kehazaei dies after family give permission to switch off life support

Immigration minister says chief medical officer will conduct an 'in-depth clinical review' of asylum seeker's medical treatment while on Manus Island

Oliver Laughland, Donya Nissi and Paul Farrell
Guardian Australia
Friday 5 September 2014 06.27 EDT

The Iranian asylum seeker transferred to a Brisbane hospital after contracting septicaemia has died after his life support machine was switched off.

The family of Hamid Kehazaei, who had been held on Manus Island, gave doctors permission to switch off his life support machine earlier on Friday.

The immigration minister, Scott Morrison, released a statement late on Friday and offered his condolences.

"I am very saddened by this man's passing and on behalf of the Australian government I extend our deepest sympathy to the man's family and friends. My department has and will continue to provide support to the family and has been in contact with family members during the course of the man's treatment," he said.

Morrison also said the department's chief medical officer would be conducting an "in-depth clinical review" on the background of his medical treatment while on Manus Island.

"I have instructed the department to make the necessary arrangements to facilitate the repatriation of the body of the deceased man to his family in Iran should this be requested," he said.

"The department will consider what additional appropriate assistance it can reasonably provide to the family, should this be required.

The family earlier told Guardian Australia from Tehran it was likely Kehazaei's life support would be switched off on Friday evening.

Kehazaei's brother Mehei confirmed to Guardian Australia that the family had given permission for Hamid's organs to be donated in Australia. The family have requested the hospital take a photograph of the 24-year-old once he is taken off life support and have made clear their desire for his body to be sent back to Iran.

Kehazaei's grief-stricken mother, Goldone, said through tears: "I want to donate his organs and I'm worried his heart will fail as well if we keep waiting."

She said the family was "furious" with the Australian government. "No one cared for my child. He was neglected - he kept saying his legs were hurting, and no one did a thing, they let him suffer."

Mehei later said his mother was so distraught she was receiving medical attention in a Tehran hospital.

Kehazaei is the second asylum seeker on Manus to die in the past seven months after 24-year-old Iranian Reza Barati was murdered during violent unrest in February. No asylum seekers on Manus have been resettled since the previous government announced the so-called "PNG solution" in July last year.

Kehazaei contracted septicaemia from a cellulitis infection on Manus and was flown to hospital in Brisbane. It is understood there were delays in his care.

On Friday the immigration minister, Scott Morrison, denied there had been any such delays and described the care provided to asylum seekers on Manus as "outstanding".

"When someone becomes ill they receive outstanding care from the people who work as part of our mainland detention network, and in the offshore processing centres that are under the management of the governments of Papua New Guinea and Nauru," Morrison said in response to a question about the standard of Kehazaei's care.

But numerous whistleblowers and independent accounts of healthcare in Australia's offshore detention centre contradict this description.

A 92-page letter of concern written by doctors on Christmas Island last December described "numerous unsafe practices and gross departures from generally accepted medical standards which have posed significant risk to patients and caused considerable harm".

A leaked, independent assessment of healthcare on Nauru revealed the desperate state of health care for asylum seeker children and families detained on the island.

Greens senator Sarah Hanson-Young said Kehazaei's case was representative of the healthcare problems on Manus and renewed calls for its closure.

"Hamid should never have been put in harm's way like this and there now needs to be a thorough, independent medical examination of the Manus Island detention camp," Hanson-Young said.

"Scott Morrison says Hamid received 'outstanding' care on Manus Island. Well, if 'outstanding' care on Manus Island sees someone die because of a cut foot, it needs to be shut down.

"Hamid is the second victim of the Manus Island detention camp and it must be closed immediately."

theguardian.com/../hamid-kehazaeis-family-give-doctors-permission-to-switch-off-his-life-support

MEDIA RELEASE: Justice for Hamid: Close Manus Island, end offshore processing

Friday September 5, 2014
Refugee Action Coalition
Ian Rintoul
mobile 0417 275 713

"The death of Hamid Khazayi, the 24 year-old Iranian asylum seeker whose life support system was turned off on Friday evening, is senseless and inexcusable," said Ian Rintoul, spokesperson for the Refugee Action Coalition.

"That a man could die in this way while supposedly in the care of the Immigration Department says everything about the lack of care on Manus Island.

"It is absurd for Scott Morrison to claim that asylum seekers who get ill on Manus Island get 'outstanding care'. Hamid's death speaks for the medical neglect, and to the culture of punishment, and indifference that pervades Manus Island.

"Like Reza Berati, Hamid is a victim of the offshore processing regime being run by the Coalition government. There is another 1000 potential Hamids on Manus Island. Infections and skin disease are endemic in the detention centre. It is unhygienic, unsanitary and unsafe.

"All the detainees on Manus must be brought to the mainland. The many ex-Manus detainees already on the mainland for medical treatment must be allowed to stay.

"While we mourn for Hamid, we are determined to fight for justice and to continue to campaign to close Manus Island."

Attempted suicide as asylum seeker threatened with return to Manus Island

Only hours before Hamid's In Wickham Point detention centre, this afternoon (Friday 5 September), an Iranian asylum seeker reportedly swallowed razor blades and attempted to hang himself when threatened with being returned to Manus Island. This was the second time in three months that the Department of Immigration has tried to return him to Manus Island.

He is presently in a Darwin hospital.

He too was a victim of delayed medical treatment on Manus Island after suffering a stroke in December 2013 that resulted in the loss of sight in one eye. He also waited over 4 months for an appointment with a neurologist after being transferred to Darwin.

'Close Manus' petition reaches over 86,000 signatures

The tragic news of Hamid's plight has fuelled growing opposition to off-shore processing. A petition calling for the closure of Manus Island has been growing at the rate of almost 1,000 signatures an hour in the 24 hours leading to Hamid's death, and now has over 86,200 signatories.

See https://www.getup.org.au/campaigns/refugees/shut-down-manus/shut-down-manus

For more information contact Ian Rintoul - mobile 0417 275 713

Asylum seeker death: Family's organ donation wish unable to be granted

The Age
September 6, 2014 - 8:07PM
Cameron Atfield

Iranian asylum seeker Hamid Kehazaei, who died in a Brisbane hospital on Friday, will not have his organs donated, due to the illness he suffered leading up to his death.

Mr Kehazaei, 24, had been declared brain-dead at the Mater Hospital following the former Manus Island detainee's transfer from the Pacific International Private Hospital in Port Moresby, Papua New Guinea.

He had been on life support for a week prior to his death on Friday night.

Mr Kehazaei's family had requested his organs be donated once his life support system had been switched off, but doctors were unable to carry out that wish due to his septicaemia.

A Mater Hospital spokeswoman said she was unable to comment as Mr Kehazaei's death was now a matter for the coroner.

But Refugee Action Collective spokesman Ian Rintoul said a team of doctors at the Mater had made the assessment prior to Mr Kehazaei's death.

"It was one of the issues (Mr Kehazaei's family) wanted resolved before they agreed to turn the life support off," he said.

"They're resigned, it's what they wanted to happen but when they were informed that it wasn't going to be possible, they very reluctantly said the time had come."

The decision to offer Mr Kehazaei's organs up for donation to needy Australian patients was applauded by many this week and provided a small comfort to his grieving family, who remained in Iran.

A spokesman for Immigration Minister Scott Morrison said he was unable to comment as it was a "private matter".

Opposition immigration spokesman Richard Marles said the review announced by Mr Morrison into Mr Kehazaei's clinical treatment should be made public.

"Every single Australian funded facility must be run in a manner that is safe, humane, dignified and allows for proper oversight," he said.

Refugee Action Collective Queensland spokesman Mark Gillespie said a second vigil for Mr Kehazaei, following on from one outside the Mater on Thursday, would be held at 6pm on Sunday at King George Square in Brisbane.

theage.com.au/../..familys-organ-donation-wish-unable-to-be-granted-20140906-10dfc3.html

Lawyer investigates negligence in death of asylum seeker

Lawyer for family of deceased Iranian asylum seeker Hamid Kehazaei says there is possibility of Government negligence

ABC News Online
First posted Sat 6 Sep 2014, 2:52pm
Updated Sat 6 Sep 2014, 3:27pm

The family of deceased Iranian asylum seeker Hamid Kehazaei have enlisted the help of a lawyer to investigate whether they have a case of negligence against the Australian Government.

The family's lawyer has indicated that there may have been at least three critical points where other actions could have been taken that may have saved Mr Kehazaei's life.

The 24-year-old cut his foot at the Manus Island detention centre about three weeks ago, developed septicaemia as a result and died due to complications late yesterday.

Lawyer Ruth Hudson will be representing the family and believes there are obvious signs of negligence.

"This wasn't a fatal injury until the Government made it so," she told the ABC's AM program.

She said all the family is looking for is "justice for Hamid".

Ms Hudson said at this stage, the family have been given very little information about the treatment or the events prior to Mr Kehazaei being transferred to the Mater Hospital in Brisbane.

'Does not happen in civilised society'

"They want me to find answers as to why their son is now gone, in circumstances where his life could have been saved," Ms Hudson said.

Ms Hudson said it needed to be investigated how Mr Kehazaei could have died as a result of such a non-threatening condition whilst in Australia's care.

"This just does not happen in a civilised society."

Ms Hudson said she will be investigating three critical points in the timeline of Mr Kehazaei's treatment.

"There is a possibility there was an inadequate initial diagnosis, potential failure to transfer him quickly enough to Australia; and also a failure to provide adequate treatment," she said.

"Unfortunately, there has not been a great deal of information provided prior to Hamid being transferred to the Mater. So there is still some question as to the specific timeframe."

The Immigration Department's chief medical officer has been asked to review the case.

"Any review needs to be an independent, open inquiry into what has happened. Otherwise we just don't feel that justice will be properly served here," Ms Hudson said.

Social Services Minister Kevin Andrews said he is satisfied the case is being properly investigated.

"I understand the chief medical officer of the Immigration Department will be enquiring into this and I understand the matter's been referred to the Queensland coroner, so there's quite appropriate legal, administrative inquiries going ahead," he said.

"We should await the outcome of those inquiries before we speculate or make any further comments."

The Federal Opposition has said the family deserves to know whether Mr Kehazaei received full and proper medical care.

The family have requested that his body be returned and repatriated to Iran so that a funeral service can take place in his honour.

abc.net.au/../lawyers-for-asylum-seeker-who-died-claim-government-negligent/5724670

Family of asylum seeker Hamid Kehazaei demands answers

The Age
September 6, 2014 - 1:47PM
Lisa Cox

The family of 24-year-old asylum seeker Hamid Kehazaei, who died in a Brisbane hospital after a severe leg infection, has demanded justice.

Ruth Hudson, the solicitor acting on behalf of Mr Kehazaei's family in Iran, said his shattered mother and brother were demanding to know why his life had been lost to a treatable infection.

Ms Hudson said that by the time Mr Kehazaei, a Manus Island detainee, was transferred from a Port Moresby hospital to the Mater Hospital in Brisbane, he was already "gravely ill".

Immigration Minister Scott Morrison confirmed the asylum seeker's death on Friday night in Brisbane's Mater Hospital, where he had been on life support for a week.

Mr Morrison said there would be a review into the death and he would also request a medical review from the health service provider on Manus Island, International Health Medical Service.

Ms Hudson said on Saturday that any review had to be independent to ensure a proper investigation.

"They [Mr Kehazaei's family] have just said to me they want justice," she said.

"They want answers.

"They want to know why their son has died of a non-threatening health condition while in Australian care because this just doesn't happen in a civilised country."

Ms Hudson said no medical records had been supplied yet to show the chain of events before Mr Kehazaei's transfer from Manus Island.

She said three problems with the medical care he received could have contributed to his death.

The first was an inadequate initial diagnosis on Manus Island, where it was still unclear when Mr Kehazaei had first complained of symptoms after sustaining a leg wound.

The second was that authorities took too long to transfer the asylum seeker after his case was deemed an emergency.

Ms Hudson said a recommendation was made around August 25 to urgently transfer Mr Kehazaei, but he was not transferred to the Pacific International Private Hospital in Port Moresby until the following day and it was a day later before he was sent to Brisbane.

"I understand that by the time he reached Mater Hospital, he was beyond a critical condition," she said.

Ms Hudson said the final concern was with conditions on the island and inadequate treatment both in the initial stages of the infection and through the course of his transfers.

"We want to make sure any review is independent and open because that is the only way that justice can be done," she said.

The Labor Party said on Saturday the government had to commit to making all information on Mr Kehazaei's case available, given a fairly minor injury appeared to have led to his death.

"The family and friends of Mr Kehazaei deserve to know he was afforded proper healthcare at every step," immigration spokesman Richard Marles said.

theage.com.au/../..seeker-hamid-kehazaei-demands-answers-20140906-10dbfo.html

Manus Island whistleblower describes 'filthy' conditions inside detention centre

ABC News Online
By Andrew Greene and Benjamin Sveen
First posted Sat 6 Sep 2014, 8:34pm
Updated Sat 6 Sep 2014, 9:02pm

A former detention centre guard says he is not surprised an asylum seeker has died from an infection he caught at Manus Island because he witnessed filthy living conditions inside the facility.

Hamid Kehazaei cut his foot at the detention centre about three weeks ago, developed septicaemia and was sent to Brisbane's Mater hospital.

The 24-year-old suffered a heart attack, and was later declared brain dead.

His family in Iran made the harrowing decision to switch off their son's life support late Friday.

Former Manus Island detention centre employee Beau Mitchell has told the ABC he is not surprised at Mr Kehazaei's plight after recording evidence of poor hygiene inside.

"There's no air conditioning, the beds are extremely close together. The living standards are pretty quite filthy," Mr Mitchell said

"Often they'd be standing on concrete to have a shower that was literally falling apart underneath them, just completely rotting away."

Mr Mitchell, who was employed as a guard with contractors G4S and the Wilson's Security, says he used secret cameras to record some of the conditions inside the compounds which house asylum seekers.

He says he quit his job in June disgusted at what he saw, but insists medical staff at Manus Island are trying to do their best to look after detainees.

"The people that were actually working there did a fantastic job with what they had to work with," he said.

"They were seen on almost on a triage basis. Obviously if it was something quite severe they'd be seen quickly but if it wasn't an emergency it was a 2-3 day wait normally."

Family to investigate claims of negligence

The family of Mr Kehazaei have enlisted the help of a lawyer to investigate whether they have a case of negligence against the Australian Government.

Lawyer Ruth Hudson will be representing the family and believes there are obvious signs of negligence.

"This wasn't a fatal injury until the Government made it so," she told the ABC's AM program.

Ms Hudson said the family, who are seeking "justice for Hamid", were given very little information about the treatment or events prior to Mr Kehazaei's transfer to the Mater Hospital in Brisbane.

"They want me to find answers as to why their son is now gone, in circumstances where his life could have been saved," she said.

Ms Hudson said an investigation was needed to establish how Mr Kehazaei could have died as a result of the non-threatening condition while in Australian care.

"This just does not happen in a civilised society," she said.

Ms Hudson said she would investigate three critical points in the timeline of Mr Kehazaei's treatment.

"There is a possibility there was an inadequate initial diagnosis, potential failure to transfer him quickly enough to Australia; and also a failure to provide adequate treatment," she said.

"Unfortunately, there has not been a great deal of information provided prior to Hamid being transferred to the Mater. So there is still some question as to the specific timeframe."

The Immigration Department's chief medical officer has been asked to review the case.

"Any review needs to be an independent, open inquiry into what has happened. Otherwise we just don't feel that justice will be properly served here," Ms Hudson said.

Social Services Minister Kevin Andrews said he was satisfied the case was being properly investigated.

"I understand the chief medical officer of the Immigration Department will be inquiring into this and I understand the matter's been referred to the Queensland coroner, so there's quite appropriate legal, administrative inquiries going ahead," he said.

"We should await the outcome of those inquiries before we speculate or make any further comments."

The Federal Opposition said the family deserved to know whether Mr Kehazaei received full and proper medical care.

The family requested that his body be returned and repatriated to Iran so that a funeral service can take place in his honour.

abc.net.au/../manus-island-whistleblower-describes-filthy-conditions/5725042

Hamid Kehazaei virtually unrecognisable when evacuated

Claims asylum seeker Hamid Kehazaei virtually unrecognisable when medically evacuated

The Age
September 14, 2014 - 1:47AM
Sarah Whyte

When Iranian asylum seeker Hamid Kehazaei was medically evacuated to Brisbane from Port Moresby, he was unconscious, his body almost unrecognisable due to his swollen state, it has been alleged.

The 24-year-old man, who was treated at Brisbane's Mater Hospital, was pronounced dead a week later by Immigration Minister Scott Morrison. But new details have emerged, suggesting the young man's condition was already critical by the time he reached Papua New Guinea's capital on August 26 from Manus Island.

Mr Kehazaei was known as an "all right bloke" by security guards on Manus Island. He died from severe septicaemia, a bacterial disease that had entered his blood stream after he cut his foot at the offshore processing centre.

An expatriate contractor, who has asked to remain anonymous, described the 24 hours on August 26 in Port Moresby as being "panicked" and "critical" to saving Mr Kehazaei's life.

"From when he arrived, he needed oxygen," the worker said.

The man then had five cardiac arrests, the worker said. Medical staff told the worker they would have to amputate Mr Kehazaei's leg, due to the spreading of septicaemia, but his condition worsened.

A leaked report obtained by Fairfax Media shows that the mood in the detention centre continues to be low and Iranian asylum seekers are blaming medical provider the International Health and Medical Service for Mr Kehazaei's death.

Mr Kehazaei is the second Iranian asylum seeker on Manus Island to die this year. Reza Barati died during violence in February.

The report by a service provider on the island says: "It is likely some Iranian transferee will spread malicious rumours about GDD059's death to further their own personal agendas, as well as to exploit unrest to further their own agendas and standings amongst their countrymen."

It also says that "low-level animosity and reproach will be directed towards IHMS" by the asylum seekers.

But the worker claims two nurses from IHMS in Port Morseby worked tirelessly to save the man, claiming Mr Kehazaei had fallen ill "very quickly" on Manus Island.

"They tried to do everything they could for him but the word was he was finished," he said.

The worker said Mr Kehazaei's body was swollen, unrecognisable and then completely covered up when medically evacuated by charter plane to Brisbane.

Mr Morrison has since ordered a medical investigation into the death and the care he received while on Manus Island.

"The matter is currently before the coroner and the minister has asked the department's chief medical officer to conduct an in-depth clinical review on the background to the transferee's medical condition and care while at Manus OPC," a spokesman for Mr Morrison said.

theage.com.au/../..unrecognisable-when-medically-evacuated-20140913-10ge11.html

Explainer: What Killed Hamid Kehazaei

The infection that appears to have killed asylum seeker Hamid Kehazaei has a high mortality rate - but can be avoided with basic medical care. Max Chalmers looks at what could have been done to save Hamid Kehazaei's life.

New Matilda
9 Sep 2014
By Max Chalmers

On Friday night, the Brisbane Mater Hospital confirmed that 24-year-old asylum seeker Hamid Kehazaei's life support had been turned off.

It has been widely reported that the young Iranian had developed sepsis - also known as septicaemia - and subsequently suffered a heart attack which left him brain dead.

Mr Kehazaei's death raises a series of difficult questions about the appropriateness of Australia's offshore detention centres, questions that become all the harder to answer when the characteristics of sepsis are brought into the story.

Griffith University Professor Leanne Aitkin is a sepsis expert, and says the condition is best understood as the second stage in a two-part process.

"Somebody doesn't get sepsis as the first problem. They will usually have had some sort of local infection - that might be an infection as a wound or it might be a respiratory infection or a urinary tract infection," Professor Aitkin says.

"It's only when that infection progresses to effecting multiple organs in their body that somebody is considered to have sepsis."

Once sepsis has developed, the patient is at great risk. According to Aitkin, sepsis has a 20 per cent fatality rate in Australia, but the number is far higher in under-developed countries. The Global Sepsis Alliance says one third of the 26 million annual sepsis cases globally result in a fatality.

But relatively harmless infections can be prevented from developing into sepsis if they are quickly and appropriate cleared out and, if need be, surgery is performed.

"So it's really; get rid of the infection, and treat it with the appropriate antibiotics if it's a bacterial infection," says Aitkin.

Given that unattended infections can trigger such devastating consequences, there's already a lot to be concerned about in regards to Mr Kehazaei's internment on Manus Island.

Doctors and those in contact with asylum seekers have long warned of the centre's dangerous conditions, and that it's common for those held to have to walk through open sewerage barefoot or in thongs.

Refugee advocates also say asylum seekers are forced to wait for treatment and that guards, not nurses or doctors, are sometimes involved in triage.

Aside from minimising and managing exposure to infections, Aitkin says that a rapid response is vital in order to head-off sepsis developing. When a systematic infection has developed, studies show patient outcomes are improved by intervention within six hours.

"Time is of the essence when it's a local infection and time is even more of the essence when it's a systemic infection, so when it's become sepsis," Aitkin says.

Writing in The Conversation, Ian Kerridge (an Associate Professor in bioethics) and David Isaacs (Professor of Paediatric Infectious Diseases) have already raised issues around the timeliness of Mr Kehazaei's treatment.

"What happened to Hamid Kehazaei raises concerns about the adequacy of care provided to him during initial treatment, including wound care and antibiotics, and how soon he was transferred to expert medical care, first to Port Moresby and subsequently to Brisbane."

A key measure when assessing the care given to Mr Kehazaei will be who first responded to his requests for help, what their level of medical training was, and how long it took for his complaints to result in treatment.

Conclusive proof that his treatment was delayed, as has been alleged by Greens Senator Sarah Hanson-Young, will be damning.

According to Aitkin, general awareness of sepsis and the risks associated with the condition are poor.

"One of the challenges is that because people start with all sorts of different infections, we often don't realise that people die from sepsis," says Aitkin.

"For example, (Pope John Paul II), according to the media, died of a urinary tract infection, but by the time he died of it, it would no doubt have been sepsis."

Next Saturday marks world sepsis day, organised to help draw the condition to the public's attention.

Back in Australia, two concurrent inquiries into Mr Kehazaei's death may eventually provide us with answers to help piece together how a simple foot injury was able to kill an apparently healthy 24-year-old man.

Immigration Minister Scott Morrison has confirmed that a 'clinical review' will be conducted by the Department of Immigration's chief medical officer and the Queensland coroner will also hold an inquiry.

Given the backlog of claims about the Department of Immigration's tendencies to delay medical evacuations, the Coronial inquiry could be of particular interest, unmoored from the self-interest of the Department's internal review.

That said, if it's anything like previous reviews of Manus, the facts that come to light won't tell us much we don't already know about the implications of holding asylum seekers in offshore detentions centres.

https://newmatilda.com//2014/09/09/explainer-what-killed-hamid-kehazaei

Hamid Kehazaei treated as death in custody

The Age / AAP
with Latika Bourke
September 8, 2014 - 2:57PM

The death of an asylum seeker in a Brisbane hospital last week will be treated as a death in custody.

There will be an inquest into the death of Hamid Kehazaei after the matter was reported to the Queensland coroner on Monday, according to a spokeswoman for the coroner's office.

Mr Kehazaei, who had been detained at the Manus Island detention centre, had his life support turned off at a Brisbane hospital last week.

The Iranian had been airlifted from Papua New Guinea after developing severe septicaemia from an infected cut foot.

Ruth Hudson, from the Sydney Law Firm Stacks, is acting for Mr Kehazaei's family and said the "less formal court hearing" would allow the coroner to call "any evidence in any manner they think is appropriate".

The inquest would run alongside a separate medical review already promised by Immigration Minister Scott Morrison.

The chief medical officer is also conducting a "clinical review" of Mr Kehazaei's case. Mr Morrison said he would "await the outcomes of this report" before making any further comments on the quality of care provided to asylum seekers.

But Ms Hudson said she held "grave concerns" that the medical treatment he received was not "outstanding" as has been claimed by Mr Morrison.

On Monday, Mr Morrison described Mr Kehazaei's death as a very sad incident, noting about 1200 Australians die each year of septicaemia.

He also noted incidents of septicaemia were much higher in tropical areas. "We need to look calmly at this," Mr Morrison told Macquarie Radio.

The Minister said he was "disappointed" so many had "jumped to conclusions" about the quality of care provided to Mr Kehazaei and accused the Greens party of trying to make "political mileage" out of the tragedy.

Mr Morrison said the "well equipped medical teams" stationed on Manus Island can carry out blood tests and praised their "outstanding work".

The Minister said those who called their "credibility and professionalism" into question "without any assessment of the primary facts" was "typical and disappointing".

Ms Hudson said she expected the inquest would examine whether "the initial diagnosis was adequate and whether [Mr Kehazaei] received appropriate and timely treatment and was transferred [to Australia] as quickly as he should have been".

She said Mr Kehazaei's family are not planning to travel to Australia, but want "justice for their son" and answers as to how he could die from a cut to his foot.

She said "remedies" for the family would potentially be examined as part of the legal action.

theage.com.au/../hamid-kehazaei-treated-as-death-in-custody-20140908-10dse7.html

Ill-fated asylum seeker forced to wait for medical transfer

Hamid Kehazaei case: Ill-fated asylum seeker forced to wait more than 24 hours for medical transfer

ABC News Online
Mark Willacy, Mark Solomons and Alex McDonald
First posted Mon 8 Dec 2014, 3:07pm
Updated Mon 8 Dec 2014, 3:22pm

A request to fly a seriously ill asylum seeker off Manus Island was not acted on for more than 24 hours because of delays including the man's lack of a visa to enter the PNG mainland.

Hamid Kehazaei, whose skin infection had turned into potentially fatal septicaemia, was later taken by air ambulance to hospital at Port Moresby and then on to Brisbane where he was pronounced brain dead and his life support switched off.

Documents obtained by the ABC show staff working for government contractor International Health and Medical Services (IHMS) warned that all antibiotic treatment at the Manus camp had been exhausted and Mr Kehazaei's condition was deteriorating.

A "recommendation for medical movement", written on the morning of August 25, recommended "urgent transfer by commercial carrier, with a medical escort and ground transfer from airport to hospital in Port Moresby".

"There is a commercial flight leaving Manus to Port Moresby today at 17:30," Dr Yliana Dennett wrote at 11:30am.

"The medical officer Dr Richard McGrath is already booked on this flight and can act as a medical escort if approved."

Mr Kehazaei, a 24-year-old Iranian, had been diagnosed with severe septicaemia in his leg spreading to the groin, which medical staff warned in their request for a hospital transfer could lead to a "life-threatening systemic infection".

According to the documents Mr Kehazaei had presented to the detention centre clinic two days earlier with an "infected blister in the left shin and intermittent fever".

The condition of Mr Kehazaei, also known by his identification number GDD059, had "worsened considerably" with staff warning that the "infectious process can spread quickly and if not treated appropriately can develop into a life or limb-threatening situation".

But the seriously ill man was not flown off the island until the afternoon of the following day.

"Plans to transfer patient to [Port Moresby] never came to fruition due to delays/visa requirements, so [patient] spent another night here," detention centre medical staff wrote on the morning of August 26.

"Patient remains very unwell despite all of our efforts," staff wrote at 10:11am.

It was not until 4:15pm - more than 24 hours after it was recommended that he be flown to Port Moresby - that Mr Kehazaei made it to the Pacific International Hospital in the PNG capital.

The documents also reveal that once Mr Kehazaei made it to hospital in Port Moresby his condition deteriorated further and he went into cardiac arrest.

He died at the Mater Hospital in Brisbane a few days later.

Delays in remote locations 'inevitable'

Dr Peter Young, a psychiatrist who until the middle of this year had ultimate responsibility for mental health services in immigration detention for IHMS, told the ABC that delays in treating patients in such remote places are inevitable.

"The severity of this person's condition looked like it really needed treatment in Australia right from the outset. He was never going to get adequate treatment in Port Moresby," Dr Young said.

"The processes are that those type of recommendations are made and put through to the relevant decision-makers in the department fairly quickly, certainly in my experience when I was there.

"The difficulty then becomes what happens through the internal processes in the department and the minister's office.

"And often they come back with questions and further questions and then all of that just delays the process.

"The department has been very critical of IHMS at different times in these sort of circumstances, and their feedback has been consistently that IHMS has been too ready to refer people for treatment offsite.

"It's come up in lots of discussions and feedback from the department."

International Health and Medical Services declined to comment to the ABC, referring questions to Immigration Minister Scott Morrison's office.

Mr Morrison also declined to comment, saying the case was a matter for the Queensland Coroner.

abc.net.au/../ill-fated-asylum-seeker-forced-to-wait-for-medical-transfer/5952756

Hamid Kehazaei death: visa delays stalled transfer of gravely ill asylum seeker

The 24-year-old Iranian, who died in a Brisbane hospital after an infected blister turned septic, was forced to wait almost a day for a medical transfer from Manus Island to the PNG mainland

Guardian Australia
Ben Doherty
Tuesday 9 December 2014 11.38 AEST

Gravely ill asylum seeker Hamid Kehazaei was not taken off Manus Island for treatment because of a delay in getting him a visa, medical records of the dead man show.

The 24-year-old Iranian died in a Brisbane hospital after a blister on his leg became infected and turned septic.

In August, when Kehazaei was on life support, Guardian Australia reported there had been delays in getting him off the island after a recommendation by International Health and Medical Services (IHMS) that he be urgently transferred.

Documents obtained by the Australian and the ABC confirm that Kehazaei's transfer was delayed by bureaucratic obstacles, that the antibiotic treatment to help him had run out on Manus and that Kehazaei was "very unwell" and deteriorating.

But delays in getting him a visa to travel to the Papua New Guinean mainland meant his transfer was delayed for 19 hours.

Kehazaei was ultimately transferred on 27 August to Brisbane's Mater hospital, where he died on the evening of 5 September.

The IHMS documents show Kehazaei first presented on 23 August with an infected blister on his left shin and a fever.

On the morning of 25 August, IHMS recommended Kehazaei's "urgent transfer" to Port Moresby for treatment.

A flight was leaving that afternoon with a medical officer on board. But Kehazaei's transfer was delayed.

"Plans to transfer patient yesterday to POM never came to fruition due to delays/visa requirements, so pt [patient] spent another night here," detention centre staff wrote at 10am on the morning of 26 August.

"Patient's breathing is now much more laboured case is now considered an emergency requiring medical evacuation."

Six hours later, at 4pm on 26 August, Kehazaei was taken to Port Moresby, still conscious, but confused and with dangerously low blood pressure.

He was sent on to Brisbane the next day.

Kehazaei's mother, Goldone, told Guardian Australia her son was "gentle and loving", a "very sensitive, harmless lovable person". She said she never got a chance to speak to her son after he fell ill.

Dr Peter Young, the former director of mental health services at IHMS, said Kehazaei's death highlighted the inherent flaws in the offshore detention system, and inadequacies in accessing advanced medical care in detention.

"It illustrates the deficiencies in being able to provide adequate medical care for people in offshore centres, how difficult it is to do that, the delays and obstructions that exist due to remoteness, and the lack of access to tertiary health care that is available to absolutely anybody in Australia."

He told Guardian Australia the delay in getting Kehazaei treatment did not result from an isolated breakdown in care, but a systemic failure.

"This is how the system normally operates, these delays are inevitable, they cannot be avoided if people are held in these conditions."

Young said the government was reluctant to transfer ill asylum seekers to Australia because it might allow them access to legal representation.

Immigration minister Scott Morrison said Hamid Kehazaei received "outstanding" care while in Australia's immigration detention system.

His department told the United Nations Committee Against Torture last month healthcare for detainees on Manus was "comparable to that in Australia".

Following Kehazaei's death, Morrison's spokeswoman said the government would review his care.

"The department's chief medical officer is reviewing the background to the transferee's condition and medical care while at Manus OPC."

The minister's office has not responded to questions about whether the review was completed, or who conducted it.

Kehazaei's death is currently before the Queensland coroner.

theguardian.com/../hamid-kehazaei-death-visa-delays-stalled-transfer-asylum-seeker

Medical reports spark fresh concerns over asylum seeker treatment delay

The Age / AAP
December 9, 2014 - 11:40AM

The opposition is demanding Immigration Minister Scott Morrison release the full medical report for an asylum seeker who died after a cut on his foot became infected.

There was almost a day's delay between a request for urgent medical evacuation of Iranian asylum seeker Hamid Kehazaei from Manus Island and when he was actually moved to Port Moresby, medical reports obtained by News Corp and the ABC show.

A medical report from the Manus Island detention centre on the morning of August 25 says all antibiotic treatments available to Mr Kehazaei on the island had been exhausted and he should be transferred in the care of a medical officer on a commercial flight at 5.30 that evening.

A subsequent report said he didn't arrive in Port Moresby until 4.15pm the next day, when he came via air ambulance.

The 24-year-old was then transferred to hospital in Brisbane, where he later died.

Labor's immigration spokesman, Richard Marles, wants the government to release its Chief Medical Officer's report into the incident.

"We need to know how someone with a cut to their foot ends up losing their life," he said in a statement.

The minister had given a draft final report into the incident to the Queensland Coroner and Mr Marles believed it should be made public.

The Australian Greens said the leaked medical documents showed Mr Kehazaei "died of wilful neglect at the hands of the immigration minister" and called for Mr Morrison to be sacked.

theage.com.au/../..-concerns-over-asylum-seeker-treatment-delay-20141209-123680.html

Manus death raises serious questions over care: AMA

Sonia Kohlbacher
The Australian
December 10, 2014 12:00AM

The Australian Medical Association has expressed serious concerns about the nature and timeliness of medical treatment given to dying Manus Island ­asylum-seeker Hamid Kehazaei.

AMA vice-president Stephen Parnis said Kehazaei's treatment, detailed in The Australian yesterday, raises questions about the treatment of asylum-seekers in Australia's detention network.

Kehazaei, 24, died in Brisbane's Mater Private Hospital on September 5 when his Iranian family chose to turn off his life support after treating doctors confirmed he was brain dead on September 2.

Medical records show it took 19 hours for the detainee to be evacuated to Port Moresby after medical staff at the detention centre recommended to the federal government his immediate transfer.

Kehazaei had been admitted to the island detention centre's medical facility on August 23 "for high fever and generalised unwellness" and an abscess on his left leg which developed in severe cellulitis. Kehazaei was transferred to Brisbane on August 27, after having a heart attack in Port Moresby the day before.

Dr Parnis said the AMA had serious questions about Keha­zaei's "access to timely and appropriate care".

"All of these individuals are the responsibility of the Australian government and the provision of healthcare is something we cannot compromise on," he said.

"The AMA does have concerns about this specific case. It raises a number of serious questions relating to the care that was provided not only to this gentleman, but may be provided to other (offshore) asylum-seekers."

Dr Parnis called on the Department of Immigration and Border Protection to show greater transparency around health provisions in detention centres.

Doctors for Refugees co-founder Richard Kidd said: "There was a delay in staff appreciating the seriousness of this infection and that's poor.

"It raises the question of whether they've had appropriate training for managing medical emergencies and serious infections on an isolated Papua New Guinean island."

Authorities ought to have anticipated such an emergency and ought to have had a process for swift evacuations that did not involve a hold-up over a patient visa.

"The PNG Guidelines are clear that Hamid should have been having Gentamicin and Chloramphenicol either immediately or certainly within 24 hours of oral antibiotics not making significant improvement," he said.

"Yet these notes suggest these antibiotics were not available in the detention centre clinic.

"If (government health services contractor) IHMS has not provided supplies of Gentamicin and Chloramphenicol in that environment, I would say that's serious negligence."

Immigration Minister Scott Morrison said it was "entirely inappropriate for people to be speculating" on outcomes of a coronial inquest into the death.

theaustralian.com.au/../serious-questions-over-care-ama/story-fn9hm1gu-1227150412230

MEDIA RELEASE: Cover-up & Neglect: Visa delay killed Hamid Kahazaie

Monday December 8, 2014
Refugee Action Coalition
Ian Rintoul
mobile 0417 275 713

The shocking revelations from leaked IHMS reports on the treatment of Hamid Kahazaie show the scale of medical negligence and departmental culpability in his death in the Mater Hospital in Brisbane in September.

IHMS documents show that when Hamid presented to IHMS on the 23 August, he had already been suffering intermittent fevers for two days. It took a further 36 hours of deteriorating conditions before a recommendation was made on 25 August, for his medical evacuation to Port Moresby hospital.

At 11.00am, 25 August, Hamid was reported to be "moaning in pain."

But, it took another day before he was flown to Port Moresby on 26 August, and yet another day before he was finally flown to Australia on 27 August. By then, he had been running a temperature of, at times, over 40 degrees for at least four days.

"If Hamid had received the correct antibiotics when he first sought treatment; if he had been flown to Australia, at the first sign that the treatment was not working, he would likely be alive today. Even as his condition became critical, the Australian government delayed issuing a visa thereby preventing his transfer to Australia," said Ian Rintoul, spokesperson for the Refugee Action Coalition.

"Since Hamid's death, Scott Morrison has deliberately and consistently misled the Australian public about Hamid's medical treatment. He explicitly denied that Hamid had been mistreated, while the IHMS reports clearly show that he was -- by IHMS and by the Australian government," said Rintoul.

"Morrison claimed that Hamid had received 'outstanding' treatment. But, just like Morrison's claim that Reza Berati was killed outside the Manus detention centre, the claim that Hamid received 'outstanding' treatment is a lie.

Scott Morrison said in a press release, 5 September, "I can advise that the department's Chief Medical Officer is conducting an in-depth clinical review on the background to the transferee's medical condition and care while at Manus OPC. This will be in addition to any medical review that will also be undertaken by the medical services provider, International Health and Medical Services."

"That too seems to have been a lie," claimed Rintoul, "The inquiries have either never taken place or the Minister is covering them up. "Morrison has been deliberately deceived the Australian public. He has covered up both the medical negligence by IHMS and the role of his own department delaying Hamid's transfer to Australia.

"The responsibility for Hamid's death ultimately lies with Scott Morrison. He should resign or be sacked.

"There must be an immediate open inquiry into the Hamid's treatment and the role of the Immigration department in that treatment.

"Without an inquiry, the asylum seekers on Manus remain at risk. Infections are rife on Manus. One asylum seeker on Manus Island (photos attached) has been suffering an ear infection for four months, and is now deaf in his left ear. Doctors have warned the infection could spread.

"Waiting months for the coroner's inquiry is a recipe for more Hamids on Manus."

For more information contact Ian Rintoul - mobile 0417 275 713

"Cheap And Available" Drugs Could Have Saved Hamid Kehazaei, Doctor Claims

Doctors for Refugees co-founder says leaked reports indicate key drugs were not on hand to treat a sick asylum seeker who later died after a delayed medical evacuation. Max Chalmers reports.

New Matilda
10 Dec 2014
By Max Chalmers

Advocates and asylum seekers are warning conditions remain bleak in the Manus Island detention centre after documents leaked to the press suggested inadequate medical supplies and a significantly delayed evacuation led to the death of asylum seeker Hamid Kehazaei in September.

Medical reports, which appear to have been leaked to both the ABC and the Australian earlier in the week, revealed the August evacuation of Kehazaei was delayed by more than 24 hours, apparently because of a visa issue.

Dr Richard Kidd, a co-founder of Doctors for Refugees who has seen the leaked documents, told New Matilda they also suggest an inadequate supply of basic antibiotics contributed to Kehazaei's death.

"I am concerned - having looked a bit more at what happened to Hamid and those notes - about systemic and governance issues that need to be addressed," Dr Kidd said.

He said the records show a range of antibiotics used to treat Kehazaei but reveal no reference to either gentamicin or chloramphenicol, which he described as "cheap and available" and said were standard drugs for dealing with infections in Papua New Guinea's tropical climate.

Kidd said the doctor who wrote the leaked medical report could have lied about the treatment provided to Kehazaei but that the more likely scenario was the Manus facilities had simply not been stocked with the antibiotics.

"I think it's very likely [that with access to gentamicin or chloramphenicol] Hamid would have recovered very well," Kidd said.

Health services in the detention centre are contracted out to private medical provider International Health and Medical Services (IHMS).

Contacted for comment, a receptionist told New Matilda that IHMS's regional medical director Dr Mark Parrish was on leave. Calls to the company's media spokesperson have not yet been returned.

As the circumstances surrounding Kehazaei's death become clearer, the approximately 1,000 asylum seekers still detained on Manus Island continue to raise objections about the conditions of the camp, reiterating reports that overflowing ablution blocs force those interned to walk barefoot through sewerage.

Victoria Martin, a refugee advocate, has continued to receive regular messages of distress from the men on the Island since Kehazaei's death.

"It's awful. Everywhere is dirty. Shower curtains are very filthy. More than 20 per cent of us got skin diseases," one asylum seeker recently wrote to her.

"It's terrible. If you have any pain the only thing doctor says is to drink water. We call it Holy Water because it apparently heal you. If you write IHMS request it will take at least 6 days to get appointment."

Another asylums seeker wrote: "They always prescribe pain killers instead proper curing, and if we get injured or wounded they offer us drink more water."

Martin said the conditions in Manus had not improved since Kehazaei's death.

"I can't see that the conditions on Manus have changed at all, certainly not for the better," she said.

"I think that the focus has moved off Manus over the last few months, there's less scrutiny, there's less oversight and it's been some time since the centre has been inspected by any outside agency, it appears that guards and staff now feel they have carte blanche any way they like."

"We have growing complaints that anyone who's not passively complying to even the most absurd request from guards is taken out the notorious Chauka compound.

"The toilets haven't been fixed, they still overflow regularly, there's still a lack of basic supplies like shoes, and increasingly the medical care is either not provided at all.

In late September Commonwealth Ombudsman staff visited Manus.

"The purpose of the first visit to Manus Island was for the Ombudsman team to familiarise themselves with the operating environment," a spokesperson told New Matilda.

"Our Immigration Detention Review - Inspection team makes regular visits to onshore facilities. It is our intention to visit the offshore processing centres at least once a year."

Fairfax reported in October that 87 men held in the centre were still waiting for specialist medical care.

Dr Kidd said the delay in Kehazaei's arrival indicated significant shortfalls in emergency planning on behalf of both IHMS and the Immigration Department.

As New Matilda reported in September, time is a vital factor in treating sepsis, the disease which appears to have killed Kehazaei after a localised infection spread to his organs.

"At the end of the day, these people are our concern, even though they've been stuck on a little island in the Pacific," Dr Kidd said.

Update: an IHMS spokesperson told New Matilda the company would not be providing comments in regards to the Kehazaei case.

newmatilda.com/../cheap-and-available-drugs-could-have-saved-hamid-kehazaei-doctor-claims

Nick Riemer: The Price Of Australia's War On Asylum

Refugees aren't the only group being damaged by Australia's 'war on asylum'. Our community is being degraded as well, writes Nick Riemer.

New Matilda
9 Sep 2014
By Nick Riemer

So often, since the Tampa, we've asked, what next? What will the next asylum outrage be that the Australian government finds it necessary to justify?

Last week, Hamid Kehazaei's death from septicaemia after a foot infection became the latest answer. Another sacrifice to the idols of "border protection" and "preventing deaths at sea".

With the same contempt for truth with which he intones those two deadly phrases, Morrison has described as "outstanding" the medical arrangements on Manus that led to Hamid's death.

The public can judge for itself the plausibility of Morrison's description, noting that his record for accuracy is already deeply compromised: following Reza Berati's murder in February, Morrison claimed, falsely, that asylum seekers were not attacked within the confines of the barbed wire compound.

Hamid fled Iran only to become a casualty of a savage and gratuitous war - Australia's war on asylum. The decisions that led directly to his death - the appalling conditions on Manus, a reported delay in treatment, the very fact that any refugee is sent offshore at all - are the most recent of the raids in this war: raids on common decency, reason, hope, and the bodies and souls of refugees themselves.

In the recent past, we've learned of an epidemic of suicide attempts on Christmas Island; 157 people being made the objects of state piracy on the high seas; a 16 year-old severely slashing his arms when told he was being sent back to Nauru; and a Hazara asylum seeker forcibly deported to the sectarian hell of Afghanistan, where we can only imagine the fate awaiting him.

Governments have made sure we never witness the horrors of its war on asylum directly, but we hear of them so often they've become normal.

One victim of the war, though, goes easily unnoticed: Australian society. This country is the walking wounded of the government's campaigns against refugees. The poison of Australia's asylum policy is slowly seeping through the veins and arteries of this society, just as it made its way through Hamid's.

Australians aren't, of course, subject to the same kinds of war-crimes as asylum seekers. We're not risking death on the murderous and disease-ridden nightmares of Nauru or Manus, where untreated sewage covers the ground. We're not stitching our own lips together. We're not being tortured by the corrosive despair of bridging visas, or driven to hunger-strike or to set ourselves on fire by the futility and hopelessness of our situation.

We're spared all this, but still, our society is collateral damage of the war on asylum.

We bear the scars in the racist attacks that are on the rise - no wonder, when all we hear from federal politicians is that we have to stop dark-skinned refugees from getting here, whatever the price.

And we bear them in the budget attacks on ordinary people that the government has been emboldened to make.

In brutalizing refugees, governments have established the principle that no matter how weak and in need of help someone is, the state owes them precisely nothing.

And, at the same time as it tries to remove one social protection after another, it will use taxpayers' money, that should be being spent on schools and hospitals, to write cheques to the companies who run the sickening detention camps like the one where Hamid spent this last year.

All the while, it will try to distract us from these acts with decoy catchwords like "border protection", "terrorism" and "economic migrants".

Can people do anything about this? In a war, we have to fight. It's not enough to just express outrage. There's only one real option for people who care about what their government is doing to refugees: help build a social movement that can force refugee rights to the centre of the national agenda, and not back down until those rights are honoured.

What that means is not just acting oneself; it means continually encouraging new people to act as well, so that the voices calling for justice for refugees grow so loud and insistent that they're impossible to ignore.

If that doesn't happen, one thing IS clear: slowly but surely, complacency will poison this society, just as Hamid's blood was poisoned.

Without a real movement for refugees, we will allow our society to become more violent, unfair and unliveable, just as it already is for the refugee women on Nauru who asked to terminate their pregnancies because they'd rather lose an unborn child than condemn it to the life of affliction and loss that they themselves are living.

Since Reza Berati's death, the cracks in the government's facade have been getting wider. Senior figures of the detention regime like Peter Young are defecting.

Religious leaders are getting arrested for sit-ins in politicians' offices. Doctors, union members, grandmothers, Christians, and ordinary people in places like Sutherland, Bennelong, Balmain, or the Blue Mountains are all starting to lead the fight against Abbott, Morrison and all the corrupted apparatchiks of expediency and Real Politik in Federal Parliament, whichever major party they're in.

With these developments, perhaps, the heavy and lumbering wheels of change are starting to inch forward. Whether they speed up or slow down depends on what sort of movement Australian civil society can build.

How many more Hamids will needlessly be allowed to die is, quite simply, up to the Australian public. The scandal of history is that it's ordinary people who make change happen when they decide that things cannot continue as they are.

If we don't make that decision now, it's certain that Hamid won't be the last casualty of the wanton futility of this war.

Nick Riemer is a member of the Refugee Action Coalition, and [he teaches] in the English and Linguistics departments at the University of Sydney.

https://newmatilda.com//2014/09/09/price-australias-war-asylum