The Department of Immigration and Citizenship (DIAC) has released some information pertaining to a freedom of information request filed in March 2013. The scope of the original request was as follows:
1. All research undertaken by or at the instigation of DIAC relating to the presence of malaria at Manus Island RPC, and risks involved with being at the centre;
2. Details of malaria prevention strategies in place at the Manus Island RPC for staff and detainees;
3. Details of any steps taken to mitigate [the risk of malaria to staff and transferees];
4. Details of anti-malarial medication used at Manus Island;
5. A copy of information provided to asylum seekers regarding the risk of malaria, to discharge Australia's responsibility to attain informed consent for any medical treatment;
6. Details of specialist medical treatment available at Manus RPC;
7. Details of anti-malarial treatment offered to pregnant women and small children;
8. Information relating to the reason asylum seekers were transferred from Manus Island to Inverbrackie IDC in March 2013; and
9. Information as to whether Manus RPC offers preventative treatment for malaria for local residents, in accordance with AusAid goals.
1. Very little information was provided regarding research as to the presence of malaria at Manus Island, other than to confirm that the Australian Government was directly aware of significant risks of malaria by at least November 2012. The released information also acknowledged information available through WHO reports, the latest being the WHO World Malaria Report 2011 (available here).
2. The only details of malaria prevention strategies that were not redacted were:
a. Anti-malarial medication is provided to all transferees at Manus RPC;
b. Treated mosquito nets are provided;
c. Chemical sprays are used at the camp at least once every two days; and d. Information to be provided regarding transmission of malaria and personal prevention strategies such as high coverage
clothing and repellent.
3. These were the same steps to mitigate the risk of malaria to transferees. A separate document (towards the end) shows that staff must be pre-screened for health risks, and must show they are willing to assume the risk of malaria by travelling to Manus Island to work. No such consent is required of transferees.
4. Some details were obtained regarding medication used at Manus Island. The primary medication used is Malarone, which is the most effective preventative treatment for the P. Falciparum strain of malaria (80% of cases at Manus Island). This treatment is contraindicated for pregnant women and small children.
A 2012 Report included in the FOI release notes the problems of chemoprophylaxis for pregnant women and small children, and also notes that 5-10% of people undergoing preventative treatment will suffer psychological side effects. This number could be higher among vulnerable populations with higher baseline rates and severity of mental health problems, such as asylum seekers (see HRP's report on the Immigration Ombudsman's long-term detainees and mental health for more information).
6. Details of specialist medical treatment available were scarce; the information that was not redacted includes:
a. No specialist treatment or advanced diagnostic equipment is available at Manus RPC;
b. The only equipment available is in the form of basic rapid test kits;
c. The local Manus Island hospital (at Lorengau, the regional capital) routinely provides advanced malaria care.
7 and 8. Anti-malarial treatment is contraindicated for pregnant women and children under 5 years old. Despite having knowledge of this in at least November 2012, Australia continued to send pregnant women and small children to Manus Island until March 2013, at which time it flew families with pregnant women and/or young children to South Australia where they were detained at Inverbrackie IDC.
At one point, the Department goes so far as to express ire at the IHMS report for coming to strong conclusions such as recommending against the transfer of pregnant women and children, saying:
"These recommendations do not acknowledge that it is safe with appropriate prophylactic and preventative measures to reside in these environments, in fact many clients will have already voluntarily come through such regions"
This sentence is incorrect and reprehensible. Not only does it completely ignore all medical research and analysis (that it is unsafe for pregnant women and small children to use any prophylactic treatments to protect against P. Falciparum malaria), but it also misrepresents the asylum process by claiming that refugees choose to travel through unsafe environments to reach safety.
The released document is available in full (with names and email addresses redacted) below. Please email us for further information.