The healthcare provider for Australia’s offshore processing regime, International Health and Medical Services has been contracted by the Papua New Guinean government to stay beyond the closure of the Manus Island detention centre at the end of the month.
Under the recently signed contract IHMS will continue providing healthcare to refugees – who are expected to settle in the PNG community – and non-refugees in Lorengau and in Port Moresby, but it is not known how long for.
PNG’s general healthcare system is in crisis, with reported shortages of medication across multiple regions, including Manus province.
“Medical care will continue to cover mental health services and will transition clients on to a PNG formulary, where it is considered clinically safe to do so,” an IHMS spokeswoman told Guardian Australia.
“Of course, with closure of the Manus RPC [regional processing centre], services can no longer be provided at that location.”
The spokeswoman said as a result detainees were being assisted to “self-manage” their medications during the transition to having to access services in the community or in Port Moresby.
“We would note that self-management of medications is the norm in most doctor-patient relationships around the world.”
But some medical professionals were concerned at the decision, noting the high prevalence of mental health issues among the cohort.
“This is potentially a very risky strategy in that some of the medication these people are on relate to mental health problems,” said Prof Louise Newman, a spokeswoman for the Asylum Seekers Advocacy Group.
“There is heightened tension there at the moment, reports of people whose mental health is deteriorating, we have a couple of deaths thought to be suicides.
It’s a very volatile environment so from a mental health perspective this is a very risky strategy.”
Guardian Australia understands risk assessments were conducted before patients were given a month’s worth of medication, but IHMS would not detail how many – or if any – patients were deemed too much of a risk to include.
Questions as to whether it was an interim measure or if larger prescriptions would continue to be handed out once the new system was in place were also not answered.
Dr Peter Young, the former head of mental health at IHMS, said without knowing what support the organisation was giving to patients once the centre closed, it was impossible to know if the decision was reasonable.
“Of that cohort of people being released in the community, you’d expect there to be a number with mental health problems requiring a high level of support and follow-up attention,” Young said.
“Without knowing what is constituting the service IHMS says they’ll be providing, I’d certainly think handing out a month of medications without supervision could be negligent and dangerous. They should be open about this and to show exactly what support will be provided.”
About 900 men remain in Papua New Guinea after being sent there for detention and processing by Australian immigration authorities.
Authorities have been steadily closing sections of the centre around detainees, shutting basic services and threatening arrest as part of efforts to encourage people to move into the nearby town of East Lorengau – if they are refugees – or to return to their country of origin if they are not.
On Wednesday the United Nations warned of a looming humanitarian emergency as a result of the closure and urged the Australian government to step in.
A letter distributed to detainees on Thursday warned that all food, water, sewage facilities and electricity would cease inside the centre after 31 October. The note, written in Farsi, also said the fences would be taken down and the site returned to the control of the PNG defence force.
The Kurdish Iranian journalist Behrouz Boochani said the note had sparked fear among his fellow asylum seekers and refugees.
“The refugees have already had a bad experience with PNG navy soldiers, on Good Friday this year, when they attacked the detention centre and fired guns into the centre,” he said.
“It is unacceptable to put refugees in this situation – either move to Lorengau where they risk attack by angry local people, or be taken over by PNG defence forces who have already seriously threatened their safety.”
The director of legal advocacy at the Human Rights Law Centre warned the situation “could be about to turn into a bloodbath”.
“PNG military personnel have attacked these men once before,” Daniel Webb said. “Now our government is tearing down the fences and putting them in charge.”