While much focus this week has been on whether President Trump will honour the covert deal made by prime minister Malcolm Turnbull and the Obama administration to accept some of the refugees held in Australia’s offshore detention camps, a medical crisis has been rapidly worsening on Nauru for a young woman suffering from life-threatening health complications.
More than 36 weeks pregnant with symptoms of pre-eclampsia and a history of miscarriage, her baby is currently breech. Based on medical opinion, these symptoms present a challenging and risky birth for a well-equipped Australian hospital staffed with highly qualified medical experts. Doctors raised the alarm weeks ago. And yet for the past month this woman has been languishing on Nauru, all because the Australian government has backed itself into a dangerously dogmatic corner, where political point scoring is more important than the life of a vulnerable woman and her unborn child.
After more than a month of lobbying by doctors, lawyers and advocates, Nauru officials said on Thursday that the woman would be flown to Australia to give birth.
Although one of the worst cases to have surfaced in the media for some time, sadly this woman’s situation is representative of a broader risk women face on Nauru, particularly in relation to access to high level medical care.
Over recent years I’ve spoken with numerous women who have experienced complicated pregnancies while held in detention on Nauru. Prior to 2015, it was government practice to fly women identified as high-risk to Australia for medical treatment, before attempting to return them to Nauru while the baby was still very young. There was general acknowledgement by the Australian government that the medical facilities and personnel on the island were not adequately equipped to deal with complex pregnancies.
Women who’d undergone preliminary checkups at the Royal Nauru hospital spoke of their fear at having to give birth there. One young mother shook as she recounted the blood-stained examination couch she was asked to lie down on after suffering a bad fall in the shower. She’d been told repeatedly by guards that she would not be taken off the island to deliver, despite medical staff raising the alarm.
Another former client, eight months pregnant, was assessed by an Australian doctor as high risk shortly after her arrival on Christmas Island. He alerted the Department of Immigration and advised that she’d need immediate transfer to a high-level care hospital on the Australian mainland. When he returned to review her the next day, he was advised she’d instead been flown to Nauru to “set an example”.
There was little reprieve for women fortunate enough to be transferred to the Australian mainland for medical treatment. Women admitted to hospital were constantly monitored by guards (often male). One young first-time mother delivered her baby with a guard standing on either side of her hospital bed. Shortly after delivery, her husband was escorted back to immigration detention by one of the guards, while the other remained standing at the door of her delivery suite, watching while she attempted to breastfeed her daughter for the first time.
Return to Nauru occurs quickly and often contrary to medical advice. In one instance, a mother I acted for was told she was to be returned before her newborn baby had been discharged from the intensive care unit. After giving birth to her son, she’d been swiftly returned to immigration detention and only permitted to visit her baby during set times dictated by the Department of Immigration. These women are some of the lucky ones compared with the situation currently unfolding on Nauru. They were able to give birth in Australian hospitals.
Since 2015, the government’s policy has been to leave pregnant women, including those identified as extremely high risk, on Nauru. Not because there has been an adequate improvement in the facilities and specialist care available on the island for women diagnosed with high-risk pregnancies, but because the government is instead concerned that if returned to Australia, they may be able to access legal assistance.
Despite a much-needed upgrade to the Nauruan hospital facilities – and misguided attempts by the Nauruan government to overrule any decision to transfer dangerously ill women to Australia – medical consensus remains that the island is unable to accommodate complicated deliveries. Local Nauran women, for example, are still routinely flown to Australia in complex cases.
Less than a year ago, a young Somali women also suffering from pre-eclampsia was left to give birth on Nauru, only to be medically evacuated to Australia with her newborn where their lives hung in the balance. Her condition, and that of her child, should never have been allowed to deteriorate to that point.
News that this latest woman to be placed at risk will finally be air-lifted to Brisbane is welcome. But it simply shouldn’t have been delayed so long. In maintaining their dogmatic political line, the Australian government is playing Russian roulette with the lives of vulnerable women and children. In this horrifying game of chicken, the Australian government seems intent on seeing how long it can leave critically ill women before something tragic inevitably occurs.
Katie Robertson is a lawyer in the Social Justice Practice at Maurice Blackburn.