Nauru overrules Australia over decision to transfer sick pregnant refugee
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Version 0 of 1. The Nauruan government has said a heavily pregnant refugee – facing a potentially life-threatening, complex delivery on Nauru – does not need to be flown to Australia to give birth, defying the Australian immigration department which reluctantly decided she should be moved. The 37-year-old Kuwaiti is more than 36 weeks’ pregnant and, according to doctors who have examined her case notes, appearing to be suffering from pre-eclampsia. Her baby is in breech position and she has a large fibroid or benign tumour on the wall of her uterus. She has previously had a miscarriage on Nauru. Doctors for Refugees says five obstetricians in Australia, including the president of the Australian Medical Association, Dr Michael Gannon, have reviewed the woman’s case notes and said she faces a complex and difficult delivery, and that she should be urgently transferred to a hospital with appropriate neonatal facilities. Nauru – a country of 10,000 people – has limited medical facilities and only one small hospital. Nauruan women facing complex delivery are regularly flown to Australia, Fiji or Singapore to give birth. The Australian government, which controls the offshore detention centre on the island, initially resisted calls to transport the woman to Australia, saying it provided “comprehensive medical support services” to the country. However, after significant lobbying from doctors in Australia, the Department of Immigration’s chief medical officer, John Brayley, agreed the woman should be flown to a Queensland hospital for treatment. But the Nauruan health department issued a statement Thursday saying those calling for the woman’s transfer were “not on Nauru and not aware of the facts”. “All pregnancies on Nauru are treated with due diligence and care by both Nauruan medical staff and partner health service providers,” the department said. “Presented complex cases are carefully treated and medical evacuations are activated with priority if required. Such decisions remain that of health professionals based on patient medical evaluations. “Both mother and baby continue to be monitored by skilled and professional medical staff, who have extensive experience in the delivery of babies and pre- and postnatal care. Our medical teams and specialists are available and prepared with patient care as our first priority. We will always recommend treatment in accordance with the best interest of the patient and will not hesitate to recommend a medical evacuation if the situation requires.” Since 2015, it has been Australian government policy that asylum seekers and refugees deliver babies on Nauru because of their “propensity” to exercise their legal rights in Australia’s courts and seek an injunction against their removal from Australia. The policy has led to extraordinary circumstances on the island for pregnant refugee women. In 2015, a government health contractor advertised on LinkedIn for a neonatologist to fly the very next day to Nauru to oversee a complex birth. The ad even invited doctors to nominate their salary for a week’s work. Doctors told the government the mother should be flown, with the baby in utero, to a tertiary hospital. Last year, a Somali refugee and her newborn infant were medically evacuated from Nauru in a critical condition and placed on life support in a Brisbane hospital after she gave birth by caesarean on the island one-month prematurely. In Australia, when the government sought to return the infant known as Baby Asha to Nauru, protesters surrounded the Lady Cilento hospital to stop her being removed. Doctors refused to discharge the baby from hospital, stating the Nauru detention centre was not a safe environment for her. Baby Asha was ultimately discharged to live in the community in Australia. The government’s policy around babies born to refugee women has led to an unusual legal sophistry. Babies born in Australia to women moved from offshore detention are regarded by the department as “illegal maritime arrivals” to the country, despite having never been on a boat nor having left Australia. |