The government of Nauru has moved to scrap a vital mental health service for refugees detained on behalf of the Australian government, adding pressure to an already dire situation.
Medecins Sans Frontieres (Doctors Without Borders) has been operating on the island since late 2017 to treat the mental health needs of both Nauruans and refugees.
"On 5 October, after 11 months of providing mental health care on Nauru, the Nauruan government informed MSF that our services were "no longer required" and requested that our activities cease within 24 hours," the international humanitarian organisation said in a statement on Saturday.
"At this stage MSF wishes to reiterate our strong commitment to providing quality mental health care to all those in need on the island.
"We are extremely concerned that the health of our patients may be affected by this decision and urge the authorities to grant us permission to continue our lifesaving work."
MSF has been giving free psychological and psychiatric support through its own clinic at the Republic of Nauru Hospital and to people in their homes.
Its abrupt dismissal follows a report by two prominent Australian refugee organisations saying most refugee children on Nauru are experiencing life-threatening mental health problems, including not eating or drinking and suicidal symptoms.
Australian advocacy group Refugee Action Coalition said MSF's absence would "add enormously to the distress among asylum seekers and refugees" because the Australian government's contracted mental health care provider, International Health and Medical Services, was "stretched to breaking point".
The Department of Home Affairs said on Saturday evening MSF's dismissal was a matter for the Nauruan government.
"The Australian government has and continues to provide appropriate healthcare and mental health support to refugees and asylum seekers through contracted service providers," the department said.
"Health professionals regularly engage with refugees and asylum seekers in regards to their mental health and individuals have access to counselling services as needed."
Refugee Action Coalition spokesman Ian Rintoul said the Nauruan government's move followed Federal Court decisions ordering the Australian government to bring sick refugees to Australia for medical assistance not available on Nauru.
He said the island nation wanted to stop the transfer of refugees because its elite wanted to continue receiving cash from the Australian government per refugee.
MSF uses more than 30,000 doctors, nurses and other mostly volunteer personnel to provide medical aid in over 70 countries.
Australian Associated Press