Australia ignored three requests from Nauru medical staff to move Abyan

The immigration department failed to act on three requests from senior medical staff on Nauru to move the pregnant refugee Abyan to Australia when she sought a termination.

The 23-year-old Somali woman’s pregnancy resulted from an alleged rape on the island. The requests appear to contradict comments made by the immigration minister, Peter Dutton, about the highly politicised case. On 19 October Dutton told federal parliament Abyan had not been transferred due to “an initial delay … because of other, unrelated health issues which meant she could not fly, and also a delay around getting an appointment”.

Guardian Australia can reveal that International Health and Medical Services (IHMS) staff made the first request for her urgent transfer on 16 September in a “request for medical movement” form, with follow-ups on 29 September and 6 October.

Transfers from Nauru to Australia require the approval of the immigration department, but it failed to act on the three requests. Guardian Australia understands that Abyan (not her real name) became increasingly unwell and was found unconscious on 8 October. She was then admitted to hospital in Nauru and was found not fit to fly until 11 October.

The Somali woman’s story first emerged in a report by the ABC’s 7.30 program on 28 September. Her case has been the subject of intense media scrutiny and public debate over the past three weeks.

Abyan was brought to Australia on 11 October, but suddenly flown back to Nauru on 16 October without having had the termination. She disputed the government’s claim that she had decided against it.

Dutton announced on Wednesday she would be brought back for a second time to Australia to consider a termination.

The minister has repeatedly suggested in parliament and to the media that the immigration department acted on medical advice in assessing Abyan’s case.

The 16 September request from IHMS states: “[The woman] alleges she was sexually assaulted and is requesting a termination of pregnancy.

“Termination of pregnancy is not legal in Nauru. Termination of pregnancy is not legal in Papua New Guinea unless two doctors agree a woman life is at risk.

“Should [the woman] not be transferred, there are risks of deteriorating mental health and psychological distress relating to an unwanted pregnancy under these circumstances. There are medical risks related to a termination of pregnancy in later stages.

“IHMS assistance therefore recommends transfer to Australia within two weeks to undergo the required procedure.”

The update on 6 October said: “With increasing delay in performing the termination of pregnancy, the more complex the procedure becomes, from a medical point of view. Therefore the transfer for this procedure to be completed should be expedited to avoid increasing risk factors and the likelihood of complications.”

A fitness to travel assessment can only be completed once the department approves a request for medical transfer or provides a flight list. A separate policy document seen by Guardian Australia states: “The FTT process can commence when IHMS receives interim transfer lists and the results are often provided to the department before it issues the latest transfer list.”

In a press conference on 9 October, Dutton said: “There’s not been a case where the doctors have said to me that this person needs to come to Australia for medical assistance and we haven’t provided that support.”

He later said the government had provided “a significant amount of support to this lady who is in a very difficult circumstance”.

The immigration department said that it “followed established processes in the transfer of Abyan. This involved reviewing the original request to transfer Abyan to Australia, seeking advice from the government of Nauru on the transfer, and then approving the request”.

It said the allegation that the department failed to act on the requests “was wrong”.

Ian Rintoul from the Refugee Action Coalition said the revelations in The Guardian –that the minister had ignored IHMS recommendations to transfer Abyan – were damning of the government’s handling of her case, and confirmed advocate’s version of events.

“It is now quite clear who peddled the lies and fabrications about Abyan’s treatment and who misled the parliament and the public. It was not Abyan, it was not refugee advocates, it was the minister. His credibility is zero.”

He said the government’s flying of Abyan to Australia, and then her rapid, secret return to Nauru without having had the operation, had caused significant pain and anguish, and had further harmed her health.

Rintoul said other women still on Nauru had been victims of sexual assault and that the government had “allowed refugees to be left vulnerable to abuse in the Nauruan community”.

Labor’s immigration spokesman, Richard Marles, said it was difficult to comment on specific circumstances, but that the health considerations of asylum seekers should be paramount, and “if people require treatment that can only be provided in Australia, then that should be provided”.

“People need to have as much time as they feel they need to recieve that treatment.”

Greens senator Sarah Hanson-Young said the minister for immigration had questions to answer.

“The government has to explain why there was such a significant delay in getting Abyan off of the island, despite the urgent medical advice that was being given to the immigration department,” Hanson-Young said.

The minister had failed in his duty of care, she said.

“This poor young woman has been through so much. It is now coming to light that despite requests from medical professionals on Nauru that she be transferred, the government ignored them. That is simply appalling.”

Hanson-Young said the politics of Abyan’s case had taken priority over her welfare.

“Clearly, the management of Abyan’s case, from the government’s perspective, has not been about her care. Because if it was, they would have listened to her and they didn’t.”

Abyan reached Australia on Wednesday night, and is understood to be undergoing counselling over the coming days.