For the past 10 months, asylum seekers held in Australia’s controversial offshore processing centers in the Pacific islands have been able to seek transfers to Australia for urgent medical treatment.

Australian Home Affairs Minister Peter Dutton claims the policy has helped people migrate into Australia “through the back door.” Physicians and refugee advocates say it has saved sick asylum seekers’ lives.

And Wednesday, Australian lawmakers voted narrowly to revoke the policy, in what Doctors Without Borders described as a move that “endangers patients in need and ignores the ethical framework of the entire medical profession.”

At least 135 asylum seekers have sought treatment or assessment in Australia since the policy was approved this year. The law required physicians to deem their transfer to Australia necessary. It is unclear whether these asylum seekers are still in Australia.

Paul McPhun, executive director of MSF (the French initialism for Doctors Without Borders) Australia, said that his organization has documented a mental-health crisis on the island of Nauru with “unprecedented levels of suicidal behavior.”

“Having a policy of indefinite detention will cause mental and physical harm,” McPhun said. “It’s unconscionable and it’s unbelievable.”

MSF was banned from operating on Nauru last year, and McPhun said that officials on the island later also banned asylum seekers from seeking health advice through a program MSF set up for them to speak to health professionals remotely.

In a news conference, Dutton said that there are 51 health professionals currently contracted to provide care to asylum seekers on Nauru. He said that includes 22 mental-health professionals, 1 per 12 people.

The law, Dutton said, “was never about bringing people here for medical need because people were already receiving that medical need."

“This was always a law that was always about getting people here through the back door,” he said. “And today we’ve closed that back door.”

MSF said their psychiatrists and psychologists had determined that most patients on Nauru “had their lives impaired by mental illness.” The group said the repeal came “against the medical advice of many individual doctors and Australian professional bodies as well as MSF.”

Opposition lawmakers reacted to the law’s repeal with outrage. “Denying people medical care is un-Australian,” Sen. Kristina Keneally from Australia’s Labor Party said this week. “It’s inhumane. It’s uncompassionate.”

Australia began detaining migrants and asylum seekers who tried to reach Australia by boat in offshore centers in 2013. Instead of being allowed into Australia, they have been indefinitely held on Nauru or Manus Island, a part of Papua New Guinea, as they search for ways to move elsewhere. Physicians and advocates working with the populations held on the two islands have described a sense of absolute hopelessness among those held there.

They reported that many children had stopped speaking or eating, affected by a condition called “resignation syndrome.” Some had self-harmed or attempted suicide. In February, the last children being held on Nauru were moved to the United States for resettlement.

Prime Minister Scott Morrison helped craft the offshore policy when he served as immigration minister. When he defied polls and was reelected as prime minister in May, reports emerged that multiple asylum seekers stuck on Manus Island attempted suicide, fearing they would never be resettled. Morrison’s government has insisted that allowing asylum seekers to be medically evacuated to Australia put the country’s national security at risk.

About 3,000 people have been held on the two islands since 2013. Many have been relocated, but hundreds of adults are still searching for a way out. At least a dozen people held there have died, including Hamid Khazaei, an Iranian who died in 2014 after he contracted a foot infection that left him brain-dead. A probe by an Australian coroner into his death found that the clinic on Manus Island was not properly equipped to handle his illness and that he should have been transferred to Australia far earlier for treatment.

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