The Nauruan government has moved to block the implementation of the so-called Medivac Bill. The Medivac legislation, passed earlier in February, would require Australia’s Minister for Home Affairs to transfer refugees held in camps on Nauru and Manus Island to Australia for medical treatment whenever a “panel of medical experts” recommends it.

The Australian government is in freak out mode. The Medivac Bill was passed over their objections by the opposition and cross benches in an exceedingly rare parliamentary defeat for a sitting government. The government is moving to re-open the mothballed Christmas Island detention centre so that it can “transfer” refugees “to Australia” without actually providing access to adequate medical care.
But the Australian government isn’t the only government in freak out mode. The Medivac Bill represents an existential threat to the government of Nauru.
Nauru has responded to the Medivac Bill with legislation that would enable their government to veto medical transfers. According to the Sydney Morning Herald the new Naruan legislation also bans telemedicine.
Nauru has manifestly inadequate medical facilities. The United States State Department warns:
There are few health care facilities available in the Republic of Nauru. Medical care for routine problems is available, but not up to the standards of industrialized countries. On occasion, basic medications can be difficult to obtain. Emergency response capability is extremely limited. Serious medical conditions requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Doctors and hospitals often expect immediate cash payment for health service. There is a recompression chamber in Nauru. Before diving, check that facilities are operational.
Travel.State.Gov, Nauru
The situation facing refugees is worse, as both the Australian government, detention centre operators, and the Republic of Nauru have actively obstructed refugees access to medical services.
Because of this, refugees transferred to Australia for medical treatment are rarely transferred back to Nauru. In 2016 staff at the Lady Cilento Childrens Hospital simply refused to discharge a baby facing deportation to Nauru.
The Nauruan government knows that after six years of abuse and neglect, refugees held in detention on Nauru all face chronic mental and physical health conditions that require adequate treatment. The Nauruan government also knows that if refugees are allowed to consult with medical practitioners in Australia, newly empowered to order evacuations for adequate medical treatment, their highly profitable detention centre will rapidly empty.
Their answer, ban telemedicine and veto transfers. Without telemedicine, medical professionals are unlikely to be in a position to consult refugees and asylum seekers. Nauru prevents critics accessing the island nation by charging prohibitive non-refundable visa application fees for visas that are rarely approved.
The detention and abuse of refugees is big business for the government of Nauru. The Republic of Nauru charges $1000 a month for a refugee visas. The ABC estimated Nauru makes $18 million dollars a year from visas (about 18% of Nauru’s GDP), and has received hundreds of millions of dollars worth of Australian government funded projects connected to the detention centre.
If refugees are evacuated from Nauru, Nauru’s bloated and corrupt government will once again face bankruptcy. The government of Nauru are more than prepared to endanger the lives of hundreds of refugees in order maintain access to the rivers of gold that flow from the detention centre.
Further reading:
Michael Koziol, 19 February 2019, Nauru bans ‘telemedicine’ for medical transfers in threat to new Australian laws, SMH.