The devastated family of a refugee who died after a fatal fall in offshore detention before being flown to Australia have broken their silence as an inquest into the 27-year-old’s death gets under way.
A quiet vigil was held for Faysal Ishak Ahmed outside the Brisbane Magistrates Court on Monday as a handful of witnesses revealed crucial details surrounding the Sudanese refugee’s death, including whether he may have suffered a seizure before hitting his head.
It included a statement from Suliman, Mr Ishak Ahmed’s next of kin, who said the family wanted answers over his death.
“After his death the family lost hope in all life and they always think about their deceased son,” Suliman said in a statement.
“From there they lost everything and their wishes were destroyed.”
Mr Ishak Ahmed, a Sudanese refugee, suffered a critical head injury from a fall on Manus Island on December 22, 2016.
His medical evacuation to mainland Australia did not begin until a day later at 2.15pm.
Despite attempts by staff at the Royal Brisbane and Women’s Hospital (RBWH) to keep him alive, he died on Christmas Eve, aged 27.
During his time in offshore detention, Mr Ishak Ahmed repeatedly complained of gastric symptoms, kidney pain, chronic sinusitis, mental health issues and chest pains to staff.
Days before the fall, Mr Ishak Ahmed said he had shortness of breath and chest pains.
A coronial inquest into his death is examining the adequacy and appropriateness of the medical care Mr Ishak Ahmed received while detained on Manus Island.
It will also examine if there was any avoidable delay in his medical evacuation and whether this may have contributed to his death.
On Monday, the court was told a doctor had opined that Mr Ishak Ahmed suffered a seizure, likely caused by severe hyponatremia, that led to his fall.
Hyponatremia is a condition caused when the concentration of sodium in a person’s blood is abnormally low.
A test of Mr Ishak Ahmed’s blood levels the day before determined his sodium levels were normal.
Dr Mark Little gave evidence on Monday that he had reviewed clinical records of the refugee’s presentations on Manus Island, including his medications.
Of the 60 presentations, eight occurred in December 2016.
The records indicated Mr Ishak Ahmed had been treated for schistosomiasis – a disease caused by parasitic worms – in July 2014.
Dr Little considered the medications prescribed were “reasonable” and there was no firm medical diagnosis of his conditions.
In 2016, Mr Ishak Ahmed presented with symptoms of jaundice, with no clear cause established.
“I would have thought it would have been reasonable to investigate further why someone would become jaundice, which could have meant seeking advice from a haematologist,” Dr Little said.
Dr Little had opined that staff in the offshore detention centre would have had basic equipment and would not have been able to perform more specialist testing for disease symptoms.
“You can certainly get a rapid onset of hyponatremia … if people drink a lot of water,” he said.
“All the results (for Mr Ishak Ahmed) are at the lower end or lower range, other than sugar.”
Dr Little said he thought the treatment of Mr Ishak Ahmed was “reasonable” considering the limited resources on the island and the difficulty in detecting his low sodium levels.
“Low sodium is a very difficult clinical diagnosis,” he said.
“It’s a very non-specific finding and to be fair to the clinics on the island, they had done all these tests.
‘I don’t think they would have picked it, I don’t think I would have picked it prior to his fall.”
Asked if he thought the delay could have contributed to Mr Ishak Ahmed’s death, Dr Little said the time between the refugee’s transfer from Manus Island to Brisbane was hampered by the availability of aircraft
“I don’t think any delay of transport for this patient would have been any different,” he said.
Dr Little still wondered whether the process could have been simplified by better organisation through the preferred aircraft carrier on Manus Island.
The inquest continues.