A medical emergency on Papua New Guinea's Manus Island has exposed what the United Nations describes as inadequate healthcare services for refugees.
On Saturday, a 38-year-old refugee with a known heart condition collapsed at the detention centre where about 600 refugees are refusing to evacuate despite essential services being cut off.
They are under pressure to move to the nearby transit centre which refugees say medical staff would not leave to attend to the man.
With no ambulance service on the island, refugees flagged down a passing car which took the man to the island's medical clinic.
There they say the man received no treatment, as the clinic lacked the necessary equipment and he was sent back to the detention centre.
The deputy regional director of the UN refugee agency Nai Jit Lam visited Manus last week and found the healthcare service for refugees had been downgraded.
"Many in the refugee population have medical and mental health issues as well which need constant monitoring and constant attention," said Mr Lam.
"That has been withdrawn and we haven't seen and kind of improvement of the maintenance of that service."
The sick refugee, who has recovered somewhat, said staff from the UN agency were prevented from visiting him in the health clinic by a drunken Australian security guard.
Refugee on Manus with severe kidney stones, crying from pain. Govt obviously violating human rights. I'm witnessing a tragedy, a disaster.— Behrouz Boochani (@BehrouzBoochani) November 5, 2017
The Kurdish journalist and refugee Behrouz Boochani said he had documents that showed a specialist had recommended the sick man be transferred overseas for treatment as appropriate tests were not available in PNG.
In 2016, a Queensland coroner's court heard that delays in evacuating Manus Island refugee Hamid Khazaei had contributed to his slow and agonising death from blood poisoning after he developed a small leg infection.
Buzzfeed recently published an interview with a doctor, who was employed at Australia's refugee detention centre on Nauru, who said Australian officials had delayed the transfer of patients off island "worsening their conditions and potentially endangering their lives."
The PNG government had also raised concern about the standard of healthcare services Australia would leave on Manus for refugees.
Today, Mr Boochani tweeted that PNG Immigration and a local health monitor had visited the camp to check hygiene conditions.
Over the weekend, refugees reported the sewer had backed up as its pumps were unable to function with generators removed from the centre.
A statement issued by the PNG immigration minister Petrus Thomas said refugees should leave the centre in the interest of their own health.
"The PNG government... will not tolerate a situation that leads to the deterioration of the health and well-being of the residents because of refusal to move to access services," he said.
Refugees lawyers were applying to the PNG supreme court today to reconnect services to the centre but Mr Thomas said that was not possible.
"I want to be very clear that there is no capacity to restore services, there is no service provider to deliver services and... as services are available at the new facilities there is no need for services to be reconnected."
Immigration and health monitor are inside the centre. They are saying we'll do a report to send a doctor to see sick people.— Behrouz Boochani (@BehrouzBoochani) November 6, 2017