When the quest for freedom goes horribly wrong

Brisbane, Australia (CNN)Dr. Sayed Mirwais Rohani wanted to heal people, but he died a broken man.

Trained in China, the young Afghan doctor fled the Taliban in Kabul only to become trapped in Australia's offshore immigration detention system.

He ended his own life in a Brisbane city hotel on October 15. He was 32.

A coroner's investigation into Rohani's death is in its very early stages.

The family's lawyer, George Newhouse, says it deserves a full inquest. "His family want to get to the bottom of what happened to their son," said Newhouse, from the non-profit legal service the National Justice Project.

"But more importantly, to examine the systematic failures in the provision of healthcare that left an able-bodied doctor so seriously debilitated and in a state where it appears he took his own life."

Rohani died in Australia, but his family says his mental health problems began thousands of kilometers away in an Australian processing center on Manus Island in Papua New Guinea (PNG).

He was one of thousands of asylum seekers sent there, and the tiny island nation of Nauru, under a policy of offshore immigration detention revived by Canberra in 2012 to address a rush of migrant boats entering Australian waters.

On July 19, 2013, the government announced an extra deterrent -- anyone who arrived after that date would never be resettled in Australia.

Those found to be "genuine refugees" would stay in PNG or Nauru -- or a third country, if a deal was agreed.

Almost seven years on, the policy has had its desired effect.

Between 2008 and 2014, more than 50,000 people embarked on the dangerous sea journey to Australia.

Now, few even try.

Offshore detention may have stopped the boats, but refugee advocates say it has also created a cohort of traumatized people.

Rohani was one of them.

"It's the worst case of abuse and neglect I have ever seen in 48 years of health work," said Gabrielle Rose, a retired academic who acted as Rohani's voluntary advocate in Australia.

"Every system just failed that guy."

Australia's Home Affairs department declined to comment on Rohani's detention or health care, citing privacy issues for the latter.

'Maybe they need you'

Rohani was born in Kabul in 1987. He was the second eldest son of six children, and he spent most of his younger years in his father's village of Tassan in Ghazni province.

"He was very active, he was healthy, and he liked to study," his father, Ahmad Tassangwal, told CNN on the phone from Newcastle in the United Kingdom.

Tassangwal fled Afghanistan in 2001 after Taliban gunmen arrived at the family's home to arrest him. They didn't approve of his university degree and work in agriculture, he said.

"I left my six children and my wife, I was alone for about eight years in England."

Rohani was 14 when his father left, but by the time Tassangwal received permission to remain in the UK, Rohani was himself an adult and, unlike his mother and younger siblings, he wasn't eligible for a family reunion visa.

The two spoke often by phone, and when Rohani scored almost full marks in biology in his senior year at Kabul's prestigious Abdul Hadi Dawe High School in 2006, his father offered to pay for him to study medicine.

Together, they found an affordable program in English at Taishan Medical University in China.

Rohani's father paid for his medical degree with money he earned in the UK.

It wasn't easy. Tassangwal sent money he earned working in the UK to pay for his son's course and living expenses at a student hostel in Taishan in Guangdong province.

Milind Zade lived at the same hostel for most of the five and a half years of their course. He told CNN Rohani was "happy and friendly."

Zade, now a doctor at a hospital in New Delhi, India said Rohani talked about going to work in the UK or even Germany after he graduated.

"He was talking about settling in some European country... We never talked about Australia," he said.

Sayed Mirwais Rohani graduated from Taishan Medical University in late 2012.

Yet, within one year of graduating in late 2012, Rohani paid a trafficker he met in Kabul to take him by boat to Australia, Tassangwal said.

It was 2013. The Afghanistan war had been dragging on for more than a decade, and Taliban militants were escalating their attacks on the capital. They knew who he was, and that he'd studied Western medicine abroad.

"He told me 'I'm not safe in this country, I need to leave my country, I need to go to some safe country,'" Tassangwal said.

Tassangwal told him not to waste years of his life, as he had, trying to gain access to the UK.

"I told him if you go to Australia, it's an English-language country, it's a big country with no economic problems ... you are already a doctor."

"Maybe they need you."

Tassangwal concedes he knew very little at the time about Australian's immigration policy.

"It was my fault. It was my fault, he accepted my decision, my advice," Tassangwal said.

In September 2013, Rohani's boat was intercepted by Australian Border Force agents and, as an "unlawful non-citizen," he was detained and sent to Manus Island where he remained for almost four years.

On Manus Island

Manus sits to the north of the Papua New Guinea mainland, a location that once saw the jungle-covered island play an important role during World War II as a base for the Allied naval fleet.

Decades later, the dilapidated Lombrum Naval Base was repurposed as an Australian Regional Processing Center (RPC), which, at its peak capacity in 2014, held as many as 1,353 detainees. Many were stateless. Others came from Iran, Afghanistan, Pakistan, Iraq and other war-torn or impoverished countries.

Conditions were hot, cramped and basic. Detainees were prevented from leaving the locked, guarded compound while their asylum claims were processed. They had the option to go home, but as many had risked their lives to flee violence and the threat of imprisonment, few opted to leave.

Rohani took the top bunk in a small room in Foxtrot compound; Iranian refugee Farhad Rahmati slept below.

Rahmati says his bunkmate spent most of his days reading medical textbooks he thinks had been loaned to him by sympathetic healthcare workers. "He used to read books, for 10, 12, 14 hours a day. And when I asked him (why), he said I have to keep myself updated. In the future, at some point I have to be updated in my profession,'" Rahmati said.

Rohani spoke six languages and was the go-to person for English translations, said Shamindan Kanapathi, a Tamil man who fled Sri Lanka and talked to CNN from the PNG capital, Port Moresby.

"He always said that he wanted to start his life and work for the poor people, you know, to help the people."

Rohani's claim for asylum was accepted and he was told he could join the other refugees at the East Lorengau Transit Center (ELTC) near the main town on Manus Island.

The East Lorengau Transit Center.

There was more freedom in Lorengau, but not every refugee wanted to go.

In 2015, refugees told Human Rights Watch that they feared being attacked and robbed by locals.

Kanapathi recalled a conversation he'd had with Rohani before he left.

"I said, 'don't leave, if you leave they will resettle you in PNG permanently.' He said, 'No, no, it's not going to be (like) that.'"

Rohani told his friends that he'd been offered a job at the local hospital, Kanapathi said. But the work didn't materialize.

CNN has been unable to verify if the offer existed and, if so, why it was withdrawn.

Either way, once Rohani had left the gated compound, his friends and family say he started to change.

Gabrielle Rose, his advocate in Australia, was more blunt in her assessment.

"He went psychotic. And he was left psychotic, undiagnosed, untreated for years," said Rose, who has a doctorate in international public health.

Rose said Rohani's manic behavior marked him as a target at Lorengau. He told her he was regularly beaten.

Video posted to Twitter in 2015 shows a man that Rose identified as Rohani, hogtied and being carried out of the East Lorengau Transit Center.

In 2016, a UNHCR report found that 88% of 181 refugees and asylum seekers interviewed on the island were suffering from a depressive or anxiety disorder and/or post-traumatic stress disorder, largely due to "open-ended mandatory detention."

The policy of indefinite detention has been roundly condemned by human rights and aid groups, including the United Nations High Commissioner for Refugees (UNHCR), Amnesty International, Human Rights Watch, Doctors 4 Refugees and Médecins Sans Frontières (MSF).

Until its contract expired in April 2018, health services on the island were being provided by International Health and Medical Services (IHMS), a subsidiary of global health and security company International SOS.

CNN contacted IHMS for comment on Rohani's case, but they referred the matter to the Home Affairs Department, which declined to comment on individual cases.

John Brayley, the former Chief Medical Officer of the Australian Border Force who was responsible for detainees' health from October 2015 to 2017, also declined CNN's request for comment.

The Australian government has repeatedly defended its policy of offshore immigration detention as a matter of national security.

It says denying asylum seekers the opportunity to settle in Australia reduces the incentive for people to make the journey, preventing deaths at sea and making the country's borders safer.

Please do something for him

In May 2017, Tassangwal became so concerned about his son's mental health that he flew from the UK to Manus Island in an attempt to take him home.

Rohani had no travel documents and couldn't leave without the permission of the Australian and PNG authorities.

Tassangwal said he told immigration officers his son needed urgent medical attention.

"The nurses and the doctors, no understand," he said.

Reluctantly, Tassangwal said goodbye to his son, with a promise that he would help him.

But soon after he left, Rohani took an overdose and was transferred to Australia.

There, doctors diagnosed him with bipolar affective disorder, a condition which causes extreme mood swings and typically worsens without treatment.

He was in and out of hospital, before being released to community detention in Brisbane, where he lived in a house with other refugees, his movements limited by curfews, unable to work but receiving a weekly allowance, Rose, the advocate, said.

Once a month he was monitored by a case officer from ACCESS, a non-profit community group that helps to settle refugees.

"He needed someone who knew what they were doing, not a monthly five-minute drop-in by a service provider," Rose said.

She shared a text message from another refugee to his case worker, who used the initial M for Mirwais, as he was known to his friends:

"Hi M is unwell he is singing all the time, all night he is mentally unwell. I told you more than 20 times. Please do something for him."

ACCESS declined to comment on Rohani's supervision in Australia "due to confidentiality."

The Home Affairs department said in an email: "Health care services for detainees in immigration detention in Australia are comparable to those available to the Australian community, under the Australian public health system."

Meanwhile, Rohani's father was consulting lawyers in the UK about ways to take him back, and flew to Australia in September 2018 to take the matter further.

Ahmad Tassangwal flew to Australia again in September 2018 to check on his son.

Separately, Rose said she sent emails to the Department of Home Affairs and Home Affairs Minister Peter Dutton, supported by a letter from Rohani's doctor.

"(Rohani) has limited psychosocial supports in Australia and would have a higher chance of relapse than if he were to be reunited with his family in the United Kingdom," the letter said.

Rose said the request was ignored.

George Newhouse, the family's lawyer, said they deserve to know why.

"I'm dumbfounded as to why the government would deny him the opportunity to be with his family and yet at the same time, from what we've been told, they were failing to adequately care for him," he said.

"That unnecessary cruelty hastened his decline."

He says an inquest would expose the circumstances that led to Rohani's death.

He believes inquests should be mandatory for all refugees sent to foreign islands under Australia's offshore immigration policy.

Currently, the deaths of people sent to remote islands aren't subject to the same scrutiny as they are in Australia, where inquests for deaths in custody are mandatory.

So far, 13 refugees have died, according to the unofficial Australian Border Deaths database.

Some have been investigated by Australian authorities, others have not.

Some are suspected suicides. Others relate to upheld and alleged failures of medical care.

Newhouse pointed to the case of Hamed Shamshiripour, a 31-year-old Iranian refugee who died on Manus Island in August 2017. PNG police investigated his death, but Shamshiripour's family does not accept their finding of suicide.

Newhouse says the family of Rakib Khan -- a 26-year-old Bangladeshi man who died on the tarmac in Nauru in while waiting for medical evacuation to Australia -- are still waiting for answers almost four years after his death.

The human rights lawyer is not alone in his calls for an independent investigation into all deaths.

In July 2018, Queensland state coroner Terry Ryan recommended that the Australian Attorney-General "establish and fund a statutory framework to ensure the independent judicial investigation of the deaths of asylum seekers transferred by the Australian government to regional processing countries."

Eighteen months after his recommendation, there is still no formal process.

In an email to CNN, the Attorney-General's office said the recommendation "raises practical difficulties and complex legal issues" as regional processing centers are located in foreign countries.

"Investigations into deaths in these centers, as well as any contractual arrangements in place are matters for the governments of those countries," it said.

"It would not be appropriate for Australia to implement a statutory framework for the repatriation and independent judicial investigation into the deaths of asylum seekers in sovereign foreign countries.

"However the Australian government is considering options to build the capacity of regional processing countries in respect of their ability to conduct coronial inquiries," the email said.

Newhouse said the suggestion that Australia has no responsibility to investigate the deaths of people who have spent extended periods of time in offshore detention centers "ignores the reality that individuals like Dr. Rohani are totally dependent on the Australian government for their survival."

"Pretending that another government is responsible for investigating their deaths on remote Pacific islands is simply a subterfuge."

Furthermore, he said "the proposal to build the capacity of foreign governments to investigate these deaths is a diversion to draw attention away from the dark secrets of our government's negligence and their political interference in the provision of health care."

A closed door

On the day of his death, Rohani can be seen on closed circuit television, walking into a hotel in central Brisbane, a black bag slung over his shoulder.

He made a final call to his mother, Hamisha Tassangwal, who was in Australia to support him. The next day, police phoned her to confirm his death.

The following week, members of Brisbane's Afghan community gathered around Tassangwal, a grieving figure in a black headscarf, at Kuraby mosque in the city's outer suburbs.

The mosque's lights were dimmed as Rohani's body was wheeled into the parking lot on a gurney for final prayers.

Ahmad and Hamisha Tassangwal took their son's body back to Kabul where he was buried on November 1.

He was buried in Kabul on November 1, surrounded by family and friends.

Ahmad Tassangwal said six years of immigration detention had robbed his son of all hope.

"When you lock one cat in the room and you close the door. The cat runs this way, this way, this way, no point in anything," Tassangwal said.

"The immigration stop him to travel, the immigration stop him to work, and immigration not allow him to join with family.

"The problem was this."

How to get help: In the US, call the National Suicide Prevention Lifeline at 1-800-273-8255. The International Association for Suicide Prevention and Befrienders Worldwide also can provide contact information for crisis centers around the world.