Some refugees detained by Australia on Nauru and Papua New Guinea's Manus Island have waited for more than five years for medical transfers recommended by doctors.
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Medical records obtained by the Asylum Seeker Resource Centre (ASRC) for 49 refugees show the majority of people waited for two to three years for transfers.
Twenty-five of the refugees are still waiting.
Members of the group suffer from a wide range of treatable physical conditions such as cardiac and respiratory problems, kidney stones, infections and joint conditions as well as gynaecological and urological problems, ASRC said.
Some have mental health conditions manifesting in suicide attempts and self-harm.
The records show that when transfer requests for physical problems were neglected, people developed mental problems parallel to intensifying physical symptoms.
"There are over 1080 people held offshore, and the ASRC has a waiting list of 215 people needing our help to push for desperately needed medical treatment," the advocacy group said.
"The transfer system is failing and will lead to more deaths."
Eleven refugees detained on the two islands have died with some deaths attributed to transfers being delayed.
Currently, a panel comprised mostly of bureaucrats is responsible for transfer decisions.
The Australian government contracts International Health and Medical Services to care for refugees on Nauru.
In March 2018, the company left Manus, where services are now provided by Pacific International Hospital.
Former IHMS staff member, Peter Young, said requests for medical transfers to Australia were being blocked by Canberra to make the refugees suffer.
"It's appalling and unconscionable that our government is doing everything it can to prevent doctor's advice being followed and to increase illness and suffering of people in offshore detention," Dr Young said.
"Medical transfer requests are made sparsely and reluctantly because doctors know they will be blocked by the department. So many people who need them but have not reached critical need yet don't get transfer requests," he said.
"The department doesn't like it if we make too many requests for the one person either, so staff would sometimes just give up after a while."
Transfers for over 260 refugees in the last six months had been brought about through legal intervention in Australia, including for children needing life-saving medical treatment, ASRC said.
The government had spent about $AU500,000 in legal fees fighting the transfers.
ASRC has released the information in anticipation of next week's vote in the Australian parliament on the Urgent Medical Treatment Bill.
The bill would allow the temporary tranfer of refugees to Australia for medical treatment at the request of two or more doctors.
It is opposed by the minority government led by prime minister Scott Morrison, who said it would lead to hundreds of refugees being transfered to Australia and give a green light to people smugglers to re-start the trade in asylum seekers trying to enter Australia by sea.
His argument proved the Australian government was guilty of medical neglect, according to the award winning novelist and Manus refugee Behrouz Boochani, who implied in a tweet that Mr Morrison had conceeded that hundreds of refugees required treatment.
In another tweet, ASRC chief executive Kon Karapanagiotidis accused the prime minister of lying and pointed out the transfer of more than 800 refugees to Australia had not led to an increase in asylum seeker boats.
Meanwhile, a Sudanese refugee detained on Manus for almost six years, Abdul Aziz Muhamat, said the situation on the island was now so bad "that many men will be left permanently disabled or needing extensive medical and psychiatric care to recover from indefinite detention".
"We are living with painful sickness that gets worse over years. People feel so bad they harm themselves and attempt suicide," Mr Muhamat said.
"I take care of at least 30 people who have harmed themselves and don't have anyone else to turn to. I am not a doctor but I try to do my best. I get very tired and I am traumatised myself."
Where to get help
These are services across the Pacific for people who may be thinking about suicide, or those who are concerned about family or friends.
In Tonga
Lifeline
23000 or
25144
In Fiji
Lifeline
+679 667 0565
In Papua New Guinea
Lifeline Port Moresby
- 675 326 0011 -
In Samoa
SAMOA LIFELINE 800-5433
In New Zealand
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7)
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz
What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.
Where to get help:
Lifeline: 0800 543 354
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7)
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz
What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.