The teenager was transferred not in an ambulance, but in the back of the 10-seat vehicle of the island's police commissioner, and not to the hospital, but to the local lock-up, where he spent 24 hours in a small cell with about 20 locals.

His enduring memory is the mosquitoes, especially the one that bit him deep inside his right ear. The locals left him alone.

When he arrived back at the guarded transit centre that has been his home for the past five months, he was warned he would face a much longer stretch in jail if he tried to take his life again.

For the first few months of his captivity in Papua New Guinea, Sawari was an aberration: the boy in a detention centre that is supposed to be exclusively for single men.

He was 17 when he arrived in Papua New Guinea in August of 2013, one month after the then Labor government decided to remove children and family groups from the detention centre.

He has the letter from Australian immigration officials confirming his age and telling him he would be "treated as a minor for the purposes of accommodation, placement and other purposes".

He remained in isolation until his 18th birthday, when he was told he would be staying. The smug expression on the face of the official who conveyed this news is etched in his memory.

Now he is a contradiction: a certified refugee who tried to take his life after finally being given the recognition asylum seekers crave, the status that differentiates those found to be owed protection and the opportunity to rebuild shattered lives from the rest. It isn't supposed to work that way.

What compelled the 19-year-old to turn a towel into a makeshift noose, attach it to a rafter outside his room and step from a chair to oblivion is hardly a mystery. His bottom lip trembles uncontrollably as he tries to explain that anger, despair and an all-consuming sense of hopelessness propelled him.

Anger at the local immigration officer who, he says, incited him to go ahead when, out of frustration, Sawari told the officer he planned to kill himself. With calculated indifference, he says the officer replied that he was free now to do whatever he liked.

Despair that the prospect of seeing the mother he misses desperately is as distant now at it was when he was first taken to Manus against his will from Christmas Island. He has been told he will have to wait eight years to either travel to see his mother or sponsor her to join him. "If I wait for eight years, maybe my mum die. Maybe I die. This is not good."

And hopelessness, because each day passes so slowly he says it feels like a year. Tablet-induced sleep offers the only respite, except when it leads to the recurring nightmare that terrifies him, where five menacing dogs stand before him, and the biggest one is jet black and demands money he doesn't have.

When the lightly-framed Sawari arrived at the transit accommodation in April, there were only 12 other residents. Now there are more than 50 others in the same situation: recognised as refugees, but denied almost all the basic rights that are supposed to come with refugee status.

They cannot earn a living, learn, move freely, buy property or be re-united with family members. For the Rohingyas among them, it is a reminder of what they left behind in Myanmar, except that the threat of extreme physical violence is much reduced. Others come from the Sudan, Iraq, Bangladesh, Afghanistan and Pakistan.

They are the forgotten exceptions to the generosity of one of the last decisions of Tony Abbott's prime ministership: the commitment to resettle 12,000 refugees from the conflict in Syria and northern Iraq.

They are also the cruel, lingering footnote the one of Abbott's proudest achievements: stopping the boats. Their continued misery, and that of those in limbo on Nauru (at a cost to taxpayers of more than $900 million a year), is considered essential to deter others from trying to come by boat.

Australia's new and popular Prime Minister, Malcolm Turnbull, says one of the most important qualities for a leader is to possess "emotional intelligence and the empathy and the imagination that enables you to walk in somebody else's shoes".

Sawari's only plea to Turnbull is to muster enough empathy and imagination to walk in his shoes, and those of the others on Manus and Nauru.

"Kyaw", for example, is a Rohingya who is too fearful to have his real name published. Like many in the transit centre, he spends most of his time in his room: afraid, damaged and vulnerable. If he was born in another country, he might be at university now, well advanced on his way to a PhD.

Like many of the others, Kyaw remains traumatised by what he saw in the country he calls Burma, what he endured while fleeing and what he witnessed the night Reza Barati​ was killed at the detention centre in February last year, when locals joined PNG security and others in breaking into the centre and attacking detainees.

Kyaw says he would rather be back in the detention centre, where the refugees can line up, show their blue "mental help" card, and receive their nightly sleeping tablet.

At the transit centre support is limited and the refugees must pay for everything beyond the basics from the 100 kina ($50) allowance they receive each Monday, including their medications.

There is a push for some of the refugees to be offered jobs in the town, provided they are not paid and return to the centre by 6pm. The local mayor, Ruth Mandrakamu​, says she is keen to involve the refugees in local activities and looking at offering two positions.

But the refugees are deeply suspicious and believe the PNG government is simply trying to demonstrate that something is happening.

Even without the 6pm curfew that is not strictly enforced, the refugees fear going out at night, when they are easy targets for those locals who turn nasty when they have had too much to drink.

It isn't that Manus is normally violent place. These are a friendly and peace-loving people. It just that, since the detention centre re-opened, is has become one. "When the asylum seeker project was brought in, a lot of youths and a lot of people get employment and when they have money in their pockets, they use it unwisely," says provincial police commander Alex N'Drasal​.

"Most of that money is used on alcohol, whether legal or home brew, or used on drugs and that is when they get involved in all kinds of social issues that speed up the rate of crimes in the province so high."

So concerned is the island's governor, Charlie Benjamin, about the rising crime rate that he recently rang the country's prime minister, Peter O'Neill​, and asked for members of the country's riot squad to be sent to help to restore order.

Benjamin is a supporter of the detention centre, on the grounds that it will deliver important infrastructure and employment to Manus, but he remains disappointed with what has so far been delivered and is opposed to the refugees being settled on the island.

"We only happy to process them in here, but we're not happy to resettle them in Manus," he says.

If the upside of the detention centre was the promise of economic development, the downside has been that locals do not receive the same pay as fly-in, fly-out foreigners who do the same jobs; that local contractors have not shared in the work; that the promised "Manus package" has so far failed to materialise; and that food prices have increased.

Although there have been no complaints to authorities so far, there is also deep apprehension about the prospects of integrating scores, and maybe even hundreds, of single men, many of them damaged by their experiences in their own countries and in detention, who come from a different culture and a different religion.

Benjamin says he has no issue if the young refugees form relationships with local women, so long as they are single, but the police commissioner has a different view, saying this is prohibited.

"They shouldn't be going around with ladies or consuming alcohol or going around with youth and consuming drugs," he says. "Of course it is illegal."

Another frustration for local politicians and law officers is that they do not know what is happening inside the detention centre. "If I want to go there I would ask permission like everybody else," says the governor. "If they allowed me to go then I will go, but if they not allow me to go then I will not go. It's like a country in a country, that's how I see it."

One advantage Sawari and the others in the transit centre have over the 900 asylum seekers still in detention is that they have a voice. During my stay on Manus, I attempted to speak with a group of detainees who were allowed out on an "excursion" to a secluded harbour near the airport.

I approached once they were out of the mini-bus and shook the hands of an Iranian and a Sudanese before a stocky guard with the empathy of a robot delivered an ultimatum. "Talk to him and the excursion over," he barked. "Your choice!" I retreated.

Sawari still suffers depression, but retains the capacity to hope for a happy ending. "Everyday I pray, 'Please god, not only help me, help everyone'," he says.

Others, like a young Rohingya who is a new arrival at the transit centre after 25 months in detention, are so utterly consumed by pessimism and despair that hope is beyond them. "Better, after my boat broken, that we die in the ocean," he says. "Then finish. Better than this."