Refugees on the tiny Melanesian island nation of Nauru have made several suicide attempts and acts of self-harm since learning of a $35 million deal between Cambodia and Australia to resettle them here, according to advocates for the refugees.

The advocates said yesterday that five people – including four minors – have sewn their mouths shut in protest at the prospect of “voluntary” resettlement in Cambodia, an arrangement celebrated over glasses of champagne at Cambodia’s Ministry of Interior on Friday.

A teenage girl is also recovering in a Sydney hospital after swallowing washing powder and vomiting blood, prompting the Australian authorities to airlift her off the island for medical treatment. The fate of an adult male refugee who reportedly slit his throat was unknown at press time.

“There are now five people who have stitched up their mouths – two unaccompanied minors and two underage people and one adult,” Ian Rintoul, spokesman for the Refugee Action Coalition, said yesterday. “It does seem like at least one of the Pakistani-Afghani refugees has done damage and has had stitches. We don’t know the fate of the one who cut his throat. Protests are continuing.”

The protests on the island broke out after Australia’s Minister of Immigration and Border Protection Scott Morrison – who signed the deal in Phnom Penh with Minister of Interior Sar Kheng – sent a video message to the refugees saying they could accept resettlement or stay on Nauru for another five years, but would never be resettled in Australia.

Morrison’s message followed the news that temporary visas would be issued for resettlement in Australia to refugees in off-shore detention, but those on Nauru were not eligible.

The refugees planned to march on the Australian Embassy on Nauru today but had not been granted official permission to do so.

“After there was a stand-off with police on Friday, they requested to march and police seem to have implied they would be allowed,” Rintoul explained.

Suvendrini Perera of Curtin University’s Asia-Pacific Institute said the suicide attempts prompted by Morrison’s message had retraumatised the young refugees.

“Some bureaucrats arrived with the message. This was what triggered the distress,” she said.

“I am hearing that this news has thrown the children in the … camp into overload and guilt and a whole lot of other uncontainable emotions. These are their friends; [they] came on the same boats.”

The memorandum of understanding and operational guidelines signed by the two ministers – posted to Morrison’s website over the weekend – could be worse, according to Denise Coughlan of the Jesuit Refugee Service.

“I don’t think it’s too bad. [But] I have some concerns about a few things,” she said. “What does ‘security’ mean? It’s very important that it doesn’t mean police with guns and batons. There are some good things in it. It seems to be pretty good on freedom of movement. The packages of assistance are pretty good. But there’s no reference to mental health.”

The agreement says that only refugees who “voluntarily accept an offer of settlement” will be resettled, and Cambodia will determine the timing and numbers of refugees, who will be given permanent residency.

“The thing that’s very good is that they will provide residency cards. It’s what JRS has been advocating for many years,” Coughlan said.

But other sections of the accord were less well received.

One clause appears to suggest that the ultimate goal of the program may be to facilitate the return of the refugees to the countries they fled in the first place.

“Within 12 months of the date of departure from temporary accommodation of each refugee, Australia will help facilitate the process of voluntary repatriation of the refugees … to their country of nationality, or to another country where the refugee has a right to enter and reside, as consented or requested by the refugee,” it says.

Australian officials did not respond to requests for comment yesterday.

The type of temporary accommodation offered to the refugees also has Coughlan concerned.

“There’s a thin line between a refuge and a detention centre,” she said.

Last month, General Sok Phal, the head of Cambodia’s immigration department, which will be the main point of contact for the refugees, said they would be encouraged to seek work – a line Australian officials have also taken with their temporary resettlement on Nauru.

Estimates put the unemployment rate on Nauru at 90 per cent. About 95 per cent of those with jobs are employed by the government, which is on the cusp of a financial crisis brought on by mounting debts owed to a US investment firm. The politically connected Australian bank Westpac has frozen the country’s accounts.

“The deal involves Australia once again shirking rather than shouldering its responsibilities to refugees in our region and globally,” Australian lawyer David Manne said.

As of last month, the detention centre on Nauru where the refugees are “processed” housed 1,233 people, in conditions that were described by a veteran nurse at the facility as “like a concentration camp” last year.