Proud to Halt HIV Child Deportations

posted: 30/04/2010

It was New Year's Day 2008 when Martin Narey, head of the children’s charity Barnardo’s, opened the letter he had been waiting for. Inside were the names of 63 HIV-positive children and their families who had at last received a reprieve from the British Government. They no longer faced deportation back to Malawi and Rwanda, to an almost certain death.
 

In a candid interview before he steps down as chief executive of the children's charity Barnardo's, Mr Narey told The Independent that the letter was the proudest moment of his professional life.
The 54-year-old former head of the prison service had fought long and hard to keep the children in this country, lobbying Tony Blair to argue that it would be "cruel and inhumane" to return them to die when anti-retroviral treatment in the UK could give them a near normal life expectancy.
 

Behind the scenes
George House Trust and the Greater Manchester Immigration Aid Unit work closely with Barnardo’s Gregory’s Place to support HIV positive children and their families in NW England remain in the UK. He came to Barnardo's met families and staff from both organisations. We all fed him the facts and harsh realities facing HIV positive migrant children and their families.

Martin Narey instantly grasped the inhumanity of deporting HIV positive children to an early death. He used his unrivalled access to people in power and his passionate commitment to justice and care for children to win protection from removal for 63 children with HIV.
 

Manchester visit sparked action
"On a visit to one of our services in Manchester I met Josephine, a mum whose appeal against a decision not to grant her asylum had just been rejected. Josephine and her son Michael, then 14, were about to be deported to Malawi," he said. George House Trust and the Immigration Aid Unit had given expert evidence and pleaded the family’s case at the immigration tribunal.
 

"Both Josephine and her son were HIV positive. The clinical evidence I was subsequently able to read indicated that without anti-retroviral treatment in Malawi, both would die within months, whereas Josephine's life expectancy here was considerable and Michael's was essentially that of any other 14-year-old. What most shocked, upset and moved me about Josephine was not her quiet acceptance about her own death, but her abject fear over the reality that because she had a radically lower blood count she would die first and leave Michael to die on his own a few weeks or months after her.”
 

Take it to the top
"I went straight from there to the Labour conference in Manchester where I was speaking in a Fabian Debate and I spoke very frankly about what I'd seen. That got me in front of the All Party Parliamentary Group on HIV. That got questions asked at PM's Questions. That got me a meeting with Tony Blair and eventually – and to his enormous credit – a list of more than 60 children, all HIV positive, and their families were given indefinite leave to remain.
 

"The reprieve list, which was sent to me on New Year's Eve and I opened on New Year's Day 2008, was, and I suspect always will be, the best moment of my professional life."
 

Source
 

Using HIV Detention and Removal Guidelines

posted: 01/09/2009

Advice on how to make full use of the NAT-British HIV Association (BHIVA) new guidelines on 'Detention, Removal and People Living with HIV' has been circulated by Medical Justice. Migrants living with HIV should not be removed if this breaks these guidelines. Using the guidelines has halted some recent removal attempts.

A number of removals of HIV+ detainees that Medical Justice are involved with have been stopped because the NAT and BHIVA guidelines were breached.

Below Medical Justice explains how to help someone living with HIV by using the guidelines.

The new NAT-BHIVA guidelines (page 13) state that;

• 3 months supply of anti-retroviral medication should be supplied to people with HIV on removal
• they should also be given a letter for their future treating physicians, and
• contact details of trusted HIV support organisations in the country the detainee is being removed to.

Page 12 of the guidelines states that

'Upon notification that an HIV positive detainee is to be removed, IRC [immigration removal centre] healthcare staff should inform the local HIV specialist of the detainee's pending removal and ensure the detainee is provided with sufficient medication. Normal NHS clinical practice is to dispense three months' supply of ARV medication. This will cover detainees during the removal process and arrival in their destination country.'

In the case of Yarl's Wood, the local clinic is Bridge House GUM clinic, at Bedford Hospital, 01234 792146.

Less than three months medication?

These guidelines are endorsed by Dr Celia Grummit of the IRC Healthcare Steering Group (see page 4 of the guidelines). Given her position, and the Secretary of State's avowed policy to provide NHS equivalent care to immigration detainees (see Home Office Operating Standards Manual for IRCs), if a person facing removal has not been provided with 3 months medication, removal might be stopped on the basis that the guidelines have been breached.

Need to start treatment?

If it is clear that someone needs to start anti-retroviral (ARV) treatment but cannot do so before removal (e.g. because the necessary resistance tests have not been done yet), legal representatives might be able to make representations to the effect that the person should not be removed until it is possible to provide them with 3 months appropriate anti-retroviral medication.

Indications that someone may need to start on ARVs may include -

• the person is HIV+,
• has a low CD4 count,
• has a letter from a specialist that they need or may need ARVs (this could include a letter following their HIV diagnosis), or
• they have been on ARVs in the past.

Tests have to be done before someone is started on ARVs.

Stopping Removals that Breach the Guidelines

What you can do when someone is scheduled to be removed in breach of the guidelines ;

• Call up the local specialist clinic (listed in the BHIVA guidelines p 20-21) and find out whether they have been informed of the removal and whether they are supplying 3 months of appropriate medications.
• If they have not been informed and can't provide the necessary medication, provide the detainee's legal representative with a copy of the BHIVA guidelines and information on the person's medical condition and possible complications, and ask if legal representations can be made.
• If there is no legal representative or the legal representative is not able/willing to make epresentations on the basis of the BHIVA guidelines, you could contact the MP (either the MP in whose constituency the detainee was living prior to detention or the MP in whose constituency the detention centre is) and/or the detainee could directly make their own representations to the responsible home office caseworker.

Fitness to travel / is the detainee medically stable?

Page 10 of the guidelines says "At least 95% adherence to treatment is required , as even one or two missed doses can seriously compromise both the efficacy of therapy and lead to drug resistance. This means missing no more than one dose a month if a detainee is taking once-daily therapy, or two doses a month if a detainee is taking twice daily therapy. IRC healthcare staff should ensure that every detainee in need gets their medication each day."

If medication has been missed then removal may need to be delayed until it has been established that the medication is still effective.

Page 13 says "Final judgement as to whether an HIV positive detainee is medically stable and is fit to travel must be determined on a case-by-case basis and should always rest with the IRC GP in consultation with HIV specialists." Here are some of the main medical issues that should be considered -

• the person is pregnant or has given birth less than six months previously
• the person is awaiting an HIV test result or appropriate post-test counselling and a baseline assessment to clarify clinical condition
• the person has had a recent, new HIV diagnosis, or having just started ARV therapy or a new drug regime
• the person has a co-infection with another sexually transmitted infection or tuberculosis
• the person has co-existing mental health issues
• there are ongoing medical complications

Referring a case to Medical Justice / getting advice from Medical Justice

Please complete a referral form (a link to which can be found at the bottom of the About making referrals to Medical Justice webpage). Please note that making a referral means you are making a commitment to gather all necessary information and progress the case yourself as far as possible.

So you must ensure that you ascertain all relevant information about the detainee mentioned in these 'using the BHIVA guidelines' and include it in the referral form.

email contact   

phone 07807 726546

Note on children detained with an HIV+ parent
Some removals of families with a parent who is HIV+ have been stopped by the European Court of Human Rights (ECHR).

Medical Justice has no information on ECHR's basis on stopping these removals, if they are stopping all such removals, or for how long ECHR may stop such removals. You may want to contact ECHR or make an application to ECHR about such removals.

Medical Justice does not give immigration advice
Medical Justice is not qualified to give immigration advice and suggests that immigration advice is always sought in every case from a qualified advisor.

This advice on using the BHIVA guidelines is from Fadiga & Co
Advice is available from Hani Zubeidi at Fadiga & Co 0208 673 6699

Good Guide - Detention and Removal

posted: 23/06/2009

NAT (National AIDS Trust) and the British HIV Association (BHIVA) have launched the first ever best practice guidance to support detainees living with HIV in Immigration Removal Centres (IRCs).

There is growing concern about the failure to meet the HIV-related needs of asylum applicants. The process of detention and removal has resulted in real difficulties for asylum seekers living with HIV. Research shows that people living with HIV have not always received the care they need and in some cases asylum seekers have had vital antiretroviral treatment interrupted whilst at an IRC.

The advice entitled Detention, Removal and People Living with HIV, produced in partnership with IRC healthcare managers, is a practical resource for healthcare, voluntary sector and other professionals working with detained HIV-positive asylum seekers in IRCs.

Deborah Jack, Chief Executive of NAT, comments:

“With many asylum-seekers coming from countries with high HIV-prevalence, it is important that those working in removal and detention centres understand the needs of people living with HIV. Healthcare managers and HIV clinicians working in IRCs have a duty to ensure asylum applicants living with HIV receive the best possible treatment, care and support throughout the process. We hope this guide will become a constant reference and useful tool for those working in this field.”

Dr Ian G. Williams, Chair of BHIVA, said:

“It is extremely important that asylum seekers with HIV infection detained at IRCs receive best care for their HIV infection. Failure to do so increases the risk of adverse consequences of HIV infection on their future health. It is important the IRCs recognise this and that HIV specialist clinicians are able to liaise effectively with the IRCs to ensure continuing best care for HIV infected detainees. This guide is an important and useful resource to enable this to happen.”

Download Detention, Removal, and People living with HIV

Zimbabwe - Removals Halted

posted: 17/12/2008

The government has effectively decided that most Zimbabweans in the UK can now remain, at least until the situation in Zimbabwe radically improves.

It has said it will not appeal the key decision of the Asylum and Immigration Tribunal that the situation in Zimbabwe has deteriorated so far that only people who can prove they are supporters of the governing Zanu-PF should be returned. 

On 19th November 2008 the Asylum and Immigration Tribunal published a determination on a significant country guidance case for Zimbabwe.

The Tribunal found that anyone who is unable to demonstrate support for or loyalty Zanu-PF or the regime is at risk if returned to Zimbabwe. However, each case will have to be decided one by one, depending on the person's own relationship to Zanu-PF - friend or foe?

Fresh Claims

If a failed asylum seeker can show that they will not be able to demonstrate loyalty to the regime, then that could be enough to make a fresh claim. A significant number of Zimbabweans who have been refused asylum should now benefit from this decision, particularly those who have been in the UK for some time.

The Asylum and Immigration Tribunal's decision in RN  was long awaited by thousands of Zimbabwean asylum seekers in the U.K. The decision at last offers real hope to the 7,500, a significant number of whom are living with HIV, whose applications for asylum in the UK had been refused by the Government and the Tribunal on the basis that there was nothing stopping them from returning to Zimbabwe.

Humanitarian claims too, if no basic necessities

The Tribunal’s momentous decision was for a person known as RN, a teacher from Zimbabwe who came to the UK nearly three years ago to escape violence from supporters of Mugabe’s regime. In allowing RN’s appeal on refugee and human rights grounds, the Tribunal concluded that all those Zimbabweans in the UK who cannot demonstrate loyalty to the Zanu-PF regime should be granted permission to stay and work in the UK until it is safe for them to return to Zimbabwe. The Tribunal also recognised that those who may be deprived of all the basic necessities of life if returned to Zimbabwe should be granted permission to stay here on humanitarian grounds.

The Tribunal made a similar decision in 2005 but the Government appealed and the decision was overturned by the Court of Appeal. Several further test cases went to the Court of Appeal and the matter remained unresolved until the Government’s decision this week not to challenge RN. The solicitor for RN, from the Immigration Advisory Service, Julian Bild, commented:

“The Government’s decision this week not to challenge the judgement in RN’s appeal is a welcome recognition of the real dangers that face Zimbabweans if removed from the UK. I am sure that most of the Zimbabweans in the UK would choose to go home if they could do so safely and with dignity but with the current appalling levels of violence and destitution to which Zimbabwe has descended the result of the test case was clearly the correct one. The Government must act quickly to implement the decision.

“Those Zimbabweans who have previously failed in their applications for asylum in the UK should quickly get legal advice from accredited legal representatives on their position following the test case decision”.

source source2

Briefing from Refugee Council

The Tribunal's decision reference for the case is RN (Returnees) Zimbabwe CG [2008] UKAIT 00083 [November 2008]