Medical Justice Network response to Yarls Wood Report

Medical Justice Network response to the publication of the "Inquiry into the quality of healthcare at Yarl's Wood Immigration Removal Centre" by HM Chief Inspector of Prisons, published Wednesday 4th October 2006.

• Posted on Oct 5, 2006

"[The inquiry] was 'appalling' in what it revealed and should be a source of shame to those involved.. I am not totally surprised at the results, though shocked and genuinely appalled at the depth of failures revealed and inadequacies of those with care and responsibility for detainees Š [IND's] repeated attempts to removed sick detainees went beyond comprehension and decency". Alistair Burt MP

"I was a victim of the Ugandan authorities and this inquiry shows I became a victim of the UK authorities". Enid Ruhango (Ms B) - ex-detainee

"The overall picture the inquiry paints of institutional malfunction at Yarl's Wood is very disturbing. But not nearly as disturbing as the reality". Dr Frank Arnold - Medical Justice

The Chief Inspector of Prisons, Anne Owers, published today the inquiry into how Sophie Odogo, a Ugandan asylum seeker, was reduced to a state of mental collapse at Yarl's Wood Immigration Removal Centre and the healthcare provided there. Sophie's case, a catalogue of alleged abuse, self-harm, and the self-inflicted death of Manuel Bravo at Yarl's Wood while Sophie and Enid were detained there, led Medical Justice, Alistair Burt MP and others to call for an inquiry into the treatment of detainees at Yarl's Wood.

Sophie is a rape and torture survivor, who was detained for 7 months whilst her asylum claim was determined through the "Fast Track" process at Yarl's Wood, the UK's main immigration removal centre for women and families. She and her roommate, Enid Ruhango, were part of a 38-day mass hunger strike by detainees. They were both hospitalised a number of times and on release, Sophie was discharged to the psychiatric wing of the Maudsley Hospital where she remained for over 6 months.

Medical Justice Network regards the most important recommendations in today's report:

* The healthcare service was not geared to meet the needs of those with serious health problems or the significant number of detainees held for longer periods for whom prolonged and uncertain detention was itself likely to be detrimental to their well being. The number of detainees has more than doubled in the last year, as had the number detained for more than 3 months, and that one woman had been detained for 18 months.

*The management arrangements for healthcare are complex Š it was not easy to establish where responsibility for specific service delivery lay

* There are weak clinical governance systems, inadequate staff training, insufficiently detailed policies and protocols, that mental health care provision is insufficient, and that these inadequacies are compounded by the unresponsiveness of the IND to clinical concerns about an alleged history of torture or adverse medical consequences of continued detention.

* There is a growing concern among medical and other commentators that the increased use of immigration detention raises serious concerns about the mental health of detainees, particularly in cases of prolonged detention of uncertain duration.

* Independent medical opinion was not sought or adhered to and in some cases IND caseworkers, with no declared medical qualification, appeared to be making their own clinical judgements.

* There was evidence that IND caseworkers served removal directions on detainees late to pre-empt legal challenge

Medical Justice Network calls for:

1. The Home Office to immediately make arrangements for healthcare in detention centres to be transferred to the NHS.

2. The Home Office to stop violating its own policies by routinely detaining torture survivors, children, and people with serious medical and psychological problems.

3. Doctors and nurses in detention centres to make themselves familiar with, and act on national guidelines. These are required everywhere else in healthcare in the UK. Where appropriate guidelines do not exist, they should be produced as a matter of urgency.

"Some times I blank out, I can't hear what anyone is saying. Other times I feel I can't escape. They told me Manuel killed himself - perhaps death was his ultimate freedom." Sophie Odogo (Ms A)

"I was a victim of the Ugandan authorities and this inquiry shows I became a victim of the UK authorities. When will my suffering end? I have waited for 9 months for this inquiry. Every week I have reported to the Immigration Enforcement Unit - every time, and even today, I am liable to be detained again. In Uganda the torture was quicker. Here, living destitute, not entitled to medical treatment for the harm that has been inflicted on me, whether in detention or not, I die a little every day. The Home Office's strategy is to dehumanise, humiliate and inflict pain until we give up and go back to our country. I have seen bookcases of reports like this; is this the one that will bring change?"
Enid Ruhango (Ms B)

"For a long time Sophie was mute and she has severe memory problems. It's as if her natural defence mechanism blocks out traumatic memories, but she also can't remember simple, non-traumatic things. It's like her memory, her identity, has been snatched away. She is often confused and seems as though she has lost all her reference points. Some times the blocking evaporates and she is haunted by terrible flashbacks. Once I found her in the bushes, hiding, and petrified because she had seen a white van, and thought Yarl's Wood had come to take her back into detention. Sophie has not improved much since being released from Yarl's Wood 9 months ago. Right now she is not capable of living independently, but we are not giving up hope." Gill Butler, Sophie Odogo's Yarl's Wood Befriender and Litigation Friend

"The inquiry highlights the existence of guidelines and policies which safeguard against ordinarily detaining victims of torture and those with serious mental illness, and that these policies are often breached. In Ms A's case there was lot of rubber stamping going on, which provided no safeguard whatsoever, and in fact actually meant nothing at all". Harriet Wistrich - Birnberg Peirce & Partners Solicitors

"The HMCIP 's report on healthcare at Yarl's Wood IRC makes it clear that if Home Office's agencies adhered to their own criteria which exclude from detention 'those suffering from serious medical conditions and the mentally ill' and 'those where there is independent evidence that they have been tortured', there would be far fewer cases of neglect and abuse by their health care staff. How can the Home Office be made to account for breaching its own rules?" Dr Felicity de Zulueta

Inquiries/further information
Contact: info@medicaljustice.org.uk

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