Stories, according to poet and Seeds of Thought co-founder Tawona Sithole, have a dual purpose: they affirm the things we already know, strengthening our sense of belonging and identity, and also introduce us to new realities, causing us to revaluate what we previously accepted as ‘true’.

Tawona's observations at the Asylum Seekers and the Right to Health event at Declaration, chaired by Amal Azzudin of the Mental Health Foundation, resonated strongly with the impact of first-hand accounts by asylum seekers of their healthcare experiences in Glasgow. The testimonies of Jaan Abdulkadir and Lubna Salim reassert the shared importance of a 'universal right to health' and at the same time alert us to how many are currently prevented from accessing from this most fundamental of human entitlements.

Alongside Amal, Jaan and Lubna, researcher Lisa Curtice presented findings from their peer-led research project, carried out with asylum seekers, refugees and people with experience of homelessness: 'What do you mean, I have a right to health?'. Led by Neil Quinn of the Centre for Health Policy at the University of Strathclyde in partnership with NHS Health Scotland, the ALLIANCE, SNAP, Glasgow Homelessness Network and the Mental Health Foundation, the project ran in Glasgow from December 2015 to January 2016, exploring how human rights affect the use, design and implementation of services for some of the most vulnerable members of society. It also echoes Amaan, (MHF’s mental health and wellbeing toolkit for female asylum seekers and refugees) and the Sanctuary Project (which filmed first-hand accounts of asylum seekers), in prioritising stories over statistics, reasserting the 'human' aspect of human rights.

One of the main findings was that many of the participants were unaware of their right to health and often encountered system-level barriers to accessing help, underlining a striking mismatch between the theory of rights (such as specific articles on health in the Convention of Economic, Social and Cultural Rights (1966) and Scotland's National Action Plan for Human Rights (SNAP, 2013)), and the lived reality of people in need.

The event also called for greater clarity around definitions, particularly in relation to healthcare. While asylum seekers are escaping from similar situations as refugees (armed conflict, persecution, sexual violence and torture), this latter category have already had their claims recognised by the UK Home Office (under the UN Convention on the Status of Refugees (1951), or Article 3 of the ECHR), allowing them to stay for 5 years in the UK and access the same healthcare services as British citizens. Asylum seekers, however, occupy an in-between zone, having left one country yet unable to truly 'arrive' in the next, their status pending investigation by the UK Border Agency.

Claimants therefore have to navigate a complex terrain of bureaucracy and rapidly changing laws around residence and eligibility for primary and secondary treatment, often without recourse to legal aid or effective language support. In addition, research has shown that asylum seekers already experience poorer social, mental and physical wellbeing than the general population, with the stresses and uncertainties of the asylum process further exacerbating poverty and social marginalisation – conditions that are in themselves more likely to lead to ill-health.

Difficulties in accessing healthcare were powerfully conveyed by Jaan and Lubna, as they recounted their personal experiences in Glasgow. According to Jaan, asylum seekers often find it hard to access a GP and frequently encounter negative attitudes from surgery receptionists, alongside an overall lack of cultural awareness. While the NHS may claim 'health is for everyone', in reality no one appears to take responsibility for the treatment of asylum seekers, who often have to resort to A&E or pharmacies instead. Poor access to suitable interpreters exacerbates fear and shame around help-seeking, particularly for mental health issues or little-understood conditions associated with FGM or torture. Given the precarity of their situations, claimants are often hesitant to speak up for themselves or complain, fearing this may damage their case.

Asylum Seekers and the Right to Health

Echoing Jaan, Lubna also stressed how far reality differs from policy. She noted how many ‘suffer in silence’, particularly around gender issues, and described her efforts to raise awareness as 'an ongoing fight'. Indeed, Lubna herself was almost misdiagnosed when a doctor wrongly took her description of tinnitus to be ‘schizophrenia’, with only a chance intervention by an interpreter in the waiting room saving her from unnecessary and potentially harmful medication.

A final key topic in the discussion was the plight of destitute asylum seekers, with Amal drawing on her work with the Glasgow Night Shelter and the Glasgow Homelessness Network. Those who have had their claims rejected and are as yet unable to leave the UK – so-called ‘failed’ or ‘refused’ asylum seekers – no longer have any access to treatment for chronic conditions (High Court ruling, 2009), and are also forbidden from working, resulting in high rates of destitution and adverse effects on mental and physical wellbeing.

Instead of highlighting these cases, the media usually portrays asylum seekers as benefiting from UK welfare, whereas in reality Britain has received only a tiny percentage of the asylum claims submitted to the EU. Asylum seekers receive approximately 50% of the standard weekly benefit rate, while ‘failed’ asylum seekers need to ‘prove’ destitution and show that they are taking ‘all reasonable steps’ to return to their home country before they can receive Section 4 emergency support (Immigration and Asylum Act, 1999). This equates to just over £35 a week, with accommodation on a no-choice basis in ‘hard to let’ properties which often fall below acceptable standards of living. Since reducing health inequalities is one of the Scottish Government’s top priorities, it is clear that the situation for asylum seekers must be addressed as part of this strategy.

In a global context where forced migration, economic crises and political upheaval undermine the very notions of ‘citizenship’ and ‘justice’, the rights for all of us are increasingly placed in doubt. At a domestic level, threats to the continued existence of the NHS, as well as new forms of political and economic uncertainty, have tended to lead to ‘moral introversion’, where people declare the importance of ‘looking after our own’ – with ‘our own’ becoming ever more exclusive and exclusionary.

In contrast, Tawona’s poems at the close of the event remind us of the vital importance of personal stories – like those of Jaan and Lubna – which must be heard, acknowledged and shared with others. Stories like these reaffirm our common humanity, while also raising awareness of how the right to health is being violated – even in the heart of a supposedly developed first-world democracy.

by Clare Blackburne

Lubna Salim