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What Medical Justice does

Medical Justice aims to defend and promote the health rights and associated legal rights, of immigration detainees in the UK; and to end the medical abuse of detainees and the damaging effects of immigration detention on their health. We campaign for the immediate release of vulnerable groups from immigration detention who, according to Home Office policy, should only be detained in “exceptional circumstances”, in particular victims of torture, children, pregnant women and people with serious physical and mental illness, who cannot be appropriately cared for in detention.


Case-work

Current rate: 1,000+ cases a year. We arrange for independent doctors to see detainees, provide independent medical advice and medico-legal reports, including the documentation of scars of torture. We help detainees challenge instances of medical evidence being ignored by UKBA and immigration judges. We challenge denial of medication and treatment, deal with medical emergencies, assess detainees’ injuries after being subjected to excessive force, and help detainees find legal representation.  More about Medical Justice casework.


Policy work

Based on medical evidence from our case-work, we have secured a number of UKBA policy changes - for example, a ban on the routine handcuffing during hospital visits, and the creation of a protocol on re-feeding of hunger-strikers. We identify instances of medical abuse, facilitate a legal challenge, and help detainees to exercise their rights – within hours when necessary.


Research

As an integral part of policy and campaigning work, our research is based on casework evidence. We produce themed reports and publish papers in medical and legal journals .

In 2008 we published our “Outsourcing Abuse : The use and misuse of state-sanctioned force during the detention and removal of asylum seekers” dossier, documenting injuries sustained in 300 alleged assault in transit cases.  The report secured the commissioning of an inquiry into the issue by the Home Secretary.

In 2010 we published “‘State Sponsored Cruelty’: Children in immigration detention”, the UK’s first large scale investigation into the harms caused by the immigration detention of children. It was based on 141 children that we had dealt with. One child had spent 166 days in detention. 48% of the children were born in the UK. 74 children were psychologically harmed. 34 children exhibited signs of developmental regression, and six children expressed suicidal ideation and three girls attempted to end their own lives.  

In 2011 we published our “Detained & Denied” dossier, based on the first ever comprehensive analysis of treatment of HIV+ immigration detainees in the UK. Many of the 35 men, women and children studied are torture survivors from countries where rape is used as a weapon of war. UKBA / detention centres threaten detainees’ lives by withholding life-saving HIV medication and denying access to hospital.

In 2012 Medical Justice published “The Second Torture”, a dossier exposing how victims of torture are routinely detained in breach of UK Border Agency (UKBA) “Rule 35” policy which requires them to release detainees who have evidence of torture, absent very exceptional circumstances. The dossier investigates the cases of 50 detainees who have evidence of torture they sustained.  Only one detainee was released as a result of Rule 35. One spent more than 1,000 days in detention. Two were deported to countries where they were tortured again - both managed to flee, claimed asylum for a second time in the UK, and were detained again (Medical Justice volunteer doctors were tasked with distinguishing new scars of torture from old scars of torture). 


Litigation

  • In 2009, after dialogue with UKBA failed regarding their attempts to restrict access to detention centres by independent doctors, we started Judicial Review (JR) proceedings against them. UKBA settled the case with us ; detainees’ rights to access independent doctors was preserved.

  • In 2010 we challenged the UKBA’s policy enabling deportation without prior notice of unaccompanied children and those considered a suicide risk. The High Court ruled the policy unlawful, a decision that was upheld by the Court of Appeal.

  • In April 2011 we issued legal proceedings against UKBA, challenging their failure to review continued detention of detainees claiming to be victims of torture and those for whom detention is injurious to their health.

  • In July 2011 we intervened in the case of 3 HIV+ ex-detainee patients in the Court of Appeal

  • In May 2012, Medical Justice assisted (ex)detainees to initiate a wave of judicial reviews challenging UKBA’s failure to implement their Rule 35  safeguard against the routine detention of torture victims.  The judicial reviews were initiated on the same that we launched "The Second Torture" dossier exposing the routine detention of torture survivors.

  • In September 2012, Medical Justice applied the Court of Appeal to intervene in the case of HA.  We provided a witness statement for the HA, case one of our patients.  HA won – the High Court judge found that his unlawful detention amounted to “inhuman and degrading treatment” and that a key UKBA policy change affecting all sick and vulnerable detainees, was unlawful. UKBA are appealing.


Campaigning work / raising public & parliamentary awareness

Exposing and challenging excessive use of force during the deportation process
In January 2012, the Home Affairs Select Committee backed some key findings of the Medical Justice “Outsourcing Abuse” dossier, documenting 300 cases of alleged assault during deportation.  Injuries we came across included broken bones and a punctured lung.  We warned of the type of abusive scenario in which one deportee – Jimmy Mubenga –later died at the hands of G4S guards. Two of the guards were found during the last year to have posted offensive images, understood to be depicting deportees, on their facebook pages. We learned that G4S whistleblowers had issued warnings similar to ours, to G4S management, UKBA, parliamentarians and the police.  This included details of the disturbing technique involved bending deportees over in their seats and placing their head between their legs which became known within G4S as "carpet karaoke"

Deaths, near-deaths, and “inhuman and degrading treatment”
News in 2012 that G4S guards, at whose hands Jimmy Mubenga died during deportation in 2010, would not face criminal charges made many feel like G4S had been given a license to kill.  

In May 2012, the inquest into the first of three deaths in immigration detention last summer found "Neglect contributed to the death of Mr. Shukat", that there was a "total and complete failure of care in the management of his health at Colnbrook", and that report into the death prepared by Colnbrook Healthcare failed to identify any of the failures. Mr Shukat's cell-mate used the emergency button in their locked cell 10 times in a frantic effort to get help for Mr Shukat who was groaning in agony, complaining of very bad chest pains, and who was disbelieved by a guard and nurse until it was too late.  He died. UKBA refuse to say what action they are taking against Serco who run Colnbrook.

It was disclosed in court in July 2012 that UKBA officials planned to "unbalance" a detainee suffering schizophrenia by moving him from prison to immigration removal centre. In another case, the high court found that shackling a detainee to Serco guards for 8 days in hospital amounted to inhuman or degrading treatment in breach of article 3 of the European Convention of Human Rights.

The High Court has ruled four times in the last year that the immigration detention of three severely mentally ill people amounted to inhuman or degrading treatment . UKBA continued the detention of one man despite their own healthcare contractor declaring him unfit to be detained. UKBA’s apparent indifference left this man on the verge of death.  UKBA wilfully gambled with his life, fully aware of the risks. They proved incapable of monitoring his health, but were ready to manage his death, concerning themselves with handling press interest should he die.

Medical Justice has documented hundreds of cases of injury sustained during deportation attempts, disturbingly inadequate healthcare provision and subsequent alarming number of near-death incidents. Some detainees have suffered permanent damage, some life threatening.  Warnings by us and many others have been ignored or trashed by UKBA over the years.  

Few detainees get to legally challenge their treatment. Many of the near-death incidents will never independently investigated.  Of the relatively few legal challenges there are, most get settled out of court by UKBA with no judgement in the public domain. In many cases of deaths in immigration detention, there are few witnesses willing to speak out or family members to demand information from UKBA and keep a campaign in the spotlight.  

We fear the lack of much parliamentary and media interest may lead UKBA to feel impervious. As detention and deportation reaches an industrial scale, we wonder if UKBA and its private contractors will ever face appropriate consequences for the death and injuries, or if they enjoy state-sanctioned impunity.

Our campaigning includes lobbying the Home Affairs Select Committee to conduct an inquiry into these lethal detention conditions.

Ending the detention of children – twice as many detained in August 2012 than in August 2011
The immigration detention of children, which continues despite government promises to end it.  The government ended the detention of children at the notorious Yarl’s Wood Immigration Removal Centre (IRC), but increased facilities to detain children at Tinsley House IRC and created a new detention facility for families with children at Pease Pottage near Gatwick which is run jointly by G4S and Barnardo’s.  For many children, parts of the detention regime remain unchanged, starting with a door being broken down in a dawn raid on their home, some witnessing their parents being handcuffed, floored, injured, and separated from them.  Some have been deported to a country that they have never been to, and others have been deported without one of their parents.

We have assisted 15 children from 8 families, including 11 parents, detained in the Pease Pottage detention facility.  5 of the children were removed and 10 were released.  Medical Justice’s policy work includes communicating with UKBA, Barnardo’s, the newly established “Family Removals Panel”, and HM Inspector of Prisons.  We often work as a part of the Refugee Children’s Consortium (RCC) – e.g. making joint submissions to UKBA’s Operating Standards consultation.


Media work

Recent coverage has included the Guardian, the Independent, the BBC Radio 4 Today Programme interviews, the Daily Telegraph, the Daily Express, the New Statesman, Channel 4 news, the Times, the Telegraph, the British Medical Journal, and the Lancet.


Public meetings

The majority of our work is done by volunteers. Medical Justice is an organisation built on the extraordinary generosity of everyone involved in working with it, who show simple kindness to others and share belief in human dignity and freedom. Most detainees we deal with are released and many go on to get leave to remain in the UK. There are often emotional reunions at our public campaign meetings, attended by ex-detainees, befrienders, doctors, lawyers and others.  Ex-detainees are on the Management Committee.


Working with other organisations


Medical Justice is the only organisation that regularly organises for independent doctors to see detainees in detention centres and challenges the inadequacy of healthcare provision. Beyond this casework, we collaborate with other organisations in terms of research, policy work and campaigning, including BID, Asylum Aid, the Immigration Law Practitioners Association, the Refugee Council, Freedom From Torture, the Helen Bamber Foundation (HBF), the Migrants Law Project and many others.