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Migrant health: what are doctors' leaders doing?
Editorial
Migrant health: what are doctors’ leaders doing?
BBC Wales News
The printed journal includes an image merely for illustration Published Online January 15, 2008 DOI:10.1016/S01406736(08)60111-7
See Correspondence page 201
Last week, UK immigration officials removed a terminally ill Ghanaian woman from a hospital in Wales and escorted her back to Ghana, where she is unable to afford the treatment she needs to prolong her life. 39-year-old Ama Sumani came to the UK 5 years ago and was diagnosed with multiple myeloma in January, 2006. Until last week, she had been receiving dialysis at the University Hospital of Wales in Cardiff. Sumani was in the UK on a student visa but was unable to enrol on the banking course she wanted to take because of her lack of English. She started working. Although her visa had expired by the time she was taken ill and she had contravened its conditions by seeking employment, her solicitor made representations for her to stay in the UK on compassionate grounds because she could not afford life-saving treatment in Ghana. But the Home Office rejected her appeals. As soon as her doctors deemed her fit to travel, immigration officials removed her from the country. According to news reports, Sumani, now in Ghana, has been refused treatment at the main hospital in Accra because she has no source of funding.
Sumani’s case has shocked many people in the UK. Her solicitor has been inundated with calls from members of the UK public offering money and even their bone marrow for a transplant. Ghana’s High Commissioner in London has appealed to Britain to reverse its decision. What about doctors’ leaders? Have they expressed their outrage? Have they called for compassionate treatment of Sumani? Unfortunately not. There has been a disappointing and deafening silence about the case from those who are supposed to represent doctors’ voices in the UK. Sumani is not the only migrant who has fallen seriously ill in the UK, begun treatment, and then been removed or deported to a country where treatment is unaffordable or inaccessible. Individual doctors who work with these patient groups have been campaigning on their behalf (see Online/Correspondence). To stop treating patients in the knowledge that they are being sent home to die is an unacceptable breach of the duties of any health professional. The UK has committed an atrocious barbarism. It is time for doctors’ leaders to say so—forcefully and uncompromisingly. ■ The Lancet
Change or die
Reuters
The printed journal includes an image merely for illustration For the Health Affairs study see DOI:10.1377/hlthaff.27.1.58
178
Among the Democrats running for the US Presidential nomination, the watchword du jour is “change”. Barack Obama’s tagline is “change we can believe in”; Hillary Clinton says she has been creating change for the last 30 years. Voters seem weary of the status quo on many fronts, both foreign and domestic, so change looks like smart politics. And in at least one arena— health care—change is crucial to the nation’s future. A recent study in Health Affairs showed that the USA had the highest rate of preventable deaths from 1997–98 to 2002–03 when the most industrialised countries in the world were compared. These deaths were defined as those occurring in people younger than 75 years, from such conditions as bacterial infections, cardiovascular diseases, and some cancers, that are treatable with widely available medical or surgical interventions. Preventable deaths from other causes, such as diabetes and measles, were also examined in younger age groups. The results showed that 101 000 deaths could have been prevented each year had the USA performed as
well as France, Japan, and Australia. The average decline in preventable deaths was 16% during the study period, but the US decline was only 4%. This means that the USA fell from 15th to 19th place. Dead last, 19th out of 19, despite a yearly expenditure on health that exceeds US$2·1 trillion, or more than 15% of the nation’s gross domestic product (GDP). By contrast, the other industrialised countries spend an average of 9% of GDP. Tellingly, the USA is also the only country in this list that does not have a national system for health-care coverage. The number of Americans who are uninsured has continued to rise, and is now around 47 million people. It is no coincidence that as the number of uninsured has risen, so has the number of preventable deaths. So here is a clear message for the Presidential candidates who claim to be all about change: change the US health-care system. The candidate who fails to do so could find himself or herself facing an increasingly sick population—not to mention all those potential voters lost to early—and preventable—death. ■ The Lancet www.thelancet.com Vol 371 January 19, 2008
Migrant health: what are doctors’ leaders doing?
BBC Wales News
The printed journal includes an image merely for illustration Published Online January 15, 2008 DOI:10.1016/S01406736(08)60111-7
See Correspondence page 201
Last week, UK immigration officials removed a terminally ill Ghanaian woman from a hospital in Wales and escorted her back to Ghana, where she is unable to afford the treatment she needs to prolong her life. 39-year-old Ama Sumani came to the UK 5 years ago and was diagnosed with multiple myeloma in January, 2006. Until last week, she had been receiving dialysis at the University Hospital of Wales in Cardiff. Sumani was in the UK on a student visa but was unable to enrol on the banking course she wanted to take because of her lack of English. She started working. Although her visa had expired by the time she was taken ill and she had contravened its conditions by seeking employment, her solicitor made representations for her to stay in the UK on compassionate grounds because she could not afford life-saving treatment in Ghana. But the Home Office rejected her appeals. As soon as her doctors deemed her fit to travel, immigration officials removed her from the country. According to news reports, Sumani, now in Ghana, has been refused treatment at the main hospital in Accra because she has no source of funding.
Sumani’s case has shocked many people in the UK. Her solicitor has been inundated with calls from members of the UK public offering money and even their bone marrow for a transplant. Ghana’s High Commissioner in London has appealed to Britain to reverse its decision. What about doctors’ leaders? Have they expressed their outrage? Have they called for compassionate treatment of Sumani? Unfortunately not. There has been a disappointing and deafening silence about the case from those who are supposed to represent doctors’ voices in the UK. Sumani is not the only migrant who has fallen seriously ill in the UK, begun treatment, and then been removed or deported to a country where treatment is unaffordable or inaccessible. Individual doctors who work with these patient groups have been campaigning on their behalf (see Online/Correspondence). To stop treating patients in the knowledge that they are being sent home to die is an unacceptable breach of the duties of any health professional. The UK has committed an atrocious barbarism. It is time for doctors’ leaders to say so—forcefully and uncompromisingly. ■ The Lancet
Change or die
Reuters
The printed journal includes an image merely for illustration For the Health Affairs study see DOI:10.1377/hlthaff.27.1.58
178
Among the Democrats running for the US Presidential nomination, the watchword du jour is “change”. Barack Obama’s tagline is “change we can believe in”; Hillary Clinton says she has been creating change for the last 30 years. Voters seem weary of the status quo on many fronts, both foreign and domestic, so change looks like smart politics. And in at least one arena— health care—change is crucial to the nation’s future. A recent study in Health Affairs showed that the USA had the highest rate of preventable deaths from 1997–98 to 2002–03 when the most industrialised countries in the world were compared. These deaths were defined as those occurring in people younger than 75 years, from such conditions as bacterial infections, cardiovascular diseases, and some cancers, that are treatable with widely available medical or surgical interventions. Preventable deaths from other causes, such as diabetes and measles, were also examined in younger age groups. The results showed that 101 000 deaths could have been prevented each year had the USA performed as
well as France, Japan, and Australia. The average decline in preventable deaths was 16% during the study period, but the US decline was only 4%. This means that the USA fell from 15th to 19th place. Dead last, 19th out of 19, despite a yearly expenditure on health that exceeds US$2·1 trillion, or more than 15% of the nation’s gross domestic product (GDP). By contrast, the other industrialised countries spend an average of 9% of GDP. Tellingly, the USA is also the only country in this list that does not have a national system for health-care coverage. The number of Americans who are uninsured has continued to rise, and is now around 47 million people. It is no coincidence that as the number of uninsured has risen, so has the number of preventable deaths. So here is a clear message for the Presidential candidates who claim to be all about change: change the US health-care system. The candidate who fails to do so could find himself or herself facing an increasingly sick population—not to mention all those potential voters lost to early—and preventable—death. ■ The Lancet www.thelancet.com Vol 371 January 19, 2008