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You are here: BAILII >> Databases >> England and Wales Court of Appeal (Civil Division) Decisions >> RS (Zimbabwe) v Secretary of State for the Home Department [2008] EWCA Civ 839 (18 July 2008) URL: http://www.bailii.org/ew/cases/EWCA/Civ/2008/839.html Cite as: [2008] EWCA Civ 839 |
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COURT OF APPEAL (CIVIL DIVISION)
ON APPEAL FROM IMMIGRATION APPEAL TRIBUNAL
JUDGE GLEESON
HR/00707/2004
Strand, London, WC2A 2LL |
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B e f o r e :
LADY JUSTICE ARDEN
and
LORD JUSTICE LONGMORE
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RS (Zimbabwe) |
Appellant |
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- and - |
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Secretary of State for the Home Department |
Respondent |
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Mr Parishil Patel (instructed by Treasury Solicitors) for the Respondent
Hearing date : 15 April 2008
Written submissions 20 June 2008
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Crown Copyright ©
Lord Justice Pill :
"On that point, the appellant's evidence is that her husband is still alive and reasonably well and that, with his family's help he has been able to find at least some money for treatment. There is not total denial of treatment as in D v UK . . . on that basis, the Zanu-PF angle is merely an aspect of the difficulty in accessing treatment. It is not sufficiently different from the facts considered in N to amount to a special factor and to entitle the Immigration Judge to allow the appeal"
"The area in which they live is impoverished and has suffered violence at the hands of Zanu-PF supporters because it was an area of MDC support. There is no source of treatment available there for HIV and the appellant's husband is not receiving treatment . . . The appellant's husband, in common with other non Zanu-PF supporters, finds it difficult to purchase food or even to obtain general medical assistance."
The appellant is stated presently to be in "fair health", having responded favourably to anti-retroviral treatment. It was likely that she had been infected for seven or eight years.
"Because of lack of availability of drugs and general decline in the healthcare situation there is no practical availability to the ordinary person, that is other than the affluent or influential, of treatment in Zimbabwe for opportunist infections attacking the HIV positive and much less so for anti-retroviral treatment."
"In the result I find that it is likely that the appellant on return to Zimbabwe would live in circumstances of privation. . . . I find that the appellant, even with help from her sisters, could not be expected to access private anti-retroviral treatment even if it were available. The effect of lack of access to anti-retroviral therapy and to appropriate treatment for opportunistic infections is likely to be a rapid decline in the appellant's health . . . I find that the rapid decline in the appellant's health will be attended by considerable mental and physical suffering. . . . I therefore find, in accordance with the estimate given by the appellant's own physician, Dr Evans, that the life expectancy of the appellant on a removal to Zimbabwe is likely to be no more than one or two years at most, as against a possible life expectancy of a possible ten years on her present regime."
"For all the force of the foregoing, I acknowledge that this seems to bring one only to the point described by Dyson LJ in N above as tragic but by no means exceptional or very exceptional and not raising humanitarian considerations so exceptional as to engage article 3. The appellant must, if she is to win protection, show that something more referred to by the Court of Appeal in N."
"To my mind, this is an extraordinary situation that provides the further relevant factors, referred to in N, that elevate the totality of circumstances in this case to that degree where, even applying with the greatest of circumspection the principle exemplified in D, it would be properly seen that the protection of article 3 is engaged. Among the added factors to be borne in mind in this particular case are that the appellant entered the country lawfully and has abided by immigration laws, as did her husband before her; that her husband has not sought to advance any false claim for protection but he, despite his condition, has returned to his home, while still enjoying a right to remain in the United Kingdom, upon the death of his father; that the appellant herself, although her sisters-in-law are able to show an acknowledged claim for asylum, has not sought falsely so to claim but has placed her situation frankly and honestly before the respondent; that the United Kingdom has already assumed a burden of medical care towards the appellant over the past two years and has in so doing so given her some hope. The particular reason for holding the strict requirements of N to be met, however, is that on top of all this remains the added factor of the malign contribution of the Zimbabwean government to the individual circumstances of hardship and want that the appellant will face."
"Not only that but, perhaps the most telling circumstance of all, that shows the protection of article 3 to be engaged, is that the appellant is reasonably likely to face not merely an absence of continued health but the very denial, as a result of perverted policies by the ruling party, of medication and even nutrition. It is in no respect whatever exaggerated or colourable to hold it reasonably likely that the appellant will rapidly decline to a condition stripped of her human dignity, reduced, by government oppression afflicting the family area where she will have to live, to subsistence gardening, meagrely vested in tattered clothes and barefoot, just as is her husband today, who barely two years ago was a student in London receiving medical treatment that would have prolonged his life had he not felt the duty to return to his home and his children upon his father's death."
The Adjudicator then referred again to the contribution of "the abhorrent policies of the government" and its likely effect on the appellant's prospects.
"...In August 1998 [the applicant] developed a second AIDS defining illness, Kaposi's sarcoma. The CD4 cell count of a normal healthy person is over 500. Hers was down to 10.
As a result of modern drugs and skilled medical treatment over a lengthy period, including a prolonged course of systematic chemotherapy, the [applicant] is now much better. Her CD4 count has risen to 414. Her condition is stable. Her doctors say that if she continues to have access to the drugs and medical facilities available in the United Kingdom she should remain well for 'decades'. But without these drugs and facilities the prognosis is 'appalling": she will suffer ill-health, discomfort, pain and death within a year or two. This is because the highly active antiretroviral medication she is currently receiving does not cure her disease. It does not restore her to her pre-disease state. The medication replicates the functions of her compromised immune system and protects her from the consequences of her immune deficiency while, and only while, she continues to receive it.
The cruel reality is that if the [applicant] returns to Uganda her ability to obtain the necessary medication is problematic. So if she returns to Uganda and cannot obtain the medical assistance she needs to keep her illness under control, her position will be similar to having a life-support machine turned off."
"... So long as [the applicant] continues to take the treatment she will remain healthy and she will have several decades of good health to look forward to. Her present condition cannot be said to be critical. She is fit to travel, and will remain fit if and so long as she can obtain the treatment that she needs when she returns to Uganda. The evidence is that the treatment that she needs is available there, albeit at considerable cost. She also still has relatives there, although her position is that none of them would be willing and able to accommodate and take care of her. In my opinion her case falls into the same category as SCC. v Sweden, Henao v the Netherlands, Ndangoya v. Sweden and Amegnigan v. the Netherlands, where the court has consistently held that the test of exceptional circumstances has not been satisfied. In my opinion the court's jurisprudence leads inevitably to the conclusion that her removal to Uganda would not violate the guarantees of Article 3 of the Convention. ..."
"[Any extension of the D. principles] would have the effect of affording all those in the [applicant's] condition a right of asylum in this country until such time as the standard of medical facilities available in their home countries for the treatment of HIV/AIDS had reached that which is available in Europe. It would risk drawing into the United Kingdom large numbers of people already suffering from HIV in the hope that they too could remain here indefinitely so that they could take the benefit of the medical resources that are available in this country. This would result in a very great and no doubt unquantifiable commitment of resources which it is, to say the least, highly questionable the states parties to the convention would ever have agreed to. The better course, one might have thought, would be for states to continue to concentrate their efforts on the steps which are currently being taken, with the assistance of the drugs companies, to make the necessary medical care universally and freely available in the countries of the third world which are still suffering so much from the relentless scourge of HIV/AIDS."
The Grand Chamber also cited, at paragraph 17, the test indicated by Baroness Hale of Richmond:
"...whether the applicant's illness has reached such a critical stage (ie he is dying) that it would be inhuman treatment to deprive him of the care which he is currently receiving and send him home to an early death unless there is care available there to enable him to meet that fate with dignity. ...[The test] is not met on the facts of this case."
"[i]n view of these exceptional circumstances and bearing in mind the critical stage now reached in the applicant's fatal illness, the implementation of the decision to remove him to St Kitts would amount to inhuman treatment by the respondent State in violation of Article 3."
"The Court accepts that the quality of the applicant's life, and her life expectancy, would be affected if she were returned to Uganda. The applicant is not, however, at the present time critically ill. The rapidity of the deterioration which she would suffer and the extent to which she would be able to obtain access to medical treatment, support and care, including help from relatives, must involve a certain degree of speculation, particularly in view of the constantly evolving situation as regards the treatment of HIV and AIDS worldwide."
"There is no doubt that in the event of removal to Uganda the applicant will face an early death after a period of acute physical and mental suffering. In this case we are satisfied of the existence of such extreme facts with equally compelling humanitarian considerations. After all, the highest judicial authorities in the United Kingdom were almost unanimous in holding that the applicant, if returned to Uganda, would have to face an early death. The expelling State's responsibility, because substantial grounds are thus shown for believing that the applicant almost certainly faces a risk of prohibited treatment in Uganda, is engaged."
"Article 3 principally applies to prevent a deportation or expulsion where the risk of ill-treatment in the receiving country emanates from intentionally inflicted acts of the public authorities there or from non-State bodies when the authorities are unable to afford the applicant appropriate protection"
"The Court does not exclude that there may be other very exceptional cases where the humanitarian considerations are equally compelling."
Lady Justice Arden:
"While it is necessary, given the fundamental importance of Article 3 in the Convention system, for the Court to retain a degree of flexibility to prevent expulsion in very exceptional cases, article 3 does not impose an obligation on the Contracting State to alleviate such disparities through the provision of free and unlimited health care to all aliens without the right to stay within its jurisdiction. A finding to the contrary would place too great a burden on the Contracting States. "
Lord Justice Longmore :