Thursday, March 20, 2008

Act of omission kills medical migrant - Ami Sumani is dead

The case of Ama Sumani is far from unusual. The 39 year old widowed mother of two died on Wednesday in Accra of cancer. What is unusual is how her preventable death was brought about by British immigration authorities. Ms Sumani went initially to the UK to further her studies but eventually fell ill. A bone marrow transplant would have preserved her life and prevented her premature death. Instead the British Home Office removed her from her hospital bed in Cardiff after her visa had expired, and put her on a plane back to Ghana. Ms Sumani, unsuprisingly perhaps, was unable to afford continuing private medical care in Ghana and eventually died, about 2 months after her forced return to Africa.

It goes without saying that the British Home Affairs ministry is unequivocal that it has followed procedure. Her visa expired, and medical care for her condition was available in Ghana. The immigration bureaucrats omitted to mention that minor snag, namely that Ms Sumani needed to generate a huge amount of money to pay for such medical treatment, because unlike in the UK in Ghana such care is not available thru its national health service. Not unusual in a two-tiered health care system. Everything is available - for a price. Miserable basic care exists for the overwhelming number of poor Africans and first class care for the continent's wealthy elites. So, Ms Sumani found herself in a situation not unlike very many Africans dying preventable deaths due to the lack of resources in their countries' health care systems - well, if whatever is in existence deserves the label ' health care system' to begin with.

The interesting ethical question is, of course, whether Ms Sumani deserved to be given compassionate leave of stay in the UK, and with that the right to receive continuing free care in that country's public health care system. This question, it goes without saying, is relevant not only to the case of Ms Sumani and not only to the UK, but equally to Canada, Australia and many other countries at the receiving end of medical migrants from the developing world. Why should we pay for the health care of impoverishes migrants from developing countries?

Well, for starters, because we can. The reality today is that our health care systems are able to absorb the comparably small number of medical migrants from developing countries suffering life-threatening illnesses. We could comfortably afford to resource our health care systems such that these additional patients won't break the proverbial camel's back. It's not unreasonable to suggest that we are morally obliged to act to prevent harm from happening if it is within our means to do so, and if the costs we have to bear are comparably small.

There is a second good reason: Only about 18% of the world's doctors and nurses reside in developing countries. We developed world people continue to recruit health care professionals that were initially trained in the developing world. About one out of every five Africa-born medical doctors works today in the developed world. The rich, in other words, are free-riders depending to some extend on a continuing transfer of health care professionals from the developing to the developed world. Developing countries use their resources to train very many of our doctors and nurses. Ghana, the country of which Ms Sumani was a native citizen has only about 6 doctors for every 100,000 citizens. It lost 3 out of every 10 Ghana-educated doctors to the US, UK, Canada, and Australia.

Perhaps we should consider offering free care to medical migrants that make it to our shores as one possible means to compensate the developing world for our continuing complicity in the stripping of their fledgling health care systems of health care professionals.


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  2. No Borders WalesMay 22, 2008

    The deportation of Ama Sumani (described by Lin Homer, chief executive of the Border & Immigration Agency, as “not exceptional”) not only shows a total lack of compassion, it suggests a vindictive cruelty in the methodology of the Border & Immigration Agency.

    By denying her the drugs she needed & the support people were willing to give, the Border & Immigration Agency are guilty of no less than culpable homicide.

    It is horrific that someone receiving treatment vital to their survival can be removed from hospital against their will. What is chilling is that this is the operational practice of a government funded executive agency.


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