Open letter from health professionals in the UK on the health consequences of the forced expulsion to Rwanda policy

Dear Prime Minister

Cc.  Home Secretary, Health Secretary

As health professionals, we, the undersigned, are writing to express our grave concerns about the health implications of ongoing plans to forcibly remove individuals seeking protection in the United Kingdom to Rwanda, as set out in the ‘Migration and Economic Development Partnership’. Using this approach to advance hostile border policies rooted in unevidenced deterrence and externalisation objectives, despite clear documentation of the medical harm caused, is unconscionable. We urge you to abandon this policy immediately to ensure that the rights, safety and humanity of people seeking asylum in the UK are acknowledged and safeguarded.

International examples of externalisation policies have led to wide-scale abuse and been found to cause catastrophic mental and physical harm. In 2017-18, Médecins Sans Frontières’s mental health project on Nauru Island, where people seeking safety were detained by the Australian government, more than two thirds of their 208 asylum seeker and refugee patients - including children - engaged in self-harm, suicidal ideation and acts. 

It is therefore unsurprising that the prospect of removal to Rwanda, which is modelled closely on the failed Australian system, has exacerbated the mental health conditions (including post-traumatic stress disorder and depression) of the men, women and age disputed children who have been threatened with expulsion, triggering fear, confusion and uncertainty about their safety. It has proven increased risks of self-harm and suicide, and undermined resilience to the psychological effects of trauma. 

Subjecting people seeking sanctuary in the UK, many of whom have mental health conditions and have histories of torture, trafficking and trauma, to such an inhumane process is a matter of significant concern for the medical community. As health professionals, committed to alleviating suffering, we cannot turn a blind eye to the harmful effects this policy is having and will continue to have on people who are made vulnerable by restrictive border policies.

We cannot stand behind this policy on medical, ethical and humanitarian grounds and we join lawyers, civil society, the UN High Commissioner for Refugees, trade unions and many Home Office officials themselves in their condemnation of this scheme. We find this policy, with its inevitable toll on the mental and physical health of those subject to it, unconscionable and abhorrent. We urge you to abandon it in its entirety and ensure that any further reform of the asylum system leads to a strengthening, rather than a weakening, of protection and dignity for those seeking sanctuary in the UK.

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