| National and International | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Persecuted Foreigners --- Human Rights Violation at Immigration Center under the Ministry of Justice --- |
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YAMAMURA Jumpei M.D. Minatomachi Medical Center, 7-6 Kinko-Cho, Kanagawa-Ku, Yokohama-Shi, Kanagawa-Ken, 221-0056 Japan. 22nd March, 2005 |
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| <Introduction> |
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| At Japanese immigration centers, prolonged confinement deteriorates the detainee’s health, yet no adequate medical care is provided. Continuing intimidation at the centers robs the detainees of any pride they have left. Forcible repatriation of foreigners including asylum seekers occurs without advance notice. This situation is, concealed from public’s eyes. The author has been visiting the East Japan Immigration Center in Ushiku City once a month to meet with the detainees and monitor their health conditions. The deteriorating health of the detainees and the medical services provided at the center have already been outlined in an earlier report [1]. This paper is a sequel giving a more detailed account of the situation, including what happens to former detainees after forcible deportation and provisional release. |
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| <Method of survey> | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| In the present study, a total of 67 detainees were interviewed between
August 2003 and September 2004. The average age of those interviewed was
37.5 years, and the male to female ratio was 10 to 1. With most of the
detainees, the ones who were either asylum seekers or foreigners married
to a Japanese, the interview was conducted face-to-face. In thirteen of
the cases, however, the information was gathered secondhand through support
groups. Interviews were permitted only through a glass division with the
time restricted to 30 minutes. This made it impossible to conduct palpation
or auscultation, posing limits to the diagnosis of the nature and gravity
of their disorders. The conditions of the detainees granted provisional
release were double-checked through medical consultation conducted by support
groups, and if necessary, they were referred to a hospital for final diagnosis.
As for those forcibly repatriated, face-to-face interviews were conducted
in their home countries to gauge their subsequent living situations and
health conditions. When such interviews were impossible, information was
obtained through their relatives in a third country. |
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| <Result> |
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| Among those surveyed, the largest nationality group was Burmese (42%),
which was followed by Turkish (Kurdish), Iranian and Pakistani. Asylum
seekers constitute 81% overall (Table 1). |
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| *Period of survey: Aug 2003 - Sept 2004 *Number of detainees surveyed: 67 *Average Age: 37.5 (median age: 37: the ages ranged from 20 to 58 years old) *Men-to-women ratio: 10 to 1 Table 1: Nationality distribution
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| The average period of detention was 13 months among those in detention at the time of the survey, 14 months among those granted provisional release, and 16 months for forcible repatriation. The period exceeds a year in 65% of the cases (Table 2). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table2. Detention Period
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In twenty cases, the detention of parents, spouse or children resulted in family separation. Juveniles, nursing mothers shortly after delivery, and even ambulatory patients were detained alike (Table 3). |
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Table3. Cases of unjust detention
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| Nearly half of the detainees developed varied symptoms, such as apprehension about family, headaches, loss of appetite, sleeplessness, and body pains and etc (Table 4). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table4. Symptoms in detention (multiple answers permitted)
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The most common disorder observed was psychogenic reaction (42 cases). This is followed by suspected PTSD (Post Traumatic Stress Disorder), gastritis/duodenal ulcer, discopathy and etc. Deterioration of these symptoms sometimes resulted in suicide attempts or general debility (Table 5) |
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Table5. Diagnosis observed (multiple answers permitted)
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| Seventeen of the twenty-two asylum seekers who had undergone detention or persecution in their homelands felt that detention in Japan brought back the memory of their past hardships (Table 6). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table6. Experience during detention of asylum seekers
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| Five cases of violence by immigration personnel were noted, of which one resulted in cervical discopathy and two in lumbar discopathy (Table 7). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table7. Violence by immigration officials
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| Immigration centers provide only symptomatic treatments for aggravating illnesses. On top of that, major tranquilizer, minor tranquilizer, sleeping pills, or pain relievers are administered for an extended period of time. Sometimes the dosages exceed 30 tablets. A typical schedule is illustrated (Figure 1). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No palpation or auscultation was conducted by immigration doctors, and
essential screening tests were carried out only sporadically. No interpreter
was available, and the lack of explanation as to the sickness or medicines
caused strong anxiety about the medication. Therefore, the detainees had
little trust in the medical staff at immigration centers (Table 8). |
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Table.8 Medical consultation in detention
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| Repatriation took place abruptly without any advance notice to the detainees themselves or their families. Two of the detainees were forced to take medication by the immigration staff the same day or the day before and then deported in a state of trance (Table 9). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table.9 Drug usage during deportation
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| Subsequent to deportation, four of the detainees continued to suffer from the disease developed while in detention. One having cervical lymphadenitis by tuberculosis convalesced through administration of tuberculosis medicine, but another with cervical discopathy, unable to receive any medical treatment, showed clinical deterioration. Four of the asylum seekers were interrogated and detained by local authorities in their home countries. One thereamong was still in detention at the time this survey was conducted, and three were released after a few months upon posting a high bail (Table 10). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table.10 Circumstances after deportation
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| Among those provisionally released, eleven continued to suffer from disease such as depression, brain infarction aftereffects, gastritis/duodenal ulcers, and discopathy. Their lives were made quite difficult by the disorders they had developed in detention (Table 11). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Table11. Circumstances after provisional release
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<Discussion> |
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| The present survey highlights an increasing number of cases in which a family was separated or a foreigner with a Japanese spouse was detained, features unseen in the previous report. Also to be noted is the detention of sick people and juveniles. The period of detention, averaging 15 months, was twice as long as reported in the previous survey, 7.4 months. This trend became apparent around the fall of 2003 and is believed to reflect the general crackdown on “illegal” aliens operated jointly by the Immigration Bureau, National Police Agency and Tokyo Metropolitan Government. Salient features revealed in the present survey are the alarmingly sharp rise in the number of foreigners questioned and arrested at train stations or on the streets, as well as in the number of asylum seekers forcibly detained when they arrive at the immigration office for monthly reporting. What are the conditions in which these foreigners were put subsequent to their detention? 1. Damage by detention Our earlier survey has noted mental as well as physical damage to the detainees’ health [1]. Asylum seekers have already undergone persecution in their home countries and suffer from mental symptoms such as PTSD. They, therefore, need special considerations. Nevertheless, these individuals are subjected to prolonged detention, causing increased incidence and severity of disease. Not knowing when they will ever be released, they live in constant fear of their future and deportation. Indefinite detention with possible deportation at any moment is nothing but mental torture. An asylum-seeker, age 20, who had already been in detention for more than a year highlighted the injustice of the detention by saying: “This detention is nothing but a prolonged murder.” Another detainee, a twenty-eight year old male, who had been detained for almost two years and finally won refugee status three months after being provisionally released, expressed: “The two years I spent in detention were absolutely meaningless.” Mentally cornered and strongly depressed, some detainees attempt suicide. Seven such cases have been noted including those reported in our earlier report. Some detainees, unable to endure prolonged detention, have no choice but to return home or exit to a third country. Detention of an unspecified period destroys the minds of these humans. Physical disorder routinely seen among detainees is discopathy. After years of living in a small space with limited chances to work out, it is only natural that muscular disuse atrophy develops, worsening their backaches. Additionally, the stress they have to put up with is tremendous due to being under control of harsh rules and living in the same room with other foreigners with different cultural and linguistic backgrounds. Such environments could trigger gastritis/duodenal ulcers, hypertension, and angina related to psychogenesis. Recently, communicable diseases such as tuberculosis, hepatitis, and HIV have been spreading among foreigners residing in Japan [2–3]. Several tuberculosis cases have been found in immigration detention centers as well [4–5]. It is believed that the prolonged detention in poor living conditions prompted the development of these diseases. Tuberculosis was also found among immigration staff [6], which probably originated from a detainee whose contraction went unnoticed. The danger of tubercular contraction at the immigration center has been pointed out for some time [1] but immigration authorities have failed to appreciate its significance and have never exercised infection control. Whenever a detainee calls for improved treatment at immigration centers, the attempt is always quashed by the authorities. In the year 2004 alone, two incidents were reported in which the protester was physically abused [7–8]. Violence and crackdown on detainees are not new. Similar incidents are known to have taken place at the Omura Immigration Center in Nagasaki Prefecture [9], which opened immediately after World War II to accommodate residents from South and North Korea. This is a history of violence and suppression which has carried on until today. Although cases of mental and physical disorder and violence-induced damage have been exposed, medical services at immigration do no address these problems adequately. Treatments are only symptomatic, with no attempt made to effect a permanent cure. Any prior outpatient treatment at hospital is disrupted by the detainee’s arrest and never resumed during detention. Likewise on arrest, the compensation of labor accident is terminated. This deprives the detainees not only of the right to receive medical treatments but also the right to social security. During the consultation with doctors, no consideration is made of the detainees’ linguistic and cultural backgrounds. No explanation is given as to the medicines and the disease diagnosed, which enhances distrust of the medical staff at immigration centers. The bottom line is there is no trusting relationship between the doctors and the patients. The majority of the detainees cried out: “The doctors at immigration are not doctors at all.” Damage to the detached members of the family is also grave. A child, whose parents were both arrested, was taken into custody by a child consultation office. It kept on crying from anxiety. The grief of children separated from parents is simply unimaginable. Another serious problem is that detainees married to Japanese are deported only after prolonged detention. Deep is the sorrow of the Japanese who, after paying so many visits to the immigration center hoping for provisional release, are removed abruptly from their spouses by deportation. 2. Damage by forcible deportation A case was encountered in which a detainee, who was about to sue the Government for redress of damage from cervical discopathy inflicted by violent treatments at immigration, was deported [4]. Similar cases of abrupt deportation of individuals preparing for national redress litigation have been known for some time [9]. Cases have also been found in which a dozen immigration officials intimidated and immobilized detainees, so that they could not resist, and then deported them. Some were even forced to take medicines which were believed to be minor tranquilizer or sleeping pills [4]. Although the immigration authority strongly denies drug usage during deportation, it is no surprise considering the fact that (i) deportation after putting the detainees into a trance state using drug injection has been reported previously [10] and (ii) heavy and long-term administration of major tranquilizer, minor tranquilizer and sleeping pills has been a common practice at immigration centers. In many of the cases, symptoms remained after deportation. Even those with severe illnesses were refused a continuing supply of the prescribed medicine at the time of deportation, and no referral letter required for receiving medical consultation at hospitals back home, was provided to them. An individual told by the immigration doctor that he probably had cancer was correctly after deportation, at hospital in his home country, with cervical lymphadenitis by tuberculosis. In a letter to the author, he wrote: “They dumped me just like throwing away garbage.” Another detainee was unable to overcome the mental shock caused by the violent treatment by immigration officials when he was repatriated, and remained ill with abdominal pain and nausea. Even if deportation has to be conducted, the prospective circumstances after going home should be considered. In case detainees with a severe sickness are to be deported, immigration should see to it that they receive continued and seamless medical care in their home countries. This is never done, violating medical ethics. Four of the asylum seekers deported were detained again in facilities in their homelands. One of them, who was lucky enough to be released, remarked: “Since the authorities here refuse to give me any ID, I have nothing to prove my identity. So I am unable to work and hard up. Moreover, the authorities keep me under constant surveillance.” For asylum seekers, forcible deportation could mean death. It was found recently that the refugee-recognition department of the Japanese government visited Turkey to conduct, together with the local police and the military security unit, an interview with the family of a Kurdish asylum seeker detained in Japan [11]. This is an extremely dangerous act jeopardizing the refugee and his family. The refugee inspection officers and the immigration personnel of the Ministry of Justice lack any understanding of what refugees are and what would await them if they should be deported forcibly to their countries of origin. 3. Continued health problem after provisional release The author has been conducting medical consultation at a refugee support organization. There half of the comers have experienced detention at an immigration center and still suffer from sickness developed during detention [12]. In addition to physical sickness such as discopathy and gastritis/duodenal ulcer, many suffer from mental disorders. Cases of PTSD have also been recognized, indicating the deepness of “mental wounds” which take substantial time to heal. Even for patients with aggravated sickness requiring continual medical care, upon provisional release, the immigration authorities do not provide referral letters to hospitals or a continuing supply of the medicine prescribed in detention. Their situation in that respect is similar to that of forcibly deported detainees. Even after provisional release, former detainees are required to report once a month to the immigration office, putting them in constant fear of being detained again and deported. “Upon entering immigration, my hands start to tremble and my heart starts to palpitate.” “The traumatic experience during detention keeps coming back.” After provisional release, the detainees are unable to return to their former jobs, causing them to lose their income and making their lives extremely hard. Prolonged confinement into a small space induces loss of spatial and temporal senses. As a result, return to normal life takes a significant amount of time. If health problems from detention continue, the former detainees have no choice but to pay expensive medical fees, a major financial drain on their resources. For example, a detainee with deteriorating disc herniation, after he was provisionally released, found himself unable to pay his medical bills and stopped going to hospital. 4. “Damage” on immigration staff and cost issue An immigration staff member who uses violence may come into contact with the blood of a detainee with hepatitis or HIV. Contact with this blood would put him or her at high risk of contracting the infectious disease. As pointed out earlier, the immigration authority has no appreciation of such infection risk and has taken no countermeasures. An immigration official once blew the whistle, confessing that violence against detainees was routine and that he could no longer stand it [9]. Violence destroys our conscience in the end and, in that respect, the immigration officials themselves may be “victims”. A few words about costs: Every time a detainee is taken to an outside hospital, three to four staff members accompany him or her. The cost of the trip, including salary, transport, etc. is substantial. As the period of detention increases, morbidity rate rises and sickness is aggravated, resulting in higher medical costs and increased workload on immigration personnel. When a detainee is deported, three immigration officers accompany him or her. The total expenditure, including normal airfare, hotel accommodation and personnel costs, is enormous. All this is supported by our taxes. 5. Remaining problems Prolonged detention takes away freedom, divides family, brings on disease, and causes violence-induced health disorders. Their effects remain after deportation or provisional release, doubling or tripling the damage to the detainees. Many of the asylum seekers stated indignantly, “All I did was apply for a refugee status. Why should I be treated like a criminal?” It is simply wrong to detain foreigners without any criminal offense for an extended period of time. Immigration authorities pay almost no attention to providing medical care for sick detainees. According to an immigration staff member, “The duty of immigration medical personnel is to check if the detainee endures detention.” Here the notions of prevention and cure, which are the basis of medicine, are absent, and the right of the patients to receive medical care is completely ignored. That the right is ignored should be construed as representing the real thinking of the immigration staff, whose priorities are detention and deportation. Given that, the medical services at immigration will never ameliorate even if they increase the budget, reinforce the workforce, or upgrade the facilities. Even if the quality of the medical services improves, the medical treatment at immigration centers will be meaningless in view of the mistrust of the detainees toward the immigration doctors. Medical services are based on mutual trust between patient and doctor. To guarantee the basic right of the detainees to receive medical care, they should be treated at an independent medical facility unrelated to the immigration center. If that cannot be arranged, we should keep constant monitor of the immigration medical services and continue to appeal for provisional release. Every time the author visits an immigration center to see a detainee, he submits an advice/request sheet in which he states: “When a sickness breaks out, the medical personnel have to investigate its cause and bend over backward to its prevention, early detection and adequate early treatment. However, since the detention itself is causing and aggravating disease, treatment at the immigration center is nearly impossible. Provisional release is the best way of preventative and curative care under the circumstances. It is too late to start an action after the damage becomes irreparable. It is unforgivable to leave the patient untreated knowing that such irreversible change is due to occur.” Inadequate medical treatment, violence, and forcible deportation are merely the tip of the iceberg. There are many more alarming cases. We should step up monitor of immigration, conduct similar interviews with the detainees, and trace the detainees’ development, not only during detention, but also after provisional release or deportation. The outcome of such surveys would be valuable for checking if immigration conforms to the international laws and ought to be reflected in refugee policies. This, however, is a job that goes beyond the capacity of a single individual and a systematic operation is called for. Cooperation with attorney groups, human rights organizations, refugee/foreigner support groups, and foreigners’ associations is indispensable. We ought to set up a framework for such collaboration. Also, information exchange and coordinated action with overseas human rights groups will be important. The Japanese government pushes ahead with overseas aid and emergency relief operations for disaster victims and refugees. If you look inside Japan, however, the Government is repeatedly violating the human rights of foreigners and “persecuting” the refugees just as these refugees are persecuted in their homelands. Prolonged detention at immigration centers and forcible deportation are in obvious violation of international conventions ratified by the Japanese government, such as the International Covenant on Civil and Political Rights, the Convention Relating to the Status of Refugees, and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. If Japanese government fails to observe international “rules”, it will lose its international trust. The basic spirit of international conventions is the protection of human rights. Is Japanese government able to exercise this spirit inside the country at all? Finally, after the author gave a talk at the Association of International Health Care and referred to human rights violation at immigration centers under the Ministry of Justice in Japan showing the picture of a detainee who underwent extreme body weight loss (Fig. 2), a professor came up saying, “This is like an Auschwitz!” The country may differ, the time may differ, and the degree of damage may differ, but there are concentration camps similar to Auschwitz around us. |
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| <References> |
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| [1] Yamamura J.: Wounded Asylum Seekers in Japan – The health condition of
detainee and situation of medical services at immigration center --, Medical
Asahi 2004; February: 52-55. [2] Yamamura J. and Sawada T.: A Study of Tuberculosis Cases among Overstaying Foreigners. Tuberculosis 2002; 77: 43-49. [3] Yamamura J. and Sawada T.: The Situation and Problems of Overstaying Foreigners with HIV. J. of AIDS Research 2002; 4: 53-61. [4] Yamamura J.: Wounded Foreigners in Japan – Violence at Immigration Center, Deportation using Drugs, and Tuberculosis caused by Prolonged Detention. Medical Asahi 2004; Vol. 397: 51-51. [5] Yamamura J.: Interview with Immigration Detainees – “Advice/Request” Concerning a Burmese Asylum Seeker. Dec. 10, 2004. [6] Amnesty International Japan: Record of Negotiation with the Ministry of Justice – Remark by Mr. Nishio, chief immigration officer, Nov. 9, 2004. [7] Yamamura J.: Interview with Immigration Detainees – “Advice/Request” Concerning a Kurdish Asylum Seeker. June 11, 2004. [8] Asahi newspaper: Dec. 16, 2004. [9] Immigration Review Task Force: Human Rights Violation behind a Closed Door -- Situation in Immigration Detention Centers. Tokyo, Genndai-Jinbun Publisher, 1996. [10] Asahi newspaper: Dec. 27, 1999. [11] Kyodo press agency: Aug.4, 2004. [12] Japan Association for Refugees: Medical Consultation of Refugees in Japan (internal document). |
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