Making scapegoats of asylum seekers and people coming into Britain with HIV has become a hot issue in 2003. Martin Flynn reports
Four out of five heterosexuals diagnosed with HIV in the UK have arrived from abroad. Is this country still a 'safe haven' for them? The recent equation of immigrants and asylum seekers as potential terrorists in the tabloid press, and alarmist stories about HIV-infected émigré health workers, brings this into question. Stories about Britain as an overcrowded island with a lack of resources to cope with asylum seekers have dominated much of the political discussion this spring.
A special conference in January, organised by Naz Project London, brought together doctors, nurses, health advisers and voluntary sector experts to look into this thorny question as the propaganda war built up in the media.
George Alagiah, BBC Six O'clock News journalist and a Naz patron, told the meeting that he came to this country as a migrant at the age of 12.
"There is now a general fear and unease about asylum seekers and immigrants coming into Britain", he said, "but the major problem is not so much about racism and prejudice as a lack of sound information.
"Britain has accepted fewer immigrants and asylum seekers than many other countries in Western Europe", he added, "but the myth persists that Britain is a soft touch for immigrants and also that they are swamping this country."
Dr Amrit Wilson, a researcher from the Department of Politics at the University of Huddersfield, said that aspects of racism in Britain are deeply rooted in our culture and pervade all parts of society.
"All British people grow up in the context of a racist ideology," she said. "HIV is fraught with racism and asylum seekers are at the sharp end of this."
Asylum seekers are often portrayed as scroungers and even terrorists in the media, Dr Wilson said, and they often have to live in poor hotels facing poor conditions and racist violence.
In reality, she said, "asylum seekers face humiliation, isolation and intimidation as well as poor human rights. They are exploited in the workplace and often do the dirtiest jobs for poor wages."
Emma Colyer, director of Body and Soul, described how asylum seekers with HIV face double discrimination. "Entitlement to treatments and services is a mess. The new government Sexual health and HIV Strategy is supposed to encourage access to HIV testing when in reality the opposite is now the truth," she commented.
There is now a huge backlog of asylum applications in Britain. Dr Surinder Singh, a GP from South East London, said that some local advice centres for immigrants and asylum seekers are now only open five hours over three days a week because of funding cutbacks.
Gaener Bruce, a specialist immigration barrister, said that under new rules, if applicants do not apply for asylum as soon as they enter Britain, they would not get any money, vouchers or housing assistance.
"Over 100 cases a week are already failing under this category," she said, "and the Refugee Council is predicting that soon we are going to see asylum seekers homeless on the streets."
Dr Chris Wood, an HIV consultant at North Middlesex Hospital, said that there is confusion and a lack of consistency in government policy.
"The crackdown on immigration and asylum is forcing many people with HIV underground."
Lisa Power, director of policy and campaigns at THT, said people coming to Britain from Zimbabwe now face a worse situation than those coming from other African countries.
The government has just launched a major new enquiry around immigration, TB and HIV, Power explained, to be led by the Cabinet Office. The HIV voluntary sector has to ensure its voice is heard.
Neil Gerrard MP, chair of the All-Party Parliamentary Group on Aids, said the Home Office is an administrative disaster area and has been for many years.
"Papers and passports get lost and I think we should ban any further Home Office legislation until they sort their systems out."
Even though many asylum seekers are escaping from countries where HIV infection is endemic, they are still unlikely to seek out testing or access treatments when they arrive in Britain. Late diagnosis is still the rule rather than the exception.
Dr Deenan Pillay, of the Public Health Laboratory Service (PHLS), said that predictions were for over 5,800 new HIV cases in 2002 in Britain compared with 4,650 diagnoses in 2001 - a 25 per cent increase in one year. Eighty per cent of heterosexual cases acquired their HIV abroad: 70 per cent of them (56 per cent of the heterosexual total) in Africa.
Dr Ade Fakoya, HIV consultant at Newham General Hospital, said that over 85 per cent of his patients are now from sub-Saharan Africa and primary care facilities in his part of London are now "very scarce and very poor".
"The issue of mandatory testing for HIV rears its ugly head every five years or so and we have to say it didn't work then and it won't work now."
Dr Ranjababu Kulasegaram, an HIV consultant at St Thomas' Hospital, echoed this view: "We need to encourage HIV testing and make it more easy and accessible, not compulsory."
Dr Annemiek de Ruyter, also of St Thomas' Hospital, said stigma and homophobia in the Afro-Caribbean community is driving up HIV and we are just seeing the beginning of a huge problem for the future.
Dr Chris Ford, of the Royal College of General Practitioners, said that psychological and voluntary sector support for people with HIV has dropped off because of funding cuts with the health authorities being forced to spend the bulk of their HIV budgets on a massive drugs bill.
The Naz conference heard two moving case histories, which highlighted some of the problems faced by people coming into Britain with HIV.
The first case was of a former Colombian naval officer who faced persecution and violence after he was diagnosed with HIV.
He told the conference that he came to the UK and sought asylum because he thought it was a safe and democratic place, but was expected to live on less than £3.30 a day.
"One hundred and forty people were each being charged £250 a week to stay in a pokey hotel, which means that the government is getting ripped off and someone is getting very rich."
Another case study was of a woman from Ethiopia who had paid £2,500 to a man to come to England only to find herself HIV positive, abandoned, homeless and ill.
"Being an asylum seeker is not something you choose," she said. "You're seen as a beggar and treated as a second class citizen. We're human beings. We deserve human rights but I'm seen as a burden."
For advice on asylum, citizenship and HIV, contact: THT Direct, tel 0845 1221200. Visit: www.tht.org.uk - click on campaign with us icon. Blackliners, tel 020 7328 5274. Joint Council for the Welfare of Immigrants, tel 020 7251 8706. Refugee Council, tel 020 7582 6922.
