International Coalition for the Rights of Iranian Refugees

 
 

 
May  25,  2011-­‐ICRIR:  Deadly  Interactions:  Refugees  and  Denial  of  Access  to  Health  Care  in  
Cyprus  
An  Open  Letter  to  the  European  Union  Court  of  Human  Rights  
 
To  the  European  Union  Court  of  Human  Rights:  
 
We  are  writing  to  you  concerning  the  life-­‐threatening  medical  situation  facing  an  asylum-­‐
seeker  in  Cyprus.    A  refugee  is  in  the  process  of  dying  a  slow  and  painful  death  due  to  the  
Cypriot  government's  practice  of  functionally  denying  medical  care  to  refused  asylum-­‐
seekers.  (1)    
 
Elahe  Rahimi,  an  Iranian  asylum-­‐seeker  who  fled  the  notorious  depredations  of  the  Islamic  
Republic,  suffers  severe  consequences  of  diabetes,  including  among  others  complete  renal  
failure  and  ischemia  of  her  lower  extremities.    As  can  be  seen  from  the  attached  images,  the  
progression  of  gangrene  in  her  feet  over  the  course  of  6  weeks  without  appropriate  medical  
care  has  been  significant.  
 
As  a  result  of  the  refusal  of  the  Cypriot  government  to  provide  timely  and  appropriate  care  
for  Mrs.  Rahimi's  gangrene,  she  is  now  at  risk  for  necrotizing  fasciitis,  according  to  her  
consulting  physician  in  the  United  States,  which  will  result  in  Mrs.  Rahimi  dying  a  horrific  
death  within  one  week  of  the  ascending  infection.    Note  that  her  current  condition  has  been  
deemed  "not  urgent,"  and  thus  Mrs.  Rahimi  has  been  denied  even  emergency  care  on  this  
basis.  
 
Due  to  the  courageous  persistence  of  Mrs.  Rahimi's  family  in  trying  to  obtain  care  for  her  in  
the  face  of  severe  negative  pressure  from  the  Cypriot  government,  UNHCR,  and  hospital  
administration  and  staff,  Mrs.  Rahimi  has  found  two  doctors  who  are  willing  to  deal  with  
her  case.    However,  they  have  chosen  a  very  conservative  (and,  not  coincidentally,  
inexpensive)  approach  to  managing  her  case:  they  have  chosen  to  administer  antibiotics  for  

 
 
Members  of  the  International  Coalition  for  the  Rights  of  Iranian  Refugees  include  Action  for  Democracy  
and  Human  Rights  in  the  Middle  East,  International  Federation  for  Iranian  Refugees,  Iranian  Refugees  
Action  Network,  Iranian  Refugee  Amnesty  Network,  and  Mission  Free  Iran.  
http://icrir.org  
 International Coalition for the Rights of Iranian Refugees

 
 

a  month  to  see  what  happens.    Given  Mrs.  Rahimi's  condition,  her  consulting  physician  in  
the  United  States  writes,  "I  am  very  worried  that  this  patient  may  not  last  the  one-­‐month  
trial  of  conservative  management.  I  am  very  worried  that  this  patient  is  dying  a  slow  painful  
death.  The  gangrenes  of  her  feet  are  no  longer  dry.  They  are  weeping  with  exudate...  I  am  
very  worried  that  amputation  one  month  from  now  will  be  too  little  too  late."  
 
Further,  although  Mrs.  Rahimi  has  been  prescribed  medication  and  is  at  this  moment  in  the  
hospital  (though  at  high  risk  of  being  sent  home),  the  hospital  will  not  fill  the  prescriptions.    
Instead,  the  family  is  forced  to  try  to  find  the  money  to  purchase  the  very  expensive  
medications  and  buy  them  outside  the  hospital  and  bring  them  back  to  Mrs.  Rahimi  to  take.    
The  family  cannot  afford  the  medications  necessary  to  keep  Mrs.  Rahimi  alive.  
 
It  should  be  noted  that  these  terrible  circumstances  are  a  direct  result  of  a  succession  of  
violations  of  Mrs.  Rahimi's  rights  that  have  taken  place  under  the  auspices  of  the  Cypriot  
government:  
 
1)  Under  the  1951  Convention  and  the  1967  Protocol  relating  to  the  Status  of  Refugees,  
Mrs.  Rahimi  has  a  guaranteed  right  to  asylum,  which  has  been  denied  through  the  
draconian  refugees  status  determination  practices  in  Cyprus  that  result  in  a  refugee  
recognition  rate  of  only  about  1  percent.    What  this  refugee  recognition  rate  guarantees  is  
that  in  Cyprus,  nearly  all  asylum-­‐seekers,  including  Mrs.  Rahimi,  are  denied  their  
internationally-­‐recognized  right  to  asylum.  
 
2)  Because  access  to  health  care  in  Cyprus  for  asylum-­‐seekers  is  denied  once  their  asylum  
application  is  denied,  Mrs.  Rahimi  has  been  functionally  denied  her  right  to  health  care  -­‐  a  
right  that  has  been  recognized  as  human  right  by  various  international  instruments  ratified  
by  European  Union  member  states,  including  Cyprus.  (2)  
 
3)  When  UNHCR  staff  was  asked,  given  this  emergency,  what  UNHCR  could  do  to  help,  the  
reply  was,  "Nothing."    UNHCR-­‐Cyprus  staff  advised  that  Mrs.  Rahimi  should  simply  return  to  

 
 
Members  of  the  International  Coalition  for  the  Rights  of  Iranian  Refugees  include  Action  for  Democracy  
and  Human  Rights  in  the  Middle  East,  International  Federation  for  Iranian  Refugees,  Iranian  Refugees  
Action  Network,  Iranian  Refugee  Amnesty  Network,  and  Mission  Free  Iran.  
http://icrir.org  
 International Coalition for the Rights of Iranian Refugees

 
 

Iran  to  obtain  health  care  there.    For  a  UNHCR  staffperson  to  make  such  a  suggestion,  given  
the  repression  in  the  country  and  given  that  the  Islamic  Republic  regime  has  promised  to  
prosecute  returned  asylum-­‐seekers,  is  unconscionable.    The  UNHCR  staffperson  was  told,  
"She  can  not  return  which  means  that  she  stays  here  and  dies,"  to  which  the  UNHCR  
staffperson  replied  only  "with  a  meaningful  smile,"  according  to  a  family  member  of  Mrs.  
Rahimi.  
 
Mrs.  Rahimi  has  faced  violation  after  violation  of  her  human  rights  and  her  rights  under  
international  and  EU  law.    It  is  unacceptable  and  we  demand  that  these  violations  stop  
now.    We  request  that  the  European  Court  of  Human  Rights  urgently  direct  the  government  
of  Cyprus  to  provide  Mrs.  Rahimi  full  and  unfettered  access  to  appropriate  health  care.      
 
Further,  Mrs.  Rahimi  has  a  right  to  asylum,  and  this  right  should  be  immediately  granted  by  
Cyprus.    The  European  Union  should  urgently  investigate  the  practices  regarding  refugee  
status  determination  and  illegal  refoulements  in  Cyprus.    
 
If  Cyprus  cannot  brings  its  standards  of  performance  in  the  area  of  human  rights  up  to  the  
level  demanded  by  the  European  Union,  we  suggest  it  be  considered  for  expulsion.  
 
(1)  Note  that  this  case  has  implications  for  most  asylum  applicants  in  Cyprus,  which  has  a  
refugee  recognition  rate  of  approximately  1  percent,  among  the  lowest  in  the  EU.  
 
(2)  Access  to  health  care  is  a  right  that  has  been  recognized  as  human  right  by  various  
international  instruments  ratified  by  European  Union  member  states,  including  Cyprus:  
 
-­‐  Article  4  of  the  European  Union's  Charter  of  Fundamental  Rights  prohibits  torture  and  
inhuman  or  degrading  treatment  or  punishment.    Allowing  a  person  to  be  consumed  by  
gangrene  because  she  is  a  denied  refugee  and  cannot  afford  to  pay  is  indeed  both  torture  
and  inhuman  and  degrading  treatment.    It  is  illegal  under  the  EU  Charter  of  Fundamental  
Rights.  

 
 
Members  of  the  International  Coalition  for  the  Rights  of  Iranian  Refugees  include  Action  for  Democracy  
and  Human  Rights  in  the  Middle  East,  International  Federation  for  Iranian  Refugees,  Iranian  Refugees  
Action  Network,  Iranian  Refugee  Amnesty  Network,  and  Mission  Free  Iran.  
http://icrir.org  
 International Coalition for the Rights of Iranian Refugees

 
 

 
-­‐  In  Article  13.2  of  Council  of  Europe  Resolution  1509,  Human  rights  of  irregular  migrants,  
provision  of  emergency  care  is  defined  as  the  minimum  for  meeting  the  human  right  to  
health  care:  "13.2.  emergency  health  care  should  be  available  to  irregular  migrants  and  
states  should  seek  to  provide  more  holistic  health  care,  taking  into  account,  in  particular,  
the  specific  needs  of  vulnerable  groups  such  as  children,  disabled  persons,  pregnant  women  
and  the  elderly;"  
 
-­‐  Article  12b  of  the  International  Covenant  on  Economic,  Social  and  Cultural  Rights,  which  is  
part  of  the  International  Bill  of  Rights,  states  that  "health  facilities,  goods  and  services  have  
to  be  accessible  to  everyone  without  
discrimination,  especially  the  most  vulnerable  or  marginalized  sections  of  the  population,  in  
law  and  in  fact,  without  discrimination  on  any  of  the  prohibited  grounds.  
 
-­‐  Article  24  of  the  Convention  and  Protocol  relating  to  the  Status  of  Refugees  also  refers  to  
the  minimum  standards  that  should  be  applied  to  all  refugees  seeking  asylum:  The  
Contracting  States  shall  accord  to  refugees  lawfully  staying  in  their  territory  the  same  
treatment  as  is  accorded  to  nationals  in  respect  of  the  following  matters:  Social  security  
(legal  provisions  in  respect  of  employment  injury,  occupational  diseases,  maternity,  
sickness,  disability,  old  age,  death,  unemployment,  family  responsibilities  and  any  other  
contingency  which,  according  to  national  laws  or  regulations,  is  covered  by  a  social  security  
scheme).  

 
 
Members  of  the  International  Coalition  for  the  Rights  of  Iranian  Refugees  include  Action  for  Democracy  
and  Human  Rights  in  the  Middle  East,  International  Federation  for  Iranian  Refugees,  Iranian  Refugees  
Action  Network,  Iranian  Refugee  Amnesty  Network,  and  Mission  Free  Iran.  
http://icrir.org