S5E10 Female asylum seekers: Healthcare, housing, and the hostile environment
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Welcome to MediaStorm's final episode of the series, but don't worry, it won't be very long until we're back on your feed. We'll be back in three weeks' time on the 15th of May. Mark your diaries. Hi listeners. Many times on MediaStorm, we have covered the myths and misunderstandings about refugees, migrants and asylum seekers in our daily news.

The mainstream media really just keeps giving and giving in this area. Well, lots of these myths come into play with the topic we're looking at today. Female asylum seekers pregnant.

in unsafe housing and apparently without access to free healthcare. You said female asylum seekers, but wait, aren't they all men? Judging by the mainstream media, you could easily think so. It is true that the majority of asylum seekers who make longer journeys like to Europe and the UK are men, about two-thirds give or take. And my first response to that would be that the media has objectively failed to point out the very simple reasons for this. And

And those are? For example, conscription. The fact that men and boys have to leave younger often because of being forcibly conscripted into child militias. Another reason is that men often want to make dangerous journeys so that women and children they're related to don't have to in the hope that they can claim family reunification and bring their families over safely. And if that doesn't work, at least send them money so that the women and children in their family don't have to choose between starving in refugee camps and...

content warning being raped most likely while making the journey themselves. The male nature of asylum migration is a natural consequence of the lack of safe routes and to be honest the reason that even more women and children are not starving to death in camps and war zones is because of the money being sent to them by male relatives who have done the journey and gotten jobs. This

desperate, gender-based refugee migration. It's actually a really, really core underlayer of the global economy. And our media basically pretends it doesn't exist. It's really, really frustrating to me. You know, I actually do think that we should do an episode about refugee men. And then we can simply ask them to explain why they're men. Lol, why are you men? Why are you men?

OK, but I understand what you're saying. And also, even though the majority are men, the media's fixation on this group, which they have deemed the most problematic and the easiest to demonise, it also means that the thousands of female asylum seekers also coming get almost...

No coverage at all. And no coverage means no awareness, which, as we often hear on this show, often leads to policy holes. Yeah. OK, so you said a lot of common myths play into today's episode. So pregnant asylum seekers lacking NHS care, living in unsafe housing, but...

Hang on, don't they all come for five star or four star or three star luxury hotel accommodation? Yeah, we spoke about this one on yesterday's Newswatch thanks to a Daily Mail article. Go listen to it if you haven't.

What I would say to this is in my personal experience of visiting families and asylum seekers who are staying in these hotels, I get quite confused by the coverage because they really, really, really are not luxury facilities. And while I have on occasion been to see families who've been in quite nice hotels, the context that's not included is that you have entire families staying in rooms for, you

And so that is the experience that I have had working in the refugee sector. But we will hear some lived experience on that in the episode today. Wait, but something else we hear is that migrants are coming over to milk our NHS to get free health care. And now you're saying that's not how it works? Yeah, this is a common misconception. It also conflates lots of different types of migration issues.

In reality, most migrants actually pay more into the NHS than citizens. On top of the national insurance tax that we pay, they also pay a surcharge. Wow. I'm sorry. You just never, ever hear about that. True. Also...

Migrants are quite literally the backbone of the NHS. You can't have this conversation without pointing out that one of the single biggest visa types that has driven up immigration in the UK is healthcare worker visas. Half of the NHS workers who died on the COVID front lines were migrant workers.

Now, when it comes to asylum seekers, asylum seekers experience huge healthcare inequality when displaced. If they make it safely to the UK, in theory, they should be eligible for free healthcare. While they are asylum seekers, the problem in reality is that this often isn't implemented. They often get erroneously charged. So today, we look at healthcare injustices for female asylum seekers. How big a problem is this? Who's picking up the pieces? And

And what does the mainstream media have to do with it? All the immigrants that we have are men. Given lovely hotel rooms, what was wrong with what they did in Greece where they had these huge encampments? How can asylum seekers get fast track NHS care before British citizens? Is this a blinking joke? One in three babies born in this country were born to foreign mothers. Does this pose serious issues for the future makeup of our country?

Welcome to MediaStorm, the news podcast that starts with the people who are normally asked last. I'm Matilda Mallinson. And I'm Helena Wadia. This week's MediaStorm. Female asylum seekers, healthcare, housing and the hostile environment. Welcome to the MediaStorm studio.

A story broke this week in The Guardian. An asylum seeker from Zimbabwe with the pseudonym Kim was approached by a debt collection agency and handed a £10,000 NHS bill for giving birth. She'd had to have an emergency caesarean section and those do not come cheap.

Well, Kim is joining us on MediaStorm today, as well as an asylum seeker. She is a performer, dancer and actress. She's joining us via Zoom as she has a small child to take care of in Bradford. Welcome, Kim. Thank you so much. Firstly, can you tell us how did you cope when you first received this bill, learning you had to pay £10,000 while living off an asylum seeker's allowance?

So first of all, I was shocked. Like, how did I get charged? And I'm like, because I was supposed to give like a normal birth. So when I gave like a cesarean, I was like, they should have just left me maybe like that. I didn't want the cesarean because it seems to be more expensive. But you know, like those thoughts. And then I'm thinking like, where am I going to get all this money? And I'm an asylum seeker. This bill keeps adding on. There's one that is came,

before I'd given birth, I was charged and then now I'm charged again.

It was really, really stressful. My baby was still small and was still breastfeeding. In my culture, I believe when you're breastfeeding, that energy, that stress, you're supposed to avoid stress because you're breastfeeding to the child. So it was all my worry to say, oh, the child, me, what's going to happen? Are they going to remove me from this house? Because now I owe them a lot. That was my main worry. It was so stressful. And thinking that they might retain me

back to Africa or something like that because I cannot afford that 10,000 by bloods, the 3,650 that they said. So it was too much because the baby was still small. So how am I going to be able to buy everything and pay them at the same time? And I don't have a bank account. So it was so stressful. Now, as an asylum seeker, Kim is not actually supposed to have to pay these NHS charges, charges that target most migrants. But she's not alone in being hit with them anyway.

Hello, Judith. Hello.

Hello. In the UK, the topic of migration in the NHS, it's a very sticky issue. We will get into it in more detail, but let's start with the specifics here. Judith, is it standard practice to charge refugees and asylum seekers thousands of pounds for life-saving and reproductive care? The government policies to charge those who are not ordinarily resident in the UK, but there are exemptions for people in certain circumstances, including those who've made a claim for asylum, as you've said.

But as we've seen through Kim's experience, the rules aren't always applied correctly. At Maternity Action, we help women who've been charged either to challenge the rules, as NCT helped Kim, or to agree reasonable payment plans, or where the woman has no funds, sometimes we're helping them to ask for the debt to be written off.

We're talking about women who live in this country and who don't have the means to pay. We don't think that women should be charged for maternity care. We've seen how frightening it is.

But equally, some of those women are wrongly charged. Thank you for clarifying. And you mentioned there the NCT who had helped Kim. That's the National Childbirth Trust. And they did indeed help Kim to have her billing corrected. So we're pleased to say Kim is not having to deal with that debt today anymore.

A 2022 report by the charity Doctors of the World revealed that over a third of migrant women are being charged to give birth, some up to £14,000 and many, as you've pointed out, mistakenly. Women who have been affected by these charges report serious mental health issues arising from these charges. Some have been evicted from housing, others moved and even deported whilst pregnant, despite official protected periods.

Vulnerable women are forced to avoid seeking help for their pregnancy, risking their lives at fear of being charged thousands by the NHS. And three quarters of migrant mothers who lost their babies and needed an interpreter didn't get one and had to navigate that heartbreaking trauma terrified and alone. These are just some of the stories that we are not seeing portrayed in the mainstream media.

Kim, I wonder if you can tell us, did your migration status in any way endanger the health and safety of your baby during pregnancy, during birth or afterwards? Yes, yes. Because I feared being charged again. When I was pregnant, I was admitted into the hospital. So when I stayed there, they continued with other tests. They didn't find any diagnosis. I came out and then I saw the bill.

So I was like, you know what, I cannot register. How am I going to register the pregnancy? They are already charging me this money. And if I delayed more, it was going to harm the child because I was fearing, where am I going to get all this money? But at first I was so scared. It was putting the pregnancy at risk.

I remember the time when I was pregnant, there was a lot of Zimbabweans that were sent back. Lots. Like in one time they were just being deported. I said, no, not, I cannot be deported as well.

Can you explain to us, Judith, what kind of supports are in place for pregnant asylum seekers? And what would maternity action recommend on top of this? I mean, apart from the fact that the charging issue is clearly putting lots of stress on women like Kim, the asylum system does as well. You know, women seeking asylum are here because it's not safe for them to be in their own country.

So already they've had a lot of difficulty in their lives. The fear of being sent back and the fear of having to rely on the government for all their support and not knowing where they're going to be placed, combined with the fact that black and minoritised women often have poorer health outcomes. So we'd really like to see the focus on the health of the women, particularly when they're pregnant.

The biggest issue really for women in the asylum system is where they're accommodated. Often housed in hotels, they can't cook for themselves, they don't have any choice about where they're living. So it's really a lottery. Some of the women with whom we work have access to amazing specialist teams of midwives who have wanted to help these women and they understand the need for interpreters, they understand the difficulties that they're going through.

I think the problem is that women are either housed in isolated hotels where they're the only pregnant woman, they don't really have very much support. We'd like to see them be a priority for longer-term appropriate accommodation where they can have their baby, come back from hospital and look after their baby and recovering from what's often a traumatic birth. I would just say that the refugee charity Maternity Action and the Home Office...

jointly worked on some guidance back in 2016 around the care of pregnant women and new mothers. That's all really fallen away when women have been housed in hotels. So yes, we'd just like to see that prioritised a bit more. Absolutely. And you know, Judith, on that point,

There is this common myth that is pervasive in the media that asylum seekers come to live in luxury hotels for free. We actually broke down a Daily Mail example of that on yesterday's episode. Kim, you are currently living in asylum accommodation. Can you tell us what it is actually like in your experience and what it's like living there with a small child?

I've been dispersed about five houses in different areas. Currently where I am living, like the living conditions, they are not how people say we are living in luxury for free and everything. It's not like that. Like this accommodation that I live in, there's cockroaches everywhere. They've done two heat treatments, nothing helps. No matter how much cleaning...

and where the child, because my daughter is asthmatic, we are not living in luxury like that. The properties will be falling apart. I remember one time out of my room when I was coming out, the light and the ceiling just fell down. So I'm thinking like, what if I'd opened the door and my daughter came out first?

We are being told, yeah, it's a luxury, people living in the hotels. Even the ones that live in the hotels, you go out, you're supposed to come back at a certain time. It's not a luxury because it's more of a prison with the hotels. If you're not back at this time, or if you go and visit a friend, don't come back the next day, tomorrow.

That's not a luxury. There's rules that are put in place where you cannot go and do as you please. So you're seeking asylum, it's like, I should have stayed in my country and maybe be in prison by being an asylum seeker. By being a new mom, you've got a newborn, why should we get such treatment?

We do appreciate that we have been given a refuge. We do appreciate 100%. We've been given refuge. We are being assisted. The food is there. There's housing. There's electricity. There's all that. But then it's those things like, you know, where there's cockroaches and nothing's being done about it. Like, we are eight ladies there with their kids. So it's 16 of us living in that house. We're sharing three bathrooms. So there's bound to be infections.

So it's not luxury. From my experience, it's not luxury. Thank you for clearing up some of the misconceptions, both of you, in the area of asylum seeker accommodation.

Continuing on this theme of myths in the mainstream media, we want to look at some of the most common misconceptions that contribute to the health care injustices faced by female asylum seekers. So the next one we want to tackle is this idea that all asylum seekers coming here are men, the they're all men myth.

We tackled this one a little bit in our introduction and highlighted the fact that while the majority of asylum seekers arriving in the UK are men, there are still thousands of women arriving each year, yet almost none of the news coverage mentions or includes them. Kim, do you feel the experiences of female asylum seekers like yourself get enough attention in the media?

Not really. Honestly, not really, because it's true that they'll be showing videos of men on the television that are crossing the channels, that are doing that. But from a woman's perspective, the way they're saying, oh, it's only men. No, there's women and children that come and seek asylum as well. As for me, when we seeked asylum, it was an all-female group, but that media coverage, it wasn't there.

I've been to events where there's more women. You see, in one, there's more women. There's loads of women and children that are there seeking asylum. So I think it's just a myth about only men seeking asylum. Judith, do you see any problems arising from the very male-dominated nature of coverage of asylum seekers? I think it's important we see all refugees as individuals and not a sort of amorphous mass. And I think that actually the men who've come here

often experience sort of negative coverage as a result of that. You know, people are referred to as hanging around, loitering, that kind of thing. It's very difficult for people to actually tell their stories, male or female. I think there are additional difficulties for women. Lots of the women that we work with in the asylum system have experienced

violence, sexual violence, you know, they need to concentrate on recovering from those experiences and battling the asylum system. So we can understand why the stories are difficult to tell, they're difficult to hear.

But we've seen from Kim's example that actually given the right support, lots of women don't want to be seen as victims. They do actually want to recover, build their lives again and participate in society. And so it's really important that we're bringing those stories to the public eye, really.

Another myth that we want to look at is probably the main one that runs through all of these topics we've been talking about here today. The myth that migrants are all coming here for free health care. Here's a report that appeared over the past few months in GB News, The Telegraph, Talk TV and LBC.

GB News headlined the report, The Telegraph went for...

GB News, again, went for fury as asylum seekers handed preferential medical treatment over Britain's facing soaring waiting times, hyphen, broken Britain. These incredibly misleading, outraged reports revealed that a scheme known as 987 Inclusion Health allows undocumented migrants to bypass standard A&E waiting times at centres.

Now in reality this scheme, which is not by the way NHS wide but exclusive to one NHS trust in London, is designed to cater to people who specifically cannot cope with long waiting times because of various social or psychological circumstances and will therefore probably not seek medical care at all as a result of them. This might be for example asylum seekers,

appealing decisions, who have insecure documentation, whose movements are monitored, who may not know where they'll be for very long. And also it's not just for vulnerable migrants. Inclusion health is an umbrella term used to describe people who experience interacting risk factors for poor health. For example, stigma, discrimination, poverty, violence, complex trauma. These can lead to people

avoiding future contact with NHS services. And that's something believed by researchers to contribute to significantly poorer health outcomes and earlier deaths among people in the identified groups. Basically, this is not a priority migrant service, as The Telegraph calls it.

called it. It's a correction service that also extends to homeless people, people struggling with drug and alcohol misuse, and it's based on evidence of health inequality, something asylum seekers, on the contrary to being privileged in, are actually exceptionally vulnerable to. Judith, turning to you,

Could you just give us an overview about the facts of asylum seeker access to health care in the UK? How does it work? Well, I think there's several factors. I mean, primary health care, so access to your GP and midwifery services will be free at the point of access as it is to everyone. And that is the most efficient way of delivering health care.

The problem is that rules are misunderstood. People move around, not of their own volition, as we've heard from Kim's story, being moved multiple times might mean you have to re-register with GPs each time. If it's temporary accommodation, you might not be encouraged to register with a GP. And then women who are fearing charges...

will often not present until it's an emergency. So you often see a sort of higher peak, if you like, of people accessing emergency services because they haven't been able to access the primary health care. I mean, we know of women who don't seek any help at all until they're in labour. So I think that one of the things that we need to think about is the mismatch between what people are eligible for and what's actually happening in practice. Absolutely. And, you know,

This idea of free healthcare in inverted commas is just one example of national media liking to focus on the whole factor, i.e. why people are coming here to the UK, rather than the push factor, why people are leaving their home countries when they tell the story of migration flows.

Kim, you mentioned a little bit about your journey earlier, but can you help us to fill in some of the gaps and help us to understand, as far as you're comfortable, why and how you came to be in the UK and whether the UK's healthcare system was a factor in your decision to claim asylum in the UK? I'm from Zimbabwe originally.

So we're doing a political play, pointing out the things that the government are doing, the unfairness. The government in my country, they did not like that. The police, they did not like that. Most people, they get prosecuted for doing that. You cannot face the government and say, oh, this is what you're doing. This is wrong. This is inhuman. It's the government's way or the police way or nobody's way. I came to the UK 2017 on tour.

doing a play and we found out that we cannot go back because the police went to my family looking for us. When I discovered that I'm going to face prosecution, that's when we were to seek asylum in the UK. I'd left my son by that time he was what? He was five. And I couldn't go back. I know like how the police are there, how the prison system is. I was like, okay, the UK can protect us from being prosecuted.

Mind you, when we are applying for visas, we already pay an NHS charge. So it's not to say I decided, "Oh, there is Beta K." We are coming for free medication. No, no, I didn't even know that there was Beta K. I only knew that circumstances couldn't allow me to go back. It's not like I want the good healthcare of the UK. I was just there to do what I was passionate about.

Judith, I think something that people in the UK are concerned about when they look at the state of the NHS and how much it is struggling with funding issues right now, people are concerned about the cost of supporting asylum seekers who are not at that point of time in their life paying taxes into the system.

How is it or could it be sustainable to provide free health care to asylum seekers? You know, what would you say to people who are concerned about that?

I think it's important to point out that asylum seekers aren't allowed to work until there's been a long delay on their application. Not all asylum seekers will be able to work, you know, due to the recovery from experiences that they've had in their home countries and on the journey here. But many want to and many come with skills and professions and want to contribute. I think also the length of time that asylum seekers

decisions are taking and that's due to a range of issues including some deliberate halting of decision making but it's certainly not due to the high numbers that we have in this country if you look across the world we don't take very many people into our asylum system and we really could cope if it was run well

So I think a combination of making sure that decisions are right first time shouldn't be done really, really quickly. And a support system needs to acknowledge that some people will be in it for some time. Therefore, allow people to work, allow them to live in the community. You know, going back to the hotel issue, most of us like to stay in a hotel as a break from reality. For these people in the asylum system, this is their reality. And that's a very, very different experience.

People who are catering for themselves, living in their own accommodation, albeit often shared, usually feel that they have a bit more agency over their lives, particularly when they're able to cook for their children, etc. Hotels is a very, very expensive way of supporting people. So, you know, we have a system that's quite dysfunctional, even though the aim of it is to provide people with international protection if they need it.

The health service, you know, if we make sure that people are not deterred from seeking help, I really want to emphasise how the fear that Kim talked about is really common amongst women with whom we work and not accessing that antenatal care that's provided throughout the pregnancy.

means that the cost of the care as well as the risk to the woman and her baby just gets bigger. So we're not doing anybody a good service here. We're not protecting the health service for the people who really need the urgent treatment by providing it early enough because of the charging and because of the way that people in the asylum system and those reliant on the state due to no fault of their own are treated.

Thank you so much. Yeah, it's so important to get the reality of those myths that are so pervasive in our media out to people so that people have a far greater understanding and empathetic understanding of what people go through in this system. And one thing you mentioned in your answer there was this kind of overreaction

overinflated sense of the numbers that we are often fed through the media about asylum seekers, you know, flooding the UK, whereas, as you mentioned, relatively we've taken far fewer. We have an example of this in

in an article that came out recently in The Times and The Sunday Times. They were writing a story about the number of visa applications, yet the image that they used to portray this story was an image of a sinking, overfilled small boat at sea. I mean, this image has absolutely nothing to do with the visa application process. We want to point this out to listeners because this is a classic example

example of the mainstream media conflating different types of immigration in a way that obscures public understanding of what is actually driving this immigration. When headlines broke of record levels of migration a year and a half ago, the images of those headlines also showed

boat crossings, despite these accounting for less than 10% of the immigration actually being reported on. Asylum immigration actually hadn't even risen that year. It had dropped from the year before. The spike in immigration these reports were actually about came mostly from either visas for healthcare workers or international students who literally fund our impoverished university sector.

It is really, really misleading and in some cases I think just ignorant on the part of editors and journalists who don't really understand different types of immigration. But it gives people the false impression we are overrun with asylum seekers when they in reality account for less than 0.2% of the population.

And as well as obscuring the numbers, the media often fails to humanise the numbers. But being stuck in the UK's asylum backlog is incredibly painful and difficult for many. Kim, we want to ask you, how long have you been stuck in the asylum system, waiting for a decision? And can you just explain to us what it feels like to be in that position? A sick asylum in the UK, which was a two-year wait, I got refused asylum.

And then COVID came, I didn't know what they were doing or get any information as if the case was thrown somewhere. Only for the case to start again when they discovered I was pregnant. So you give birth again, you wait for another two years only for them to refuse you. It's like, if I go back there,

I will face prosecution. Why are you not believing me or why are you not caring or something like that? It was so frustrating. Like you don't know what's going to happen. I don't want to lie.

It was really, really stressful. It's been eight years in this country waiting for a decision without even seeing my son in person. So it's stressful. It's so annoying, honestly. I just want to give listeners the context that in Zimbabwe, Amnesty International has pointed out that the treatment of political critics in detention and prosecution is deeply inhumane. There are accounts of

torture and beating and other appalling conditions in prison. So the threat for people who speak out against the government is very, very real. Judith, thank you so much for joining us. Before we lose you, is there anything that you would like to plug to our listeners, any way they can help Maternity Action or follow Maternity Action?

Oh sure, do keep in touch with us. We've just produced a guide with the Royal College of Obstetricians and Gynaecologists to help them understand their role that they can play when women are charged, either to help them find a resolution or to have the charges lifted if they were incorrectly applied.

We also work with women seeking asylum in hotels. We'd like to see the end to that. We'd like to see no need for us to work in hotels because pregnant women and those with small babies are not housed there. And of course, we'd like to see the end of charging for maternity services. Thanks very much for the attention that you've given this issue. We're really grateful. Kim?

Is there anything final that you would like to tell our listeners? I would love to say, as an asylum seeker, number one, we thank the UK for giving us refuge. And thank you for the people that listen to our stories, the people that care, the people that take time to bring change. In those asylum seekers, there's great potential. There's people that can make a change in this world, people that are not here to just take money from the government, but help.

if they're given that right to work, to study, to do what, you know that, okay, I'll make a great difference. I'll give back to the country that gave me refuge, that accommodated me when I was seeking essential. And I would like to say to everyone, thank you so much. I love you. We love you too. That was really beautiful. Thank you so, so much. That was a great way to end our MediaStorm series.

As we wrap this season, we want to give a big shout out of thanks to Bryony Kay, who's a MediaStorm listener and also works in the sector, who brought this story to our attention and was hugely helpful in getting these amazing guests for us. Thank you, Bryony. Thank you.

Thank you for listening. If you want to support MediaStorm, you can do so on Patreon for less than a cup of coffee a month. The link is in the show notes and a special shout out to everyone in our Patreon community already. We appreciate you so much. And if you enjoyed this episode, please send it to someone. Word of mouth is still the best way to grow a podcast. So please do tell your friends.

You can follow us on social media at Matilda Mal, at Helena Wadia and follow the show at MediaStormPod. MediaStorm is an award-winning podcast produced by Helena Wadia and Matilda Mallinson. The music is by Sam Fire.