Upper Tribunal (Immigration and asylum chamber), 2022-04-19, PA/13502/2018
| Appeal Number | PA/13502/2018 |
| Hearing Date | 17 November 2021 |
| Published date | 04 May 2022 |
| Date | 19 April 2022 |
| Status | Unreported |
| Court | Upper Tribunal (Immigration and Asylum Chamber) |
PA/13502/2018
Upper Tribunal
(Immigration and Asylum Chamber) Appeal Number: PA/13502/2018
THE IMMIGRATION ACTS
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Hearing at Field House |
Decision & Reasons Promulgated |
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On the 17th November 2021 |
On the 19 April 2022 |
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Before
UPPER TRIBUNAL JUDGE MANDALIA
Between
JI
(anonymity direction made)
Appellant
and
SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent
Representation:
For the Appellant: Dr S Chelvan and Mr J Rylatt, instructed by Bristol Law Centre
For the Respondent: Ms Z Ahmad, Senior Home Office Presenting Officer
DECISION AND REASONS
Anonymity
As this a protection claim, it is appropriate that an anonymity direction is made. Unless and until a Tribunal or Court directs otherwise, the appellant is granted anonymity. No report of these proceedings shall directly or indirectly identify her or any member of her family. This direction applies amongst others to all parties. Failure to comply with this direction could lead to contempt of court proceedings.
Background
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The appellant is a national of Uganda. Her appeal against the respondent’s decision to refuse her claim for international protection was dismissed for reasons set out in the decision of First-tier Tribunal Judge Davidge promulgated on 27th August 2019. Although the appeal was dismissed on international protection grounds, Judge Davidge accepted the appellant will face very significant obstacles to integration on return to Uganda, such that the requirements to be met by an applicant for leave to remain on private life grounds are met. The appeal was allowed on Article 8 private life grounds. The respondent does not challenge the decision to allow the appeal on Article 8 grounds.
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Permission to appeal the decision to dismiss the appeal on international protection grounds was granted by Upper Tribunal Judge Jackson on 18th October 2019. The appeal was considered by me without a hearing under Rule 34 of The Tribunal Procedure (Upper Tribunal) Rules 2008. The respondent accepted Judge Davidge materially erred in her consideration of the background and expert evidence relied upon by the appellant. The decision of Judge Davidge was set aside for reasons set out in my error of law decision. I directed the decision will be remade in the Upper Tribunal.
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The matter was listed for a resumed hearing before me on 17th November 2021. At the conclusion of the hearing I reserved my decision. I informed the parties that my decision and reasons will follow in writing and this I now do.
The appeal before me
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The respondent accepts the appellant is a national of Uganda. The respondent considered the appellant’s claim that she would be at risk upon return because she is a ‘vulnerable disabled woman’ who suffers from homozygous sickle cell disorder, a hereditary disease which requires treatment and medication, and because of the state of her mental health. The respondent rejected the appellant’s claim that she is a refugee because the respondent concluded her claim is not based on a fear of persecution in Uganda because of her race, religion, nationality, membership of a particular social group or political opinion.
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The appellant has appealed under s82(1) of the Nationality, Immigration and Asylum Act 2002 against the decision of the respondent to refuse her claim for asylum. The appellant claims to be a refugee whose removal from the UK would breach the United Kingdom’s obligations under the 1951 Refugee Convention.
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The appellant bears the burden of proving that she falls within the definition of “refugee”. In essence, the appellant has to establish that there are substantial grounds for believing, more simply expressed as a ‘real risk’, that she is outside of her country of nationality, because of a well-founded fear of persecution for a refugee convention reason and she is unable or unwilling, because of such fear, to avail herself of the protection of that country.
The evidence
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The appellant’s representatives have filed and served a consolidated bundle comprising of 2 parts. The ‘Agreed Consolidated Bundle (1)’ comprises of some 442 pages and the ‘Agreed Consolidated Bundle (2)’ comprises of some 538 pages. The bundles include the material that was previously before the First-tier Tribunal and further material that is relied upon by the appellant that post-dates the decision of the First-tier Tribunal. A further supplementary bundle was filed on 15th November 2021. I have also been provided with a ‘skeleton argument & chronology’ comprising of some 35 pages, and a bundle of authorities comprising of 20 Tabs. I also have a copy of the respondent’s bundle.
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The appellant has previously filed four witness statements that were before the First-tier Tribunal. They are dated 18th June 2018, 13th August 2018, 12th March 2019 and 30th May 2019. Two statements have also been made by her father. The first is dated 24th May 2018 and the second is dated 9th March 2019. For the avoidance of doubt I have read those statements and had regard to the evidence set out by the appellant and her father in reaching my decision. Given the volume of material, it is entirely impractical for me to refer to all the evidence and background material that it before this Tribunal in this decision. However, for the avoidance of any doubt, I have carefully considered the evidence and background documents set out in the consolidated bundles, whether expressly referred to in this decision or not.
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The appellant has made applications under Rule 15(2A) to rely upon evidence that post-dates the decision of the First-tier Tribunal. The appellant’s reliance upon that further evidence was not opposed by Ms Ahmad, and it is admitted.
Dr Tom Latham
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Dr Latham is a Consultant Haematologists employed by the University Hospitals Bristol and has been involved in the care of the appellant. In his letter dated 25th May 2018, Dr Latham confirms:
“[The appellant] has homozygous sickle cell anaemia. This is an inherited blood disorder which has been lifelong. The condition typically manifests with episodes of severe pain and sufferers are also at risk of long-term complications such as bone damage, stroke, kidney failure and respiratory failure.
[The appellant] has a very severe phenotype. She has had admissions to hospital with painful sickle cell crisis and infections. She also has avascular necrosis of her hips, has had a previous hip replacement and is due to have the other hip replaced at the beginning of June.”
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Dr Latham notes that there has been a marked improvement in her condition since she started a programme of exchange transfusions every eight weeks, and her hospital admissions have been much reduced since then. He notes the appellant still has reduced mobility due to her hip and has daily carers to support her at home. He goes on to say:
“I would consider that there would be a deterioration in her condition if she was unable to access exchange transfusions. She would have an increase in severe pain crises and would need increased admissions to hospital for opiate analgesia. It would be likely that she would be at increased risk of having more serious complications such as a chest crisis or stroke.”
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Dr Latham has provided various updates. In his letter dated 25th February 2019, he reported that there had been no significant changes to the appellant’s sickle cell anaemia since his letter of 25th May 2018. He noted she had had further admissions to hospital with painful crises but there was no material change to her underlying condition. Again, he expressed the opinion that it is likely there would be a deterioration in her sickle if the exchange transfusions were discontinued. In an update dated 26th October 2020, Dr Latham confirmed that the appellant’s condition and prognosis remains essentially similar to that previously reported. He noted the appellant has been diagnosed with recurrent cholecystitis, a common complication of sickle cell disease, and is on the waiting list for a cholecystectomy. He confirmed that a previous attempt at stopping exchange transfusions was followed by an increase in hospital admissions.
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Most recently, in a letter dated October 2021, Dr Latham reports that there have been no significant developments in the appellant’s sickle cell anaemia since his previous letter dated 26th October 2020. He states the appellant remains a high user of healthcare services with a number of emergency admissions for care. He maintains the opinion that if the appellant’s exchange transfusion programme is discontinued, there would be an increase in severe pain. He states the appellant needs opioid analgesia to manage episodes of painful crisis and it is unclear whether opioid analgesia would be readily available in her country of origin. He states:
“My opinion is that if she had a lack of access to exchange transfusion there would be a high risk of a serious deterioration in her health and reduction in life expectancy. This point is distinct from 2 above since it relates to the...
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