In 1999, 48-year-old Roseline Akhalu’s husband, a nurse, was diagnosed with a brain tumour. The pair lived a simple life in a shared flat in Benin. Rose worked in local government and earned N22,000 - at the time about £80 - a year. The doctors told Rose’s husband that he’d need to raise £8,000 (N2,000,000) and go to South Africa or India for treatment. There was no way they could do it. Rose stood by as he lost his sight, then his ability to walk, and then to talk. She watched him die, and it broke her heart.
In Nigeria men used their children’s names as next-of-kin and since they did not have any children (prior to this, Rose had suffered a miscarriage) her husband used his brother’s name. His family took all of his possessions, including his pass book and cheque book. She wanted to challenge them, but was dissuaded by her mother, a traditionalist who told her she should be thankful to God that she was still young and had her life ahead of her. Rose was alone in the world. She set about putting her life back together.
Five years later, she was one of just 23 people to win a Ford Foundation scholarship to study in England. She took a masters degree in Development Studies at Leeds University. Inspired by her experiences, she wanted to establish an NGO to cater for the education of young girls. Back in Nigeria, she'd been helping young girls in her community and trying to give them awareness of their rights to encourage them to return to school, even as teenage mums. Whenever she went back to her village to see her family she would organise meetings under a tree near her house.
Rose began to attend St Augustine’s Catholic Church in Leeds. It’s a little parish about three miles from the centre of town. It’s a poor area, but the church has a buzzing middle-aged community; a mix of immigrants and people who’ve lived there all their lives.
Claire McLaughlin, a fellow parishioner, became her friend: she and Rose attended coffee mornings after mass. “She’s quite a private person,” she says, “But she’s really interested in other people.” The two women began working on community initiatives for young girls. “She’s brave, too,” says Claire. “She works with asylum seekers, and goes out doing street pastoring work in Harehills - she’s never evangelical with the people on the street: she just wants to help them.”
I ask Rose for a few more details on what she does in the church. “I’m a member of the choir and I lead the Bible study group. On Mondays I serve the older people tea, coffee and cake. After food we clean up and play Dominos and Bingo for biscuits. It’s like a day centre for women. They love it and the volunteers love it too. I’ve made so many friends in the church: I spent Christmas and Boxing Day with Paul and Dot...”
That’s the new life she built for herself. Christian, innocent and - though how bitter it feels to use this word in the light of what’s to come - somehow rather English.
One day, Rose went to a routine vaccination appointment and was told her blood pressure was too high. She was sent to a nephrologist at Leeds General Infirmary who ran tests and diagnosed renal failure. She planned to return to Nigeria, but was told the only way she could survive was by going on dialysis, or having a kidney implant. In May 2005, she was put on dialysis three times a week.
In 2009, she had a successful kidney implant. The next year, her consultant, Dr R J Baker, wrote to her former MP, Fabian Hamilton, explaining how the treatment had complicated her residential situation. She would need regular hospital check-ups and immunosuppressant drugs for the rest of her life.
Her plan had been to return to Nigeria. Now, however, it changed. Rose was no "health tourist". But it was her misfortune the medication to protect from rejection of the kidney would cost £10,000 per year in Nigeria - a sum Rose would never be able to earn given the wage differential (85 per cent of the population live on less than $1 a day), high unemployment and fact she is of retirement age in that country. She had no support network there, besides three siblings, all of whom lived in poverty. Moreover, as medical experts - Nigerian and British - have testified, the sanitary and medical facilities she required could not be provided. If deported, she would die within two to four weeks. She began to fight for the right to remain in the UK.
In March 2012, Rose arrived at the UK Border Agency (UKBA) Reporting Office for her monthly reporting when she was told she was being detained. Staff from Reliance – a firm contracted by UKBA – told her she was being transported from Leeds to Yarl’s Wood detention centre.
Close to Manchester, Rose asked to use the toilet. The female security officer told her she would be taken to a police station where it would be “safe” for her to go. On arrival at Manchester, after another 30 minutes of asking for the toilet she was taken to the Reliance Office for a duty change-over. Her pleas were ignored. She could see a toilet in the office through the van's window. She couldn’t bear to hold it in any longer, and stood up in the van. The officers started to look for a plastic bag into which she could urinate. They couldn’t find the bag for women, so she was given the one for men. The design didn’t work, but Rose couldn’t hold it in any more. She urinated all over her hands and the rest of the van, in full view of the CCTV camera.
She tells me: “I felt humiliated and degraded. I was treated like a common criminal. As if I had no dignity, no rights and no voice.” She was left covered in her urine, as was the van. She claims that as a result she suffered a urinary tract infection: she had to sit in her wet clothes until she arrived at Yarl’s Wood at 10.30pm. There is a civil case pending as a result of this incident. Negotiations are ongoing, but at the time of writing Reliance have refused the disclosure of records and documents required for a claim to be quantified.
The Home Office was attempting to remove Rose from the country. UKBA had decided that she was indeed a health tourist, even though she applied for her scholarship back in 2002 and her renal specialist had testified that her illness three years later was sudden and impossible to predict.
Rose would spend 26 days at Yarl’s Wood. Having been returned home, in May, Rose was then taken back to Yarl’s Wood. The second time round she was not given access to medication for 24 hours. She was then moved to Colnbrook detention centre in Middlesex. There was not enough room for Rose in the women’s space, so she was taken to the male secure cell. The room was, she tells me, “Stuffed with cigarette smoke and rubbish. The officer left another woman and I there, so we started banging on the door, asking for him to let the cigarette smoke out of the room. The officer’s boss came and threatened us, telling us we’d be moved somewhere worse. Eventually a cleaner was sent.” Rose spent 16 days on this second detention.
At the end of May Rose was released from detention: her solicitors won an injunction which prevented the Home Office from deporting her until a renewed application for permission to proceed with judicial review was heard on 24 July. Greg Mulholland, her MP, said: “I will be writing to the Home Secretary to ask why, despite being granted an appeal hearing, the judge thought it acceptable to allow UKBA to continue harassing Roseline and continue to seek her deportation from the UK. As well as the distress caused, this has been a farce and has wasted considerable amounts of taxpayers’ money. The system clearly needs to be looked at so this cannot happen.”
In September the Home Office made a fresh decision: Rose’s appeal was refused. There were a number of outraged responses. Some came from her community: John Packer, the Bishop of Ripon and Leeds, told OurKingdom: “Roseline has made a life in this country (gaining qualifications here) and is loved and respected in her community in Leeds. It saddens me to think that, having been accepted and cared for in the UK to the extent of being given a kidney transplant which has transformed her life, she should now find herself being forced to return to Nigeria where she would not be able to receive the medical treatment she needs to survive.”
Others were medical: representations to the Home Office had come from the National Kidney Federation and from Rose’s consultant, among others. Some were political: as well as a renewed call from her MP, the Joint Chair of the All Party Parliamentary Kidney Group, Madeleine Moon, urged the Home Secretary “most strongly to allow Mrs Akhalu to remain in the UK”. Even the actor Colin Firth also spoke out against the decision: “Our Home Secretary has effectively condemned an innocent woman to death - a decision surely repugnant to every person in this country. It should be reversed immediately and Rose should be allowed to live."
Rose’s lawyers were able to appeal to the First-Tier Immigration Tribunal, and in November, Judge Saffer overturned the Home Office’s decision. At the hearing the Home Office accepted – for the first time – that she would definitely die if returned to Nigeria. Astoundingly, it continued to maintain that her removal was proportionate and not in breach of her human rights. However, the judge found she had come here legally, was diagnosed while here legally, that the cost of treatment was not excessive, and that she had established a private life of value to her.
At the time, Mulholland said he hoped the Home Office would "see sense and not appeal" against the ruling. "It would be a serious misuse of the public purse to appeal this decision given the evidence that has been presented." But the Home Office appealed the decision on 14 December. The judge refused the appeal. This could have been the end of the matter. Instead, a second appeal was made to the Upper-Tier Immigration Tribunal. A decision is pending.
Why is the Home Office continuing this cruel and ludicrous campaign? It seems the department is concerned about growing case law that would facilitate health tourism. Under the present laws it is acceptable to deport someone even if they’ll become terminally ill on arrival in a new country, and this is why Rose’s case has been argued under Article 8 of the European Convention of Human Rights: a right to a private and family life. But this is an exceptional case: is the fight against case law really worth a human being’s life, not to mention the massive legal cost? And as representatives from the National Kidney Foundation have said, donors would think their efforts were a waste of time if a recipient was allowed to die.
“It’s just dragged on and on,” says Claire McLaughlin. “It’s time to let her stay. She’s a widow, she’s not going to be a drain on the country and she’s such a useful person to have around.” Her solicitor, Tessa Gregory of Public Interest Lawyers, says: “I cannot comprehend why the Home Secretary is continuing to pursue Rose through the courts after conceding at the last hearing that if Rose is deported to Nigeria she will not be able to access medical care and will die a painful death within four weeks of her return. Not only is such conduct deeply inhumane, it is also a complete waste of scarce public funds on unnecessary and time consuming litigation.”
There are a few lines in an email I received from Rose that rather touch my heart. I think it’s the straightforward way she expresses herself: “I’m very happy here in Leeds as I’ve made so many friends. Leeds is now my home. To think that I might be removed made me feel very bad and empty - the thought of losing my wonderful friends is very painful. And they don't want to lose me either.”