Jean-Pierre Restellini, MD, LLBHead of the National Commission for the Prevention

of Torture (Swiss NPM) and Acting 2nd Vice-President of the CPT

“The immigration removal process and preventive monitoring”

Medical assessmentPre (fit to fly) and post

(failed) removal 

FIT TO FLYFIT TO FLY

Why should the question be asked?

because there is a relatively high medical risk

all preventive steps should be taken to avoid serious medical consequences, particularly death

Geneva march 2012 European NPM Project’s 2

Different types of flight Different types of flight

1.Flights operates by commercial airlines

2.Flights organised by FRONTEX

3.Special flights organised at national

level

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Usual recommendations for all flights

Usual recommendations for all flights

Pregnancy (until the 36th week; after the 28th

week of pregnancy necessity of a medical green

light)

Acute cold and severe feverish illness

Severe heart or lung-related illness: breathing

difficulties, recent heart attack, angina pectoris,

cardiac insufficiency, pneumothorax, etc.

Recent stroke

Severe anemia Geneva march 2012 European NPM Project’s 4

Usual recommendations for all flights (2)

Usual recommendations for all flights (2)

Recent surgery, especially abdominal and

thorax operations

History of thrombosis or pulmonary

embolism, hereditary coagulation disorder,

cardiac insufficiency or chronic vein

insufficiency

Certain acute psychological / psychiatric

troublesGeneva march 2012 European NPM Project’s 5

Usual recommendations for all flights (2)

Usual recommendations for all flights (2)

Recent surgery, especially abdominal and

thorax operations

History of thrombosis or pulmonary

embolism, hereditary coagulation disorder,

cardiac insufficiency or chronic vein

insufficiency

Certain acute psychological / psychiatric

troublesGeneva march 2012 European NPM Project’s 6

Additional risks linked to:Additional risks linked to:

1. Security measures which are

sometimes dangerous in themselves

2. Major stress caused by tight

immobilisation (especially if the

detainee physically resist !)

3. Total immobilisation for a prolonged

period of timeGeneva march 2012 European NPM Project’s 7

Medical examination before the flight

Medical examination before the flight

1. Some (prison) doctors refuse to perform

it

2. Systematic or only in case of suspected

medical problems?

3. What should the examination involve?

When should it be carried out?

Geneva march 2012 European NPM Project’s 8

Doctors/nurses on boardDoctors/nurses on board

1. Presence necessary in all cases?

2. Profile? Equipment?

3. Independence?

Geneva march 2012 European NPM Project’s 9

FAILED REMOVALFAILED REMOVAL

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FAILED REMOVALFAILED REMOVAL

7th General Report on the CPT's activities covering the period 1 January to 31

December 1996

This is a risk situation, sometimes leading to ill-treatment either at the hands of the escorting team or when the detainee arrives back at the custodial institution. (…)

It is important that all the events leading up to this outcome be properly documented and that any complaints on the part of the detainee be included in the records.

Geneva march 2012 European NPM Project’s 11

FAILED REMOVALFAILED REMOVAL

13th General Report on the CPT's activities covering the period 1 January 2002 to 31 July

2003… all persons who have been the subject of an abortive deportation operation must undergo a medical examination as soon as they are returned to detention (whether in a police station, a prison or a holding facility specially designed for foreigners).

In this way it will be possible to verify the state of health of the person concerned and, if necessary, establish a certificate attesting to any injuries. Such a measure could also protect escort staff against unfounded allegations.

Geneva march 2012 European NPM Project’s 12

13Geneva march 2012 European NPM Project’s