A year after the death of a young mother from malnutrition in Galway, the Irish Refugee Council (IRC) has said that access to adequate medical care is still a "big issue" for people seeking asylum.
IRC policy and campaigns officer Deo Ladislas Ndakengerwa says the Galway case is not isolated. Lack of access to medical help, including psychiatric help, has proved fatal in several instances in the past year.
Brenda Kwesikazi Mohammed (27) was found dead in her room on January 5th last year in the Eglinton Hotel, Salthill. The Eglinton accommodates some 235 residents, and has been a hostel for asylum seekers since 2001.
An inquest into the South African's death last October ruled she had died of lethal cardiac arrhythmia due to cardiac atrophy, brought on by anorexia. The inquest heard that a psychiatrist and social worker had supported Mrs Mohammed's request to move to self-catering accommodation, where she could cook her own food.
A Department of Justice official told the inquest that the Reception Integration Agency (RIA) had secured self-catering accommodation for the family in Mosney, Co Meath, but this had been turned down by Ms Mohammed's husband.
The coroner, Dr Kieran McLoughlin, noted that Ms Mohammed was suffering from depression, and it would have taken time to find a suitable location for her where she could receive continued care. He recommended that when letters were written on behalf of an applicant recommending a transfer on medical grounds, these should be sent from a consultant.
Eglinton Hotel manager Patrick McGovern regrets Ms Mohammed's death deeply. The Eglinton, formerly a hotel, is regarded as a "home from home" for many asylum seekers in Galway, and its computer room was one of the first hostels to set up a community website in partnership with NUI Galway's Digital Enterprise Research Institute.
"We have a residents' committee, residents work with the chef on menus, and we have a creche in the mornings which has 20 kids," Mr McGovern says. "Yes, our residents have to cope with direct provision, but we try to empower them and make them feel they are being listened to."
Medical issues have arisen, and will continue to do so, but the Health Service Executive (HSE) has recently provided a twice-weekly clinic at the hotel. More complex cases have proved challenging, Mr McGovern admits. "I've found myself arguing the case for people and their children requiring special help, and have found that no one in authority wants to take responsibility."
The IRC says even the GP service, now common in many centres, has its limitations. "There is such a demand for the service that people are often not seen regardless of how serious their complaint, and then when they do get to see the GP there is very little time to talk to the doctor or have a proper examination," Mr Ndakengerwa says.
"It should be remembered that people forced to stay in direct provision centres have often experienced severe trauma which sometimes includes torture," he says.
GPs also required training in working with asylum seekers, he said, as cultural and religious differences were still proving to be a constant difficulty.