[2003] UKIAT 181
- Case title: AG (Kosovo, Rape victims, Psychiatric treatment)
- Appellant name: AG
- Status of case: Reported
- Hearing date:
- Promulgation date:
- Publication date:
- Last updated on:
- Country: Serbia and Montenegro
- Judges: Professor DB Casson, Mr A Jordan, Mr Bremmer JP
- Keywords Kosovo, Rape victims, Psychiatric treatment
The decision
AG (Kosovo - Rape Victims - Psychiatric Treatment) Serbia & Montenegro [2003] UKIAT 00181
IMMIGRATION APPEAL TRIBUNAL
Heard at Field House
On: 6 August 2003
Prepared: 8 August 2003
Before
Mr Andrew Jordan
Professor D. B. Casson
Mr D. R. Bremmer
Between:
Claimant
and
The Secretary of State for the Home Department
Respondent
For the claimant: Mr J. Gillespie, counsel
For the Secretary of State: Mr J. Gulvin, HOPO
DETERMINATION AND REASONS
1. The appellant is a national of Serbia and Montenegro and comes from Kosovo. He appeals against the decision of an adjudicator, Mr James R Devittie, following a hearing on 26 February 2003 dismissing his appeal against the decision of the respondent to refuse both his asylum and his human rights claims.
2. The claimant was born on 2 April 1976. He is an ethnic Albanian. He claimed to have entered the United Kingdom on 22 December 1999. He applied for asylum on the following day. As an ethnic Albanian in Kosovo, he claimed that he had been persecuted by the Serbs.
3. In paragraph 5 of the determination, the adjudicator makes it clear that he considered that the appeal lacked merit. He decided that the claimant's evidence was vague and lacking in detail. The adjudicator referred to the presence of KFOR and UNMIK and considered that there was a sufficiency of protection.
4. The claimant comes from Mitrovica, an area where the adjudicator accepted ethnic tensions still prevail. The adjudicator, however, classified the claimant as a young man who was able to relocate himself elsewhere in Kosovo.
5. The grounds of appeal argued that the adjudicator's determination was fundamentally flawed. It is said that the adjudicator was not justified in his finding that the claimant's account was vague and lacking in detail. In our judgment, the claim was bound to fail whether or not the adjudicator had made this finding.
6. The situation in Mitrovica is set out in paragraphs 5.33 to 5.39 in the Country Assessment for April 2003 prepared by CIPU:
Mitrovica
5.33 The area of greatest ethnic tension and hostility in Kosovo is the city of Mitrovica. Divided by the river Ibar, the city has about 9,000 Serbs controlling the north bank and more than 90,000 ethnic Albanians living on the south side. The presence of 2,000 Albanians in the north, living under great pressure to leave from extremist Serbs, adds to the tension.
5.34 Violence first swept the city after a rocket attack on a UNHCR bus killed 2 elderly Serbs in the south of the city on 2 February 2000. Revenge attacks left 2 ethnic Albanians dead and soon afterwards grenades at two Serb cafes injured 25. Others died in a series of clashes and shootings across the city.
5.35 A curfew was introduced in the city and a large KFOR presence installed at the main bridge across the Ibar. Ethnic Albanians held a series of mass protests against the partition of the city. The most dramatic of these was a march from Pristina to Mitrovica by a crowd estimated at about 70,000 people, which had to be kept at bay by KFOR using tear gas. Demonstrations by both ethnic Albanians and by Serbs required the intervention of KFOR troops with several injuries sustained.
5.36 In August 2000, UNMIK assumed responsibility for and subsequently shut down the Zvecan lead smelter, (part of the Trepca mining complex, once the main source of Yugoslavia’s mineral wealth) because of concerns about high levels of lead pollution
5.37 After 9 months of relative calm, riots erupted in April 2002 after the arrest of one of the Serb “bridge watchers” (paramilitaries who monitored people crossing the bridge) for a traffic violation. Over 300 Serbs confronted UNMIK police armed with stones and hand grenades, resulting in injuries to 22 UNMIK policemen. UNMIK responded by doubling the number of UNMIK police in northern Mitrovica.
5.38 in November 2002 UNMIK established its administration in northern Mitrovica, thus extending its authority throughout the whole of Kosovo for the first time. This was made possible by agreement with the (then) FRY authorities to discontinue financing parallel Serb structures and to support UNMIK in assuming control of the administrative functions and developing the KPS in northern Mitrovica.
5.39 By early 2003, KFOR and UNMIK police were manning the bridge instead of the "bridge-watchers" and 20 Serb KPS officers were patrolling the streets. Sixty Serbs had been recruited to work for the UNMIK administration and Serb teachers had signed contracts with UNMIK. Nine "quick impact" projects were initiated to help with regenerating the north of the city, including relocation of the Kosovo Trust Agency HQ to northern Mitrovica, the installation of traffic lights and the refurbishment of schools.
7. This clearly demonstrates that the claimant is able to return to Mitrovica. It will, of course, be a matter for him whether he chooses to go to northern Mitrovica or re-locate in the Albanian dominated southern part of the town. Alternatively, he is a young man and, as found by the adjudicator, able to relocate himself in any other part of Kosovo.
8. We have considered the medical evidence adduced by the claimant in support of his claim. The report was prepared by Dr Nikki Taranto on 23 February 2003 after a single consultation. On page 4 of the report it is said that the claimant had not seen a psychiatrist before but that he had spoken to his GP about stress on two or three occasions in the past and had been given some medication for his sleeping problems. It is clear that he had never taken the opportunity of seeking counselling in spite of his presence in the United Kingdom for well over three years prior to the consultation. The Psychiatrist appears to make a diagnosis of post-traumatic stress disorder but there is no reference to methodology. She suggests that specific psychotherapy would be of benefit but, of course, the opportunity for this treatment has been available to the claimant for many years. We do not consider that this report is helpful. It emerges after a short consultation with the claimant and is highly dependent upon what the claimant himself says about his medical condition. It fails to set out the basis upon which the diagnosis was made. It is made many years after the trauma and, in the intervening years, the claimant appears to have had very little treatment, save for regular analgesia. We note, for example, that a letter from Southend Hospital dated 18 December 2002, the writer refers to tension type headaches that the claimant attributed to being brought on by stress and too much studying.
9. The provision of medical services in Kosovo is considered in paragraph 5.44 to 5.50 of the CIPU Country Assessment for April 2003:
Medical services
5.44 The health services are capable of providing satisfactory primary care and are continuously improving. But some conditions requiring more complex or long term treatment are beyond current resources. Details are not included here because health provision is constantly developing.
5.45 All hospitals are working, but the capacity of their laboratories and x-ray departments is limited. Also, patients with conditions that require regular laboratory control (eg. transplantation patients taking immuno-suppressive drugs) may not be able to find the necessary laboratory tests. All health houses (large health centres in the main towns of the municipalities) are working but their diagnostic capabilities are limited.
5.46 There is a growing AIDS problem in Kosovo, thought to originate from the large influx of prostitutes into the province. Patients with rare, chronic diseases (e.g., lack of growth hormone, hemophilia, HIV/AIDS) may not be able to find the drugs they need in public health care institutions or state pharmacies. Private pharmacies may be able to import the drugs they need, but they are likely to be expensive and the supply may be uncertain.
5.47 A review of the WHO mental health project in July 2002 made a positive evaluation of the progress in mental health sector in Kosovo. The WHO mental health programme has impacted on the development of a comprehensive mental health strategy developed in collaboration with local mental health professionals. This may come to be used as a model for use in other areas emerging from a period conflict. Also a Mental Disability and Mental Health Policy Implementation Task Force has been established.
5.48 Although mental health provision in Kosovo is underdeveloped, treatment for psychological conditions including Post Traumatic Stress Disorder (PTSD) is available in Kosovo. Details of the “Kosova Rehabilitation Centre for Torture Victims (KRCT)” which provides treatment for PTSD are included in the source documents. Growing numbers of people in Kosovo are suffering from PTSD. The number of patients treated for psychiatric disorders by KCRT increased from 1,187 in 2001 to 2812 in 2002.
5.49 As with medical treatment, the range of medical drugs available in Kosovo is constantly developing. Many standard drugs are now available, including Fluoxetin and Sertralin from the Selective Serotonin Uptake Inhibitors group (SSIs) often used for the treatment of PTSD.
5.50 A report by Mental Disability Rights International revealed that patients at the Shtimle Hospital were subjected to abuses by the staff. However, at the end of 2002, physical protection of inmates was still inadequate.
10. We note, in particular, paragraphs 5.48 and 5.49 dealing with the availability of drugs and the treatment of Post Traumatic Stress Disorder.
11. Dr Taranto suggests on page 6 of her report that, were the claimant to return to the scene of his traumas, it would be almost inevitable that his condition would significantly worsen. We do not understand the basis upon which she reached that conclusion. In any event, it cannot be construed as ruling out the claimant's return to every part of Kosovo. In our judgment, the adjudicator was entitled to find, as he did in paragraph 5 of his determination, that the medical evidence did not establish that the claimant has a serious psychiatric condition. We agree with that conclusion. In those circumstances, the adjudicator's conclusion that the claimant's return to Kosovo would not violate his human rights is sustainable.
Decision: The claimant's appeal is dismissed.
Andrew Jordan
Vice President
8 August 2003
IMMIGRATION APPEAL TRIBUNAL
Heard at Field House
On: 6 August 2003
Prepared: 8 August 2003
Before
Mr Andrew Jordan
Professor D. B. Casson
Mr D. R. Bremmer
Between:
Claimant
and
The Secretary of State for the Home Department
Respondent
For the claimant: Mr J. Gillespie, counsel
For the Secretary of State: Mr J. Gulvin, HOPO
DETERMINATION AND REASONS
1. The appellant is a national of Serbia and Montenegro and comes from Kosovo. He appeals against the decision of an adjudicator, Mr James R Devittie, following a hearing on 26 February 2003 dismissing his appeal against the decision of the respondent to refuse both his asylum and his human rights claims.
2. The claimant was born on 2 April 1976. He is an ethnic Albanian. He claimed to have entered the United Kingdom on 22 December 1999. He applied for asylum on the following day. As an ethnic Albanian in Kosovo, he claimed that he had been persecuted by the Serbs.
3. In paragraph 5 of the determination, the adjudicator makes it clear that he considered that the appeal lacked merit. He decided that the claimant's evidence was vague and lacking in detail. The adjudicator referred to the presence of KFOR and UNMIK and considered that there was a sufficiency of protection.
4. The claimant comes from Mitrovica, an area where the adjudicator accepted ethnic tensions still prevail. The adjudicator, however, classified the claimant as a young man who was able to relocate himself elsewhere in Kosovo.
5. The grounds of appeal argued that the adjudicator's determination was fundamentally flawed. It is said that the adjudicator was not justified in his finding that the claimant's account was vague and lacking in detail. In our judgment, the claim was bound to fail whether or not the adjudicator had made this finding.
6. The situation in Mitrovica is set out in paragraphs 5.33 to 5.39 in the Country Assessment for April 2003 prepared by CIPU:
Mitrovica
5.33 The area of greatest ethnic tension and hostility in Kosovo is the city of Mitrovica. Divided by the river Ibar, the city has about 9,000 Serbs controlling the north bank and more than 90,000 ethnic Albanians living on the south side. The presence of 2,000 Albanians in the north, living under great pressure to leave from extremist Serbs, adds to the tension.
5.34 Violence first swept the city after a rocket attack on a UNHCR bus killed 2 elderly Serbs in the south of the city on 2 February 2000. Revenge attacks left 2 ethnic Albanians dead and soon afterwards grenades at two Serb cafes injured 25. Others died in a series of clashes and shootings across the city.
5.35 A curfew was introduced in the city and a large KFOR presence installed at the main bridge across the Ibar. Ethnic Albanians held a series of mass protests against the partition of the city. The most dramatic of these was a march from Pristina to Mitrovica by a crowd estimated at about 70,000 people, which had to be kept at bay by KFOR using tear gas. Demonstrations by both ethnic Albanians and by Serbs required the intervention of KFOR troops with several injuries sustained.
5.36 In August 2000, UNMIK assumed responsibility for and subsequently shut down the Zvecan lead smelter, (part of the Trepca mining complex, once the main source of Yugoslavia’s mineral wealth) because of concerns about high levels of lead pollution
5.37 After 9 months of relative calm, riots erupted in April 2002 after the arrest of one of the Serb “bridge watchers” (paramilitaries who monitored people crossing the bridge) for a traffic violation. Over 300 Serbs confronted UNMIK police armed with stones and hand grenades, resulting in injuries to 22 UNMIK policemen. UNMIK responded by doubling the number of UNMIK police in northern Mitrovica.
5.38 in November 2002 UNMIK established its administration in northern Mitrovica, thus extending its authority throughout the whole of Kosovo for the first time. This was made possible by agreement with the (then) FRY authorities to discontinue financing parallel Serb structures and to support UNMIK in assuming control of the administrative functions and developing the KPS in northern Mitrovica.
5.39 By early 2003, KFOR and UNMIK police were manning the bridge instead of the "bridge-watchers" and 20 Serb KPS officers were patrolling the streets. Sixty Serbs had been recruited to work for the UNMIK administration and Serb teachers had signed contracts with UNMIK. Nine "quick impact" projects were initiated to help with regenerating the north of the city, including relocation of the Kosovo Trust Agency HQ to northern Mitrovica, the installation of traffic lights and the refurbishment of schools.
7. This clearly demonstrates that the claimant is able to return to Mitrovica. It will, of course, be a matter for him whether he chooses to go to northern Mitrovica or re-locate in the Albanian dominated southern part of the town. Alternatively, he is a young man and, as found by the adjudicator, able to relocate himself in any other part of Kosovo.
8. We have considered the medical evidence adduced by the claimant in support of his claim. The report was prepared by Dr Nikki Taranto on 23 February 2003 after a single consultation. On page 4 of the report it is said that the claimant had not seen a psychiatrist before but that he had spoken to his GP about stress on two or three occasions in the past and had been given some medication for his sleeping problems. It is clear that he had never taken the opportunity of seeking counselling in spite of his presence in the United Kingdom for well over three years prior to the consultation. The Psychiatrist appears to make a diagnosis of post-traumatic stress disorder but there is no reference to methodology. She suggests that specific psychotherapy would be of benefit but, of course, the opportunity for this treatment has been available to the claimant for many years. We do not consider that this report is helpful. It emerges after a short consultation with the claimant and is highly dependent upon what the claimant himself says about his medical condition. It fails to set out the basis upon which the diagnosis was made. It is made many years after the trauma and, in the intervening years, the claimant appears to have had very little treatment, save for regular analgesia. We note, for example, that a letter from Southend Hospital dated 18 December 2002, the writer refers to tension type headaches that the claimant attributed to being brought on by stress and too much studying.
9. The provision of medical services in Kosovo is considered in paragraph 5.44 to 5.50 of the CIPU Country Assessment for April 2003:
Medical services
5.44 The health services are capable of providing satisfactory primary care and are continuously improving. But some conditions requiring more complex or long term treatment are beyond current resources. Details are not included here because health provision is constantly developing.
5.45 All hospitals are working, but the capacity of their laboratories and x-ray departments is limited. Also, patients with conditions that require regular laboratory control (eg. transplantation patients taking immuno-suppressive drugs) may not be able to find the necessary laboratory tests. All health houses (large health centres in the main towns of the municipalities) are working but their diagnostic capabilities are limited.
5.46 There is a growing AIDS problem in Kosovo, thought to originate from the large influx of prostitutes into the province. Patients with rare, chronic diseases (e.g., lack of growth hormone, hemophilia, HIV/AIDS) may not be able to find the drugs they need in public health care institutions or state pharmacies. Private pharmacies may be able to import the drugs they need, but they are likely to be expensive and the supply may be uncertain.
5.47 A review of the WHO mental health project in July 2002 made a positive evaluation of the progress in mental health sector in Kosovo. The WHO mental health programme has impacted on the development of a comprehensive mental health strategy developed in collaboration with local mental health professionals. This may come to be used as a model for use in other areas emerging from a period conflict. Also a Mental Disability and Mental Health Policy Implementation Task Force has been established.
5.48 Although mental health provision in Kosovo is underdeveloped, treatment for psychological conditions including Post Traumatic Stress Disorder (PTSD) is available in Kosovo. Details of the “Kosova Rehabilitation Centre for Torture Victims (KRCT)” which provides treatment for PTSD are included in the source documents. Growing numbers of people in Kosovo are suffering from PTSD. The number of patients treated for psychiatric disorders by KCRT increased from 1,187 in 2001 to 2812 in 2002.
5.49 As with medical treatment, the range of medical drugs available in Kosovo is constantly developing. Many standard drugs are now available, including Fluoxetin and Sertralin from the Selective Serotonin Uptake Inhibitors group (SSIs) often used for the treatment of PTSD.
5.50 A report by Mental Disability Rights International revealed that patients at the Shtimle Hospital were subjected to abuses by the staff. However, at the end of 2002, physical protection of inmates was still inadequate.
10. We note, in particular, paragraphs 5.48 and 5.49 dealing with the availability of drugs and the treatment of Post Traumatic Stress Disorder.
11. Dr Taranto suggests on page 6 of her report that, were the claimant to return to the scene of his traumas, it would be almost inevitable that his condition would significantly worsen. We do not understand the basis upon which she reached that conclusion. In any event, it cannot be construed as ruling out the claimant's return to every part of Kosovo. In our judgment, the adjudicator was entitled to find, as he did in paragraph 5 of his determination, that the medical evidence did not establish that the claimant has a serious psychiatric condition. We agree with that conclusion. In those circumstances, the adjudicator's conclusion that the claimant's return to Kosovo would not violate his human rights is sustainable.
Decision: The claimant's appeal is dismissed.
Andrew Jordan
Vice President
8 August 2003