European NPM Project 8th Thematic NPM Workshop: Geneva, Switzerland on 20-21 March 2012

1. European NPM Project 8th Thematic NPM Workshop:Geneva, Switzerland on 20-21 March 2012 “The immigration removal process and preventive monitoring” Medical assessment Pre (fit to fly) and post (failed) removal Jean-Pierre Restellini, MD, LLB Head of the National Commission for the Prevention of Torture (Swiss NPM) and Acting 2nd Vice-President of the CPT

2. FIT TO FLY Whyshould the question beasked?  becausethereis a relativelyhighmedicalrisk  all preventivestepsshouldbetaken to avoidseriousmedicalconsequences, particularlydeath European NPM Project’s

3. Different types of flight • Flightsoperates by commercial airlines • Flightsorganised by FRONTEX • Specialflightsorganisedat national level European NPM Project’s

4. Usualrecommendations 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 European NPM Project’s

5. Usualrecommendations 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 troubles European NPM Project’s

6. Usualrecommendations 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 troubles European NPM Project’s

7. Additionalriskslinked to: • Security measureswhich are sometimesdangerous in themselves • Major stress caused by tight immobilisation (especially if the detaineephysicallyresist !) • Total immobilisation for a prolongedperiod of time European NPM Project’s

8. Medicalexaminationbefore the flight • Some (prison) doctors refuse to performit • Systematic or only in case of suspectedmedicalproblems? • Whatshould the examinationinvolve? Whenshoulditbecarried out? European NPM Project’s

9. Doctors/nurses on board • Presencenecessary in all cases? • Profile? Equipment? • Independence? European NPM Project’s

10. FAILED REMOVAL European NPM Project’s

11. FAILED 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. European NPM Project’s

12. FAILED 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. European NPM Project’s

13. THANK YOU FOR YOUR ATTENTION European NPM Project’s