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Views & Reviews Personal View

Asylum seekers and undocumented migrants must retain access to primary care

BMJ 2011; 343 doi: (Published 18 October 2011) Cite this as: BMJ 2011;343:d6637
  1. Paquita de Zulueta, general practitioner, London, and honorary clinical senior lecturer, Department of Primary Care and Public Health, Imperial College, London
  1. p.dezulueta{at}

They come singly or in huddled clusters, subdued, their eyes downcast, their shoulders stooped. They tell us tales of loss, of devastation, of living in the shadows, always fearful of exposing themselves to bureaucratic scrutiny. They sleep, if lucky, on the sofas of friends or in hostels, otherwise in doorways, on park benches, or in churches and bus stations. They are like Dante’s lost souls, wafting in limbo, neither in heaven nor hell, but in a cold and lifeless purgatory, a place the world refuses to acknowledge.

They tell me their stories, their faces etched with suffering, their eyes reflecting dull despondency or despair. And yet I am humbled by their grace, dignity, and endurance. Somehow they manage to look clean, orderly, and well presented. The tell tale sign may just be the tightly clutched plastic bag. That bag may hold all their possessions, including documents such as a dog eared letter, years old, from the Home Office, blandly reporting information about the status of their asylum appeal. Many of them have …

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