Refugee faces death after cancer undetected

LANGUAGE BARRIER: Khua Kam Thang Nawl and wife Far Can Uk in Wellington Hospital.
LANGUAGE BARRIER: Khua Kam Thang Nawl and wife Far Can Uk in Wellington Hospital.

Burmese refugee Khua Kam Thang Nawl was prescribed paracetamol for months, instead of much-needed cancer treatment, after multiple visits to a doctor during which his only interpreter was his 14-year-old son.

Health advocates say the case is "appalling", and highlights the difficulties faced by migrants and refugees in accessing healthcare.

By the time Mr Nawl referred himself to Kenepuru Hospital on February 5, lung cancer had spread to his liver and brain. His chances of survival are slim.

Through an interpreter, refugee advocate Ahniang Hlawn Ceu, Mr Nawl said yesterday that he did not want to make trouble.

New Zealand had been "perfect" since he and his family arrived as part of the United Nations refugee quota seven years ago. But he believes that, if he could speak English, he would have been taken seriously and received the correct treatment earlier.

"I don't want anybody to get upset because of me, but I don't want more people who are like me to be ignored. I just want to help a little bit," he said.

Mr Nawl was a farmer in Myanmar before it became too dangerous. He and his family were smuggled over the border to Thailand and into Malaysia by hiding among cargo and under vehicles.

He spent eight months in jail in Malaysia until being allocated a place in New Zealand by the United Nations.

He began coughing and feeling run-down a year ago, and went to a doctor, who suggested paracetamol.

His condition worsened, and he had been back to the GP three times with his son since November, he said. He was given paracetamol and antibiotics.

"He told them that he coughed a lot and it's not like a normal cough, and he's suffering a lot," Ms Ceu said.

On February 5, he went straight to Kenepuru Hospital. There he was told he needed a doctor's referral, but he refused to leave until he was given a scan.

He was immediately transferred to Wellington Hospital, where more tests were done and an interpreter told him he had stage-four lung cancer.

Mr Nawl makes $400 a week in his job as a cleaner, which supports wife Far Can Uk and four children, aged between 10 and 18. They are not sure how they will manage if he dies. "I hope that I'm going to be fine and go back to work and look after my family," he said.

The manager at the medical practice said he could not comment until the clinic had undertaken a full investigation. It served 400 refugees and migrants, and Refugee Services gave training to doctors, he said.

It had used a Wellington face-to-face interpretation service in the past, but it cost $100,000 a year. After funding was cut to the practice, it shifted to a telephone translation service - which should be offered to every patient who spoke English as a second language, he said. Some patients chose to use family members, for privacy reasons.

But Changemakers Refugee Forum general manager Tim O'Donovan said there was no situation in which it was OK for a child to translate.

"It's so inappropriate for a [14-year-old] to be telling his dad that he has a potential illness. That is appalling."

The Health and Disability Commission's code of rights says a person has the right to effective communication - which meant a professional interpreter.

Red Cross Refugee Services manager Molly Kennedy said there was some confusion among GP clinics about how to access interpreting services, and more funding was needed for district health boards to enlist specialist services.

Clarification: The Dominion Post accepts the care Khua Nawl received from the staff at Porirua Union Health Services was to the required standard and in particular there was no medical oversight or mismanagement by the medical centre in the treatment it prescribed.

The Dominion Post