It is the duty of a son to look after his parents in Pakistan

We represented an appellant who was a 68 year old national of Pakistan.  She was the mother of a UK surgeon (her son) and she had three daughters, all of whom lived with their own families in Pakistan and not with her. She made an application for leave to enter as an adult dependent relative to join her son and that application was refused and subject to an appeal which we have won.  The key question before the Tribunal was whether there was a reasonable minimum standard of care for the appellant and whether or not it is available to her in her country of origin. The Home Office position was that care facilities were available in Lahore, that offer either home care for the elderly or a residential care home and therefore they argued that suitable care could be arrange for her in Pakistan.  In preparation of the appeal we have submitted medical evidence and country evidence to demonstrate that it is neither proportionate nor reasonable, nor likely to be safe for the appellant to try to obtain private care or a care home in Pakistan.  

The immigration Judge looked and found that the appellant indeed had comprehensive needs and that she was likely to be at risk from unscrupulous individuals due not only to her physical condition but also her cognitive disability.  The most important contribution in my opinion was a report by Uzma Moeen, a country expert, which looks at the cultural factors in play.  We asked the Immigration Judge to consider the importance of cultural issues and the cultural expectations.  Culturally the responsibility for the appellant lay with the son and whilst it seems at odds with the fact that the appellant had three daughters in Pakistan none of whom seemed physically unable to provide care for their mother, the Judge accepted that they were prevented from so doing for cultural reasons.  The Judge found that the reality is that the daughters would not be able to provide care and that the appellant even with the practical and financial help of her son, would not be able to obtain the specific level of care she needs in Pakistan and there was no one who could reasonably provide it.  The most interesting part of this case was the recognition that in Pakistani culture the strain of caring for one’s parents is considered a duty of male children. Leaving one’s elderly mother with their married daughters invites ridicule and disgrace according to the country expert and subjects the family to shame and dishonour.  There is a taboo against married daughters taking care of their old and infirm parents and leaving elderly in old age homes in Pakistani culture. 

We managed to demonstrate and convince the Immigration Judge that the appellant’s daughters had to follow traditional values. With regards to care homes, we proved that there is no effective legislation to regulate functioning, accountability or performance measures of private old age care homes and generally care homes are considered places for those who are deserted by their children. We demonstrated that reliance on unregulated paid care suppliers are a significant risk for the elderly and an elderly person will not be admitted to an old age home if he or she has a serious or chronic illness or disability.