“We understand that, for the government, taxpayers come first, but we are calling for a humanitarian approach,” social worker Jeffrey Andrews, whose Sri Lankan client has a serious heart condition, said.

Rebekka Fiedler, casework and research manager at Hong Kong Dignity Institute, an NGO serving refugees, said she was helping a young Egyptian woman who needed an MRI scan to assess damage to her brain and to avoid collapsing and slipping into a coma.

As the woman was poor, jobless and could not afford the cost of treatment, Fiedler appealed to the authorities to “use their discretion and waive the medical fees”.

A spokesman for the Hospital Authority, which oversees all public health institutions in the city, said such foreigners were not eligible for subsidised treatment in public hospitals.

“Non-refoulement claimants are not Hong Kong residents. When they use medical services provided by public hospitals, they must pay the medical expenses chargeable for ‘non-eligible people,” the spokesman said.

He added that the authority would provide medical services to ineligible people only in emergencies.

But Andrews said waiting for an emergency could be too late for someone like his client.

Vijay Sivakumar* came to Hong Kong in 2007 after he fled Sri Lanka because he feared persecution for fighting in the country’s civil war for the Liberation Tigers of Tamil Eelam.

But, two years after he arrived in the city, he collapsed and needed heart surgery.

Sivakumar, who is married with a son in Sri Lanka, was granted non-refoulement in 2018, allowing him to remain and work in Hong Kong until it was considered safe for him to return home.

He found work as a junior chef in a hotel, but in 2019 was diagnosed with severe ischemic heart disease and was told he needed surgery to unblock a valve in his heart.

Sivakumar said he had to quit his job because everyday tasks such as walking and eating caused pain in his chest.

“I go to the doctor every three or four months for a check-up and medication. I beg them to do the operation but they tell me, ‘Pay the money and you can get the surgery,’” he said.

Andrews said the Social Welfare Department told Sivakumar he could undergo surgery in a public hospital only if he paid the full fee of HK$70,000 (US$8,950).

About 15,000 foreigners are in Hong Kong seeking asylum. Most who fail in their initial claims remain for years awaiting the outcome of appeals to the Immigration Department and the city’s courts.

Andrews explained that, for most, basic healthcare was provided, but problems arose when it came to urgent, life-saving interventions.

“Once any asylum seeker or refugee gets admitted to hospital, they will receive required medical treatment and investigative procedures. However, [for urgent care] most come to us for financial support after being told they are not eligible to receive it free of charge,” he said.

Christian Action, an NGO for refugees of which Andrews is vice-chairman, has referred 543 people who need urgent care to private clinics which provide free treatment since January 2021.

But he said the participating clinics were not equipped to handle complex operations.

Fiedler’s client, who asked to be identified as Noran, 20, was admitted to Queen Elizabeth Hospital in Yau Ma Tei on September 27 and diagnosed with hemiplegia, a form of paralysis caused by stroke.

“I suddenly felt numbness in my face, my mouth changed direction, I could not move my tongue or my right side,” she said.

She was discharged on October 1, but has been denied follow-up appointments because she did not pay the HK$1,230 she owed as a “non-eligible person”.

A hospital document seen by the Post showed that an eligible patient would have paid HK$180.

Noran said the doctors told her she needed a brain scan and there was a chance that if she collapsed again, she might slip into a coma.

She arrived in Hong Kong from Egypt in October last year with her mother, stepfather and three sisters to seek asylum, claiming they were escaping torture and domestic abuse.

She failed in her most recent non-refoulement claim, which means she is not entitled to basic healthcare and cannot work.

“Sometimes I wake up and I am blind in my left eye. My sight comes back eventually, but it is terrifying,” she said.

Fiedler said she checked with a healthcare community partner who said Noran’s medical bills would likely be so expensive that “there is no way the family can afford it”.

“Either the Hospital Authority waives the fees or a third party pays her bill,” Fiedler said.

Fiedler said she wrote to the Social Welfare Department, Queen Elizabeth Hospital, the Immigration Department, the Hospital Authority and lawmaker Tik Chi-yuen appealing for urgent medical help for Noran.

“Due to the continuous lack of financial and medical support, Ms Noran’s situation remains dire,” she wrote.

The Social Welfare Department said it was handling Noran’s request for a fee waiver. An Immigration Department spokesman said it was unable to comment.

*Name changed to protect the identity of the interviewee.