Deportation of people with disabilities: How sick is sick enough?

Before everything changed, William had gone on a trip with his parents. Go to Berlin, see the Reichstag and the Brandenburg Gate. Hugged by his mother and father, William smiles in the photos from back then. A skinny 13-year-old looks into the camera, eagerly waiting to finally turn 18. Then, when his body stops growing, he can get a new hip. Then he could finally walk again without crutches, put on his socks alone, go to the toilet alone, and could spend a whole day - from getting up to going to sleep - without pain.

William lives on the third floor of an East German prefabricated building. He enjoys reading science fiction novels and playing the violin. Chemistry is his favorite subject at school. But on this Friday morning in May 2025, William is not in class. “He's having a big day,” says Daniel Bouba, his father, who has just put a pile of freshly washed laundry on his bed and who, to protect his family, doesn't want his real name in the newspaper. Today William has to go to the pediatric oncology center of an East German university hospital for a blood transfusion. In a few weeks he will have stem cells transplanted, so he needs new blood.

William has sickle cell anemia, a disease in which red blood cells become misshapen. This causes them to die more quickly, causing a lack of oxygen and painful circulatory problems. Organs and bones can be damaged. William was hit in the hip. Only a stem cell transplant can cure sickle cell anemia.

The other is that the Federal Office for Migration and Refugees sent William the answer to his asylum application a few weeks earlier: inadmissible. He should leave Germany within a week, according to the notice that the taz has received. “If the applicant does not meet the departure deadline, he will be deported to Cameroon,” it continues. There are no reasons for a ban on deportation to his home country.

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William's story is about German authorities and committed doctors, about a father fighting for his son and a son fighting for his future. The question arises again and again throughout history as to whether and how children's rights also apply to refugee children.

Most children with sickle cell anemia in sub-Saharan Africa die before their 5th birthday. In the USA or Great Britain, most sufferers reach the age of 70. This is what the journal Global Public Health reports. Although the disease is comparatively widespread in Cameroon, children and young people with sickle cell anemia are often exposed to massive discrimination, the scientists write. The treatment must be paid for by the families themselves. The medication is not always available and a daily dose costs up to $20. In addition, almost exclusively clinics in urban centers treat sickle cell anemia and only a few doctors and health professionals are trained in dealing with the disease.

Press reports and the World Health Organization describe the situation in a similar way to the scientists. William's father says that no one in his family knows about his son's illness. “These children are stigmatized,” says Daniel Bouba. "It hurts when people talk badly about you. That's why we don't tell them."

Until William was 10 years old, he could run and play football, almost like healthy children. At that time he still lived in the Swedish city of Boden. William's father had studied accounting in Sweden, where his parents made their first application for asylum. William had just turned 6 years old at the time.

The doctors there treated him with a medication that kept his blood from clumping, his father says. But the family's asylum applications were rejected and after four years, William and his mother were deported to Cameroon. The father managed to escape to Germany and was able to bring William there. This is also evident from documents relating to the case. But now the German authorities are justifying the rejection of the asylum application in Germany by saying that one had already been submitted in Sweden.

“Imagine your sick child being deported to a country where he or she can’t get treatment, and you can’t do anything about it.” Daniel Bouba takes a deep breath and then exhales. “It was traumatic for me.” William lived with his mother's family in Cameroon. The attacks of illness came every two weeks. The infusions that he received every now and then in the hospital didn't help with the pain. The mother saw no other option than to send William to his father in Germany.

He started the journey alone. By plane to Europe, then by train to the East German city where he lives today. When Daniel Bouba hugged his now 12-year-old son at the train station, William could barely walk. His father doesn't know how he felt mentally after his time in Cameroon. “He doesn’t talk about it and I don’t want to pressure him,” Bouba says.

Not all people with disabilities have a relatively safe escape route like William does. “That is why it is fatal that the federal government has stopped all humanitarian admission programs and suspended family reunification for those entitled to subsidiary protection,” says Sophia Eckert. She is a policy officer in the Crossroads program at the NGO Handicap International. Eckert is also convinced that the Federal Republic is violating the UN Convention on the Rights of Persons with Disabilities (UN-BRK) in several respects. As a result, refugees with disabilities should not be worse off than people without disabilities, regardless of whether they are refugees or not.

In reality, asylum seekers are subject to the Asylum Seekers Benefits Act for the first 36 months of their stay and are only entitled to the “necessary” treatment of “acutely necessary illnesses and pain conditions”. Everything else is formally at the discretion of the authorities. “Asylum-seeking people with disabilities are entitled to disability-specific benefits under European law and the UN CRPD,” explains Eckert. These include, for example, a long cane that people with visual impairments use, mobility training, a custom-fit wheelchair and personal assistance. “The authorities usually see things differently,” explains Eckert. “We are currently seeing more and more applications being rejected.”

State and local authorities implemented the Asylum Seekers Benefits Act under their own responsibility, explains a spokeswoman for the Federal Ministry of Labor and Social Affairs upon request. The responsible authorities are obliged to exercise their discretion properly. She had no knowledge that the authorities would generally exercise their discretion to the detriment of the “group of people in question here”.

As a worker in the warehouse of a fashion company, Daniel Bouba faced logistical problems; his shift work and his son's school schedule didn't mix well. So at 3 a.m. he put William's breakfast and lunch on the table, put socks on him - did everything his son couldn't do himself - and went to work. “When I had a late shift it was a little better, then I could at least get up with him,” says Bouba. At that time, William's health was even better.

Last year, William's mother also managed to escape from Cameroon, and now his parents can take turns looking after him - when he is not in the hospital. “I’m glad that my mother is here now and I’m not alone so much anymore,” says William.

Daniel Bouba says he tried to keep worries about his residence status away from his son. His son sits next to him in the living room of the small apartment, with a busy street behind the white curtains, and listens attentively to his father. “But of course he noticed everything, he’s an intelligent child.” And of course William was frightened when the request to leave the country landed in his mailbox. That was in March 2025.

Sophia Eckert and her colleagues from Handicap International observe that disabilities that would result in protection from deportation are often not identified. “One of the reasons for this is that in many places there are still no functioning procedures for determining specific admission and procedural needs, even though the GEAS reform provides clear guidelines for this,” says Eckert. In the hearings, obvious disabilities are sometimes not asked. “The situation of people with disabilities is also rarely discussed in the situation reports on the situation in the countries of origin.”

This should actually change with the reform of the Common European Asylum System (GEAS), which came into force in June 2026 and will make asylum migration even more difficult and regulated than before. Before refugees can apply for asylum, screenings should determine whether a person is particularly in need of protection, for example because of a disability, trauma or torture. That's the rule.

However, over the past few months, cases have repeatedly become public in which protection needs were not reliably identified and taken into account. A current report from Pro Asyl describes that of a trans woman from Uzbekistan. When she arrived at Berlin-Brandenburg Airport, she said she had a chronic illness and was a victim of human trafficking. Nevertheless, she received neither appropriate medical care nor adequate care and initially had to stay in the closed facility at BER. Only with the help of a lawyer was she finally allowed to enter the country and was later recognized as a refugee.

In Germany, the Federal Office for Migration and Refugees (Bamf) is responsible for examining asylum applications. The authority is aware of its special responsibility both in terms of identification and in dealing with vulnerable people, writes the Bamf upon request. But primarily the identification task lies with the states. Even now that the Geas reform is in force. “The Federal Office is not a screening authority,” writes a spokeswoman. The federal police and federal states are responsible for this, depending on whether the screening takes place at the borders or within the country.

In mid-June 2025, William will be hospitalized as an inpatient, this time for a stem cell transplant. To do this, his bone marrow and immune cells must first be destroyed with chemotherapy. Only then can the healthy, donated stem cells be transplanted, settle in the bone marrow and form healthy new blood cells. “The chance that there will be complications is only 5 percent,” said William’s father at the time. “But of course William is still very scared because the doctors always explain what could go wrong.”

When William begins chemotherapy, the court has not yet decided whether there should be a ban on deportation, at least for the duration of the legal proceedings. “If an asylum application is rejected as inadmissible and deportation is threatened, this should be carried out as quickly as possible,” says Williams’ lawyer Robin Michalke. “So even though people have filed a lawsuit, they may be deported before the court makes a decision.” Michalke is applying for a so-called suspensive effect for Williams' lawsuit so that deportation is not carried out during the ongoing proceedings.

Four months later, the court granted his urgent application. But the family still doesn't know whether his illness will lead to a ban on deportation in the long term. “The legislature has created extremely high formal and substantive requirements for bans on deportations due to illness and has therefore deliberately given deportations priority over thorough procedures,” says lawyer Michalke.

In 2019, the then black-red federal government increased the requirements for medically-related deportation bans. Those affected must now provide a so-called qualified medical certificate, which is often associated with high costs. In the case of mentally ill people, a report is required that can no longer be prepared by psychotherapists, but only by psychiatrists. Finding a specialist in time before deportation is virtually impossible for new arrivals.

William has stacks of documents proving that he is chronically ill and is being hospitalized. But the problem is that the Federal Office fundamentally assumes that sickle cell anemia can be treated in Cameroon. “According to the available findings from the ‘Medical Country of Origin Information’ (MedCOI) database, treatment for sickle cell anemia is available in Cameroon,” writes a Bamf spokeswoman for the taz. With regard to illness-related deportation bans, it must be examined on a case-by-case basis whether a return would result in a significant deterioration of a life-threatening or serious illness and whether actual access, including financing, to the necessary health care is guaranteed.

In rejecting Williams' asylum application, the Federal Office acknowledged that the financing of medical treatment in Cameroon usually has to be borne by the families. In William's case, however, he was convinced that his father could pay for the treatment, after all, the boy had received infusions before entering Germany. The Federal Office concluded that William's health condition "will not immediately change significantly or even life-threatening" upon return and saw no obstacle to deportation.

“But the infusions in Cameroon didn’t help me with the pain at all,” says William. The fact that he needs a new hip and that only a stem cell transplant can cure sickle cell anemia is not mentioned in the Federal Office's decision. “According to the law, there is no right to a good life, only a right to survival,” says lawyer Michalke.

So he came up with a strategy. He tries to get William banned from deportation and the resulting residence permit. But he is also trying to get a residence permit for his father, Daniel Bouba. Because he lives in a household with a minor child, pays most of his living expenses and fulfills so-called integration services, he can receive a residence permit after four years of residence in Germany.

Shortly after the stem cell transplant, William experiences serious complications. The cells from the bone marrow donor recognize William's own cells as foreign and activate the immune system. It now attacks William's body. William's fear of being one of the few patients for whom something goes wrong actually comes true. “He held me tight,” William’s father remembers those bad days in the fall of 2025. Daniel Bouba has tears in his eyes as he tells the story. "I didn't know what to do. I went out of his room to cry. I didn't want him to see me."

On a Friday evening in March 2026, William sits on a high office chair in his pajamas. His parents pushed him into the living room so that he could get up more easily. He is pale and speaks quietly. “I thought I would get better quickly,” says William. "But now everything is taking so long. Every day it gets a little harder for me." His father tries to cheer him up. Today he bought vanilla ice cream with chocolate chips for William. It motivates him to leave the house. But William just wants to lie on his bed most of the time. The laughing boy in the photo in front of the Reichstag, hugged by both parents, is no longer him today.

"Even the doctors can't tell me how long I'll have to take the medication. It's so disheartening," says William. He also hasn't been able to go to school for months. His immune system is not yet able to cope with everyday life in the classroom. “There are good days and bad days,” explains William. On good days, he takes part in class with his avatar. His classmates could move him in the classroom. "But I'm not thinking too much about school right now. I'm just trying to get through the days somehow."

The family has now received good news: Daniel Bouba has received mail from the immigration authorities. He can now collect his electronic residence card. Attorney Michalke's plan worked. William now receives a residence permit through his father. He is no longer dependent on the court recognizing his illness as a reason against deportation. William can get well first.

And other affected people? Like William, they must hope that their relatives have the strength and means to fight for their very special protection.