The Immigration Services Agency of Japan on Aug. 10 released a final report on the death of a Sri Lankan woman at a regional detention center in central Japan, pointing to the lack of a proper medical response after she said she was feeling unwell and stating that the facility "lacked a sense of crisis and failed to accurately grasp the circumstances as an organization."

The Sri Lankan woman, Wishma Sandamali, then 33, died at the Nagoya Regional Immigration Services Bureau in Aichi Prefecture on March 6, after she complained of nausea and numbness starting on Jan. 15 and her condition subsequently deteriorated. She had been detained at the facility since August last year after overstaying her visa since January 2019. She first came to Japan in 2017 as an international student.

The final report acknowledged that Wishma died of illness, but stated that the detailed process leading up to her death could not be determined as several factors likely played a role. The report said the regional immigration bureau's medical response to her complaint of feeling unwell and the notable changes in her physical condition was insufficient, and presented measures for improvement to prevent a recurrence of similar incidents.

The Immigration Services Agency has admonished the then head and deputy head of the Nagoya Regional Immigration Services Bureau, and gave strict warnings to a security supervisor and another official.

The final report delved into the Nagoya immigration bureau's medical response system. It pointed out that the detention center had a limited medical arrangement in which it was allowed to assign a part-time internal medicine doctor only twice a week. The report then stated that senior bureau officials ought to have properly gotten a grasp of Wishma and other detainees' physical conditions and their requests for medical examinations, and deliberated and called for the necessary responses, but that the officials failed to develop such a system.

The report revealed that many of the guards at the bureau suspected that Wishma's complaints about poor health were "an exaggerated appeal to be granted provisional release," raising issues for future investigation such as staff education and the assignment of interpreters to understand detainees' physical conditions through communication.

During her detention, Wishma twice filed a request for provisional release, but her wishes were not granted. The final report said the bureau "should flexibly grant provisional release" to those with poor health conditions. As Wishma had claimed that she was subject to violence from a former partner, the report cited the need to reflect on the fact that the local bureau failed to investigate whether she was a victim of domestic violence. It also cited the need to share the content of appeals from detainees' supporters as something that must be addressed.

In light of these points at issue, the final report produced improvement plans in order for the bureau to "advance reforms to make it an internally and externally reliable organization that respects human rights." Specifically, the report cited measures such as the reform of all workers' awareness, boosting its medical system, and ensuring appropriate judgment on provisional release in light of foreign detainees' health conditions.

The agency's investigation team probing the background to Wishma's death conducted a total of 139 interviews with 63 individuals concerned, and also sought opinions from external specialists.