‘It’s gonna be a death sentence’: The 16-year-old New Zealand says is too sick to stay

Monday, 29 June 2026

A 16-year-old originally from Fiji may have to leave New Zealand in November due to kidney disease that requires nightly dialysis treatment at home.

An immigration health threshold requires visa applicants not exceed $81,000 in publicly funded healthcare costs over five years for residence.

Immigration New Zealand declined 6713 visa applications under health criteria between 2021-2025, including 410 cases involving dependent children with medical conditions.

For families seeking a future in New Zealand, a health condition or disability can decide whether that’s possible. In part one of a two-part series, Mildred Armah meets a family trying to keep their sick son alive - and their family together.

Every night, while other teenagers are sleeping, Paula Navunisaulaki is connected to a machine that keeps him alive.

The 16-year-old has kidney disease and receives peritoneal dialysis for close to 11 hours at home. In the morning, his parents disconnect him and check his vitals before he gets ready for school.

Speaking to Stuff, his mother, Milika Coka, said: “As a mother, it’s emotionally exhausting. At the back of my mind, I’m always thinking, ‘This is what is keeping him alive.’

“As a family, we don’t sleep peacefully; always listening, watching out and hoping he will be okay the next day… I carry that fear daily.”

The family moved to New Zealand from Fiji in 2023, hoping for a better life. Coka works as a primary school teacher, while her husband, also named Paula Navunisaulaki, is a senior corrections officer.

A family granted residence - without their son

Coka, her husband and Paula’s three siblings are New Zealand residents.

Paula is not.

He is on a student visa that expires in November and the possibility he may have to leave the country hangs heavily over the family.

Paula does not have residence as Immigration New Zealand (INZ) assessed he did not meet its Acceptable Standard of Health.

Have you been affected by this issue? Email mildred.armah@stuffdigital.co.nz

The requirements assess whether a visa applicant’s health condition or disability is likely to place significant cost or demand on publicly funded health, education or disability services.

For residence visas, some conditions are treated as likely to place high demand on health and education services. Others are assessed against a cost threshold of about $81,000 in publicly funded healthcare over five years, or over the course of the condition if it is long-term.

Some applicants can be considered for a medical waiver, but INZ says waivers cannot be granted for people who need dialysis, or are likely to need it within five years. Paula’s kidney condition meant he was considered likely to fall into that category.

His father said Paula’s kidney problems were first picked up in Fiji when he was a child. He was not on dialysis then.

But when Paula was seen privately by a New Zealand nephrologist in October 2023, after arriving in the country with his family, doctors found his kidney disease had significantly worsened.

The nephrologist said Paula’s kidney function had been normal about four years earlier, but the disease had continued damaging his kidneys. He had Stage 3b advanced chronic kidney disease, had lost two-thirds of normal kidney function, and was expected to reach end-stage kidney disease within two to three years.

After INZ wrote to Coka saying Paula did not meet the Acceptable Standard of Health, the family’s then-representative requested he be removed from the residence application so the rest of the family could proceed.

His parents and siblings were granted residence while Paula was sent back to Fiji. For seven months, he lived with relatives while his parents tried to care for him from New Zealand by phone.

“The seven months back in Fiji was hard,” Paula senior said from the family’s home in south Auckland. “It affected a lot of things in [Paula’s] life, mentally and physically. He wasn’t willing to go to school, wasn’t willing to take his medication because he was missing us.”

The Immigration and Protection Tribunal (IPT), an independent body that considers appeals against some Immigration New Zealand decisions, later noted Paula had been seen at paediatric clinics in Fiji, but there were no paediatric kidney specialists, no kidney transplant option, and dialysis was limited and costly.

Paula returned to New Zealand in June 2024 and has remained here since through temporary visas and an appeal to the tribunal.

His family hopes a kidney transplant before his visa expires in November may improve both his health and his chances of staying.

‘It’s gonna be a death sentence’

In Fiji, Coka said Paula’s treatment was occasional clinic appointments and the same medication he had been taking for years.

There was no treatment plan, she said.

In New Zealand, he is under Starship Children’s Hospital’s specialist renal team, on nightly dialysis, and being prepared for a possible transplant.

“If we have to send him back, I think it’s gonna be very harsh,” Paula senior said. “It’s gonna be a death sentence.”

Coka said the family had never heard of the health requirement until INZ wrote to say Paula did not meet it.

“I was so upset. I was torn between doing what was legally right and morally necessary,” she said.

Immigration rules ‘harsh’

Paula senior said immigration rules that could force a family to choose between leaving New Zealand or being separated from a seriously ill child at such a critical stage were “harsh” and difficult to justify on humanitarian grounds.

“Us as immigrants are coming over to a foreign land looking for greener pastures and opportunities for our family. It’s a very hard harsh decision for them to just turn away someone who is sick… that was something he didn’t choose,” he said.

INZ figures show 6713 visa applications were recorded as declined under the Acceptable Standard of Health criteria between 2021 and 2025.

Of those, 410 involved dependent children.

Áine Kelly-Costello (they/them), organiser of Migrants Against the Acceptable Standard of Health Aotearoa, said the group often heard from families who had come to New Zealand wanting to work, contribute and build a life, only to find a child or family member with a health condition treated as a liability.

“Their family member is being seen as a cost burden, and just the absolute hurt of that,” Kelly-Costello said.

They said children might not understand the immigration process, but they could sense their health was the reason their family’s future was uncertain.

Kelly-Costello said some families spent years trying to keep a child or family member in the country, while others were split across borders or lived with the stress of temporary visas, appeals and legal costs.

“Many people have told us it’s the worst thing that they’ve gone through in their lives.”

Janine Parsons, INZ operations director Northern/Pacific, said the agency recognised that Paula’s situation was “very difficult and emotional” for his family.

Parsons said the health requirements were designed to assess, consistently, whether a person’s condition was likely to require ongoing treatment or support that would place significant pressure on publicly funded health and education services.

“Decisions are based on independent medical advice and take into account the nature of the condition and the level of support likely to be needed, while recognising the very real human impact these decisions can have for families,” Parsons said.

Parsons said INZ could not pre-determine any future application, but if Paula’s circumstances changed, including his medical situation, that would be taken into account in any future assessment.

In the meantime, Coka is being assessed as a possible donor. She is hoping she is a match, and that Paula can get a transplant before November. If time runs out, the family may be forced to face another impossible choice.

“That is my only hope,” Coka said, “that he gets a transplant and he stays with us here in New Zealand for good.

“Our faith in God gives us hope as we trust him for our son's healing and permanent residency in New Zealand.”

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