"I wonder am I going to get medical attention or am I going to die before I get it.

"I was passing out blood, so I thought I'd get medical treatment immediately but whatever doctor I tried they said they were full'", said Josalyn, a Rwandan refugee.

Josalyn was one of a record 76,000 people who last year sought refuge in the UK.

But like many of her fellow asylum seekers she has been unable to register with a doctor in Britain despite serious health problems.

Josalyn fled Rwanda seven months ago after her father was murdered.

I think very often refugees are given the impression the population of the UK need to be protected from them Dr Angela Burnett

She is still too frightened to be publicly identified, fearing for her life and for the safety of the family she left behind.

All asylum seekers are entitled to be treated free on the NHS but critics say there are obstacles stopping many from accessing the care they need.

Virginia Tshibiangu of the Refugee Council said many doctors are reluctant to take on asylum seekers.

"A number of our clients will be told they can register locally, that they have entitlements.

"But then when they turn up at local GPs they're either told 'you need to bring your own interpreter' or they say 'we're not sure you're entitled'," she said.

Virginia Tshibiangu: "GPs reluctant to register asylum seekers"

Asylum seekers often ended up having to visit hospital casualty departments for routine complaints like asthma, she added.

Josalyn has tried to register with more than a dozen doctors but so far has not been successful.

Despite a hospital examination, the cause of her illness has still not been identified.

"I sometimes think to myself that one day I will just collapse and die," she said.

Torture-related illnesses

According to east London GP Duncan Trathen, the shortage of doctors in many parts of the UK adds to the troubles of asylum seekers like Josalyn.

Dr Duncan Trathen: "Shortage of GPs".

He works at a centre in Newham set up for people unable to register with a GP and 60% of the patients are asylum seekers.

Dr Trathen said the biggest problem many asylum seekers had were stress-related illnesses but staff are seeing significantly more torture-related illnesses among refugees than previously.

"We've had a lot of stories from asylum seekers who've been manacled around the ankles and some people who've been hung upside down for periods of time.

"There's people who've had electric shocks, we've heard of cases of that particularly in Kosovo but also in Somalia as well," he said.

Angela Burnett of the Medical Foundation for Victims of torture agreed that torture was a growing concern.

She said the number of people referred to them had increased dramatically.

Dr Angela Burnett said torture is on the rise

"Torture is something which has probably been underreported in the past.

"It's only recently that people have included rape as part of torture," she said.

Dr Burnett said that although refugees tended to have a higher incidence of some diseases like tuberculosis, they should not be stigmatised.

"They shouldn't be looked upon as merely being carriers of infection and certainly testing should be available and follow-ups should be available.

Dispersal

The government's policy of dispersing asylum seekers around the UK presents another challenge to health care access, according to Emma Williams of the Breathing Space project.

"Effectively what happens is that you're bussed up to an area, you're received by your landlord who is contracted by the Home Office to provide you with access to the services you need so that would include health care, education etc.

"The landlords do this to varying degrees - some would just give you a list of GPs which means if you can't speak English it's absolutely hopeless," she said.

Emma Williams: "Dispersal is obstacle to health care"

Duncan Trathen said some practices, including his own centre, give patients hand-held records, a brief summary of medical problems and what the treatments are.

Emma Williams said some refugees' mental health was not improved by treatment from some members of the public.

"They are viewed very poorly, seen as scroungers, economic migrants, thieves, dirty. The sorts of words people are using about them are terrible."