Oslo Friday June 24rd :00-12:30. FM-1.1-Simonnot-Health.pptx

Transcription

1 Health and access to care for migrants facing multiple vulnerabilities in Europe universal health in the EU EUPHA s 6th European Conference on Migrant and Ethnic Minority Health Nathalie Simonnot Médecins du monde (MdM) - Doctors of the World International Network FM-1.1-Simonnot-Health.pptx Oslo Friday June 24rd :00-12:30

2 2 Giorgos MOUTAFIS, Child trying to survive on arrival at Lesbos

3 The «migrant crisis» in figures 59,5 millions displaced persons in the world (UNHCR ) Among them are nearly 20 million refugees, over half of whom are under the age of migrants arrivals in 2015 from the Mediterranean (1,7%) In 2016 until now, refugees/migrants arrived from the sea in Europe / 157,119 in Greece alone. Greece : Lesbos: inhabitants arrivals (jan jan 2016), in 2016 (up to June 12th). Chios inhabitants, arrivals from Jan 2015 to March 2016, arrivals in 2016 (up to June 12th). Samos inhabitants and arrivals in 2016 (up to June 12th). Now: over persons stuck in Greece. Since Beginning 2016 : 35% children, 20% women, 40% males Already death/missing in 2016

4 Restrictive laws and complex administrative procedures «Legal Report on Access to Health Care in 12 countries». Doctors of the World (MdM) - June Access to health care : 4 criteria Health system / healthcoverage (population covered) What is covered Affordability (actual) Availibility / in practice Study based on : - National health care system (legal basis, organisation, access) - Access to health care for migrants - Protection for seriously ill foreigners (who cannot access care in their country) - Prevention and treatment of infectious diseases 4

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6 MdM and network In 2014: data collected in 26 towns of 11 countries BE, CA, CH, DE, EL, ES, FR, NL, SE, TR, UK patients 93,6% foreigners Report in May 2015: «Access to health care for people facing multiple health vulnerabilities in 26 cities across 11 countries» European Network to Reduce Vulnerabilities in Health : 10 MdM and 13 partners (1). In 2016, 16 collect data for International Network Observatory (11 MdM, 5 partners) BE, CA, CH, DE, EL, ES, FR, IE, LU, NO, NL, RO, SE, SI, TR, UK (1) Austria the Center for Health and Migration, Bulgaria The Bulgarian Family Planning and Sexual Health Association, Czech Republic Consortium of Migrants Assisting Organizations in the Czech Republic, Hungary Menedék, Ireland Migrant Rights Centre Ireland, Italy NAGA, Norway Health Centre for Undocumented Migrants, Poland Association for Legal Intervention (SIP), Romania Carusel, Slovenia Slovene Philanthropy, Croatia LET/Flight, Lithuania - Association of HIV affected 6women and their families Demetra", Austria - AmberMed. And ASEM in Turkey.

7 Health Status 23% of patients perceived their physical health as bad or very bad. 27% when it comes to mental health 70% had not received medical attention before going to MdM consultations MYTH of migration for health reasons: Patients had lived in average 6,5 years in the country before consulting 3% declared personal health reasons as one of the reasons to migrate 9,5% chronic patients knew their condition before migrating 7

8 Children in MdM consultations Only 42.5% had been vaccinated against tetanus (69.7% in Greece) Only 34.5% had been vaccinated against mumps, measles and rubella (MMR) (57.6% in Greece) 38.8% of patients did not know where to go to get their children vaccinated Around 90% of the EU children have completed their immunisation 8

9 Women in MdM consultations 54.2% had no access to antenatal care 81.1% had no health coverage 89.2% lived below the poverty line 52.4% did not have the right to reside 67.8% restricted their movements to varying degrees for fear of arrest 9

10 Physical /psychological violence Institutional violence 10

11 Violence and migration routes Violence and migration routes Proportion of violence at different stages of migration in the eight European countries (% of reported episodes) 9.8% report having been victims of violence after arrival in Europe 21.1% of the reported rapes took place after the victim s arrival in the host country, as did 17.7% of sexual assaults,

12 Rates of violence by gender (in 8 european countries) 12.4% of those who had experienced violence perceived their mental health to be very bad versus 1.7% of the people who did not report an episode of violence.

13 A poor and excluded population 65% were living in unstable accomodation including 10% homeless and 16% in long term shelters only 22% reported an activity to earn a living 91% < poverty line 50% with no or few emotional support 63% with no health care coverage 51% of Nationals 70% of EU citizens 82% of non EU (p<0.001) Total 7 Europe 4 3

14 Hungary (2015) 14

15 Migrants in transit First results: MdM Greece and MdM Germany 500 persons (March to mid-april 2016) Average length of migratory journey: 5 months 7% travelled for over 2 years 18% said they had never received any info on access to care Paula Lakrout 14th June 2016

16 PATHOLOGIES GENDER AGES Respiratory Dermatologic Digestive 37 % 63 % FAMILY MAIN COUNTRY OF ORIGIN 29 % (average 4 members) 6 % 2 % Syrie Afghanist an Irak Pakistan

17 VIOLENCE of women declared having faced violence (60% women & men) Among all patients having faced violence 64 % reported violence in country of origin 26 % reported violence in country of destination 4 % reported violence in migratory road Needs in mental health

18 PERCEIVED HEALTH

19 Stockholm 19

20 20 Migrants moving towards Northern Europe ( Aris Messinis)

21 Munich 21

22 5 key points Safe and legal migration channels, free of violence and provide welcome and satisfactory protection (isolated children, women...). Migrants should be able to seek asylum in the country of their choice. We must put an end to medical examinations to control immigration. Effective and universal access to care: focus on antenatal care and immunization. Seriously ill migrants should be protected against expulsion. 22

23 Visit: Contact: Thank you for your attention 23

24 Belgrade Olmo Calvo /Medicos del Mundo Luis Valtueña price - 24