Escape threats in your home country, survive an almost unimaginable journey, and finally, if you are lucky, reaching the country you want will welcome you. This is a reality for many refugees. But what do you do then? A new World Health Organization report concludes that many migrants and refugees face poorer health than locals. Investigate why healthcare systems need to change to meet the needs of the moving world.
War in Ukraine, civil war in Syria, anxiety and persecution in Afghanistan—these are just a few of the situations that are causing people to leave their country of origin.
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But what happens when they arrive in a country where they want safety? Asylum seekers will be granted and welcomed by some, as evidenced by efforts with Ukrainian asylum seekers in both the United States and Europe.
For others, the uncertainty and long struggle to prove refugee status and obtain asylum will continue. During this time, they may have difficulty accessing health care, which can lead to the “deterioration of health” described in the WHO report.
Few people are willing to leave their country, but due to circumstances they may not be able to stay. Wars, natural disasters, discrimination and persecution are some of the reasons people have to leave, all of which can leave mental and physical injuries.
According to the WHO report, most migrants are inherently healthy so that they can embark on what is almost certain to be a difficult journey. In fact, many begin their journey healthier than the host population in their destination country.
However, the WHO report found that:
“Refugees and migrants often have poor living and working conditions at the time of departure, transit, or arrival at the host country, resulting in the inability to receive timely diagnosis, treatment and care and illness. The epidemic may increase. “
If they survive long land trips or dangerous sea crossings, many migrants spend long periods in transit camps and containment centers on their way to safe destinations.
The situation at these centers is harsh and many cannot provide adequate medical care to everyone who stays there. This inevitably leads to poor health for many.
Charities such as Doctors Without Borders (MSF) and other non-governmental organizations provide health care to some people, but not all migrants.
A recent report from MSF on the status of containment centers on the Greek islands identified “a significant systematic and structural gap in the provision of essential and urgent medical care to asylum seekers, refugees and migrants.”
The condition can be particularly difficult for women.
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Dealing with menstruation in transit is especially burdensome for women in cultures where menstruation is a taboo topic.
The 2020 Oxfam report states that a shortage of sanitary supplies (MHM) and “appropriate, accessible and safe” for changing and disposing of MHM are important issues for Syrian refugee women in camps in the Bekar Valley in Lebanon. Lack of private space “was identified.
Another problem with lack of privacy is that women may be reluctant to use the facility because of the risk of experiencing sexual harassment and violence.
And this horror is not groundless. According to a 2015 survey, up to 69.3% of female migrants have experienced some form of sexual violence since their arrival in Europe.
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A person who is lucky enough to reach the destination country may arrive in good health, but that health does not always last. Dr. Luz Garcini, an assistant professor at Rice University, Texas, Today’s medical news About the situation of immigrants coming to the United States..
“Immigrants—those who can withstand such difficult journeys—are healthier than US-born citizens. Ultimately, the longer they spend in the United States, the worse their health deteriorates. I think it’s because of stress […] Disassemble them. “
Therefore, in order to maintain their health, they must try to access health care. According to the Refugee Council, access to health care is a fundamental right, but many migrants find it never easy to access health care at their destination.
In the UK, refugees and asylum seekers are entitled to completely free National Health Service (NHS) care. However, rejected asylum seekers will only receive some aspects of NHS medical care, such as emergency medical care. Complex rules create uncertainty and distress.
Helen Kidan, a volunteer coordinator at BHN, a charity working with asylum seekers in Bristol, UK, said: MNT Some of the problems facing asylum seekers there.
“The impact of Britain’s hostile environment [have] It meant that many asylum seekers and refugees were worried about registering with a general practitioner. [primary care] She had surgery because of concerns about immigration status and payment of medical assistance, “she said.
“The general practitioner also refused to register asylum seekers. [mistaken] The belief that registration is not allowed, “added Kidan.
The situation in the United States is similar.Many migrants, especially undocumented migrants, have access
“Let’s say they have chronic kidney disease that requires multiple dialysis treatments — they don’t have access to it. […] Therefore, they may have to choose to return to their home country, where they left many years ago. No one remains there, and the healthcare system is collapsing. […] And they are not ready to travel, “she told us.
“We definitely have a broken immigration system. […] The healthcare system is definitely not ready for it. In many ways. Not only from the perspective of accessibility, but also from the perspective of the provider who is ready to meet their needs. “
– Dr. Ruth Garcini
“The COVID-19 pandemic reiterates the inability to protect and promote the health of refugees and migrants and their host communities if they are not part of the national public health strategy, including preparation and response. rice field.”
– WHO Report
Refugees and migrants are facing an imbalanced burden of illness due to COVID-19. Vaccine hesitation between some groups is also a problem.
Some countries, such as Portugal, provide vaccinations to refugees and migrants regardless of their status. However, many fear that advancing vaccination may notify the Immigration Bureau.
“It doesn’t mean they don’t want it [the vaccination]But they are afraid of the consequences, […] Being away from their family. Even if it is returned. […] Survival outweighs the risk of illness. “
– Dr. Ruth Garcini
For those who are lucky enough to avoid physical illness as a result of migration, those who have not experienced these experiences have unimaginable psychological stress.
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“Even in the best possible conditions, migration is stressful and most people travel in ways that are far from ideal. The stress of migration, travel conditions, and the causes that prompted migration in the first place are all mental. It can have a negative impact on your health. “
Traumatic events in their hometown are often the driving force of migration. In addition to this, there is often the trauma of long journeys to destinations, and many migrants present symptoms of mental health problems.
Depression and post-traumatic stress disorder (PTSD) are common, according to WHO reports, and these conditions are prevalent with anxiety, especially among young migrants.
Dr. Garcini saw this in the United States
“Many children had trauma and tremendous distress, but when you talk to them, they deny it —” I’m strong, I can work. ” […] Immigrants are hiding their pain […] I’m trying to make them look strong enough so they don’t burden me. […] [T]Hats promote complications, “she told us.
Also, access to mental health services, like all other health care, is difficult for non-residents. Kidan commented:[m]Asylum seekers suffer from varying levels of PTSD, which affects their lives, but many are not diagnosed because they do not seek medical assistance. “
“Mental health issues remain stigma in many asylum seeker communities, which creates barriers, so healthcare professionals also need to understand cultural barriers,” she added.
As Dr. Garcini explained, even if they are eligible for mental health services, it can be difficult to access them in many countries. […] This created a hostile anti-immigrant environment. “
According to the WHO report, migrants often do not want access to highly needed medical services due to anti-immigrant discourse and fear of deportation.
Anti-immigrant discourse is increasing in many countries. “The changes in immigration policy enacted during the Trump administration have helped migrant families become more anxious about participating in programs and seeking services such as health insurance and care,” a 2022 KFF report said. It states.
Due in part to the COVID-19 pandemic, healthcare services are under great pressure around the world. In the UK, a recent BMA analysis shows that nearly 39,000 nursing facilities are unfilled, and the UK needs to hire 46,300 full-time doctors to reach the OECD EU average.
When resources are scarce, people don’t want to share them with “outsiders.”
“Anti-immigrant rhetoric needs to be stopped. It has done a great deal of damage to these communities. They are a burden on the system, a threat to society, a terrorist coming to the country, and a health risk. Has been portrayed as a carrier of illness. I can imagine what it would do to a person. “
– Dr. Ruth Garcini
“Basically, collective action requires greater political dedication and the necessary resources to ensure that refugees and migrants are included in health system and service policies, regardless of their legal status. In the long run, refugees and migrants “others” need to be reduced and ultimately removed to avoid policy-making and “us vs. them” discussions throughout society. “
– WHO Report
Immigrants are expected to continue to grow, as the number of migrants is increasing globally and instability is increasing in many countries. Refugees are almost invisible due to the lack of quality data today. If they are not visible, they cannot be taken care of.
Failure to reorient the health care system to include migrants and refugees denies the fundamental rights of health care to many.
in the meantime
Many countries have strict immigration policies, so it’s a good idea to keep that in mind.
