right to care - european refugee crisis dr alexander van...
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RIGHT TO CARE - EUROPEAN REFUGEE CRISIS
Dr Alexander van Tulleken
Dr Anders Björkman
Dr David Montes Bentura
Dr Hanna M. Ingelman-Sundberg
Doctors of the World International Network
Médecins du Monde
Doctors of the World
• Europe is currently
experiencing the largest
global displacement since
the Second World War.
• MdM has > 430 programs
in > 80 countries
• 15 countries which run
domestic programs and
international programs
@ Giorgos MOUTAFIS
Turkey/Syria
Iraq
Lebanon
Jordan
Greece
Albania
Bulgaria
Czech Republic
Croatia
France
Netherlands
Norway
Spain
Sweden
Germany
Belgium
Slovenia
UK
MdM and Partners
End 2014: 59.5 million displaced people in the world (UNHCR)
Over 1 million migrant arrivals in 2015 from the Mediterranean
In 2016 so far;
172,130 refugees/migrants arrived from the sea in Europe / 152,152 in Greece alone
35% children, 20% women, 45% men
711 deaths
90% from countries that have experienced conflict and war
49% from Syria
26% from Afghanistan
16% from Iraq
84% of patients
experienced physical,
psychological or
institutional
violence
Violence a recurring theme on their
journey from the conflicts they have
fled, experiences in transit and in
“host” countries
Médecins du Monde – At all the main entry, transit and exit points
LESBOS
• 59% of new arrivals came to Lesbos
• Providing access to healthcare, Mental
Health and Psychosocial support in
reception centre, the port & mobile unit
@Guillaume Pinon
• 23% of arrivals come to
Chios
• Primary healthcare and
Mental health and
psychosocial support for
refugees at Souda Camp,
Vial, port, mobile unit
MdM in CHIOS – Mobile Unit (now in Larissa)
FERRY PROJECT – Health in Transit
• 10 hours to make a difference
• Identify and provide support for those with
vulnerabilities in health via social worker
and psychologist with the aid of interpreters
• Provide access to primary healthcare
(Nurse and doctor)
• 3 – 4 emergencies per crossing
ATHENS – Health in Transit
• MdM is operational at
Elliniko, the old Athens airport
(around 8,000 refugees), and
all other camps around Attiki
• Open polyclinics in Athens,
Perama, Patras,
Pireus,Thessaloniki, Chania,
Kavala & mobile units to
villages & islands: GPs,
specialists, mental health
support and medicines
MdM clinic in Elliniko
IDOMENI – Border with Macedonia
• Despite the difficulties of working in
ever-changing conditions on the
ground, they continue to provide
healthcare and bear witness to
the crisis.
• Conditions seen over last 6 months
•Respiratory tract infections 41%
•Diarrhoea & Vomiting 20%
•Skin Diseases 12%
•Trauma 23%
SAR - Search and Rescue in Central Mediterranean
The Search and Rescue team of SOS Méditerranée
with a medical team from Médecins du
monde/Doctors of the World rescue refugees
between Libya & Italy
CALAIS • Psychologist, Art therapy, child
friendly psychosocial tent
• Community outreach and support
to families following deaths
• Socio-legal-medical support for
victims of violence
DUNKIRK• Mobile unit with 2 doctors twice a
week
• Partnership with MSF who
provide medical consultation the
other days
Trauma experienced in country of origin:
• The direct and indirect effects of conflict
• Conflict-related wounds & associated complications with wound healing
• Torture
Trauma sustained in transit:
• Accidental injuries
• Hypothermia
• Dehydration
• Burns
• Death of friends & family members
HEALTH NEEDS - Trauma
Children in MdM consultationsBetween 58% and 66% were not immunised
against MMR, whooping cough, hepatitis B or
tetanus
39% of parents did not know where to go to
have their children immunised
Around 90% of the EU children have completed
their immunisation (general population)
Pregnant Women in MdM consultationsMore than half of pregnant women had no
access to antenatal care before they came to
MdM
80% of pregnant women had no health coverage
in the EU
Health Status23% 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.
10% of patients with a chronic condition knew their diagnosis before going to MdM consultations.
10% report having been victims of violence after arrival in Europe
Doctor on the frontline in Chios, Greece
Dr David Montes Bentura, MdM Spain
What are the survivors feelings ?
Happiness? Greatfulness?
Anger?
Sadness?
Fear?
Anxiety?
Mersinidi
Souda
Tabakika
i
Nobel
Peace
Prize
2015
Secar la ropa
Get some rest
Dry clothes
Contact with the family
Medical attention
from international
team of Doctors,
Nurses and
Interpreters.
Children
Children
Pregnant women
Chronic disease
• Chronic disease
registration
• Diabetes
• HTA
• Heart disease
• Oncology
• Treatment
• Acute illness
No more Humanitarian aid.... Chios has become a detention camp
MDM RESPONSE TO THE REFUGEE ARRIVAL IN SWEDEN
Dr Hanna Ingelman-Sundberg – Doctors of the World Sweden
MdM Sweden – Läkare i VärldenSverige
• Founded in 1991, volunteer medicalclinic since 1995
• Initially medical service for undocumented migrants without access to health care
• Facilitates access to regular health care access for undocumented migrants since new legislation in 2013. Currently provides medical care for EU citizens without health insurance
• Legal advice and psychological support for undocumented migrants
The medical clinic in Stockholm
• 3 nurses, 4 dctors, 1 dentist, 1 physiotherapist
• 20-25 patients per evening
• Many patients lack proper housing
Arrival of the European refugees in Sweden
• The first trains arrived September 11th
2015
• No reliable data on the number of arrivals - many continued to neighbouring countries without registration
• > 114.000 asylum applications fromSeptember to December 2015
Dagens Nyheter 2015-11-13 Photo: Nicklas Thegerström
First mission for MdM Sweden: Information
• Many volunteers from other NGOs and “spontaneous volunteers” at StockholmCentral Station
• Disinformation about legal right to health care for asylum seekers and undocumented migrants
• MdM Sweden distributed a leaflet with correct information to >1000 people within 24 hours after the first arrivals
• Further spread through social media
Aftonbladet 2015-09-08, Photo: Robin Lorentz-Allard
Main challenge: identify immediate needs
• Similar to refugee camps in the rest of Europe, people with life-threatening or other emergent conditions needed to be identified
• MdM Sweden set up a team of mobile medical staff to visit the arrival points and preliminary refugee shelters for primary surveys
• Patients with serious conditions could be taken to hospital immediately, lighter conditions were treated on the spot
Organisation of the mobile team
• Based in the Stockholm Mosque, being one of the biggest temporary refugee shelters
• Initially only using an emergency bag, later a better equipped car
• Communication with the main refugee shelters by phone to relocate medical volunteers to where they were needed
Sweden closes its borders in 2016
• The Swedish Government decided on temporary border controlsfrom January 4th 2016
• All travellers need to show valid documents and proof of identity
• The numbers of arriving refugees has drastically dropped
• In total, only 9000 asylum applications from January to March
The Mobile Clinic from 2016
• Re-located to night shelters for EU citizens without proper housing
• Able to assist newly arrived refugees if needed, after communication withthe shelters
• Seeing around 10 people per night
The way forward
• MdM Sweden has raised great concern about newly suggested changes to Swedish legislation, severely impairing asylum rights
• Preparations for handling an increasing number of undocumentedmigrants
• “Watchdog function” to report how impaired rights to affect healthof humans already under pressure
• New campaign: Don´t stay silent!
THANK YOU!
Solidarity & care instead of fences – Thank you@ Olmo Calvo
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