Helsesenteret for papirløse migranter


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No paper, no rights? Undocumented Migrant, Health Problems and Health Care.

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  • Ratifisert Barnekonvensjon
  • (Riksadvokaten har den overordnede ledelse av straffesaksbehandlingen, herunder ansvar for fastsettelse av mål og prioriteringer, og for å gi instrukser og følge opp straffesaksbehandlingen ved statsadvokatembetene og i politidistriktene).
  • Antan, Etiopia, Iran, Irak, Mongolia, Romania, Somalia,
  • Helsesenteret for papirløse migranter

    1. 1. No papers, no rights? Undocumented Migrants, Health Problems and Health Care - front line experiences from health care provision to undocumented migrants in Oslo Frode Eick, Health Care Responsible Health Centre for Undocumented Migrants, Oslo
    2. 3. What is meant by undocumented? <ul><li>Undocumented migrants; people with no legal resident permit </li></ul><ul><li>Undocumented doesn’t necessary mean no passport or ID-papers </li></ul><ul><li>Our patients: 2/3 previous asylum seekers (with final rejection), the rest never registered, overstayed visum/resident permit </li></ul>
    3. 4. No paper, no rights? <ul><li>- right to emergency care </li></ul><ul><li>- right to necessary treatment before and after giving birth, abortion and treatment/medicines of communicable diseases (tub, hiv) </li></ul><ul><li>and new political expression; ”health care that can not wait” – open to individual interpretations! </li></ul><ul><li>rights do not guarantee access </li></ul>
    4. 5. No paper, no rights? <ul><li>No right to ”fastlege” </li></ul><ul><li>Children: right to all types of health care (and primary education) but still no ”fastlege” </li></ul><ul><li>For all: the patients have to pay themselves, no financial system, no reimbursement </li></ul><ul><li>Social service: no rights </li></ul>
    5. 7. Background <ul><li>Aftenposten ran a feature article series in 2007 </li></ul><ul><li>Oslo City Mission did a needs assessment in 2008 </li></ul><ul><li>Uncovered great needs especially for health care </li></ul><ul><li>No other Norwegian actors were engaged </li></ul><ul><li>Started a collaboration with Red Cross Feb. 2009 </li></ul><ul><li>Clinic opened 27th October 2009 </li></ul>
    6. 8. The Health Centre <ul><li>Run by Oslo Church City Mission and Oslo Red Cross </li></ul><ul><li>2.3 paid employees, aproximately 100 volunteers including professional health workers: doctors, nurses, psychologists, physiotherapists, bioengineers, etc. </li></ul>
    7. 9. Objectives <ul><li>Offer and provide health care to undocumented migrants </li></ul><ul><li>Give health information to undocumented migrants </li></ul><ul><li>Facilitate undocumented migrants access to health care in the ordinary health system </li></ul><ul><li>Convey information, documentation and experiences about the health situation and needs of undocumented migrants to external actors </li></ul><ul><li>Ultimate goal: to become superfluous, close the centre </li></ul>
    8. 10. What do we offer? Opening hours (drop in): Tuesday evening, Thursday daytime - Primary health care - Consultation (with general practitioner, psychologists, psysioterapists etc) -10 -12 volunteers - 6 treatment rooms - specialists (gynecologist, neurologist, nephrologist) - Medicines - Laboratory tests, vaccines - Treatment and follow-up whenever possible (both somatic and mental) - Volunteer and professional translators
    9. 11. What do we offer? <ul><li>Referrals to volunteer network (dermatologist, urologist, dentists) </li></ul><ul><li>Cooperation agreement with Diakonhjemmet Sykehus </li></ul><ul><li>Cooperation agreement with psychiatric centre </li></ul><ul><li>Cooperation with public hospital for postpaid abortions </li></ul><ul><li>Cooperation with pharmacy close by and the ordinary health system </li></ul>
    10. 12. Our patients <ul><li>720 patients (per 1st August 2011) </li></ul><ul><li>60 nationalities </li></ul><ul><li>35 % women </li></ul><ul><li>20-40 pasients every opening day </li></ul><ul><li>2,000 consultations to date; 4/5ths somatic, 1/5th mental health related </li></ul>
    11. 13. Countries
    12. 14. Gender and age
    13. 15. Health problems <ul><li>Top six (from ICPC-2) -Digestive ( Fordøyelsessystemet ) -Musculoskeletal ( Muskel og skjelett ) -Psychological ( Psykisk) -Respiratory ( Luftveier ) -Skin ( Hud ) -Reproductive/sexual health </li></ul>
    14. 16. Mental health problems
    15. 17. Challenges <ul><li>Identifying target group </li></ul><ul><li>Confident and consistent IDs </li></ul><ul><li>Translation </li></ul><ul><li>Referral and follow-up </li></ul>
    16. 18. Challenges <ul><li>Economy - need for external funding from 2012 or reduced opening hours / less patients </li></ul><ul><li> - who should pay the medicine / treatment for patients with chronic diseases? </li></ul><ul><li>Capacity - increase in patients - limit how many patients can serve/treat/follow-up </li></ul><ul><li>- operations are based on volunteers </li></ul><ul><li>Mental health - patients with severe mental problems - limited possibility for referral - not enough capacity nor continuity to treat all the patients in need </li></ul>
    17. 19. Ethical considerations <ul><li>professional ethics vs. the law </li></ul><ul><li>uncover undocumented </li></ul><ul><li>humanity prolongs suffering? </li></ul><ul><li>test but not treat </li></ul>