To Build a Bridge

Training for Health Professionals and Law Enforcement Officers

Summary Report on the MIPEX Health Strand and Country Reports

Border Management and Detention Procedures: Health Perspective

guidelines

Guidelines

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Migration Health: Better Health for All in Europe

AMAC

Assisting Migrants and Communities

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Improving HIV data comparability

HIV1 

HIV-related data on migrant and ethnic minority populations in EU/EEA/EFTA

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Mobility of Health Professionals

MHD RO Brussels Publications

The Health Situation at EU Southern Borders - Migrant Health, Occupational Health, and Public Health - ITALY

Full Report available here

The Italian Government has been rescuing migrants through the Mare Nostrum operation (October 2013 – October 2014), and with the support of the Frontex plus operation since September 2014. Although the new national plan of reception approved in July 2014 significantly improves the legal framework in the management of irregular migration in Italy by creating different levels of reception, the implementation of search and rescue operations remain a major challenge. However, the reception plan foresees the establishment of a set of standards for essential healthcare to migrants. The European Union is to find more innovative and concrete ways to share responsibilities among all Member States, support countries of origin and transit, and respond collectively to increasing migrations flows.

The Situational Analysis Report elaborated within the framework of the of the IOM EQUI HEALTH project – Southern EU Borders sub-action, presents the results of the assessment on Migrant, Occupational and Public Health that took place in September 2013 in Sicily, Italy.

Based on desk research, field visits and interviews with different stakeholders, including law enforcement officers (LEOs), health professionals, and public authorities as well as with migrants, the assessment provides an analysis of healthcare provision to migrants during all phases of the reception process, from rescue at sea to detention and reception centers in Italy.

This work was undertaken in line with the IOM/WHO/Spanish Presidency of the EU “Global Consultation on Migrant Health” conceptual framework (Madrid 2010).

The reception system of irregular migrants in Italy is structured through an articulated system of centres for reception and detention. Findings from this report highlight overcrowding problems and long stays in detention facilities causing shifts of tasks and functions between the different levels of the reception system: the CPSA, first aid centres designed with a minimum of services, are becoming medium-term facilities. Furthermore, while irregular migrants’ access to healthcare is guaranteed by law, the lack of knowledge of these regulations by health professionals constitutes of the main obstacles for migrants’ access to health services.

 

“The most important thing is the clarity of roles and responsibilities. Each of us needs to know what is the role and the roles cannot be invented” (HP)

 

Findings confirm that these conditions and the length of reception negatively affects the quality of services and provision of health care worsening physical and mental health conditions of migrants. In addition, the difficulty of communication, divergent perceptions, and other mediation related problems are among the main obstacles for migrants to access health care services.

 

‘Migrants return from the Emergency at the hospital with confused information, because during the night there is not a cultural mediator available’ (CSO representative)

 

Recommendations based on the assessment carried out in Italy are integrated with the outcomes of the inter-ministerial table promoted under the EQUI HEALTH action in Rome in December 2013 and revised during the three Local Consultative Committees (LCCs) meetings held in Caltanissetta, Catania and Siracusa, and the National Consultative Committee (NCC) meeting that took place in Palermo in July 2014. These recommendations are structured in line with the 4 pillars of the IOM/WHO “Global Consultation on Migrant Health” conceptual framework:

1) Policy and legal framework
2) Partnership, network and multi-country framework
3) Monitoring migrant health
4) Migrant-sensitive health system.

In this context, there is urgent need for developing common and resolute EU operational responses, and expand and promote EU legislation to allow safe entry into the EU. On the other hand, the promotion of a more structured response, involving multiple sectors and levels remains one of the main priorities to be addressed in Italy.

Within the same line, the exchanges of practices and a more effective cooperation and solidarity at Regional, EU level and globally between countries and organizations should be intensified. These measures should be complemented by an improvement of the reception system in Italy in order to address overcrowding and respect for human rights.

In order to improve migrants’ access to healthcare, the analysis from this report suggest that a more comprehensive data on migrant’s health should be collected and regularly monitored, as well as encouraging the sharing of health-related data at all levels.

Furthermore, a high priority as for recommendation has been given to the need to create an adequate health and social support system, especially by improving health mediation programmes to reinforce communication related problems.

The Assessment Report was completed by Giuliana Urso and Roumyana Petrova-Benedict, based on the draft report produced under IOM MHD, Ro Brussels guidance by Emanuela Del Zotto, peers reviewed by Margherita Giannoni and Matteo Buffa and edited by Giuliana Urso and Roumyana Petrova-Benedict. DJ Krastev copy-edited, proofread, and assist the general editing.