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 - MALTA

Full Report available here

Malta has experienced a continuing influx of migrants from Africa and the Middle East, particularly after joining the EU in 2004 (2008 migrants arrived in Malta in 20131), and has faced strong criticism over detention practices on undocumented migrants arriving in the country. However, there have been improvements related to the efforts made in providing health care services to migrants and the positive policy developments on the situation of unaccompanied minors. Nevertheless, the reception system needs further improvements in order to address overcrowding and migrants’ physical and mental health conditions.

The Situational Analysis Report, part of the EQUI-HEALTH project – Southern EU Borders sub-action, presents the results of the assessment on Migrant, Occupational and Public Health that took place in November 2013 in Malta.

Based on desk research, field visits and interviews with different stakeholders, including law enforcement officers (LEOs), health professionals, and public authorities, 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 Malta.

The work was undertaken according to the IOM/WHO/Spanish Presidency of the EU “Global Consultation on Migrant Health” conceptual framework (Madrid 2010).

Malta maintains a non-binding policy which intends to set up standard procedures and practices when dealing with undocumented migrants and asylum seekers. The limited capacity of staff available at AWAS (the agency managing open centres and responsible for identifying and assessing the vulnerability of migrants) negatively affects the vulnerability assessment of migrants arriving in Malta. Although vulnerable groups such as unaccompanied minors and persons with disabilities are not to be detained, there is no time limit set for the vulnerability assessment, which takes place throughout the reception process.

In terms of medical assistance, there is a discontinuity of access to health services during the reception process. Medical assistance at detention centres, which are run by the AFM (Armed Forces of Malta), is outsourced to private entities, and there is no health care provided at the open centres, being mainstreamed in this case, to the public system. This limits migrants’ access to health care due to lack of proper information, and transport to health centres and unclear procedures concerning the services offered to migrants.

The assessment team noted that most health professionals working with migrants possess the necessary skills to carry out with their tasks. Nevertheless, more training is needed regarding cultural mediation and common diseases present among migrants as well as more training focused on the care giving aspect of the staff’s job in detention centres.

 

“I think the communication problem is not the language, but it is the culture. Because with language, I always find interpreters within their community…….But the culture differences…no language will help till they get used to our methods or we get used to their methods” (HP)

 

Recommendations based on the assessment carried out in Malta are integrated with the outcomes of the National Consultative Committee (NCC) meeting held in Malta in September 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 facilitate the safe entry into the EU. On the other hand, Malta should develop a solid legislative framework on migration management and health care entitlements for migrants. This should be complemented by an appropriate vulnerability screening and referral for treatment of vulnerable groups.

Within the same line, Malta needs to foster the coordination between public authorities, as well as other entities working with migrants. Similarly, the exchanges of practices and a more effective cooperation and solidarity at Regional, EU level and globally between countries and organizations should be intensified.

Analysis of the findings also leads to the conclusion that more permanent and institutionalized presence of medical staff should be guaranteed during the entire reception process in order to improve migrants’ access to health care.

Concerning health professional and staff in detention centres, recommendations suggest reinforcement of health and social systems, including cultural mediation, interpretation and psychosocial assistance. These measures should be complemented by a continuous training for health professional and law enforcement officers on topics concerning the work with migrants.

The Assessment Report was draft under the IOM MHD, RO Brussels guidance by Soorej Jose Puthoopparambil, benefitted from peer reviews by Sandra C. Buttigieg and James Carabott and edited by Giuliana Urso and Roumyana Petrova-Benedict. DJ Krastev copy-edited, proofread, and assist the general editing.


 1Available data on migration trends in Malta at: UNHCR MALTA