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 - CROATIA

Full Report available here  

Dubrovnik Migrants boat

Given the Croatia’s political stability and economic growth achieved since the country’s independence in the 1990s and leading up to its accession to the European Union in July 2013, the country has been attracting increasing number of immigrants, particularly from neighboring countries. Croatia has reached benchmarks set during the EU accession process and has adopted a midterm migration policy strategy on February 2013 (the Migration Policy of the Republic of Croatia for the 2013-2015 period), containing measures in several areas, including asylum, integration policy, and irregular migration. Nevertheless, the Croatian legal framework concerning migration and asylum needs to be further developed and continuously adapted to EU legal acts. Further efforts need to address the provision of health services to migrants, which is limited under the current legal framework that does not necessarily requires medical staff to be employed at reception centres.

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 April 2014 in Croatia.

Based on desk research, field visits and interviews with different stakeholders, including law enforcement officers (LEOs), health professionals, public authorities, and non-governmental organizations (NGOs) 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 Croatia.

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

Croatia has adopted a large number of legislative acts in the process of negotiations and accession to the EU, including the Foreigners Act (October 2011)1, the Asylum Act (2003), and the Ordinance for Accommodation at Detention Centres for Foreign Citizens (2013) which regulates the medical screening of detained migrants. However, implementation measures have not been always relevant and/or adequate. The current legal framework appears to limit the provision of health services to undocumented migrants by not defining the range of health-care services they are entitle to. Furthermore, the Ordinance on the Specific Health Needs has not been adopted yet (as of mid-2015) leaving health provision for vulnerable groups to be insufficient in addressing their specific need.

Findings from field visits outline the existing limitations in the overall conditions in both detention and reception centres, which determines the overall well-being of migrants. Furthermore, there is lack of initial health screening of migrants and a limited cooperation between public health authorities and border police, responsible for migrant health data collection.


“The data collection process on migration and health situation of the migrant could be improved by setting up an on-line management system available for all relevant stakeholders.” (Expert Team member, present during the field visit)


The assessment highlights the urgent need for psychological support for staff working with migrants. Although most health professionals working with migrants possess the necessary skills to carry out with their tasks, more training is needed regarding cultural mediation, common diseases present among migrants, and safety and security at the work place.


“….It is a big lie that everything is functioning. Police officers send us questions about how they could protect themselves better or if they should be vaccinated. ….” (Police Union representative)


Recommendations based on the assessment carried out in Croatia 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 Croatia’s reception system should ensure respect for human rights and establish a better structured response, involving multiple sectors and levels during the entire reception process by developing protocols and defining roles and responsibilities.

Analysis of the findings also highlights the lack of standardized health assessment of migrants and of availability of migrant’s health related data which negatively affects the provision of adequate levels of healthcare and services to migrants. Therefore, efforts should be placed on improving health assessment and data collection, as well as overcoming communication barriers during the reception process.

In the area of professional training, law enforcement personnel working in migration management, such as border police and immigration authorities, lack of health awareness issues and specialized training on migration related issues. Conclusions from this report suggest that adequate health and social support systems, including cultural mediation need to be reinforced for all steps of the reception system.

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The Assessment Report was draft under the overall guidance of IOM MHD RO Brussels by Tea Vidovic and Mitre Georgiev, further revised and elaborated by Milen Petrov, Mariya Samuilova and Marina Rota. DJ Krastev copy-edited, proofread, and assist the general editing.


1http://www.refworld.org/docid/3fcc6cd54.html