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Access to Healthcare for Undocumented Migrants in 11 European Countries Pierre Chauvin, Isabelle Parizot, Nathalie Simonnot

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Access to Healthcare for Undocumented Migrants in 11 European Countries Pierre Chauvin, Isabelle Parizot, Nathalie Simonnot Access to healthcare for undocumented migrants in 11 European countries Pierre Chauvin, Isabelle Parizot, Nathalie Simonnot To cite this version: Pierre Chauvin, Isabelle Parizot, Nathalie Simonnot. Access to healthcare for undocumented mi- grants in 11 European countries. Médecins du Monde European observatory on access to healthcare. Médecins du Monde, pp.154, 2009. inserm-00419971 HAL Id: inserm-00419971 https://www.hal.inserm.fr/inserm-00419971 Submitted on 25 Sep 2009 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. MÉDECINS DU MONDE EUROPEAN OBSERVATORY ON ACCESS TO HEALTHCARE onde M édecins du M ACCESS TO HEALTHCARE FOR uropean Observatory on Access to Healthcare E SEPTEMBER 2009 - UNDOCUMENTED MIGRANTS IN 11 EUROPEAN “ Even as my baby was being born, COUNTRIES they were asking me for documents and to pay 2,800 euros.” F., Ugandan woman, in London NTS A N COUNTRIES A UROPE E IN 11 IN 11 RE FOR UNDOCUMENTED MIGR UNDOCUMENTED FOR RE A LTHC A ACCESS TO HE TO ACCESS 2008 SURVEY REPORT SEPTEMBER 2009 AUTHORS PIERRE CHAUVIN (French national institute of health and medical research — Inserm) ISABELLE PARIZOT (French national centre of scientific research — CNRS), Members of the Social determinants of health and health service use research team UMRS 707 -Inserm — UPMC, Paris. NATHALIE SIMONNOT Médecins du Monde Observatory, www.mdm-international.org WITH INPUT FROM Félix Wanga and Sara Collantes for the description of the legal situation; Nadège Drouot and Anne Tomasino throughout the survey; the European Observatory second survey working group (Marion Chenevas, Jérôme Pfaffman, Olivier Ricard, Christos Velissaropoulos, Ramon Esteso, Jose Maria Atienza); Michel Verdier for the design of the data capture tools; Juliette Poirson for finalising the report; Thérèse Benoit for proof-reading; Alejandra Garcia Paton for co-ordinating the translations; Karen Mc Coll and Johnathan Mair for the English translation (except for the questionnaire). WITH SUPPORT FROM ACKNOWLEDGEMENTS the French ministry of health (Direction Générale de la Santé), the French ministry of social services We are grateful to the 1,218 individuals in 11 countries who agreed to take part in our survey. This meant (Direction Générale de l’Action Sociale), the European Commission’s DG SANCO (Directorate-General for answering difficult questions which brought back their pain and difficult journeys. They told us about Health and Consumer Affairs) and the European Programme for Integration and Migration (EPIM). their daily lives, and the drama, fears, rejection and survival inherent within them. This report is dedicated to them. We are also very grateful to the survey investigators (around 100 volunteers and staff) who, despite their ISBN - ISBN 978-2-918362-01-2 // Legal deposit : september 2009 already busy schedules, agreed to help develop the questionnaires, carry out the survey, input data, ana- CREDITS // Photos : © Jobard / SIPA // Cover art : les-eclaireurs.com // inside art : Jérôme Guibourgé // Printing : CLUMIC, [email protected] lyse data and translate texts. We thank the 11 Médecins du Monde associations for their political support in carrying out this joint project. We thank readers for paying attention to these snapshots of lives. Together, let’s fight to ensure that the fun- damental rights which today are denied these children, women and men are finally recognised. Editorial The 14 organisations within the Médecins du Monde international network work with the most vulnerable populations throughout the world and in their own societies. Through our national programmes we meet people in Europe who have fled extreme poverty, violent armies and police forces, conflict areas and disasters. A tiny minority of the children, women and men whom we try to support when we work in their countries end up coming here. After migration journeys which are very often long, dangerous and exhausting, many find themselves without permission to stay in the country, forced into the shadows of our towns and cities. At home, as abroad, Médecins du Monde aims to provide some support and tries to help this population protect what is often the only thing they have left—their health. With this study, we show how undocumented migrants’ living conditions are harmful to their health and prevent them from building, or rebuilding, their lives. This is despite the fact that these children, women and men are in particular need of support, given what they have lived through and the migration journeys they have undertaken. Even worse, our own health systems often exclude them from healthcare. Serious health problems receive little medical follow-up, sometimes none at all. Because healthcare sometimes becomes a trap—due to the fact that people are being encouraged or required to report undocumented migrants—we urge that health policy must remain completely independent from immigration policy, respecting the obligations of health and social care professionals in terms of patient confidentiality. Because, in Europe, children can go untreated and women can be denied ante-natal care or be hassled until the moment of childbirth, we call on the relevant national and European authorities to ensure the right to access healthcare for all, irrespective of immigration status. Because sending seriously ill undocumented migrants back to their countries of origin—even though they won’t receive healthcare there—can be a death sentence, we call for these vulnerable people to be granted regular immigration status. Professor Michel DEGUELDRE, Chair MDM Belgium Dr Pierre MICHELETTI, Chair MDM France Professor Wilfried SCHILLI, Chair MDM Germany Dr Nikita KANAKIS, Chair MDM Greece Dr Françoise SIVIGNON, Chair MDM Netherlands Dr Abilio ANTUNES, Chair MDM Portugal Dr Teresa GONZALEZ, Chair MDM Spain and Italy Professor Anders BJÖRKMAN, Chair MDM Sweden Professor Nago HUMBERT, Chair MDM Switzerland Ms Janice HUGHES, co-Chair MDM United Kingdom Mr Roo ROGERS, co-Chair MDM United Kingdom Report of the European Observatory – Médecins du Monde 1 2 Report of the European Observatory – Médecins du Monde Contents EDITORIAL ........................................................................................................................................................................... 1 CONTENTS ........................................................................................................................................................................... 3 SUMMARY............................................................................................................................................................................ 5 PART 1: STATISTICAL SURVEY AMONG UNDOCUMENTED MIGRANTS ATTENDING SERVICES RUN BY MÉDECINS DU MONDE AND SOME OF ITS PARTNERS ............................................................................................................................ 13 Introduction ...................................................................................................................................................................... 15 1. The population studied and legislation on access to healthcare in each country .................................................. 18 • Survey sites and legal context, by country......................................................................................................................................................................................................18 2. Survey methodology and data analysis...................................................................................................................... 38 • Survey design and interview process................................................................................................................................................................................................................38 • Analysis and report preparation..........................................................................................................................................................................................................................39 • Presentation of results ............................................................................................................................................................................................................................................39 • Interpretation of results and figures..................................................................................................................................................................................................................39 3. Demographic characteristics ....................................................................................................................................... 41 • Sex and age.................................................................................................................................................................................................................................................................41
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