EMERGENCY Italian Programme

EUMedEA Crash Course Managing Crises at EU Med Borders

Giulia Chiarenza – Eastern Sicily Project Coordinator

Catania, 5 July 2016 Emergency is an independent and neutral Italian NGO which was founded in 1994 and which provides free, high quality medical and surgical treatment for victims of war, anti- personnel mines and poverty. Emergency also promotes a culture of peace, solidarity and respect for human rights.

Emergency currently operates in 7 countries where it manages surgical centres, paediatric centres, a maternity centre, a heart surgery centre, basic healthcare and first aid centres, outPatientsclinics and mobile clinics. Since 1994 more than 7,000,000 people in 17 countries have received healthcare treatment from Emergency.

Surgical and Pediatric Centre, Goderich, Sierra Leone Ebola Treatment Centre, Lakka, Sierra Leone Cardio Surgery Salam Centre, Khartoum, Sudan Mayo Refugee Camp,Pediatric Centre, Khartoum, Sudan Pediatric Centre, Port Sudan, Sudan Pediatric Centre, Bangui, CAR Medical and Surgical Centre, Anabah, Afghanistan Afghanistan - First Aid Posts PHC on Refugee Camps, Kurdistan Article 25 - Universal Declaration of Human Rights

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection. Article 32, Constitution of Italian Republic

The Republic safeguards health as a fundamental right of the individual and as a collective interest, and guarantees free medical care to the indigent. [...] Working in . Why?

Despite being a recognized right, the right to healthcare is often denied in Italy to migrants, foreigners, and poor people due to lack of awareness of their rights, language barriers, and difficulty navigating a complex healthcare system. EMERGENCY’s Program in Italy provides free, high-quality healthcare, health education and guidance to health and social services to people in need. EMERGENCY’s staff collaborate with local services providers to ensure that proper access to care is available for the most vulnerable in the population. Projects in Italy

Basic healthcare service, some medical specialities, Social medical counselling, health education social medical counselling, health education, advocacy advocacy Outpatient clinics Street units

Basic healthcare service, social medical counselling, Basic healthcare service, social medical counselling, health education, advocacy psychological support to vulnerable groups (minors, victims of torture and trafficking…), advocacy

Mobile clinics Medical assistance at landings

Social medical counselling, training courses for Public Emergency medical care and assistance,distribution Administration officers, advocacy of food and water, distribution of blankets and medical supplies, cultural mediation service Medical assistance on S.A.R. Social medical information points vessel Social medical counselling Outpatient clinics Castel Volturno / Mobile unit / Mobile unit Marghera Polistena (Rc) Castel Volturno (Ce) Napoli Sassari

Landings – Rec. Center Mobile clinics Augusta / Harbour Polibus / Minivan (until Agrigento / Villa Sikania Siculiana 2015) / Politruck Pozzallo (RG) / Harbour SAR/ partnership with MOAS (Migrant Offshore Aid Station) Palermo – Outpatient clinic Marghera (VE) - Outpatient clinic Polistena (RC) – Outpatient clinic Information Point, FEI Project, Sicily Mobile Clinics, Doctor at work on mobile clinic Mobile Clinics, Foggia Mobile Clinics, Post-Earthquake intervention, Carpi (MO) Migration routes in Mediterranean Sea - 2016 Landings Reception Centers Unaccompanied Minor Center Post-Rescue Assistance – Mediterranean Sea

Photo by Mathieu Willcocks/MOAS Post-Rescue Assistance – Mediterranean Sea Overall Programme Data (up to 14.06.2016)

• Number of patients: 55.982 • Number of consultations: 233.425 Some data organised by projects

PALERMO OUTPATIENT CLINIC (ongoing) MOBILE CLINIC – POLITRUCK (ongoing) S.A.R. – POST-RESCUE ASSISTANCE IN From April 2006 to June 2016 From August 2015 to June 2016 PARTNERSHIP WIITH MOAS (ongoing) Patients: 14.671/ Consultations: 94.575 Patients: 2.110 Consultations: 3.572 Launched on June, 6, 2016 Data not available yet MARGHERA (VENICE) OUTPATIENT CLINIC BOLOGNA MOBILE UNIT – SOCIAL MEDICAL (ongoing) INFORMATION POINT (ongoing) From December 2010 to June 2016 From August 2015 to June 2016 FEI – SOCIAL MEDICAL INFORMATION Patients: 6.530/ Consultations: 42.135 Patients: 667 / Consulenze-Accompagnamenti: POINTS 1.743 From October 2013 to June 2014 POLISTENA (RC) OUTPATIENT CLINIC Patients: 1.645/ Consulenze:3.685 (ongoing) PRIOLO GARGALLO (SR) UNACCOMPANIED From July 2013 to march 2016 MINOR RECEPTION CENTRE (ongoing) MOBILE CLINICS (Polibus, Minivan, Politruck) Patients: 3.012/ Consultations: 13.559 From July 2013 to June 2016 From April 2011 to Dicember 2015 Patients: 5.975/ Consultations: 13.526 Interventi: Puglia, Basilicata, Sicilia, CASTEL VOLTURNO (CE) OUTPATIENT Emilia Romagna (sisma 2012), Calabria, CLINIC (ongoing) LANDINGS AND RECEPTION CENTRE – Campania e Lombardia. From March 2015 to June 2016 PARTNERSHIP WITH ITALIAN MIN. OF INTERIOR Patients: 20.192/ Consultations: 49.522 Patients: 2.632/ Consultations: 10.550 (ongoing) From June 2015 to June 2016 SIRACUSA - CENTRO “UMBERTO I” OUTPATIENT CLINIC (ongoing) Harbours: Augusta, Pozzallo, (until 2015) From July 2013 to May 2016 From September 2015 to June 2016 Patients: 1.753/ Prestazioni: 1.877 Patients: 5.975/ Consultations: 13.526 Patients: 920/ Consultations: 2.121 Reception Centre “Villa Sikania”, Siculiana (AG) Patients: 1.930/ Consultations: .3.357 SASSARI OUTPATIENT CLINIC (ongoing) From December 2012 to June 2016 Patients: 1.034/ Consultations: 5.514 Data up to 14.06.2016 Patients’ main countries of birth Diagnoses Proposals and recommendations I

• Organizing in-house service of cultural mediation at NHS and Reception Centers • Empowering PHC and health education services provided by NHS • Expediting procedures regarding the transfer at Second Level Reception Centers • Adapting hygienic conditions at reception centers to minimum standards Proposals and recommendations II

• Enhancing response to vulnerability and psychological needs • Building greater focus on migrants’ personal history, including the reasons lying behind migration • Ensuring strict application of asylum regulations at each stage of procedure Good Practices

• Basic medicine services give a prompt answer to a fundamental right of a person, reduce second level referrals and therefore reduce the costs for the NHS. I.e.: On total average of consultation on Mobile Clinics: • 10% second level consultation prescribed at NHS • 0,7% referrals at NHS Emergency Dept • 0,1% Phone calls NHS Emergency number

• Cultural mediators as permanent staff of the NHS facilitate the access of healthcare services Some good practices in managing migration at local level

• Regional Contingency Plan, in which Emergency participates as stakeholder. The plan has been launched in 2014 by Sicilian Councillor of Health in order to address the public health needs of migrants. It aims at consolidating the regional response to large influxes of migrants by establishing homogeneous procedures and defining roles and responsibilities of all actors involved; • Training Programme destined for Public Administration Officers dealing with migration issues; the courses, launched in march 2014 in the framework of FEI project, has proved to be effective and positively accepted by participants and relaunched in June 2014 ( more than 90% of participants reached passing marks at exit tests); • Good practices on first reception, protection and treatment of unaccompanied minors (including creation of networks of legal tutors, registration with NHS for many unaccompanied minors, system of tutoring during II level medical examinations, proper monitoring and management of therapy) it resulted in the low percentage of unauthorized departure from reception centres). https://www.youtube.com/watch?v=-VKiCTuFLZI&sns=em Thanks