Minutas Reunión Comité Organizador

Report Civil Society Participation

5 th European Conference on Migrant and Ethnic Minority Health 1 Pre-Conference Working Session “Perspectives of the Civil Society”

Organizing Institutions

Financing Partners

Supported in part by a Grant from the Open Society Foundations This publication arises from the 5th EUPHA European Conference on Migrant and Ethnic Minority Health which has received funding from the European Union, in the framework of the Health Programme (2008 – 2013)

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Report Civil Society Participation

5 th European Conference on Migrant and Ethnic Minority Health

Working Group of the Organizing Committee Carlos Artundo Purroy Amets Suess Ainhoa Ruiz Azarola Olga Leralta Piñán Daniel López Jaramillo Ainhoa Rodríguez García de Cortázar

Andalusian School of Public Health, 2014

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Index

1. Introduction ______1 2. Participation Formats ______2 2.1. Advisory and Participatory Committee ______3 2.1.1. Objectives of the Advisory and Participatory Committee ______3 2.1.2. Participating Organizations ______4 2.1.3. Face-to-Face Meeting ______5 2.1.4. Online Discussion Forum ______12 2.2. Best Practices Abstract Format ______13 2.3. Scholarship Policy ______13 2.4. Civil Society Participation during the Conference ______12 2.2.1. Pre-Conference ______15 2.2.2. Conference ______22 2.2.3. Parallel Activities ______25 2.4. Granada Declaration ______27 3. Evaluation of Civil Society Participation ______28 3.1. Evaluation of Civil Society Participation by the Organizing Committee ______28 3.2. Evaluation of Civil Society Participation by the Conference Attendees ______30 4. Conclusions and Recommendations ______34

5th EUPHA European Conference on Migrant and Ethnic Minority Health

1. Introduction

On April 9 – 12, 2014, the 5th EUPHA European Conference on Migrant and Ethnic Minority Health took place in Granada, Spain, opening a forum for scientific knowledge and experience exchange, and involving 332 delegates.

The general objective of the Conference was to provide a forum for sharing and disseminating current knowledge and practice in migrant and ethnic minority health care among policy makers, public health experts and practitioners, researchers, health and social care professionals, as well as civil society representatives, in order to analyse the impact of the economic crisis in the social and health status of these vulnerable populations, and to develop strategies to ensure their access to quality health care services.

The specific objectives of the Conference included: • To disseminate cutting-edge theory and practice in the field of migrant and ethnic minority health. • To analyse the impact of the economic crisis on migrants and ethnic minorities’ health and access to health care, as well as related changes in health systems and policies. • To analyse the impact of the economic crisis on specific health care issues, such as HIV prevention and treatment, occupational health, mental health and health promotion of migrants and ethnic minorities. • To analyse and share strategies, responses and good practices from different social stakeholders and within a multidisciplinary approach (health care professionals, politicians, NGOs, associations and citizens) in the context of the economic crisis. • To exchange and develop strategies to advance health equity and to reduce migrants and ethnic minorities poverty and social exclusion in the context of the economic crisis. • To analyse the specific situation regarding migrants and ethnic minority health in newer EU member states, particularly those in Eastern Europe that are becoming key transit-countries. • To share new research methodologies and intervention approaches applied to migrants’ and ethnic minorities’ health at a local, regional, national and international level. • To stimulate collaboration between various stakeholders as well as between various research disciplines to deal with the field of migrant and ethnic minority health in a comprehensive way. • To support existing networks in the field of migrant and ethnic minority health and to promote new collaborative schemes to strengthen its development and institutionalisation in decision making processes.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

• To encourage collaboration and communication among EU public health agencies and experts advocating for a research, practice and policy agenda for migrant and ethnic minority health at a regional, national and European level. • To identify future research and intervention priorities in the field of migrant and ethnic minorities health care.

Furthermore, the Organizing and the International Scientific Committees focused specifically on promoting the interaction between academia, civil society and policy makers, as well as on facilitating civil society participation in the Conference. This focus was based in the recognition of the collective knowledge contributed by civil society perspectives, as well as the importance of promoting an interaction between different stakeholders in the current moment of economic and systemic crisis.

In the following report, the different participation formats, as well as their methodologies, objectives and outcomes will be presented. Furthermore, the evaluation of the Organizing Committee and the Conference participants regarding civil society participation will be summarized.

The report ends with recommendations regarding civil society participation addressed to the organizers of upcoming EUPHA European Conferences on Migrant and Ethnic Minority Health.

2. Participation Formats

The following participation formats were developed with the aim to facilitate civil society participation at the Conference. • Advisory and Participatory Committee • Specific best practices abstract format focused on social intervention projects • Scholarship policy • Civil Society Participation in the Conference  Pre-Conference Activities  Plenary Session II  Closing Ceremony  Oral and Poster Communications  Workshops  Parallel Activities • Granada Declaration

5th EUPHA European Conference on Migrant and Ethnic Minority Health

2.1. Advisory and Participatory Committee

Parallel to the Organizing Committee and the International Scientific Committee, an Advisory and Participatory Committee was created, with the objective of introducing civil society perspectives in the Conference, developing ideas related to civil society participation at the Conference and opening a space for discussing participatory methodologies and ethics in the field of migrant and ethnic minority health.

With the creation of the Advisory and Participatory Committee, a new participation format was introduced in the EUPHA European Conferences on Migrant and Ethnic Minority Health.

This Committee counted on the participation of representatives of civil society organizations proceeding from the Andalusian, Spanish and European context.

The activities of the Advisory and Participatory Committee included the celebration of a Face-to-Face Meeting, ongoing communication by means of an Online Forum, as well as contributions to the organization of Pre- Conference and Parallel Activities.

The objectives of the Advisory and Participatory Committee, as well as the participating organizations were announced on the Conference website: http://www.eupha-migranthealthconference.com/?page_id=1364.

2.1.1. Objectives of the Advisory and Participatory Committee The Advisory and Participatory Committee was set up with the following objectives:

• To facilitate contact and networking with civil society representatives in order to encourage their participation in the event.

• To organize a civil society representatives’ encounter in the Pre-Conference.

• To increase the visibility of civil society’s viewpoints around migrant and ethnic minority health.

• To open debate around the social compromise of researchers and research ethics, especially in participative approaches.

• To strengthen the articulation between organized civil society, researchers and policy-makers on public health policies.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

2.1.2. Participating Organizations

The following organizations form part of the Advisory and Participatory Committee.

Participating Organizations Advisory and Participatory Committee

ACCEM, Spanish Catholic Migration Association (ACCEM, Asociación Comisión Católica Española de Migraciones)

Anarquerando, Roma Association (Anarquerando, Asociación Gitana)

Andalusia Acoge Network (Andalucía Acoge)

Andalusian Sociocultural Roma Centre (Centro Sociocultural Gitano Andaluz)

CEPAIM, Foundation for Social Coexistence and Cohesion (CEPAIM, Fundación Convivencia y Cohesión Social)

Doctors of the World (International Network)

Doctors of the World (Spanish Network) (Médicos del Mundo)

EPHA, European Public Health Alliance

Fakali, Andalusian Federation of Roma Women (Fakali, Federación Andaluza de Mujeres Gitanas)

Granada Acoge

Health between Cultures (Salud entre Culturas)

Migrating in Positive (Migrando en Positivo)

Platform for the Defense of Public Health Care Granada (Mesa en Defensa de la Sanidad Pública de Granada)

PICUM, Platform for International Cooperation on Undocumented Migrants

Roma Secretariat (Secretariado Gitano)

Romí, Roma Women Association (Asociación de Mujeres Gitanas Romí)

SEMFyC, Spanish Society of Family and Community Medicina (Sociedad Española de Medicina de Familia y Comunitaria)

SEPISE, Research Seminar for Social and Educational Intervention, University of Granada and University of Jaén (SEPISE, Seminario de Estudios para la Intervención Social y Educativa, Universidad de Granada y de Jaén)

5th EUPHA European Conference on Migrant and Ethnic Minority Health

SOS Racism (SOS Racismo)

Spanish Red Cross (Cruz Roja Española)

Yo Sí Sanidad Universal Platform

Furthermore, the Advisory and Consultory Committee included some individual participants related to health care services and academic institutions, among them the Andalusian Health Care Service (Servicio Andaluz de Salud), Andalusian School of Public Health (Escuela Andaluza de Salud Pública), San Pablo Health Centre, Aragon Health Service, Zaragoza (Centro de Salud San Pablo, Servicio Aragonés de Salud), University of Zaragoza, Department of Medicine, and University of Sevilla.

2.1.3. Face-to-Face Meeting

On February 7th, 2014, the Advisory and Participatory Committee celebrated a Face-to-Face Meeting in the Andalusian School of Public Health, Granada. Language: The Face-to-Face meeting was held in Spanish.

Participants

The following representatives of civil society organizations and citizens participated in the meeting.

Participants of the Face-To-Face Meeting – Advisory and Participatory Committee

ACCEM, Spanish Catholic Migration Association (ACCEM, Macarena Fandila Asociación Comisión Católica Española de Migraciones)

Acoge Network (Red Acoge) Inés Díez

Andalusia Acoge (Andalucía Acoge) Mikel Araguás

Andalusian Health Care Service (Servicio Andaluz de Pilar Baraza Cano Salud)

Andalusian School of Public Health Luis Andrés López Fernández

Andalusian School of Public Health (collaborating Bibiana Navarro professional)

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Andalusian Sociocultural Roma Centre (Centro Francisca Fernández Fernández Sociocultural Gitano Andaluz)

CEPAIM, Foundation for Social Coexistence and Cohesion Juan Francisco Barranco (CEPAIM, Fundación Convivencia y Cohesión Social)

Fakali, Andalusian Federation of Roma Women (Fakali, Mónica de la Flor Federación Andaluza de Mujeres Gitanas)

Granada Acoge Juan Laguna

Médicos del Mundo Stefan Meyer

Platform for the Defense of Public Health Care Granada Carlos Mingorance (Mesa en Defensa de la Sanidad Pública de Granada)

Proyecto de Intervención Comunitaria Intercultural (ICI) Assane Top Asociación Gitana Anaquerando

Romí, Roma Women Association (Asociación de Mujeres Emilia Cepero Gitanas Romí)

Spanish Red Cross (Cruz Roja Española) Eduardo Romero

University of Sevilla (Universidad de Sevilla) Laura Rodríguez Candea

Yo Sí Sanidad Universal Platform Mar Sacristán Germés (via Skype)

Programme

The Face-to-Face Meeting was organized with the following programme:

Programme of the Face-to-Face Meeting 10:30 Presentation of the Meeting and the Participants 11:00 Presentation of the Conference and the Participation of the Civil Society in the Conference 11:15 Thinking about Participation Formats Methodology: Panel 12:15 Break 12:45 Deepening in Participation Methodology: Focus Group 14:00 Conclusions and Next Steps 14:30 Lunch

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Results1

Panel: Thinking about Participation Formats In the first part of the meeting, the participants identified ideas regarding participation formats for the 5th EUPHA European Conference on Migrant and Ethnic Minority Health and upcoming editions of the Conference, in relation to topics, methodologies, activities and people to invite.

Topics • Migration and Mental Health • Childhood and poverty

Methodologies • Round Tables in dialogical talk show format, to make it more participative.

Activities • Round tables / meetings on the following issues . Health care professionals and users, to identify strength / weaknesses in health care. . Forging a gender alliance between migrant, Roma and non-Roma population. . Programme Strategy 2020 for the Roma community. . Views of foreign health care professionals on the Spanish health care system. . Community experiences. . City halls with experience in working with migrant populations. . Positioning of NGOs about the RDL 16/2012, work made to date and new proposals. . Positive aspects highlighted by migrants regarding health (less medicalization of many processes, better initial ways of life) and the use of the health care system. • Press Conference (or round table) • To denounce, together with NGOs, regressive reforms, reinforcing good practices. • Workshops • To form groups of migrants / ethnic minorities where they can give advices to each other about their relationships with professionals. • Workshop “El Chojín”, rap for young people.

1 The ideas contributed by e-mail by the members of the Advisory and Participatory Committee who could not assist to the face-to-face meeting were included in the list of proposals 7

5th EUPHA European Conference on Migrant and Ethnic Minority Health

• Audiovisual / workshops by Yo Sí Sanidad Universal Platform: Exposition of activities / information formats. • Workshop about coordination between civil society and health professionals. • Workshop about shared experiences; ethnic minorities and migrants. • Critical workshops social communication tools elaborated by services. • Workshops / activities to maintain the difficulties in the access to health care in the public / political agenda. • Audiovisuals • Proposal of the Andalusian Sociocultural Roma Centre (Centro Sociocultural Gitano Andaluz): Projection of the short feature “Tikinó”. • Cinema forum: “El tren de la memoria” (documentary) to make the similarity between all economic migrations visible. • Projection of the winner of the Human Rights Documentary Film Festival (April 6/7 in Madrid). • Projection of the video “Derecho a curar” (Doctors of the World). • Exhibitions • Exhibition of Doctors of the World “Migrando en positivo” (graffiti by “El Niño de las Pinturas”). • Itinerant thematic exhibition in exhibition halls in Granada during the days previous to the Conference. • Proposal of the Andalusian Sociocultural Roma Centre (Centro Sociocultural Gitano Andaluz): Exhibition of photographs from Granada. • Photo Competition for civil entities, with award addressed to provision with repercussion on health. • Music and Poetry • Recital of Roma and African poetry “Uniendo Palabras”. • Music or gastronomic intercultural festival. • Radio Programmes • Radio Shows “Kamelamos Naquerar” and “Queremos Hablar”. • Parallel activity: Radio show to gather personal experiences. • Actions / Performances • Street acts to increase visibility. • Flashmob performance.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

• Idea for an Action during the Conference: To hinder the access of the participants to the Conference → by putting intentional barriers to transmit the feeling that could have a person who experiences barriers in the access to health care. • Flashmob with simple actions like “freezing”, to explain the repercussion of the crisis and the public policies in health and the quality of life of ethnic minorities and migrants, as well as to make essential aspects visible which are put into question in all Europe, such as health care as a basic human right. • Other formats • Discussion formats

o Debate with key agents (e.g. collectives) who inspire, with Q & A format. o Discussion groups to give voice to the users of the health care system. o Meetings between health care professionals and migrant population / ethnic minorities. • Information spaces

o Panel with materials about associations, books… o Permanent space with exhibition of activities and initiatives conducted by the civil society with migrants / ethnic minorities.

o Space for experiences / Good Practices. o Space in the Pre-Conference to expose Good Practices being carried out o Daily bulletin about the Conference to be elaborated by the civil society, daily summary, alternative topics.

o Visit to “Museo etnológico de la mujer gitana” (Ethnologic museum of the Roma woman) in Sacromonte (Chumbera), proposed by Asociación Romí.

o To e nable zones for leisure, where to share opinions, chats, experiences. • Parallel event, professional commitment and needs of research related to migrants in irregular situation. • Parallel activities, information about the course of the Conference in social networks. • Panel with cards (guestbook type), so that any participant can write proposals for migrants’ and ethnic minorities’ health promotion, and present them in the final document. • To give migrant health care users health-related information materials, in order to contribute critiques.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

• Joint activity demanding the derogation of the RDL 16/2012, between Doctors of the World - Sociedad Española de Medicina Familiar y Comunitaria – Andalucía Acoge and Yo Sí Sanidad Universal Platform. • To present health intervention projects for Romanian population, mainly of Roma ethnicity, elaborated by Unión Romaní, to share knowledge about the health problems of this population group, as well as strategies which could be useful for the Conference assistants.

People / organizations to invite • To invite “La Caixa” to explain their projects. • To invite Social Workers from Primary Health care. • Assistance to the Pre-Conference of Roma people from Granada. • Presence of the media (radio, press…). • Active participation of migrants / ethnic minorities (life stories, etc.). • Participation of health care professionals from ethnic minorities (Roma). • Participation of Roma women, i.e. to enable their attendance to the Conference. • To invite FRA, European Union Agency for Fundamental Rights. • To give an own space to Plataforma Europea de revindicación de acceso normalizado (European Platform for Standarized Access to Health care).

Scholarship policy • There may not be enough scholarships to promote active participation of migrants and ethnic minorities.  Parallel scholarship system for the assistance of representatives of associations to the Pre- Conference.

Focus Group “Deepening in the Participation” In the second part of the Face-to-Face Meeting, a focus group methodology was used to open a reflection on opportunities for collaboration between civil society, academia and policy makers, as well as participatory methodologies and ethics. • Interaction between civil society and policy makers  Lack of spaces for citizen participation.  Lack of transparency and assessment tools.  Proposals:

o To create a Declaration of the Civil Society. 10

5th EUPHA European Conference on Migrant and Ethnic Minority Health

o To elaborate a Decalogue of questions addressed to policy makers. o To strengthen communication channels.

• Interaction between civil society and academic context  Lack of opportunities for interaction.  Lack of recognition of the contribution of civil society to the academic context.  Lack of inclusion of social topics in teaching contents.  Proposals:

o To create spaces of participation of the civil society in the academic context. o To include civil society participation in academic events. o To integrate academia in civil society platforms.

• Research methodologies and ethics  Current situation: o Lack of consideration of social issues in research projects and public tenders. o Research bias. o Problematic categorization and labelling dynamics. o Lack of participative approaches. o Lack of recognition of qualitative methods. o Lack of devolution of results to participants.  Proposals: o To facilitate civil society participation in all project phases. o To facilitate participants the research results, before their publication. o To include an intervention and assessment phase in research projects. o To create an Advisory Committee with civil society participation for research projects. o To strengthen crowd-funding strategies. o To create new dissemination formats. o To propose EUPHA to develop a Code of Ethics related to participatory research approaches.

Outcomes A report of the Face-to-Face Meeting was developed, in English and Spanish. Several of the proposed activities were included in the Conference.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

2.1.4. Online Discussion Forum

An online discussion forum was created, situated at the Conference website and accessible for the members of the Advisory and Participatory Committee. The Online Discussion Forum was announced on the Conference website, with access restricted to members of the Advisory and Participatory Committee (http://www.eupha- migranthealthconference.com/advprtcmt/).

Members: 36 Thematic Lines: 14 Number of messages: 79 Time Period: February 27, 2014 – April 21, 2014. Language: Although the Forum was developed to facilitate a development of all thematic lines both in Spanish and English, the discussion finally was held only in Spanish. Description General Forum Most of the discussion threads were conducted in the General Forum, related to the following thematic issues: • Presentation of the Report of the Face-to-Face Meeting of the Advisory and Participatory Committee. • Request of the organizations’ logotypes. • Engagement in the proposed activities. • Distribution of leadership in the proposed activities. • Task distribution. • Suggestions to the “Civil Society Declaration” proposed by various organizations (finally not developed).

Other specific forums were proposed but finally all discussions were conducted in the General Forum.

2.2. Best Practices Abstract Format

The abstract submission process for oral communications included two formats: research and best practices, in order to facilitate the participation of civil society representatives and the presentation of social intervention projects. The abstract evaluation process was guided by the following criteria:

Evaluation criteria • Rigorous evaluation will be carried out to ensure the quality of presentations.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

A. Research abstracts will be evaluated according to the following criteria: . Structured abstract (background and objectives, methods, main results and conclusion) and formal presentation . Methods are appropriate to objectives and adequately described (design, study population, data collection and analysis) . The main results are clearly presented . Conclusions are based on the results . General interest and originality

B. Best practice abstracts will be evaluated according to following criteria: . Structured abstract . The practice is well described and its design is appropriate . The design is appropriate for the objective/setting . Lessons to be learned are based on the practice . Innovative practices

Furthermore, the submission process for Posters and Workshops was open to the presentation of civil society perspectives and projects.

2.3. Scholarship Policy

A scholarship policy was developed in order to facilitate the participation of young scholars and representatives of civil society organizations, funded by DG Sanco, European Commission and Open Society Foundations.

Types of scholarships Two types of scholarships were offered: • 30 scholarships addressed to scholars, practitioners and representatives of civil society organizations, funded by DG Sanco, European Commission, covering the Conference registration fee. • 10 scholarships aimed at scholars and practitioners from Central or Eastern European countries working on Roma Health, funded by Open Society Foundations, covering the Conference registration fee, accommodation and flights.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Criteria The selection of scholarships used the following criteria:

DG Sanco funded Scholarships Criteria for scholarship granting were: 1. The applicant must participate in the conference with a) an oral or poster communication -accepted for presentation by the ISC-, b) an “Other Activities” presentation, c) active involvement in the Advisory and Participatory Committee or d) the moderation of a round table/session. 2. Main / presenting authors will have priority over co-authors. 3. Priority will be given to those who find themselves in the next situations: Academic situation: • Developing doctoral thesis, masters degree research project or similar study with a current thematic focus related to the conference. You will have to provide a written certification by the person academically responsible for you (e.g. thesis director, department head, etc.), which you will be asked to upload to the scholarship application form. • Post-doctoral (until 2 years after thesis reading/defence) with a current thematic focus related to the conference. You will have to provide a written certification by the person responsible for your work (e.g. project director) which you will be asked to upload to the scholarship application form. Civil society with active relationship with the conference’s thematic focus: • Active participant/associate of an NGO, Migrant and/or Ethnic Minority Association or Civil Society Platform with actual thematic focus related to the conference. You will have to provide a certification such as membership certification or written certification by the organisation’s director, which you will be asked to upload to the scholarship application form. 4. Country of residence (priority to persons residing in countries designated by the World Bank as “low- income countries”), age (priority to young researchers and practitioners up to 35 years of age) and abstract quality (based on the ISC evaluation scores) will settle ties when necessary.

Open Society Foundations funded Scholarships for Central and Eastern Europe Criteria for scholarship granting were: 1. The applicant must be resident of a Central or Eastern European country. 2. The applicant must participate in the conference with an oral communication, a poster communication or a workshop -accepted for presentation by the ISC. 3. Main/presenting authors will have priority over co-authors. 4. Priority will be given to those who find themselves in the next situations:

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Abstract topic: Abstracts focused on Roma Health will have priority.

Age: Priority will be given to young (≤ 35) researchers and practitioners. 5. Abstract quality (based on the ISC evaluation scores) will settle ties when necessary.

Outcomes • 30 scholarships were given to scholars, practitioners and civil society representatives. • 10 scholarships were given to scholars and practitioners from Central and Eastern European Countries who work on Roma health.

2.4. Civil Society Participation during the Conference

The perspective of civil society was present at the different spaces during the Conference, specifically during the Pre-Conference, Plenary Session II, Oral Sessions, Poster Sessions and Workshops, the Closing Ceremony, as well as the Parallel Activities celebrated in the city of Granada.

2.4.1. Pre-Conference

The Pre-Conference took place on April 9, 2014, organized by the Organizing Committee of the 5th EUPHA European Conference on Migrant and Ethnic Minority Health.

The Pre-Conference included the following activities: • Field visit to Almería – el Ejido • Working Session “Perspectives of the Civil Society”

Summary of the Pre-Conference Activities

Field visit to Almeria – El Ejido

Number of participants: 40. Place: El Ejido, Vicar, Almería.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Time Activity 8:00 Departure from Granada Arrival - Almeria Documentary Film “Cruzando la Miseria” (Traversing 10:00 Misery), Doctors of the World Office Almería Coffee Break Meeting with the heads of Health Centre and Poniente 11:30 Health District, Las Norias Health Centre 13:30 Lunch in El Ejido Guided Visit – Almeria Poniente Area, Doctors of the 14:45 World Meeting with Migrants Association of Almeria Poniente 16:15 Area, Vicar 17:00 Departure from Vicar 19:00 Arrival - Granada

Context El Ejido is one of Spain’s areas with mostly migrant population; some towns have up to 60% of non-local populations. El Ejido is also called ‘Europe’s fruit and vegetable garden’, with large extensions of greenhouses dedicated to mass-growing. These circumstances fall on top of each other to form a complicated reality, where the agro-industry exploits cheap labour of migrants, who often live in harsh conditions in isolated small towns, abandoned greenhouses or improvised-house settlements in the middle of large extensions of greenhouse groupings, often far away from basic services such as treated water, public transport and health-care.

Objectives The field visit was organized with the objective of raising awareness about these circumstances, in an effort to enable participants understand the dynamics surrounding migration in Southern Spain, so as to be able to propose and enact alternatives. The field visit was planned with the caution of not doing ‘misery tourism’, but to create an attempt to approach seriously these complicated realities.

Activity The field visit was conducted by the Doctors of the World network (DoW). Participants were picked up in Granada and taken to the DoW office where an introductory meeting, including a video presentation of the settlements, took place. Afterwards, the heads of the Poniente Health Centre and Health District received the participants, showed them the facilities and explained to them the work carried out by the Andalusian Public Health Care System regarding migrants’ health. After lunch, a meeting with representatives of civil society organizations involved with the presented realities took place. Participants returned to Granada in the late afternoon.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Working Session “Perspectives of the Civil Society” Number of participants: 66. Place: Andalusian School of Public Health

Time Activity Round Table I – The Beginning of a Journey: Migration Trajectories and Processes Moderator: Nabil Sayed-Ahmad Beiruti, Coordinator, Mental Health Programme for Migrant Population, Almería 12:00 Speakers: - Jesús Blasco de Avellaneda, Spanish Journalism and Human Rights Award 2013 14:00 Isidoro Macías Martín, “Padre Patera” Mikel Mazkiaran, Secretary General SOS Racismo Mohammed Bourgren, Intercultural Mediator, Almería Mª Auxiliadora Trujillo Vega, Researcher SEPISE Group, Granada University 14:00 Lunch Break Round Table II – Migrants’ and Ethnic Minorities’ Health and Health care Access in the Context of the Current Systemic Crisis Moderator: Emilio de Benito, Editor El País 15:00 Speakers: - Antonia Nuñez, Fakali Andalusian Federation of Roma Women 16:45 Tamara Amador, Fakali Andalusian Federation of Roma Women Teresa González, Doctors of the World Rogelio López-Vélez, Health between Cultures Pilar Baraza Cano, Head Citizen Attention Department Poniente District, Almería Irene Rodríguez Newey, Yo Sí Sanidad Universal Platform 16:45 Coffee Break 17:15 Workshop – Research, Social Transformation and - Action: Experiences and Strategies 19:15 Moderator: Amets Suess, Andalusian School of Public Health

Language While the Conference was conducted in English, the main language of the Pre-Conference was Spanish, in order to facilitate the participation of the local civil society organizations. During the Round Tables which formed part of the Working Session “Perspectives of the Civil Society”, simultaneous translation into English was facilitated. During the Field Visit to Almería and El Ejido, as well as in the Workshop “Research, Social Transformation and Action: Experiences and Strategies”, informal translation into English was provided.

Context Scientists from different areas and policy makers were the usual target audiences for this Conference. Civil society organisations are also working hardly on issues related to Migrant and Ethnic Minority Health. The

5th EUPHA European Conference on Migrant and Ethnic Minority Health

observation of a frequent lack of interaction between these spheres raises the interest to organize a Working Session focused on Civil Society Perspectives.

Objectives The main purpose of this Working Session is to deepen on discussions related to the processes and trajectories of migration, migrant and ethnic minority health and access to health care in the context of the current systemic crisis, and the role of research in social transformation.

Programme The topics mentioned above were addressed in two Round Table sessions and a Workshop.

Round Table I “The Beginning of a Journey: Migration Trajectories and Processes” Language: Spanish, with professional simultaneous translation into English. Video Streaming: http://new.livestream.com/easptv

Summary of the Presentations The journalist Jesús Blasco presented his photographs while describing the situation in the Southern border of Spain-Morocco (Melilla and Mount Gurugú): injuries caused by police beatings and blades on the fence between Melilla and Morocco, sex work in migrant settlements, among other incidents. He referred to the emotional and physical strength of migrants coming from Africa. At the same time, he highlighted the poor conditions in which they have to survive on Mount Gurugú and the migrant settlements, with no health care available, which converts them into victims of common diseases. He indicated that Médicos Sin Fronteras (Doctors without Frontiers) provided primary and emergency care to migrants in Morocco until 2012, in the period of greatest insecurity and violence at the border. Jesús Blasco described that Moroccan security forces were paid by the Spanish government to curb migration with violence.

Mikel Mazkiaran, from SOS Racismo, talked about detention centers for migrants in Spain (CIE, Centros de Internamiento de Extranjeros), denouncing the insufficient accessibility and quality of the health care assistance available inside these facilities. According to SOS Racismo, these centers should not exist, as being a detainee is considered an additional punishment for someone with a deportation order. Mikel Mazkiaran identified as one of the main objectives of the detention centres ensuring deportation process upon judge’s decision. He indicated that over 50% of detainees are finally released. The speaker considered the Royal Decree-Law 16/2012 to be a fifty-year backward step regarding the right to health care in Spain. He ended his speech referring to the moral dilemma of the government regarding health care assistance to migrants.

5th EUPHA European Conference on Migrant and Ethnic Minority Health

Maria Auxiliadora Trujillo introduced the diversity of trajectories of unaccompanied minors. She highlighted that in Andalusia, most of them come from Morocco. At the same time, she described the situation of sub- Saharan children, some of them victims of armed conflict and human trafficking. She stressed the invisibility of girls in these migration processes. According to her point of view, the stories share one aspect: the violation of the rights of unaccompanied minors both in their countries of origin, in transit countries and often in the destination countries.

Mohammed Bougren talked about his own familiar migration trajectory from Morocco to Spain. He described his arrival when he was a teenager, his experience as a high school student, becoming a nurse assistant and his current work as a health mediator in Almeria. The speaker highlighted a positive perspective of migrations process through his own experience.

Isidoro Macías, known as “Padre Patera”, is responsible of the Family House of the Franciscan Brothers of the White Cross in Algeciras (Cádiz), a reception center for pregnant migrant women and migrant women with children. He showed a video about rescue of migrants at sea after crossing the Strait of Gibraltar in the 90s.

During the discussion with the audience, a representative of the Spanish Refugee Aid Commission (CEAR, Comisión Española de Ayuda al Refugiado) presented some additional information on the situation of asylum seekers. Following his description, Spain is one of the European countries with the lowest number of granted asylum seekers and international protection. He refers to the "returns on the spot" of migrants and asylum seekers at the Ceuta and Melilla border. According to CEAR, people susceptible of international protection are not informed correctly about their rights. Regarding Syrian refugees, he indicated that they do not seek asylum in Spain as they think their request will not be accepted. For this reason, according to the Dublin Convention, some Syrian families are being returned to Spain from other European countries.

Round Table II. Health and Health Care Access in the Context of the Current Systemic Crisis Language: Spanish, with professional simultaneous translation into English. Video Streaming: http://new.livestream.com/easptv

Summary of the Presentations

Antonia Nuñez and Tamara Amador introduced their programme on access to health care for Roma people. They described their work as health mediators in the Public Health System, organizing training activities on disease prevention and health promotion for Roma women and girls. They highlighted that access barriers for

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Roma population are not the same as those for migrant population. According to their organization, Roma population conceptualizes health as the absence of disease and do not have preventive skills.

Teresa González presented the most recent Doctors of the World’s report on restriction of migrants’ access to health care. She stated that the organization detected large differences on health care access for migrants with irregular status among Spanish regions. Some regions are implementing Royal Decree-Law 16/2012 and others are not. She described how legal barriers are affecting access to health care for migrants, deteriorating migrant’s health and public health. According to data, access to health care in Spain was one of the best in Europe before the Royal Decree-Law 16/2012 was approved and the expenditure for health and social services was cut down.

Pilar Baraza introduced the effects of the economic crisis and budget cuts on health, the increase of economic inequalities and the distribution of poverty and social exclusion in Spain. She also analysed the legislative framework in Spanish regions before and after the approval of the Royal Decree-Law 16/2012. She made a specific reference to the 5th Andalusian Health Plan.

Rogelio López-Vélez analyzed the break of the universal coverage model, established one decade ago, after the approval of the Royal Decree-Law 16/2012 and its impact on health rights. He referred to the research and training activities the Hospital he works is leading in the field of migrants’ health care.

Irene Rodriguez introduced Yo Sí Sanidad Universal Platform as a professional and citizens’ alliance against the application of the Royal Decree-Law 16/2012, and their campaign for maintaining universal access to health care. She described how they promote civil disobedience among health professionals, develop training activities and accompany migrants to ensure health care assistance. She also referred to the impact of this legislation on the health of vulnerable groups.

Workshop “Research, Social Transformation and Action: Experiences and Strategies” Format: Focus group. Language: Spanish, with informal translation into English (finally, all participants spoke Spanish).

Objectives • To facilitate a discussion space about the interrelation between research, activism and public policies. • To propose an exchange about experiences in Participatory Action Research, Co-Research and Militant Research related to migration, ethnic minorities and health.

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• To analyze changes, challenges and priorities in this field in the current moment of economic and systemic crisis. • To open a reflection on specific characteristics of research ethics in projects situated between academia, activism and social transformation. • To identify strategies and proposals to promote civil society participation in academic contexts.

Summary The discussion focused on the opportunities and difficulties of participation of civil society organizations in academic spaces, experiences of collaboration between academia, civil society and policy makers, as well as participative research methodologies. In each topic, proposals for improvement were identified.

• Participation of Civil Society Organizations in Academic Spaces  Current situation: o Lack of opportunities for participation.

 Proposals: o To include civil society organizations in teaching activities. o To identify alternative funding strategies (e.g. crowd-funding). o To develop participative approaches. o To strengthen the recognition of activist knowledge in academic spaces. o To create synergies between academic and activist perspectives.

• Collaboration between Academia, Civil Society and Policy Makers  Current situation: o Lack of opportunities for collaboration.  Proposals:

o To design research projects related to social needs. o To develop participative approaches (Participatory Action Research). o To include the objective of social transformation in research projects.

• Participative Research Methodologies  Current situation: o Lack of training in participative research methodologies. o Lack of time for consistent participative processes.

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 Proposals: o To construct research projects based on population needs. o To allow sufficient time for constructing participative processes. o To translate results into a comprehensible language.

• Research Ethics  Current situation: o Conflicts of interests. o Lack of transparency. o Competitive logics. o Lack of reflection on whom, from where and what is researched.  Proposals: o To include assessment in research projects. o To avoid conflicts of interests: methodological rigour and transparency. o To develop research projects related to social needs. o To create shared knowledge and networks of knowledge. o To maintain a responsible use of terminology. o To create a Committee to mediate in case of conflicts of interests.

2.4.2. Conference

During the Conference, civil society perspectives were present in the following sessions:

Plenary Sessions In Plenary Session 2 “Health, a human right in Europe? Effects of the economic crisis on access to health care for migrants and ethnic minorities in Europe”, the following keynote speakers related to civil society organizations participated:

• Nathalie Simonnot, Deputy Director at Doctors of the World International. Short Bio: http://www.eupha-migranthealthconference.com/?speaker=natalie-simonnot • Deyan Kolev, Chairman at AMALIPE, Center for Interethnic Dialogue and Tolerance, Bulgaria. Short Bio: http://www.eupha-migranthealthconference.com/?speaker=deyan-kolev

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A Video Screening of Plenary Session 2 “Health, a human right in Europe? Effects of the economic crisis on access to health care for migrants and ethnic minorities in Europe” is available at the following link: http://new.livestream.com/easptv/eupha5migrantethnic

Closing Ceremony A summary of the civil society participation at the Conference, including an identification of opportunities and limitations, was provided in the Closing Ceremony of the 5th EUPHA European Conference on Migrant and Ethnic Minority Health. Video Screening of the Closing Ceremony: http://new.livestream.com/easptv/eupha5migrantethnic

Oral Communication and Poster Sessions The Oral Communication and Poster Sessions included presentations related to civil society participation. See Book of Abstracts: http://www.eupha-migranthealthconference.com/wp- content/uploads/2014/04/BOOK_EUPHA_EASP_Granada2014.pdf

Workshops Furthermore, civil society perspectives were present in several of the Workshops: See Book of Abstracts: http://www.eupha-migranthealthconference.com/wp- content/uploads/2014/04/BOOK_EUPHA_EASP_Granada2014.pdf

Audiovisual Screenings In Room 5, a continued audiovisual screening was provided, with short movies and videos related migrant and ethnic minority health.

Short movies were loaned by the following organizations, including civil society organizations: Open Society Foundations (Roma Health Project, Public Health Program and Health Media Initiative), Andalusian Sociocultural Roma Centre (Centro Sociocultural Gitano Andaluz) (International Roma Film Festival “Tikinó”) and Valeriano López. Videos were loaned by Doctors of the World and Yo Sí Sanidad Universal Platform.

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Programme • Human Rights in Patient Health. Macedonia (1) • Right to Heal • Human Rights in Patient Health. Macedonia (2) • Nobody discarded • Roma Health Mediators in Bulgaria • Greece, the Faces of the Crisis • Roma Health Mediators in Ukraine • I want to be a doctor • Roma Health Mediators in Romania • A better life • My Access to Health Care • I want to be a pilot • Strait Adventure • Confabulation

Exhibitions Two exhibitions related to migrant and ethnic minority health were organized in the Andalusian School of Public Health. One of them was loaned by a civil society organization (Doctors of the World).

The second exhibition, (“Antes… Durante… Después / Before… During… After”) was loaned by the Childhood Observatory of Andalusia (OIA, Observatorio de la Infancia de Andalucía).

“Migrando en positivo / Migrating in positive”, Doctors of the World Place: Hallways, Andalusian School of Public Health

Summary: Brought by Doctors of the World, this exhibition brings to light the hidden face of migration, without dramatism, dehumanisation, sensationalism, nor politicised approaches, in order to show us the more human, joyful and full-of-life side of these persons to whom we assign the concept ‘migrant’. This exhibition articulates formats such as photography, graffiti, illustrations and poetry.

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2.4.3. Parallel Activities

Furthermore, in the city of Granada, the following parallel activities took place, organized with the aim of strengthening the participation of local civil society organizations and to enhance the visibility of the Conference in the city of Granada.

Film Screening “An Episode in the Life on an Iron Picker” Place: Filmoteca de Andalucía, c/ Profesor Sainz Cantero, 6, Granada Time: Wednesday, April 9th, 20:30 Director: Danis Tanovic, Bosnia-Herzegovina, 2013

Presentation: Francisca Fernández, Director of Andalusian Sociocultural Roma Centre (Centro Sociocultural Gitano Andaluz); Dolores Fernández, President of Romi, Association of Roma Women (Asociación de Mujeres Gitanas Romi), Olga Leralta Piñán, Andalusian School of Public Health.

Synopsis: Senada, mother of a Roma family that makes a living from iron picking, develops strong belly pains and begins to bleed. When she attends the Health Center they inform she had a spontaneous abortion and refer her to the Hospital for an emergency surgery. As she does not have health coverage, she is requested to pay 500 EUR. For 10 days, Nazif, her husband, will try to save Senada's life by collecting iron to get the needed money. Movie loaned by GOLEM Productions.

Round Table “Civil Society: Working for Migrants’ and Ethnic Minorities’ Access to Health Care” Place: Social Work School, University of Granada, Aula 25 (c/Rector López Argüeta, s/n Granada) Time: Thursday, April 10th, 18:00

Speakers and topics • Chair: Assane Top, Anaquerando, Roma Association (Anaquerando, Asociación Gitana), Granada. • Speakers:  Irene Rodríguez. Yo sí Sanidad Universal Platform. Royal Decree-Law 16/2012. Impact, application, civil disobedience.  Mar Sacristán. Yo Sí Sanidad Universal Platform. Social and human rights movements. Encouraging citizen and professional participation.

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 Luis Andrés Gimeno. Migration and Health Group of the Spanish and Andalusian Societies of Family and Community Medicine (SEMFYC & SAMFYC). Migrant’s profiles and patterns in use of health care services.  Nuria Rodríguez. Foundation Roma Secretariat (Fundación Secretariado Gitano). Ethnic minorities and patterns in the use of health care services.  Ainhoa Rodriguez García de Cortázar, Childhood Observatory of Andalusia (Observatorio de la Infancia de Andalucía, OIA). Children and adolescence from social disadvantaged contexts. Migrants and Roma people at the risk of exclusion.

Summary The round table was attended by over 40 people, mostly university students from the Political Science Faculty. The main topics issued were: • Description of barriers to migrants' access to health care services after the approval of the Royal Decree- Law 16/2012. • The engagement of citizens and professionals against the denial of access to health care through disobedience and accompaniment of migrants to health care services. • Presentation of R.E.D.E.S., an online register for reporting health care exclusion throughout Spain. • The impact of migrants’ access to primary care in Spain and other European countries. • The characteristics of Spanish Roma population in relation to health and health care access. • Poverty and inequalities in the access to social services for migrant children and health inequalities of Spanish Roma children.

Workshop on the Spanish Register for Denouncing Health Exclusion (R.E.D.E.S., Registro Estatal para la Denuncia de la Exclusión Sanitaria), by Yo Sí Sanidad Universal Platform Place: University of Granada Time: Thursday, April 10th Social Work School: 10:00 Sociology School: 11:00 Law School: 12:00 Medicine School: 13:00 Psychology School: 14:00 Organized by: Yo Sí Sanidad Universal Platform

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Summary: Members of Yo Sí Sanidad Universal Platform organized an Itinerary Workshop about the project R.E.D.E.S., Spanish Register for Denouncing Health Exclusion (R.E.D.E.S., Registro Estatal para la Denuncia de la Exclusión Sanitaria).

Exhibition at the Roma Women Ethnographic Museum (Museo Etnológico de la Mujer Gitana) Place: Museo Etnológico de la Mujer Gitana, Camino del Sacramonte, 107 Time: Monday to Friday, 10:00 – 13:00

Summary: The permanent exhibition at the Roma Women Ethnographic Museum in Granada was included in the Conference programme.

Exhibition “Roma Destinies in Eastern Europe” (“Destinos Gitanos de Europa del Este”), Andalusian Sociocultural Roma Centre (Centro Sociocultural Gitano Andaluz) Place: Centro Sociocultural Gitano Andaluz, Avda. del Hospicio, s/n Time: April 8th – 30th, 2014

Summary: The exhibition “Roma Destinies in Eastern Europe”, organized by the Andalusian Sociocultural Gipsy Centre (Centro Sociocultural Gitano Andaluz), was included in the Conference programme.

2.5. Granada Declaration

The Granada Declaration constitutes a statement endorsed by the participants of the 5th EUPHA European Conference on Migrant and Ethnic Minority Health, as well as numerous institutions, organizations and individuals who called on European governments to take concrete steps to protect the health of migrants and ethnic minorities in Europe.

The Granada Declaration was created by initiative of the three organizing institutions of the Conference (EUPHA, European Public Health Association; CSC, Consorci de Salut i Social de Catalunya y EASP, Andalusian School of Public Health). Therefore, it does not constitute a participation format of the civil society in itself. At the same time, civil society organizations contributed actively to the dissemination and endorsement process.

The document was elaborated in the weeks previous to the Conference, and sent to the participants inviting them to make suggestions. After incorporating the contributed suggestions, the final version of the document

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was presented at the Closing Ceremony of the 5th EUPHA European Conference on Migrant and Ethnic Minority Health. Afterwards, the Declaration was published on the Conference website, in English, Spanish and French, and distributed widely among professional and civil society networks.

By July 11, 2014, 97 institutions, including European and national institutions, professional associations and civil society organizations, have endorsed the document, as well as 398 individuals (338 of them with the permission of being published) (http://www.eupha-migranthealthconference.com/?page_id=1766).

The Granada Declaration and the list of institutional endorsements were also sent to 32 EU Health Attachés, the EC Commissioner for Health and Consumer Policy Tonio Borg and high officers of DG Sanco, on the occasion of the EU Informal Meeting of Health Ministers held in Athens, Greece on April 28-29, 2014.

In September 2014, the Granada Declaration and list of institutional endorsements is planned to be forwarded to the Spanish Ministry of Health Care, Social Services and Equality, Madrid, Spain (Ministerio de Sanidad, Servicios Sociales e Igualdad), accompanied by a press conference, with the participation of the Andalusian School of Public Health, Consorci de Salut i Social de Catalunya, Doctors of the World Spain, Spanish Society of Public Health and Health Care Administration (SESPAS, Sociedad Española de Salud Pública y Administración Sanitaria) and Spanish Society of Family and Community Medicine (SemFYC, Sociedad Española de Medicina de Familia y Comunitaria).

3. Evaluation of Civil Society Participation

3.1. Evaluation of Civil Society Participation by the Organizing Committee

From the beginning, the Organizing Committee aimed to strengthen civil society participation in the Conference, identifying potential participation formats.

The introduction of formats of civil society participation in the Conference was accompanied by a continued reflection process, based on the awareness of the importance of this participation being ‘real’ and adapted to the interest of civil society representatives, and potential difficulties to put this objective into practice.

In a self-critical way, the Organizing Committee identified several difficulties and gaps in the process which limited the extension of civil society participation in this edition of the Conference, including the following

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aspects: • Dissemination of the Conference among civil society networks started relatively late, reducing the opportunity for civil society organizations to participate in the abstract submission process. • The need of a strong scholarship policy to facilitate civil society participation was identified. The scholarships funded by the European Commission included some criteria focused on representatives of civil society organizations, but slightly favoured academic applications and were limited in number. Scholarships funded by OSF, Open Society Foundations, were specifically addressed to applicants from Eastern and Central European countries with accepted abstracts, with a limited access for civil society representatives. • The Advisory and Participatory Committee was set up quite late in the preparation process of the Conference, with the first contact round in October/November 2013, the set up of the Committee taking place in December 2013, and the Face-to-Face Meeting being celebrated in February 2014, two months ahead of the Conference being celebrated. In consequence, the members of the Advisory and Participatory Committee did not have the opportunity to participate in all stages of the process. Some of the activities proposed by the Advisory and Participatory Committee could not be put into practice due to a lack of time. • A lack of active participation of European civil society networks in the Advisory and Participatory Committee was observed, partly due to time restraints in the articulation and language barriers. In the face-to-face meeting in Granada, focused mainly in the local and national civil society networks and held in Spanish, one representative of a European network (Doctors of the World) was present, representing at the same time the Spanish Doctors of the World network (Médicos del Mundo). A planned Face-to- Face Meeting with representatives of European networks in Brussels could not be carried out due to time restraints. The main language of the Online Forum, planned as bilingual communication structure, finally was Spanish, limiting the participation on non-Spanish speaking participants. • A lack of interaction between representatives of civil society organizations and academics, due to language barriers was identified. The Pre-Conference was held in Spanish, with simultaneous translation during the Round Tables and informal translation during the Workshop and Field Visit. The language of the Conference was English, with simultaneous translation limited to Plenary Sessions. Regarding the Field Visit, the participants criticized the insufficient quality of the informal translation from Spanish to English. • The parallel activities organized in the city of Granada (round table, workshops, exhibitions, film screening) did not receive a high number of audience, raising the question regarding the costs – benefits balance. • An important part of the activities related to civil society participation (Pre-Conference activities, parallel

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activities) did not form part of the main programme of the Conference, limiting the interaction between civil society and academic perspectives.

3.2. Evaluation of Civil Society Participation by the Conference Attendees

In the Conference Evaluation Form (see Evaluation Report), a question on civil society participation was included.

What do you think about the participation of the civil society in the Conference? Do you think it is important to promote civil society participation in future editions of the Conference?

The respondents contributed comments2 related to the following topics:

Positive Feedback • Good!! • Absolutely necessary to be included in any future conference. • Great idea and yes continue with this. • Crucial element in any conference. • Yes very important in order to get more real case studies, and to diversify the discussions. • Yes!!! • Yes. • Yes I do and recommend. • I think that both worlds, the academic world and the civil society, need each other to show in which way political decisions influence the people’s life and health. (Pienso que ambos mundos, el académico y la sociedad civil, se necesitan mutuamente para demostrar en qué forma las decisiones políticas afectan a la vida y a la salud de las personas.) • Useful and appropriate. • Yes. It is very important. • I consider very important to have civil society in the Conference. • It is important. • Yes. • Fantastic.

2 The comments are reproduced literally, as contributed in the Conference Evaluation Form, and ordered by topics. In case of comments in Spanish, a translation into English and the original text in Spanish is included. 30

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• Positive / yes, should continue! • Yes. Very positive! It should be a part of all conferences actually. But they could have their voices be heard and be more visible. • Very interesting and necessary. • Yes. • Definitely. • Yes, very important, in order to translate results of research into action. • Of course, it is. • Yes, it's important to learn from each other and bridging the gap between civil society and the academia. • Yes it is important. • It is important that all parties be at the table and that all get the opportunity to listen to different approaches. Liked it. • Yes, as you said in the conference it should be promoted in the next conferences. • Yes. • Yes! • Yes, it's very important to share research and practice experience. • As I find it important that research is shared with civil society, I think that the participation of the civil society was great. • Yes, it is very important. • It is very important to produce synergies between researchers and field technician. • Absolutely! Civil society participation is vital. • Yes, very important. • It is the most important for a conference on migrant health. • Yes that is definitely important and a great idea! • Yes. • Definitely. • Certainly! • Yes. • Of course. • Yes, most welcomed! The difference with the 2012 conference in Milan was enormous (this conference was a lot more 'to the point' in terms of what is going on at EU policy level). • Promoting the active involvement of the civil society in future editions of the conference is essential.

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• Yes, it is very important to promote civil society participation in future Conferences and gather a wide variety of participants and contributors. This makes for a wider range and interest and learning opportunities. • Yes. • Yes I think it is very important to promote them, because they do really good work. • Yes, I think it is crucial to assure civil society participation.

Advisory and Participatory Committee • Apart from the results, I would like to say the attitude by the participatory committee was always very open and participating and with a big implication. I would like to congratulate the committee. Thank you so much.

Scientific Quality of Civil Society Participations Presentations • Good initiative, though sometimes scientific quality of those presentations was low. • Yes, it is important. But we must not lose the scientific level of the conference.

Topics • Too much policy more research needed.

Lack of Visibility • I was not aware of civil participation, so the message cannot have been very clear! • Yes, but I didn't notice it in this conference. • Yes, for sure. But it wasn’t very much. • In my view civil society seemed very limited in my experience of the conference. In addition there did not seem to be many ethnic minority community based organizations represented or visible at the conference. • I welcomed the civil society participation but felt that it was not nearly enough. • It's a very important issue but it would be needed a better organization and mass media diffusion. • Who else was there very visible except for MDM? I think they took most of the visibility of civil society. • Participation of the civil society during the conference was limited, maybe due to language barriers. • Haven't seen very much from the civil society?

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Organization Field Visit • Unfortunately (and that is not the fault of the conference organizers) the only moment where civil society was present, apart from Medicos del Mundo, was the pre-conference activities. I just attended the visit field but I was very disappointed of the lack of possibility that the translator from Medicos del Mundo let to the migrants to express themselves and share with us their experience. The censure is unacceptable in this kind of event!!!

Translation • It is a shame that simultaneous translation was available during the plenary session - where very few people made use of it - while the civil society participation was virtually unavailable to non-Spanish speaking participants. Translation efforts should have targeted those sessions to encourage conference participants to attend.

Activities in Universities • The activities at universities (in which I participated) had low impact. Maybe it would have been better to give lectures inside an official schedule. Also, civil society is important for scientifics inside the conference. • For example the flashmob was not well organised.

Proposals for Improvement • Civil society organizations outside the host country should also be more encouraged to come for oral/poster presentations. • Not many migrants present, and rather underrepresented. I think it is important - though 'taking migrants and minorities as hostages' should be avoided. • I think parallel scientific conferences would have to create a space for NGOs and social movements to discuss and advance the generation of joint strategies to combat health exclusion. A space where people (migrated or not) could participate individually, although I understand that it is not easy or cheap to organize this. • I am not really sure what you mean with this question. But if you mean that for example NGOs and the local/regional politics are present and participate, then I believe that is a good idea. • Yes, but might be better to give them a particular session and not integrate this together with presentations of researchers • I think it would be important to include an active participation of minority groups.

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• Private health care industry and the US health care were absent. • I wonder why, in a conference that was about migrants and ethnic minorities, why were there so few black and minority ethnic women? It is up to conference organisers to ensure that a diverse range of scientists and civil society activists are present and participating. This would help with the overtly paternalist and orientalist tenor of the conference. • Generally a good idea, the interfaces need further development. • I think it is very important, and that is the reason I think that their participation should not be "before" the Conference starts, but actually part of the Conference, with activities and round tables mixed together with all the other sessions.

Further Comments • No. • I could not attend on Wednesday.

4. Conclusions and Recommendations

The promotion of civil society participation constituted a new element introduced in the 5th EUPHA European Conference on Migrant and Ethnic Minority Health, according to the objective of analyzing and sharing strategies, responses and good practices from the perspective of different social stakeholders on migrant and ethnic minority health in the context of the current economic crisis.

The creation of an Advisory and Participatory Committee composed of representatives of Spanish and European civil society organizations and networks, permitted the development of ideas regarding collaboration formats between academia, policy makers and civil society, strategies to strengthen civil society participation in academic spaces, reflections on participative research methodologies and ethics, as well as concrete proposals for including civil society participation in the Conference.

Furthermore, the Organizing and International Scientific Committees aimed to strengthen civil society participation by means of a specific call for best practices abstracts and a scholarship policy addressed to civil society representatives.

Civil society perspectives were present in different moments of the Conference, including Pre-Conference activities, during the Plenary Session 2 and Closing Ceremony, Oral and Poster Sessions, Workshops, audiovisual

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screenings, exhibitions, as well as parallel activities celebrated in the city of Granada. Civil society organizations also participated in the dissemination and endorsement process of the Granada Declaration.

The Organizing Committee identified several difficulties and limitations regarding civil society participation in the Conference, among them a lack of dissemination of the Conference announcements among civil society organizations and networks, the late onset of the Advisory and Participatory Committee, limiting the participation in all stages of the process, language barriers and a limited availability of scholarships addressed to civil society representatives.

In the Conference Evaluation Form, the attendees highlighted the interest of strengthening civil society participation in the Conference, at the same time as observing its relative invisibility in this edition of the Conference, identifying difficulties and contributing proposals for improving its inclusion.

In consequence of these observations, the Organizing Committee would like to forward the following recommendations to the Organizing and International Scientific Committee of upcoming EUPHA Conferences on Migrant and Ethnic Minority Health: • The interaction between different stakeholders and the promotion of civil society participation in academic spaces related to migrant and ethnic minority health is considered a relevant element for promoting an exchange of experiences and knowledge, with the objective of orientating future policies related to migrant and ethnic minority health. This collaboration is considered of special importance in the current moment of economic crisis. • The creation of an Advisory and Participatory Committee was evaluated as an interesting format for facilitating civil society participation in the Conference. We recommend setting up the Advisory and Participatory Committee from the beginning, in a parallel form to the onset of the Organizing and International Scientific Committees, in order to allow a ‘real’ participation in all stages of the process. • We suggest including a strong scholarship policy addressed to representatives of civil society organizations, in order to facilitate their participation. • In the summary of the Face-to-Face Meeting of the Advisory and Participatory Committee, proposals regarding formats, contents and methodologies related to civil society participation were mentioned, which could be used as ideas for upcoming editions of the Conference. • The Advisory and Participatory Committee, as well as the participants of the Workshop “Research, Social Transformation and Action: Experiences and Strategies”, celebrated during the Pre-Conference, contributed reflections on participatory methodologies and ethics related to research in the field of migrant and ethnic minority health. We recommend continuing this process, by means of establishing a

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network related to the topic, and/or introduce workshops or other activities related to participatory research methodologies and ethics in the next EUPHA Conference on Migrant and Ethnic Minority Health, using the existing contacts with civil society organizations and networks. • We suggest strengthening the interaction between the perspectives of civil society representatives, academics and policy makers by integrating civil society activities into the main Conference programme, providing adequate translation support, if needed, with the objective of facilitating the inclusion of local and regional civil society organizations and networks, a well as to overcome the civil society – academia split. • Finally and above all, we recommend asking civil society organizations and networks for their proposals, priorities and expectations regarding their participation in the next EUPHA Conferences on Migrant and Ethnic Minority Health.