Health Guidelines for Migrants Do not remove! Contents Navigating the Health System ................... 3 Nutrition ................................................... 18 Sexual Health .......................................... 25 Infectious diseases .................................. 29 Personal hygiene & disease prevention .. 36 Emotional Health ..................................... 40 Child health ............................................. 43 2 Navigating the Health System Welcome to the Maltese health system. As a migrant you have the right to be provided with appropriate health education and services to meet your physical and psychological needs according to your legal status. Adapting to a new country and coping with new social, administrative and political structures is not easy. It is understandable that you may have been feeling isolated and not physically fit. However, taking care of your health is one of your main responsibilities and this booklet will guide you to go to the right place at the right time. It is not surprising that due to cultural differences health care professionals such as doctors and nurses may have difficulty in understanding your problem or how you feel it is affecting you. We ask you to be patient and try to build a rapport with your health provider to be able to meet your needs. Being healthy does not only mean having no health problems, but it also means knowing how to look after yourself, avoiding the foods or substances that may harm you and you may also have to change your lifestyle habits. Health programmes in the form of educational sessions are normal in the western world as these prevent problems in the future as you get older. The intention of this booklet is to guide you when you need to use the existing health services. It helps you to distinguish emergency care (as in life threatening situations) from routine or non-urgent visits where you need to attend as a walk-in case or by appointment. 3 The health system in Malta is free if you are admitted to hospital in an emergency or if you need to attend a health centre. However, if you have not been issued with a pink card by the social services you may have to purchase your medicine. You may choose to visit a doctor or a consultant in a private clinic in which case you will pay for the service after the visit. On Your Arrival When you arrived by boat you were seen by a doctor for any injuries you may have suffered on your journey or any other emergency/condition such as heat exhaustion, dehydration, etc in which case you would have been treated at a health centre or sent to hospital. Screening tests for Tuberculosis Following this assessment a chest X-ray is taken in the next few days to check for Pulmonary Tuberculosis (TB) which is an infectious disease. In the case of women who are pregnant no X-ray is taken as this is harmful for the unborn baby. If the chest X-ray shows any signs of Tuberculosis, you will be referred to a specialist, who will do further tests and treat you as necessary. In order to check for TB in pregnant women and in children a Mantoux test is carried out, which involves a painless injection in the forearm. 4 The area of the injection site is examined by a doctor after 48-72 hours. If the test is positive, this means that you might have been infected with Tuberculosis in the past. You will then be referred to a specialist who may order other blood tests and start you on treatment. In the following days you may have a full physical examination by the doctors in the closed centre. It is important to inform the doctor if you suffer from any chronic illnesses such as diabetes, renal problems, asthma, high blood pressure and also if you are pregnant. Medical services in the closed centre While you are in the closed centres you are entitled to free medical services including treatment. In the case of a medical emergency, inform the soldier/police on duty who will call an ambulance to take you to the emergency department at Mater Dei Hospital. Due to the large number of residents in the closed centres, there may be a triage system whereby the most urgent cases are seen by the doctor before other cases which are not so urgent. Supervised treatment If you are prescribed any treatment which needs to be supervised by a nurse, you will be given a treatment card with your treatment written on it. The nurse will sign the card each time you take the treatment in front of her/him. 5 Health centres in Malta & Gozo In Malta, if you need to see a General Practitioner, you can either go to a Health Centre, which is run by the government and free of charge, or you can visit private General Practitioners, who charge a fee for their services. There is no patient registration system in Malta, so you are free to see any General Practitioner. It is important to note, however, that you can only attend a Health Centre that serves your locality of residence. Victoria Gzira Mosta Floriana Rabat Cospicua Qormi Paola Paola 5 pm to 8am Mosta } Floriana Emergency Service only All Health Centres: Monday to Friday - 8am to 8pm; Saturday - 8am to 1pm 6 Which Health centre should you attend? Floriana Health Centre Tel: 21243314 Triq Frangisk Saver Fenech For persons residing in: Pieta', G'Mangia, Valletta, Floriana, Hamrun, Sta. Venera, Marsa, Zurrieq, Safi, Luqa, Mqabba, Qrendi, Kirkop and Hal-Far (L/O Zurrieq). Gzira Health Centre Tel: 21337245 / 21344766 / 21337244 Pjazza Meme' Scicluna For persons residing in Msida, Ta' Xbiex, Gzira, Sliema, Kappara, San Gwann, Taz-Zwejt, St. Julian's, Swieqi, L-Ibrag, St. Andrew's, Pembroke, High Ridge and Victoria Gardens. Qormi Health Centre Tel: 21484450-3 Triq il-Vitorja For persons residing in Qormi, Zebbug, Mriehel (towards Qormi) and Siggiewi. Paola Health Centre Tel: 21691314-5 Pjazza Antoine De Paule For persons residing in Paola, Tarxien, Sta. Lucia, Birzebbuga, Zejtun, Marsaxlokk, Zabbar, Marsascala, Xghajra, Fgura, Gudja, Ghaxaq, Benghajsa Cospicua Health Centre Tel: 21675492 / 21673292-3 / 21821727 Triq Ljun For persons residing in Cospicua, Vittoriosa, Senglea, and Kalkara Mosta Health Centre Tel: 22695701/2 Pjazza tar-Rotunda For persons residing in Mosta, Naxxar, Gharghur, Mgarr, Ghajn Tuffieha, St. Paul's Bay, Mellieha, Burmarrad, Bugibba, Qawra, Bahar ic-Caghaq, Madliena, Mriehel (part of), Fleur-de-lys, Salina, Xemxija, Manikata, Bidnija, Zebbiegh, Maghtab, Ta'Qali, Ghadira, Cirkewwa. Rabat Health Centre Tel: 22563000 Civic Centre, Triq San Kataldu, Rabat. For persons residing in Rabat, Mdina, Mtarfa, Dingli, Attard, Bahrija and Kuncizzjoni. B'Kara Health Centre Tel: 21494960 Triq Tumas Fenech For persons residing in Birkirkara, Iklin, Lija and Balzan, presently Monday to Friday from 8am -8pm and Saturdays 8am - 1pm. Bkara Health Centre is closed on public holidays. For all conditions requiring acute or immediate medical care when Birkirkara Health centre is closed, these residents are to make use of the general practitioner services from Mosta Health Centre. 7 Victoria Health Centre Tel: 22156820 Triq Enrico Mizzi, Victoria, Gozo. More information can be found on webpage: https://healthcms.gov.mt/en/phc/Pages/Health-Centres/Overview.aspx Services at Health Centres General practitioner (GP) and nursing services, and other specialised health services are provided here: . Minor surgical procedures . Nursing services . Diabetes clinics . Well Baby Clinic . Immunisation . Speech therapy . Antenatal, Gynae & postnatal clinic . Paediatric clinic . Ophthalmic clinic . Life style clinics . Medical consultant clinic . Psychiatric clinic . X-Ray . Podology clinic You may need a referral note from a doctor (general practitioner) before making an appointment in some specialised clinics in the list above. Should you require more information regarding the services offered at health centres, at the back of this booklet you will find the telephone number of the health centre in the region of your residence. 8 Provision of medicines If you are a yellow or pink card holder you will be able to receive your medicines from the government pharmacy (usually within the premises of the health centre where you reside; Note Residents at Hal-Far are to use the pharmacy at Luqa). In this case you need to have a prescription from a doctor which you will take to the pharmacy together with the yellow or pink card. This medicine may be for a few days and/or prescription may have to be repeated every 2 or 3 months. Why no medications were prescribed? The doctor will decide on the best treatment for you, which may not involve any medications. Medicine may not be indicated because: many conditions can be cured without medicine, such as colds and other viral infections antibiotics (drugs to cure infection) are only prescribed if absolutely necessary There may be severe interactions between different medicines and have significant side-effects when taken together you may not need medicine! Many conditions can be prevented or cured by a simple change in lifestyle, such as giving up smoking, healthy eating and getting enough exercise. YOU MUST NEVER SHARE YOUR MEDICINES WITH OTHER PEOPLE 9 Referral to Hospital for investigations Your doctor or General Practitioner at the health centre may suggest that you need to be seen by a specialist for further tests or investigations which may be performed either at Mater Dei Hospital or Boffa Hospital. These may involve blood investigations, X-rays, CAT scans, mammogram, barium enemas, etc. Usually you will receive an appointment for such a test from the hospital. Please take time to read the instructions on the appointment form carefully. If you do not understand any part of it, you are advised to ask a health provider at your health centre. Appointments To avoid any disruption of the service you are requested to be on time.