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How Has the Refugee Crisis Situation Impacted Their Health Delivery Capacity

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In its 140th session in January 2017, the Executive Board requested that its Secretariat develop a framework of priorities and guiding principles to promote the health of refugees and migrants

In May 2017, the World Health Assembly (WHA) endorsed resolution 70.15 on ‘Promoting the health of refugees and migrants’.

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In the wake of the rise in migration, many European countries have focused their policies on minimising and containing new arrivals – seemingly forgetting, or indeed ignoring, their duty to protect and care for people. For the hundreds of thousands of people who are travelling through Europe, access to even basic healthcare is often extremely limited. Since the crisis began, the medical charity Doctors of the World has run clinics with volunteer clinicians along the migration routes, from the Greek islands all the way to Calais, for refugees and we have seen how people's healthcare needs have changed and developed over time

Problems that our volunteer medics see range from skin and breathing problems to chronic conditions such as diabetes, pregnant women unable to access any kind of antenatal care and people who have been victims of police brutality. According to the World Health Organization (WHO), the most common health conditions seen in refugee camps include hypothermia, burns and gastrointestinal illnesses. There is a high incidence of upper respiratory tract infections within the population that our medics encounter, often as a result of the damp and poor sanitary conditions, which lead to the spread of viruses and bacteria. Smoke from open fires is a risk factor for respiratory complications, lung cancer and cardiovascular disease. Skin conditions, including scabies, and the spread of parasites due to a lack of washing facilities and clean bedding are widely reported.

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Despite the greatly increased numbers of migrants and refugees worldwide in recent years, insufficient attention has been paid to addressing their health needs. While a variety of international instruments assert the right to health, in practice, migrants and refugees—especially those awaiting clarification of their status, such as asylum seekers and those without documentation—often fall in cracks between service providers and humanitarian relief programmes at national and regional levels

Moreover, the study reported that there was a tendency in many European Union (EU) Member States to restrict entitlements of undocumented migrants to health services ‘to discourage the entry of new migrants’, with nine of 27 EU countries in 2010 restricting access to health services for undocumented migrants so that emergency care was inaccessible, only five offering them access to health services beyond emergency care and only four [Netherlands, France, Portugal and Spain] affording them entitlement to access the same range of services as nationals of that country [as long as they met certain pre-conditions, such as proof of identity or residence]. Against this background, it is urgent to understand the nature of migrants’ and refugees’ health needs and the barriers that exist to meeting them, to learn from the successes and failures of different approaches and to develop new ones where required (Wild V, Zion D, Ashcroft R. H., 2015). The urgency is not only for knowledge and good practices in service provision, but also for policies that provide an effective framework for action in conformity with the UN Declaration, while engaging with and attracting broad support from the population. Running through all such practices and policies must be strong threads of humanitarian assistance and equity (McKee M., 2012).

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All things considered, legal entitlement, however, does not guarantee access, and even where entitlements are established for certain migrant groups and regulations permit access, further barriers may exist in terms of the organization of health care, unawareness of entitlements by health care providers and beneficiaries, limitations of health staff expertise, linguistic and cultural barriers, and the wider governance of migration.

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Jakab Z. Foreword. In: Bradby H, Humphris R, Newall D, Phillimore J, editors. Public health aspects of migrant health: a review of the evidence on health status for refugees and asylum seekers in the European Region. Health Evidence Network synthesis report 44. Copenhagen: WHO Regional Office for Europe; 2015. p. vii.

McKee M. A preface: how ethics failed: lessons for public health for all time. Public Health Rev. 2012

Wild V, Zion D, Ashcroft R. Health of migrants: approaches from a public health ethics perspective. Public Health Ethics. 2015;8(2):107–109.

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