At the height of the pandemic, the critical global message was “no one is safe until everyone is safe.” It referred to the common-sense view that vaccinating everyone was the only way to control COVID-19. However, vaccine inequity among the stateless presented a barrier to raising global vaccination rates.
In countries such as Montenegro, Lebanon and the Dominican Republic, vaccine inequity among the stateless was characteristic of the exclusion and marginalization that stateless people typically experience for reasons ranging from politics to discrimination. Other major reasons include administrative issues stemming from affected individuals lacking specific documentation.
Stateless people have historically suffered unequal access to health care due to systems that provide services based on nationality and faced disproportionate impacts of the COVID-19 pandemic. Vaccine inequity among the stateless presented a further devastating blow for some of the world’s most vulnerable people.
Vaccine Inequity in the Dominican Republic
Vaccine inequity among the stateless in the Dominican Republic existed due to a policy decision to exclude the affected individuals. In 2021, the president announced that only Dominicans would be included in the COVID-19 vaccination rollout, thus excluding illegal migrants or stateless people. The problem of discrimination and anti-Haitianism directed toward those born Dominican has been historically rife in the country. In fact, an overnight and discriminatory court decision in 2013 revoked the citizenship of Dominicans of Haitian descent. The court ruling stood as another example of furthering discrimination, even if it ran counter to the public health imperative.
However, several community responses echoed in unison to drive positive change. A community-based organization in the south of the country held persuasive talks with local government officials to convince the officials to consider residency status, name and age as sufficient for vaccination. Eventually, the localized vaccination distribution meant that some Dominicans without documentation could receive their shots.
Moreover, the Caribbean Migrants Observatory, a body set up in 2009 to facilitate migration and social development, also stepped in. Apart from developing the first migratory profile of the Dominican Republic, its advocacy talks with government officials led to a reversal in discriminatory vaccine policy and a subsequent commitment to universal vaccine access in the country.
Vaccine Inequity in Montenegro
Vaccine inequity has also affected the Roma community in Montenegro. A population at risk of statelessness, members of the Roma community face high fees for health care access during non-pandemic times. This is because Roma people are not on the official records for government health programs as they lack the required documentation.
The directive in the first stages of the vaccination rollout held that stateless people would be last in line to receive vaccines despite living in densely populated areas with significantly high risks of contracting the virus. Fortunately, following advocacy by the community-based organization Phiren Amenca, which emerged in 2012 to advocate for the rights of the Roma community, the new government changed the policy.
The government placed community members in a priority group, adding that all residents, regardless of citizenship status and health insurance, could receive the vaccine. Further clarifications revealed that this new development also included those in the process of resolving their legal status and those without legal documents. Phiren Amenca has also succeeded in extending the deadline for the registration of Roma people. A Roma doctor also visited a settlement to educate the community on the importance of vaccination and to deliver vaccine shots.
Vaccine Inequity in Lebanon
Vaccine inequity among stateless people in Lebanon existed primarily due to administrative issues. Oummal, a community-based organization set up in 2010 to provide universal health coverage that includes stateless people, had an eye-opening discovery. It found out, through community interviews, that stateless people could not register to receive the vaccination as no category existed for ‘no nationality’ on the registration portal. Furthermore, a lack of awareness about the importance of vaccination alongside fears of hospitalization and its associated costs stood as issues.
Oummal advocated for the inclusion of a ‘no nationality’ category on the registration platform. The organization set up a vaccination hotline for inquiries on documentation and vaccination. It also accompanied people to get their documents and receive vaccinations. Lastly, another resolution came about by waiving hospitalization costs for stateless people after meetings with the Ministry of Health. Oummal supported about 1,500 people, 1,068 of whom registered for vaccinations. The dedicated hotline for stateless people received 134 calls and the organization recorded 63 cases to follow up on regarding documentation and vaccination.
Advocacy and Community Work
Stateless people suffer from exclusion and discrimination, but the costs of exclusion during a global pandemic are far higher. Several countries excluded stateless people from accessing vaccines due to discrimination, lack of documentation and administrative issues. However, the influence of community work and advocacy resulted in the vaccination of many stateless people.
– Ottoline Spearman