Health Care Access among Asylum Seekers
Historically, migrants, particularly asylum seekers and refugees, experience several barriers when it comes to accessing health care and also face increased risks of various illnesses and health complications. Difficulties faced by refugees have intensified amid the COVID-19 pandemic and with the introduction of the Nationality and Borders Act, a piece of legislation that increases the standard of proof required to obtain permission to receive asylum and support in the U.K. By educating the public and advocating for vital policy changes, the U.K. is striving for improved health care access among asylum seekers and refugees.

An Interview with Dr. Dominik Zenner

Dr. Dominik Zenner is a general practitioner in London and also specializes in infectious disease epidemiology. Prior to this, he worked as the senior migration health advisor for the European Union and European Economic Area.

Dr. Zenner confirms the increased vulnerabilities of migrant populations to infectious diseases. He cites a systematic review from the 2018 Lancet Commission series on migration and health, which found that, on average, deaths from infectious diseases are higher among migrants than among native populations.

One can attribute these vulnerabilities to infectious diseases in part to migrants’ “origin and circumstances,” Dr. Zenner says. Furthering this vulnerability are barriers to effective treatment. According to Dr. Zenner, health workers in the U.K. may be “less familiar with some illnesses, including tropical diseases, risking a delay in diagnosis.”

The Pandemic

The COVID-19 pandemic has likely increased existing vulnerabilities in both direct and indirect ways. Even before the pandemic, many migrants were unsure of their health care entitlements and how to access health care. The WHO ApartTogether survey shows that during the pandemic itself, one out of every six undocumented migrants did not seek medical support for themselves or their household when suffering from COVID-19 symptoms. However, twice as many respondents with citizenship or permanency accessed health care services when faced with these symptoms.

Dr. Zenner names “closures and inaccessibility” as significant barriers to health care, specifically “the shift to teleconsultations,” which can be more difficult for migrants to access. A study by his colleagues revealed an approximate 20% drop in consultation rates for migrants during the first year of the pandemic. This stands in sharp contrast to the approximate 9% drop in consultations for non-migrants.

Housing and COVID-19

Poverty, housing and COVID-19 are also closely connected, with the COVID-19 mortality rate increasing for those from low-income backgrounds. The living conditions of poorer people, such as densely populated living spaces, increase the risk of COVID-19 transmission.

Dr. Zenner also discusses living conditions in refugee camps. These camps face “increased transmission of respiratory viruses, alongside decreased access to care, with high-density camps seeing the worst of this.” Some camps’ locations in remote areas may heighten risks, meaning that “emergency care and ambulances might not arrive there fast enough.” In general, Dr. Zenner states that camps are definitely “not ideal human habitats.”

The Nationality and Borders Act

The Nationality and Borders Act may exacerbate the health care access struggles faced by migrants. The act’s introduction of a higher burden of proof to gain refugee status could make it harder for asylum seekers to access health care support and security. Dr. Zenner highlights the concern of the increased difficulty gaining refugee status with these changes, which could lead to “adverse health outcomes and worse health care access for those seeking safety.”

Dr. Zenner’s travels and visits to refugee camps support his view that “health care access should be universal, not just in terms of legal eligibility but accessibility.” However, this is currently “not always the case for many migrants and definitely not for asylum seekers,” he says.

Roles and Responsibilities of the UK Government

Dr. Zenner says U.K. aid cuts have resulted in “research projects promoting our knowledge of infectious diseases being downsized or canceled, further limiting scientific advances.” He argues that access to care can be an even bigger issue than eligibility and that more signposting and support services for migrants are necessary. “The government should ensure that there is access to free care for everyone. We have witnessed tragedies; mothers unable to access maternity care and being criminalized when they can’t afford treatment. These tragedies are entirely preventable,” he says.

When asked about the U.K.’s divergence from WHO guidelines, Dr. Zenner says “for most areas, divergence is for good reasons.” For example, the U.K. has “conducted more TB screenings than initially recommended by WHO, but this turned out to be the right idea and set a precedent.”  In fact, the U.K. plays a key part in informing WHO guidance.

Provisions for Future Improvement

Some measures to improve health care among asylum seekers and refugees are visible in the U.K. These are available at a local level, from organizations offering mental health support services, and at a government level with the NHS Low Income Scheme, through which migrants and other disadvantaged groups can apply for financial aid to cover health costs.

Also, GP practices can register new patients without a passport and there is no obligation to ask for proof of immigration status. Doctors should not deny registration to those who cannot provide documents and the rules are flexible in this regard.

Dr. Zenner strongly feels that “the needs of migrants should be addressed as a matter of urgency,” not only to benefit individuals but also for public health reasons in general. This includes sustainable and robust funding and a recognition that there will be no equality until vulnerable communities receive sufficient support.

– Lydia Tyler
Photo: Flickr

NGOs in Turkey
Turkey has the largest refugee population in the world, hosting more than 3.6 million Syrian refugees and about 320,000 refugees from other countries. With mass amounts of people migrating to Turkey, there are several complications that must be accounted for, one being the issue of accessible education for those entering the country. Listed below are three NGOs in Turkey that have been helping refugees and local students access educational resources.

Darussafaka Society

Five young male scholars founded the Darussafaka Society in 1863 with the aim of providing quality education and resources to those in need. The Darussafaka Society provides scholarships and academic opportunities to children in need of financial aid or children who have lost a parent. Each year, 120 students receive opportunities from the Darussafaka Society. Its aim is to present equality of opportunity in education to its students, even though its students do not come from financially stable households. Darussafaka alumni have found successful careers in both the public and private sectors in Turkey. Many others have taken the opportunity to study and work abroad. As the Darussafaka Society boasts more than 155 years of experience, it is currently working to provide online learning options due to the COVID-19 pandemic, including international programs, through a virtual format.

Turkish Educational Foundation

The Turkish Educational Foundation (TEF) is one of the oldest educational philanthropic NGOs in Turkey, as it has been in service for about 51 years. Unique to the other NGOs, TEF is based in Berkeley, CA, allowing it to have more international connections and resources than foundations solely based in Turkey. TEF’s primary objective is to provide accessible education to those in need regardless of their ethnic or religious backgrounds. Each year, TEF supports 1,000 Turkish students with their programs. It offers several unique programs for international volunteers including a Youth Group which works to fundraise and communicate their message, and an English Learning Program where students can learn from English-speaking volunteers from around the world. TEF is currently working with its Youth Group to maintain the program’s success throughout the COVID-19 pandemic via virtual fundraisers and events.

The Imece Initiative

The Imece Initiative, one of the most prominent NGOs in Turkey, has been working since 2014 to provide education services specifically to Syrian refugees in Turkey. One of the Imece Initiative’s primary beliefs is that education should not undergo distribution based on a child’s ethnic background, but that education should be accessible to everyone. “We wanted to create a community free of political and religious considerations,” stated founder Ali Güray Yalvaçlı. “To give the opportunity for anyone, regardless of their background, to contribute with their skills and time to help those in need.” One of its most notable projects is The Solar Age Project, which supports women refugees in Turkey by teaching them life skills that help them in finding employment once they undergo establishment in the country.

With organizations like these, it is easy to see that there are lots of opportunities for both refugee and native students in Turkey to receive the best education possible. Though it can be easy to lose oneself in the negative effects of poverty in the world, organizations like the ones introduced above provide hope for a better future of education for all.

– Andra Fofuca
Photo: Flickr

Refugees in Iraq
Iraq has endured decades of armed conflict. Since 2014, around 3 billion families have experienced displacement. According to the United States of America for United Nations High Commissioner for Refugees (U.S.A for UNHCR), more than “6.5 million Iraqis…including 3 million women and girls, require humanitarian assistance and protection.” Maintaining a sense of normalcy is difficult, significantly, if war and political strife exacerbate this struggle for normalcy. Many refugees in Iraq are without power and often cannot afford to keep it on. Simple chores, like doing laundry, become arduous tasks that could take all day to complete. Thankfully, one man’s trip to India proved successful in alleviating the onerous obstacle of handwashing clothes.

Sawhney’s Development of Machines

Navjot Sawhney, whose parents fled from unpartitioned India, always had an interest in humanitarianism and helping those in need. He was first inspired to create the manually operated washing machines after watching his next-door neighbor struggle with her laundry in India. The woman’s name was Divya and, upon returning from his trip, Sawhney developed the plans to create something that would make someone like Divya endure less physical strain when doing laundry.

While only volunteering at the time, Sawhney relied on his former career in engineering to develop the hand-cranked washing machine named after his neighbor. The devices, named after Divya, undergo construction in the U.K. and weigh about 5.5 kg per unit. They also wash, clean and dry clothing. Sawhney eventually developed the Washing Machine Project in 2018 and has received orders from around 15 other countries. Among the countries receiving the Divya, Sawhney has been vigilant in providing a sufficient amount for the families of refugees in Iraq.

Impact of Washing Machines

The Divya’s functionality and convenience make laundry less of an all-day task for displaced families, especially women. According to Sawhney, the long-term goal of this invention was to give women of displaced families their time back, potentially granting them a greater opportunity for an education. In 2019, Sawhney and other Divya engineers traveled to Kurdish, Iraq, to donate the machines. The displaced families, particularly the women, reacted positively to the devices. Sawhney gushed, “We have developed partnerships with large international NGOs and a funding pipeline.”

Plans for Invention

Even though Sawhney’s sojourn inspired the Divya in India, it essentially has not rolled out in the country yet. Sawhney intends to distribute the Divya to other displaced families in India, Lebanon and Uganda, among other countries. With the machine relying solely on 10 liters of water, its small size and minimal requisites make it easy to transport to other countries. Its success in Iraq proves that this machine will make the lives of those abroad even more accessible.

The Divya is still a relatively recent technological and environmental innovation, but a quiet strength lies in its smallness. This little gadget turns something time-consuming into something trivial, showing the effects of small acts of kindness and concern for others and the significant impact on populations.

– Maia Nuñez
Photo: Flickr

Refugee CampsRefugee camps house people who had to migrate as a result of unsafe conditions in their home countries. Displaced people hve to leave everything behind in order to find safety. Recently, the United Nations reported that two refugee camps in Ethiopia were on the verge of running out of food. The refugees, dependent on organizations to bring them that food, were at risk of starvation.

What is Happening in Ethiopia?

Conflict has enveloped the Tigray region of Ethiopia. In November 2020, The Tigray People’s Liberation Front and the government began fighting. Two refugee camps in this region containing 24,000 refugees recently could not access aid. About 170 food trucks transporting the necessary food supplies ended up in the Afar region and were unable to move. Without these resources, the refugees will likely starve.

The United Nations High Commissioner for Refugees (UNHCR) is working to relocate the refugees. They are also trying to ensure safe travel out of the camp by discussing the issues with Tigrayan authorities.

The Increase of Refugees

The amount of refugees and displaced people around the world is higher than ever. As of 2020, the world had the largest refugee population ever recorded. About 25 million people experienced displacement, including 11 million children. This has only made conditions in refugee camps worse, as overcrowding compounds with a lack of resources.

The Problems with Refugee Camps

Displaced people who come to live in refugee camps often have nothing. They have no income, few to no possessions and no food. They rely entirely on what humanitarian organizations can provide for them. Unfortunately, what organizations can provide often falls short of what is necessary to survive. Two main problems that refugee camps deal with are inadequate food and water. The malnutrition and dehydration that occurs in refugee camps increase the risk of disease, like diarrhea and cholera, for the people living in the camps. Improving amounts and access to food and water will help to improve health conditions at refugee camps.

The UNHCR recommends at least 2,100 calories and 20 liters of water per person per day. However, in 2006, refugees in Tanzania received only 1,460 calories per person per day. A 1987 study of a Thailand camp showed that 30% of the camp’s population suffered from malnutrition. The UNHCR also estimates that more than half of the refugee camps across the world are unable to provide refugees with the 20 liters of water a day that they need.

Part of the problem with water is that it must also be accessible to all people in the camps. One way the UNHCR aspires to provide this is by ensuring there are water taps within 200 meters of every household. This way, individuals do not have to travel long distances to retrieve water, burning the already limited amount of calories they have.

Ways to Improve

There are a few things that can improve living conditions at refugee camps around the world. One important way is to begin to place a higher emphasis on making camps a long-term solution. When a refugee experiences displacement for more than five years, the UNHCR calls their situation a protracted refugee situation. Currently, two-thirds of refugees live in a protracted situation and the time they spend in this situation increased to 20 years. This means that more people live in camps for longer periods of time.

If displaced people are living in camps for such extended periods of time, then they are no longer temporary placements. This translates into a need to make refugee camps more permanent and more equipped to support people actually living there. The construction of more permanent housing, rather than tents, and fully functioning toilets and showers would help achieve permanent living conditions.

Camps can also allow refugees to set up businesses like barbershops and fruit stands. Some camps in Bangladesh currently allow refugees to farm patches of land to grow fruits, vegetables and spices. This is another way to increase food production and better conditions in the camps.

Looking to the Future

The struggle will continue to ensure that people living in refugee camps have enough resources to adequately survive and have livable conditions in camps. Transporting goods becomes especially difficult in war-ravaged regions. Roads are unreliable and food trucks are vulnerable to attack. Displaced persons, however, often have nowhere else to go and deserve for the world to put in its best effort toward helping them. This can begin with creating refugee camps as more permanent establishments, as cities and homes in and of themselves.

– Alessandra Heitmann
Photo: Flickr