Upload
tzoutzoukina
View
227
Download
0
Embed Size (px)
Citation preview
8/12/2019 Migrants Health v1
1/36
PROTECTING IMMIGRANTS
HEALTH: RECENT PROGRESS
PANOS EFSTATHIOU, MD, Ph.D.
NATIONAL HEALTH OPERATIONSCENTRE COMMANDER
8/12/2019 Migrants Health v1
2/36
The establishment of the migrants
detention centres was the best way to
reduce and gradually abate the
negative impacts of thousands illegalmigrants in Greece.
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
3/36
IMMIGRANTS IN GREECE
The vast majority of immigrants in Greeceremained undocumented until the firstlegalization process in 1997-1998.
The main features of this migration periodwere:
informality
temporariness employment in the "informal" economy and
mass deportations
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
4/36
IMMIGRANTS IN GREECE
In our country live between 800,000 to1,000,000 foreign nationals amounting
to 7.3% of the total population.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
5/36
IMMIGRANTS IN GREECE
More than half are coming from Albaniaand an additional 16.2% from Central andEastern Europe and the former SovietUnion.
In recent years we have seen a largeinflux of immigrants from Asian countriesand the Middle East
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
6/36
IMMIGRANTS IN GREECE
In Greece, the legal term foreign"refers to all those who do not have the
Greek nationality, but essentially it is
used only for third countries nationalsexcluding EU citizens
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
7/36
CATEGORIES OFFOREIGNERS IN GREECE
Foreign citizens who live and work in Greece and
have residence permits
Foreign citizens who live and work in Greece and
DONThave residence permits
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
8/36
CATEGORIES OFFOREIGNERS IN GREECE
Asylum seekers
Refugees who live and work in Greece
Repatriated Greeks of Greek origin
Unaccompanied underage migrants
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
9/36
IMMIGRANTS HEALTHPROFILE
Tuberculosis1
2
3
Hepatitis
HIV/AIDS
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
10/36
IMMIGRANTS HEALTHPROFILE
Scabies4
5
6
Suicide Attempts
Chronic Health problems
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
11/36
IMMIGRANTS HEALTHPROFILE
IMMIGRANT
Stress Somatization
Emotional
disorders
Psychotic
disorders
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
12/36
PROBLEMS SOURCE
1. Detention of unaccompanied minors - often in the
same places as adults.
2. Detention of people from war zones - such asSyrians - with serious psychological burden, such as
post-traumatic stress syndrome.
3. Failure of the State to provide the continuity ofongoing health interventions with many months
discontinuance that causes immigrants limited
access to health care
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
13/36
PROBLEMS SOURCE
4.Serious obstacles to interface with local health units.
5. Lack of procedures for the initial assessment of themedical situation of newcomers immigrants.
6. Lack of provision for the immediate lifting of the
detention process for serious medical incidents.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
14/36
PROBLEMS SOURCE
7. Lack of a monitoring system from the appropriate
local health authorities (Regional Directorates of
Public Health) with on-site visits in order to
safeguard public health.
8. Lack of proper interpretation services resulting
inadequate provision of psychosocial and other
services, such as information services.
9. Big detention time
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
15/36
IMMIGRANTS IN GREECE
A special category comprises
of immigrants and asylum
seekers accommodated in
detention centers.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
16/36
NATIONAL HEALTH SYSTEM (NHS)
Access of immigrants to the NHS, is a key aspect of their
integration in Greek society.
Immigrants of Greek origin (expatriates), can benefit from
public health services if they provide the necessary
documents.
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
17/36
NATIONAL HEALTH SYSTEM (NHS)
Refugees and asylum seekers enjoy
equal rights and access to healthcare as
the Greek citizens
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
18/36
NATIONAL HEALTH SYSTEM (NHS)
Access to the NHS
Is not allowed
When it comes to minors and foreigners imported
urgently for hospitalization there is an exception to the
rule (Law 3386/2005/Article 84)
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
19/36
IMMIGRANTS IN GREECE
For issues of detention, safety, hygiene, and
preservation of normality, it is necessary to
apply a serious, scientific and humanitarianappropriate program to address theproblem.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
20/36
IMMIGRANTS IN GREECE
In most cases, immigrants and especially
immigrants progenies, lack access tohealth services and education and areexposed to acts of violence against them.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
21/36
Detention Centres
must have:
Residency
Infirmary
Area of staff residence
Restrooms
Restaurant
Places of religion worship
Fire department
Sports field
Entertainment
8/12/2019 Migrants Health v1
22/36
DETENTION CENTRESMUST HAVE
The installation must havetriple link fence (NATO type)
of 3 metres in height
Custody Cleaning
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
23/36
The role of supportive social networksand non-governmental organizations(NGOs) is of great importance
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
24/36
Following a request from the Ministry of
Public Order and Citizen Protection, theNational Health Operations Centre
(EKEPY) of the Ministry of Health,
undertook the health coverage of
migrants detentions centres.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
25/36
INSIDE
THE DETENTION CENTRES
Prevention
Hygiene
Information
Comprehensive immigration policy
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
26/36
MAIN PURPOSE
The purpose of the EKEPY Operational Plan
is the recording of actions (interoperability)for Integrated Healthcare support at the
detention centres which are under the
jurisdiction of the Police
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
27/36
ASSUMPTIONS
1. The immigrants detention centres withinthe Greek territory are in specific areas
(former military camps and other
buildings), and they can provideaccommodation and safety facilities.
2. The security of these centres is under
the responsibility of the Police
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
28/36
ASSUMPTIONS
3. In Immigrants Detention Centresthere are facilities of water and
electricity without major technical
problems.4. The Detention centers have telephone
lines and alternative communication
options.
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
29/36
ASSUMPTIONS
5. Feeding of immigrants is provided seamlesslyunder Polices care.
6. The transportation to and from the centres isunder the responsibility of the Police
7. With concern of the Police there is atranslator in each detention centre
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
30/36
OPERATIONAL PLAN BASIC PRINCIPLES
Health coverage of immigrants is under
the responsibility of the State and is one
of the main principles concerning human
rights as laid down by the World Health
Organization.
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
31/36
HEALTH COVERAGE
LEVELS
1. Health Coverage in the detention centre
2. Health Coverage out of the detention centre
3. Special Health Coverage procedures
http://www.avramopoulos.gr/yykanew.jpghttp://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
32/36
HEALTH COVERAGE
IN THE CENTRE
Medical station A Type
Medical station B Type
Medical station C Type Medicines and other health products
for each station type
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
33/36
HEALTH COVERAGE
OUT OF THE CENTRE
Epidemiological surveillance
Medical transfer
Laboratory tests
Nursing
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
34/36
SPECIAL HEALTH COVERAGE
PROCEDURES Psychological & Psychiatric
Support
Preventive medicine Vaccinations
Communicable diseases
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
35/36
E.K.EP.Y Health Support
Management Team for DetentionCenters in Athens and Macedonia
and Thrace
http://www.avramopoulos.gr/yykanew.jpg8/12/2019 Migrants Health v1
36/36
The whole project is financed
by the European Return Fund
http://www.avramopoulos.gr/yykanew.jpg