Location:
22 French cities (Calais, Valenciennes, Strasbourg, Nancy, Besançon, Lyon, Grenoble, Nice, Ajaccio, Aix-en-Provence, Marseille, Montpellier, Toulouse, Pau, Bordeaux, Angers, Nantes, Lorient, Rouen, Le Havre, Paris, La Plaine-Saint-Denis, Cayenne).

Context of intervention:
Migrants have become scapegoats and are held responsible for all economic evils and social tensions. Recent legislation on immigration makes life on French soil harder: increasing requirements for asylum requests, reversal of the policy allowing regularisation for medical reasons, and edicts that recommend questioning irregular migrants even in healthcare centres. Access to free healthcare in hospitals is still problematic: many PASS (healthcare access offices) are not operational, and the regulation enabling urgent treatment excludes a high number of people who cannot therefore access healthcare.

Objectives:
Doctors of the World France offers consultations, spreads prevention messages and refers migrants to partners and public health services. Testimony on the living conditions of this population can help to slow down the process that is taking these rights away from them. Closely linked to the analysis of social and medical data recorded by each healthcare centre, these testimonies contribute to the project activity reports and to the lobbying of relevant institutions.

Activities:
The CASOs provide general and specialized health care: dental, psychiatry, ophthalmology, dermatology, gynaecology. The teams adapt their approach to the specific care demands, to enable an easy and qualified access to specialised consultations. Moreover, they work together with the population for the re-establishment of their access to the National Health System.

The healthcare and orientation centres cover consultations and the broadcasting of preventive information. Doctors of the World France acts as well as a "footbridge" and directs asylum seekers towards mainstream health services or other organisations. Also, psychological help is available for the migrants, who often have a difficult pathway behind them.  Doctors can write medical certificates, testifying of wounds or bad treatments, in order to back up an asylum request.

Collected testimonies about migrants' living in dire conditions, red tape for regularisation, and difficulties to find an accommodation are ground material for advocating migrants' rights to healthcare.

In 2006, following the example of Paris and Marseilles CASOs, the centres in Lyon, Rouen, Saint Denis and Toulouse set up specific HIV/STI prevention and screening programmes. 24 092 patients, of which 16 573 were new, visited our CASOs in 2007, and 61 979 consultations were carried out.  

Beneficiaries:
22% of the patients who come to a CASO for the first time are asylum seekers. 89% are foreigners, and 72% are in a precarious administrative situation. 98.7% of the patients have a level of resources below the poverty line. 64.2% of the patients are jobless. 22.3% of the patients are concerned by asylum request.