Uncategorised

UK’s human rights regulator calls for “clear separation” between immigration policies and healthcare

UK’s human rights regulator calls for “clear separation” between immigration policies and healthcare

Published 29th November 2018

Drawing on research coproduced with Doctor of the World and Imperial College London, the Equality and Human Rights Commission (EHRC) called on the Government to stop sharing NHS patient data with the Home Office and to end the policy of charging refused asylum seekers exorbitantly high costs to access healthcare in England.  The regulator argued that a separation between healthcare and immigration enforcement was needed in order to uphold the UK’s human rights obligations.

 

Rebecca Hilsenrath, Chief Executive of the Equality and Human Rights Commission, said:

“People seeking and refused asylum are likely to have particular health needs because of past distressing experiences and the traumatic effects of fleeing to a different country. It’s therefore crucial that they are able to fully and easily access healthcare and that their rights are protected by keeping healthcare separate from immigration enforcement. This is just about common humanity.”

 

Dr Katherine Taylor, a GP and health advisor for Doctors of the World, said:

“Everybody within society needs to have access to healthcare. It’s not just a matter of human rights and dignity, it’s basic common sense. Pregnant women need to see a midwife, children need vaccinations and people with chronic conditions need a GP. We know that for the NHS it is cheaper and less resource intensive to see patients early on, to provide preventative healthcare and treat chronic diseases before people develop complications.  Policies that prevent people from accessing NHS services just cause more problems in the long term.”

The research, which looked at the experiences of people who have been through the asylum system, showed NHS charging regulations and the policy of sharing NHS patients’ data with the Home Office stopped people getting the healthcare they need and undermined trust in health professionals and services.

 

A woman in London who had been refused asylum said: “I still have that fear they might contact immigration and they’ll come get me … It’s not just a fear about going to a surgery – it’s about being traumatised … When I found out I was pregnant, I was really frightened.  I had no money. I decided I would keep my pregnancy secret and get an abortion.”

 

Asylum dispersal policy – the policy of moving asylum seekers outside of London and South East England – was found to interrupt and delay access to healthcare, causing particular problems for pregnant women or people with complex health needs. One individual was relocated shortly after having extensive heart surgery, despite objections from her cardiologist.

 

Many asylum seekers are unable to afford the costs associated with healthcare such as travel and prescriptions. For example, a pregnant asylum seeker who needed frequent hospital check-ups faced travel costs nearing £20, whilst another individual spoke of only being able to afford food or prescription costs: “My husband often didn’t take his medication. Because he didn’t want to swap it for food. I think a lot of his conditions now are in a really bad state.”

Disabled people, people with mental health conditions, and women, including pregnant women, were more severely impacted by these barriers

The EHRC also recommended that:

  • all women have free access to pregnancy and maternity services, and all family planning services
  • asylum seekers right to work is extended or that Home Office financial support is increased.

The Equality and Human Rights Commission is the regulatory body responsible for promoting, monitoring and enforcing equality and human rights legislation in Great Britain and is recognised by the United Nations as a National Human Rights Institution.

 

Doctors of the World has been chosen by The BMJ for its Christmas appeal

Doctors of the World has been chosen by The BMJ for its Christmas appeal

Published 28th November 2018

The British Medical Journal is supporting the life saving work  of volunteer doctors who help the most vulnerable patients wherever they are; from Bangladesh to Bethnal Green, from Yemen to the Ukraine and much more.

Your donation to the BMJ Christmas Appeal could feed families in Yemen, or help pregnant women give safe births in the UK, or Syrian refugees with mental health services in Jordan. Making sure nobody suffers or dies because they can’t access health care.
Thank you
Why are we raising funds?

We believe that nobody should suffer or die because they can’t access healthcare. Yes, many people, at home and abroad, still need our help to be able to get treatment or health advice. We rely on individual donations to continue providing emergency and long-term care to vulnerable people around the world. Just this year, thanks to our supporters we were able to provide help to emergencies in Gaza, Greece, Croatia, and Yemen.

In the UK, we are struggling to meet the demand for our help. Every day, we see people in vulnerable circumstances, including pregnant women and children. However, this is still the tip of the iceberg, and much has to be done in London and the rest of the country to help people access healthcare.

 

What do we do?

Doctors of the World is an independent humanitarian movement working at home and abroad to empower the most vulnerable people to access healthcare.

We help victims of conflict and famine abroad, and those who have fallen through the cracks at home.

Our network has 350 projects in 80 countries. Whether it’s providing urgent medical care in Ukraine, giving mental healthcare to refugees in Calais, or strengthening health systems in west Africa, we meet the health needs of vulnerable people globally.

In the UK, we run clinic and advocacy programmes in London that provide medical care, information and practical support to excluded people such as destitute migrants, sex workers and people with no fixed address.

 

 

 

Day Three #SafeBirths – Jennie

Day Three #SafeBirths – Jennie

Over one year on, the government resists calls for transparency over harmful NHS charging regime 

 Jennie is the UK Policy and Advocacy officer at Doctors of the World.

 

The NHS is one of the most restrictive healthcare systems in Europe for migrants, with pregnant women, children and migrants on low incomes losing out the most, comparatively.   

Since last year’s introduction of upfront charging and ID checks in secondary care (e.g. hospitals) in England, barriers have increased further still for migrants in vulnerable circumstances.  

The NHS charging regime means that people who cannot pay inflated fees* in full have non-urgent treatment withheld.  

At the Doctors of the World clinic, we regularly see how fear, administrative gatekeeping and poor practice prevent vulnerable people with urgent medical conditions from accessing the healthcare they need.  

Pregnant women are a particular concern, as many women are too afraid to attend antenatal checks after receiving threatening bills they can’t hope to pay. This fear is made even worse by the fact that hospitals report unpaid bills to the Home Office to be used against patients in future immigration applications and potentially threatening their ability to remain in the UK. 

 

“Sometimes I can’t sleep at night” 

Even though the government ploughed ahead with the charging rules without any adequate assessment of their impact on vulnerable groups, pilots of routine ID checking were carried out in 20 English hospital trusts.  

While the publication of an independent evaluation of these pilots was expected in December 2017, the government continues to resist calls to release any findings.  

As part of the pilot evaluation, we shared eight cases from our clinic of pregnant women who had who accessed maternity services involved in the pilots. Most of the women were over 20 weeks pregnant and one was full term, without ever having accessed antenatal care. Together, they demonstrate clearly how fear of debts and being reported to the Home Office and stressful, often hostile, questioning about their immigration status prevent or delay timely treatment.  

Two women required five consultations each with Doctors of the World caseworkers to encourage them to attend their hospital appointments. One woman, at 24 weeks pregnant, was (wrongly) told she would have to pay £6,500 before she could get an appointment. Another woman, a survivor of trafficking, worried how the stress caused might affect her baby:  

“This is too much for me. Sometimes I can’t sleep at night.” 

Like other measures under the ‘hostile environment’ agenda, the rules inevitably also impact on those who are fully entitled to NHS services, but because of their membership of a migrant or ethnic group, face discrimination. The case of Albert Thompson, who broke the Windrush scandal when he was denied cancer treatment, demonstrates how relying on hospital administrators to assess immigration status leads to ill-informed gatekeeping, with potentially life-threatening (and certainly discriminatory) consequences.  

 

We demand transparency  

 

Cases like the ones described above and that of Albert Thompson demonstrate the complex impacts of these rules. To maintain patient safety, prevent discrimination and effectively safeguard vulnerable individuals, a transparent understanding of the intended and unintended consequences of these new restrictions to healthcare access is essential.   

Numerous MPs, including David Lammy and Caroline Lucas, have demanded the release of the pilot evaluation findings, but to no avail. We call on the government stop obscuring the impact of their policies on some of the most vulnerable people, to prioritise patient health and wellbeing and to demonstrate their commitment to preventing a repeat of the injustices done to the Windrush generation by publishing the evaluation report without delay.  

 

*Charges are levied at 150% of the NHS tariff for any given service. 

Day Two #SafeBirths – Sarah

Day Two #SafeBirths – Sarah

Published 27th November 2018

They are living in our communities

Sarah is a registered GP and volunteers in Doctors of the World’s clinic.

I have a portfolio career, having worked part time in general practice for the past twenty eight years, first in inner city Edmonton and latterly in leafy Winchmore Hill. My main job is in contraception and sexual health in Barnet.

 

As my children are now grown up I wanted to give something back to the community and working in the Women and Children’s clinic with Doctors of the World fulfils a bit of that need in me.

 

The clients I see are almost always pregnant, having been in the UK undocumented for several years. They have managed to get by with the limited healthcare provision they can source from their friends, or have pharmaceutical items delivered from their families back home in their own countries.

 

Pregnancy, however, means that UK healthcare is essential and in almost all cases, unaffordable. It also means that they have to share their details with authority, facing the anxieties of being deported.

 

They come from all over the country to Doctors of the World’s clinic, having been told about it usually by friends. A lot of the work that the Case Support Workers do is to reassure them as much as possible that their records will not be shared with the Home Office (although with new changes in the law this anxiety may no longer, sadly, unfounded).

 

One young woman I saw recently was in severe distress. She had outstayed her visa from her East African country, because she had told her family she is lesbian. She was denied all contact with her 4 year old daughter in case the child ‘learnt her ways’ and had death threats from her family. She felt that her only option was to stay in the UK, with her partner, in crowded conditions living hand-to-mouth with the little money she could get from child care.

 

These women rely entirely on the good will and knowledge of others who have come to the country before them. If the ‘sponsor’ turns out to be a pimp or abuser, the women are helpless.

 

We try to help our clients when they get to us, to provide them with a more reliable knowledge base, access to primary care, and signposting to legal services where needed. They are living in our communities, unknown and under the radar, without the commodities we take for granted.

Day One #SafeBirths – Bettina

Day One #SafeBirths – Bettina

Published 23rd November 2018

The Women and Children’s Clinic – A Midwife’s Perspective

Bettina is a volunteer midwife at the Women and Children’s Clinic in our London Clinic. She is a qualified midwife and has been with Doctors of the World for a number of years.

 

As a midwife the fact that the simplest definition of the word is to be “with woman” means a lot to me. It was a key factor in my decision to choose midwifery as a career and to this day prospective midwifery students will probably not get a training place unless they mention “women-centered care” a couple of times during their interview.

I started working as a midwife full of enthusiasm but after fourteen years in a maternity setting, I was exhausted and disillusioned. I found it increasingly difficult to simultaneously support two (and sometimes three) women in labor or feel I had given adequate care on the postnatal ward which, when full, housed 24 new mothers and an equal number of babies.

I bailed out, did a Master’s degree and then worked as a research assistant in a teaching hospital. However, something stopped me from relinquishing my midwifery qualification and I continued with the mandatory training and the required number of practice hours, working part-time as a midwife in the antenatal clinic.

I had been volunteering with Doctors of the World for some years when in 2014 we started the Women and Children’s Clinic to respond to the large number of pregnant women and families arriving at the Bethnal Green Clinic. It seemed natural to me to gravitate towards this new clinic.

At the DOTW clinic, midwives practice in an advisory capacity rather than a clinical one. Although it initially felt a little strange not being able to do blood pressures or abdominal palpations, I have always felt that the essence of good midwifery has less to do with the physical aspects of the job and more to do with the midwife’s responsibility to protect, nurture and care for mothers and babies.

Caring is what we do best at the Women and Children’s Clinic, especially caring for the often vulnerable and destitute Black, Asian, Ethnic Minority (BAME), women, mostly from migrant or refugee backgrounds, who form the majority of people coming through the door. These women have remained hidden from both voluntary and statutory services until pregnancy forces them to seek help to access NHS maternity care.

Unfortunately, the NHS fails these women to a large extent. For one, there is the looming presence of maternity care charges that many vulnerable migrant and asylum-seeking women are subjected to. Time and time again we see pregnant women at the clinic who delay accessing or avoid visiting hospitals altogether for fear of incurring huge debts that they cannot pay. There is also a very real fear that having an unpaid maternity care debt will result in being reported to the Home Office. NHS charges maternity care in England -inflated to 150% of the NHS tariff- are truly exorbitant.

Nowadays, bills of £6000 for the basic maternity package (i.e. for an uncomplicated pregnancy and delivery) are the norm. Often they are much higher. One of the more shocking cases I recently dealt with concerns a lady who was sent a bill of £9600 soon after her 22 week miscarriage.

Midwives are taught that it is the pregnant woman who should be the focus of maternity care, that the woman should be able to feel that she is in control of what is happening to her and be able to make decisions about her own care and needs. As a midwife, you can’t help but notice the stark contrast between the typical maternity journey of a British woman, who will generally be in the driver’s seat with an understanding of the principles of choice and control which underpin antenatal care with that of the migrant women who come to DOTW, often with little English and knowledge of their rights, will be very different. Frequently, our service users attend the clinic in the second or even third trimester of their pregnancy and have never heard the baby’s heart beat.

 

For many, the prospect of giving birth in the UK is one of stress and fear. The pregnant service users that attend the Bethnal Green clinic often cry. A feature of the clinic are the strategically placed boxes of tissues which need frequent replacing.

 

Apart from a place where there is literally a shoulder to cry on, our Women and Children’s clinic supports pregnant service users in many ways. Volunteers try to assist migrant women overcome the barriers they experience when accessing maternity services. They signpost them to debt management charities when the maternity care bill lands on the mat. Most importantly, they communicate with the service user in their first language, using phone interpreting services.

Apart from all of that, there are two key things that make the Women and Children’s Clinic such a special service and unfortunately our patients often can’t get them elsewhere: the use of interpreters and the flexible time allowed for consultations. I’ve seen how in some NHS hospitals, interpreters are only rarely or inconsistently used, meaning that mother and midwife struggle to communicate. As for time, it is so important to be able to take those extra moments with a mother traumatised by a previous birth experience, or with a woman confused about pain relief in labour – a honest, empathetic conversation always wins over a leaflet, however well designed.

 

It is because I know I have the time to care at the Women and Children’s Clinic that you will find me most Tuesdays on the Central Line heading to Bethnal Green. I know that at the clinic I can truly be “with woman”; that I can be a midwife.

 

Read also:

Day Two: Sarah

Day Three: Jennie

Day Four: Pratheep 

Day Five: Rhiannon 

Day Six: Ellen

Day Seven: Durga

 

The Big Give Christmas Challenge 2018

The Big Give Christmas Challenge 2018

Published 16th November 2018

From 12pm on Tuesday 27th November, Giving Tuesday, to 12pm on Tuesday 4th December, every penny donated to Doctors of the World will be doubled!

Any money donated before 27th November will not be doubled.

This year, Doctors of the World UK is taking part in The Big Give Christmas Challenge. We aim to raise £7,500 to be matched to a total of £15,000!

The Christmas Challenge is the UK’s biggest online match funding campaign helping charities raise funds for their cause. During this week, we will be able to double donations made on our The Big Give page with match funds.

The Challenge will make a massive difference to our work, and the funds raised will be used to support our project with refugees and migrants in the UK.

What will the funds be used for?

  • To increase outreach and take the mobile clinic to three new location
  • To expand our clinic to another city, providing nationwide support
  • To support our advice line and improve support to our service users

If you would like to donate to Doctors of the World, The Big Give Challenge will allow your money to go even further!

If you have any questions, don’t hesitate to get in touch with us at supporters@doctorsoftheworld.org.uk.

Frequently Asked Questions

Can I donate directly to Doctors of the World as part of The Christmas Challenge?

Unfortunately, no. All donations need to be made online via The Big Give at the following link.

What payment methods are accepted?

Payments are processed by Charities Trust, who require all donations to be made online via credit or debit card.

How do I know that my donation is doubled?

As long as you donate on our project page between 12pm on Tuesday 27th November and 12pm Tuesday 4th December, your donation will be doubled. Once we reach our target amount of £7,500, your donation will be added to the pot but not doubled.

Doctors of the World’s statement on Legal Victory to #StopSharing patient information

Doctors of the World’s statement on Legal Victory to #StopSharing patient information

Published 12th November 2018

UPDATE: Since this morning’s news that a controversial information-sharing agreement will be withdrawn, Government has now announced it is already working on a new deal to share patient information for immigration enforcement.  A Home Office spokesperson said: “We continue to work with NHS Digital on a new memorandum of understanding to enable us to make requests for non-medical information about those facing deportation action because they have committed serious crimes.” Leading medical bodies oppose the sharing of patient information for immigration purposes and there is plenty of evidence to show that it is dangerous both to individuals and public health, but still the Home Office is determined to exploit NHS records. Doctors of the World will continue to challenge any agreement that threatens the safety and confidentiality of our healthcare services.

The Government has agreed to drop a controversial agreement that allowed NHS Digital to share patient information with the Home Office to track down migrants. The decision follows legal action, taken by Migrants’ Rights Network and Liberty with NHS Digital, one of the parties to the agreement, confirming to the court it will withdraw from the information-sharing deal.

The decision marks the end of a government policy to use information, collected by NHS staff in NHS services, to support immigration enforcement. Irregular migrant patients, including refused asylum seekers, will now be able to access NHS primary care services without their home address being passed onto the Home Office, and running the risk of being put into detention and deported.

“Common sense and ethical medicine have won the argument. Many lives will be improved, even saved, as a result” said Dr Peter Gough, an NHS GP and Trustee of Doctors of the World (DOTW), welcoming the news:

At DOTW clinics we see people too frightened to see a doctor or midwife because they are scared it could lead to them being reported to the Home Office, and then returned to an unsafe country. This includes people who have fled war, conflict, persecution or brutal traffickers, people who are looking to the UK for protection. Now they can go to a GP safe in the knowledge that confidentiality will be respected.

The #StopSharing campaign

The change in policy comes after intense campaigning by Doctors of the World and other charities (including the National AIDs Trust and Liberty) which gained support from cross-party MPs and medical bodies.

Doctors of the World’s #StopSharing campaign mobilised over 70,000 people and saw a van spoofing Theresa May’s “go home” vans drive though Westminster and Whitehall as doctors, nurses and midwives campaigned outside the Home Office. Dr Peter Gough, NHS GP and Trustee of Doctors of the World:

We are grateful to Liberty, the Migrants Rights Network, Dr Sarah Wollaston MP, and all who supported the Campaign.

Following an inquiry into the information-sharing agreement, the House of Commons Health & Social Care Committee, led by Dr Sarah Wollaston, called on NHS Digital to immediately stop sharing patient details with the immigration authorities. The British Medical Association[1]and the Royal College of GPs[2] expressed deep concern about the Government’s approach to sharing confidential patient information.

The Government had previously said it would amend the arrangement between the Home Office and NHS Digital so it would only apply in cases (or suspected cases) of serious crime. 

Immigration enforcement and the NHS

NHS Digital has a history of sharing patient information with the Home Office to support immigration enforcement. In 2016 the Home Office made over 8,127 requests for information, which led to 5,854 people being traced by immigration teams.

In early 2017 sharing NHS patient information for immigration enforcement became official government policy when the Department of Health and NHS Digital signed a Memorandum of Understanding with the Home Office, allowing immigration officials to request patients’ non-clinical information (including home address, date of birth and GP’s details).

Anyone in need of healthcare but too afraid to go to the NHS can contact Doctors of the World UK on 0207 0789629 for free and confidential healthcare and advice.

A call for peace in Yemen

A call for peace in Yemen

Published 8th November 2018

IT IS URGENT TO ACT FOR YEMEN

As human rights and humanitarian organisations working in Yemen, we welcome the unprecedented gathering of elected representatives from all over the world in Paris on the occasion of the first International Parliamentary Conference for Peace in Yemen, to demand that their governments work together to end the crisis. 14 million men, women and children face famine in Yemen – half of the country’s population. More than ever, it is urgent to act.

14 million men, women and children face famine in Yemen

We call on governments to ensure an immediate cessation of hostilities, to suspend the supply of weapons that can be used in Yemen, to guarantee the free access and free movement of vital imports for the Yemeni population, to condemn any attack against civilians and other violations of international humanitarian law by any party and to support international investigations of such violations, including the work of the Group of Eminent Experts of the United Nations on Yemen.

RESPECT INTERNATIONAL HUMANITARIAN LAW IN YEMEN

The events of recent weeks have added to a series of examples of Saudi Arabia’s non-compliance with the rules of the international system and have again highlighted the need for the international community, particularly the United States, UK and France, to re-evaluate their partnership with Riyadh. Any arms supplier to the coalition led by Saudi Arabia and the United Arab Emirates has the moral and legal responsibility to ensure that the coalition respects international humanitarian law in Yemen. Given the unlawful attacks on civilians by all parties to the conflict, widely documented by the Group of Eminent Experts of the United Nations ,citizens around the world reiterate the call we have been making for years to all governments to suspend arms transfers that may be used in Yemen.

We call once again on governments to suspend arms transfers that may be used in Yemen. © Reuters We call once again on governments to suspend arms transfers that may be used in Yemen. © Reuters

CRISIS IN YEMEN: SEVERE RESTRICTIONS

The humanitarian crisis in Yemen is not the product of a natural disaster. It is a direct consequence of the severe restrictions imposed by the parties to the conflict on access to food, fuel, medical imports and humanitarian aid. The collapse of the Yemeni Rial and the non-payment of civil servants’ salaries only make things worse. In addition, the number of civilian casualties has increased dramatically since June ( 450 were killed in just nine days in August) and violence against women and girls has increased dramatically since the escalation of the conflict.

We call on governments to redouble their efforts to ensure free access to basic necessities (including fuel) throughout the country, including through the crucial Hodeidah port, where civilians haven been trapped in new fights in recently. Any indiscriminate attack against civilians and civilian infrastructure and any other violation of international humanitarian law by any party must be publicly condemned by the international community.

Only an inclusive peace process can solve the humanitarian crisis.

Parliamentarians have a special responsibility to represent the voices of their constituents and hold their governments to account. On the eve of the first Paris Peace Forum, convened by President Macron to promote peace and improve global governance, we hope this conference will be a wake-up call. There is no military solution to the war in Yemen. Only an inclusive peace process can solve the humanitarian crisis.

After almost four years of conflict, Yemenis can no longer wait.

ACAT

Action against Hunger

Asociacion pro Derechos Humanos de Espana

Avaaz

CARE International

Cairo Institute for Human Rights Studies

Committee on the Administration of Justice

Control Arms

Friends Committee on National Legislation

International Federation for Human Rights

Finnish League for Human Rights

Global Center for Responsibility to Protect

Gulf Center for Human Rights

Handicap International

Hellenic League for Human Rights

International Rescue Committee Europe

Latvian Human Rights Committee

League of Human Rights

Belgian League (Francophone) of Human Rights

Liga voor of Rechten van de Mens

Doctors of the World

Mwatana Organization for Human Rights

Norwegian Refugee Council

Observatory of Armaments

Oxfam

PAX (the Netherlands)

Arab Forum for Human Rights (Yemen)

Saferworld

Salam for Yemen

Save the Children

SumOfUs

War Child

Yemen Peace Project

Donate to our Emergency Appeal now.

Six months of Safe Surgeries!

Six months of Safe Surgeries!

Published 7th November 2018

Word is spreading! Just 6 months after launching the initiative, over 70 GP practices from nine cities across the UK have joined the Doctors of the World (DOTW) Safe Surgeries network. We welcomed our first CCG on board, our first GP Federation, and our first safe super-partnership. We trained over 1,200 people, including the Greater Manchester Health and Social Care Partnership who are responsible for commissioning primary care for 2.8 million patients and we held a session at the 6th Annual London GP Trainee Conference.

Working hard to engage third sector organisations, local authorities and patients in the West Midlands, we held a Safe Surgeries launch event attended by 50 healthcare professionals and commissioners which led to 16 practices joining the network. We continue to work with partners in Newcastle and Leeds to embed change one practice at a time, both of which (alongside Bradford, Norwich, Cambridge and Worthing) have gained their first Safe Surgeries since the last time you heard from us. Meanwhile, in London we’ve been helping to develop Lewisham’s new Safe Hub initiative and, with OneHealth Lewisham, we welcomed our first safe GP federation. We also shared borough-level data on registration refusals with every CCG and public health team, alongside a copy of our Safe Surgeries toolkit – so watch this space!

Why Safe Surgeries?

We know that, across the country, general practice is committed to providing excellent care to all patients. We have seen surgeries determined to resist administrative practices, such as visa checking and insisting on ID and proof of address, that turn their surgeries into unwelcoming environments for patients who don’t have paperwork. The good news is, the guidance from NHS England is on the side of the thousands of doctors and receptionists who want to prioritise the health of their patients and keep their surgeries safe for everyone.

DOTW launched the Safe Surgeries initiative to support general practice to provide holistic care to patients, like refugees, asylum seekers, undocumented migrants, and homeless people, who are often unable to provide documents. We provide resources, training and health policy updates, and we connect participating practices to each other to share their experiences.

The Safe Surgeries network was designed to support the most pivotal people in NHS access; primary care staff. Safe Surgeries don’t refuse to register patients without proof of address documentation or proof of identification. They never ask to see a visa or proof of immigration status. Staff do what they can to reassure patients that their personal information is safe and they use an interpreter when needed. They display posters reassuring patients that the surgery is a safe space and they empower frontline staff with training and an inclusive registration policy.

By following these steps (detailed in the Safe Surgeries toolkit), primary care staff can ensure that everybody can access a healthcare when they need it. 

If your practice would like to sign up to the initiative or for more information, please email safesurgeries@doctorsoftheworld.org.uk

On the Greek Islands, people live in limbo and uncertainty

On the Greek Islands, people live in limbo and uncertainty

Published 31st October 2018

In Lesvos, Doctors of the World support on a daily basis dozens of asylum seekers and migrants in vulnerable circumstances. In the camp of Kara Tepe, our work focuses on ensuring access to primary health care, sexual and reproductive health services, and psycho-social support for the population.

Since January 2018, Doctors of the World has conducted over 16,000 medical consultations. It has become clear that a direct consequence of living in a camp is the cross-cutting deterioration of the physical and psychological health of all different groups of population.

People live in limbo and uncertainty, they feel demotivated, and their morale is low.
When it comes to women and Sexual and Reproductive Health Services (SRH), the complexities faced are even bigger. From barriers faced by pregnant women in need of pre-natal and ante-natal care to family planning, pre-existing gynecological problems and cultural constraints.

Doctors of the World is responding to this need by implementing programs providing medical consultations,  enabling access to essential mental health care and psychosocial support.

The DOTW publication: “Snapshot: Greek Islands” explores the current situation in the region, highlighting the challenges posed by life in the camps.

The report can be downloaded as PDF here.

Belgium: Police violence against migrants and refugees in transit

Belgium: Police violence against migrants and refugees in transit

Published 30th October 2018

“Since the beginning of the medical consultations for migrant and refugee people in Brussels and the Coast, our volunteers have been confronted with stories of police violence,” says Nel Vandevannet, Director of National Projects at Doctors of the World Belgium, to explain the genesis of this investigation.

“This report highlights the magnitude of this problem in a structured and methodical way”. The report is based on the testimony of 440 people. 25% – or 110 – of those interviewed said they had experienced police violence.

Violence in the field and in police stations

More than half of the testimonies (58%) report blows with hands, feet or clubs. ” Half of the people say that the violence took place when they were immobilized, ” says Nel Vandevannet. “Others say they have been racketeering and stealing money” The majority of cases of violence occurred in police stations prior to incarceration. 66% of those arrested reported experiencing physical or mental violence at the time, particularly during strip searches and fingerprinting. “The police can only conduct strip searches to check for prohibited items when there are serious suspicions. ”

However, 6 out of 10 detainees were subjected to forced strip searches , which were accompanied in 72% of cases by humiliating behavior, where the naked person was beaten, mocked or pushed against a wall while another police officer took off his underpants:

“When we arrived at the police station they put us in a room and beat us up. (…) I asked them why they treated me like an animal and they hit me even more. Then we had to get all naked in front of each other for them to search us. I did not want 4 policemen stripped me off. There were women police too, they did nothing but they laughed, “said a 29-year-old Libyan.

Use of violence when taking fingerprints

35% of those arrested refused to give their fingerprints. They have all been victims of torture as defined by the Istanbul Protocol . The same methods are found through the testimonies: punches, kicks and clubs, leaving the person dressed only in a t-shirt or underwear in a cell at very low temperature (fridge house), deprivation of food, drink and sleep, denial of access to sanitary facilities or handcuffing for many hours, forcing the person to remain in a painful position.

“The policeman was shouting at me loudly for me to give my fingerprints. I did not want to give them so they told me that I was going to stay 48 hours here. I remained tied behind my back for about 48 hours . They pushed me violently into the cell and as I was tied I fell to the ground and I hurt my arm. (…) I was very cold in the cell because I only had my t-shirt and underpants and there was a fan on. I asked to have my clothes but they refused. I also asked that they detach me because I was hurting so much they said to me in English “just go back to your country and ask them”, “says a 17-year-old Ethiopian

Inhumane incarceration

” Belgian law states that anyone who is incarcerated for any reason has the right to water, access to sanitary facilities and a meal, ” says Nel Vandevannet. It appears, however, according to this report that 41% of those arrested have received nothing to drink or to eat for more than 15 hours . 4 people also said they did not have access to sanitary facilities. One person claimed to have had to feed in a bucket for 48 hours. The seizure of medicines and medical equipment is also noted :

“Between February and June 2018, about 15 of his patients came back to consult the doctors of the Hub because they had taken their medicines, like antibiotics, chronic treatments (for example treatment against epilepsy or HIV), birth control pills or medications to take before hospitalization. A woman with HIV could not get her bag after an arrest and ended up without her medication. Once at the Hub, she had to be hospitalized urgently and it took more than a week and three trips to the clerkships to get her stuff back, “says Louisa Ben Abdelhafidh, medical coordinator.

Minors treated in the same way as adults

Almost one in three witnesses (27.5%) was a minor at the time of the interview and 29% of the violence identified in this report concerns minors. ” Worrying and unacceptable! According to Doctors of the World: “Thousands of unaccompanied minors, migrants and refugees, are wandering around Europe right now. These are very vulnerable groups, easy prey for human traffickers and clandestine networks. The law provides that a police officer who assumes that a person is a minor must immediately contact the Guardianship Service of our country . According to our report, this protective measure is not applied, on the contrary: the minors interviewed are treated – sometimes extremely violently – in the same way as adults.

50% of minors report being beaten or bitten by police dogs during checks or arrests . 4 miners testified about the deep humiliation felt during strip searches at the police station. Two of them had their underwear removed violently. 1 miner was placed in a cell cooled to the extreme by an air conditioner, wearing only his underpants and t-shirt. Two others were blackmailed and had to give their fingerprints in exchange for food and drink or their release.

And then ?

This report reveals a reality that has remained hidden until now: a significant part of the migrants in transit in our country is confronted with excessive physical and psychological violence . 1 in 3 affected people is a minor. “In the short term, we demand that all forms of police violence cease immediately, that the law be respected and that those who are guilty of such practices be judged. We also believe that a fundamental debate on our migration policy must take place: this violence is a symptom and a consequence of the migration policy that has so far only aimed at the repression and criminalization of migrant people.”

This report is primarily intended for our policy makers: they are responsible for what is happening on the ground. ” Migrants but also local and federal police services have been subjected to unsustainable pressure for months and are expensive, useless and harmful migrant hunting counters. Political rhetoric has slowly but surely drifted into a dehumanization of migrants and has led to increasing pressure and a sense of discouragement by the police on the ground. ” Doctors of the World Belgium also recommends opening a reception and orientation center, protective measures for minors and a tolerance policy regarding humanitarian aid provided to them

x

With your support, Doctors of the World will make sure nobody suffers or dies due to lack of access to healthcare.