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health care center for
foreign families
Reggio Emilia 16-17
novembre 2017
Migrants
health needsMigrants Helth center( HEALTH LOCAL AUTHORITY )
Agreements since 1998
FRANZINI FOUNDATION 2010 PARTNER
Catholyc Charity
OBJECTIVES OF CSFS:
- TO GUARANTEE ACCESS TO SANITARY SERVICES FOR
IRREGULAR MIGRANTS (DEFINED BY THE LAW AS “TEMPORARY
FOREIGNER IN THE COUNTRY”)
- TO GUARANTEE QUALITY OF HEALTH CARE
- TO PROMOTE KNOWLEDGE AND CONTINUOUS TRAINING
- RESEARCH
WORKING GROUP INCLUDES:
DOCTORS, NURSES, GYNECOLOGISTS, MIDWIVES, SOCIAL
WORKERS AND CULTURAL MEDIATORS
CHARACTERISTICS OF CFSF:
- MULTIPROFESSIONALITY AND MULTIDISCIPLINARITY
- CULTURAL MEDIATORS AS STRUCTURED COMPONENT OF THE
WORKING GROUP
LEGISLATION
- NATIONAL LAW ON IMMIGRATION 1998
ARTICLE 32 OF THE ITALIAN CONSTITUTION
«THE STATE WARRANT THE FUNDAMENTAL
RIGHT TO HEALTH OF ANY INDIVIDUAL TO PROTECT THE
COLLECTIVITY»
- NATIONAL EXPLANATORY STATEMENT OF 2000 N°. 5
“SUPPLIES REQUIREMENTS FOR HEALTH INSURANCE (RESIDENCE
AND PERMIT OF STAY) AND DEFINES THE MODES TO ASSIST
PERSONS WHICH DO NOT RELATE TO THESE CRITERIA”
- REGIONAL LAW N°. 5 OF 2004:
"RECOMMENDS THE USE OF CULTURAL MEDIATION FOR SOCIAL
HEALTH INTEGRATION OF IMMIGRANTS”
AUSL: Riepilogo per nazione Utenti Famiglia Stranie ra
NIGERIA 19%
CINA REPUBBLIC9%
GEORGIA 7%
UCRAINA 5%
GUINEA 5%
PAKISTAN 4%
COSTA D'AVORIO5%SENEGAL
4%
GAMBIA 4%
MALI 3%
MAROCCO 5%
GHANA 3%
ROMANIA 3%
ALBANIA 4%
BANGLADESH 2%
TUNISIA 2%
MOLDAVIA 1%
Altri12%
AUSL: Riepilogo utenti Famiglia Straniera x fascia di età
09 |006%
19 |1012%
29 |2042%
39 |3020%
49 |4010%
59 |506%
69 |603%
79 |701%
89 |800%
99 |900%
2016 – Country of origin
2016 – Age class
AUSL: Diagnosi x raggruppamento patologia
Salute donna (compl. Dellagravidanza, del parto e del perpuerio) 24%
Bilancio di salute 17%
Malattie Infettive e parassitarie 14%
Malattie dell'apparato respiratorio 7%
Malattie del sistemaosteomuscolare e connettivo (traumatismi) 6%
Sintomi, segni stati morbosi mal definiti 6%
Malattie sistema circolatorio 5%
Malattie dell'apparato digerente 5%
Malattie della cute e del tessuto connettivo 4%
Malattie e patologieodontostomatologiche 3%
Malattie del sistema genito urinario 3%
Malattie endocrine, nutrizionali,metaboliche e disturbi nutrizionali 2%
Disturbi psichici 2%
Malattie del sistema nervoso e degli organi di senso 2%
Tumori 0%
Malattia del sangue e degli organi emopoietici 0%
OUTPATIENT SERVICE:
- RECEPTION
- INFORMATION AND ORIENTATION IN THE SERVICES
- HEALTH TRIAGE (NURSES AND MIDWIVES)
- MEDICAL EXAMINATION (DOCTORS)
- OBSTETRIC-GYNAECOLOGICAL EXAMINATION
- COUNSELLING
- HEALTH EDUCATION
- COMMUNICATION OF DIAGNOSIS AND THERAPY PROJECT
- ASSISTENCE TO HOMELESS PEOPLE
- ASSISTANCE TO PEOPLE WITH SOCIAL AND/OR PSYCHIC ILLNESS
- ASSISTANCE TO SEPARATED CHILDREN (WITHOUT FAMILY)
ACTIVITIES OF CULTURAL MEDIATORS AT CSFS
PARTICIPATION IN RESEARCH ACTIVITY:
- SEXUALLY TRANSMITTED DISEASES IN GEORGIAN MALES
- TRANSSEXUAL/TRANSGENDER PATIENTS AND HEALTH PROBLEMS
- EPATITES B IN CHINESE POPULATION
- QUALITY OF CULTURAL MEDIATION (COLLABORATION WITH UNIVERSITY)
PARTICIPATION IN TRAINING (SPEAKERS IN CLINICAL CASES):
- TUBERCULOSIS
- SEXUALLY TRANSMITTED DISEASES
- PSYCHICAL DISEASE OF ASYLUM SEEKERS
- MEDICAL ANTROPOLOGY
ACTIVITIES OF CULTURAL MEDIATORS AT CSFS
MONTHLY MEETINGS OF ALL THE STAFF OF CSF
- CONDUCTED BY A PSYCHOLOGY, FOR THE DISCUSSION OF COMPLEX
CLINICAL CASES EQUIPE (PRESENTATION OF CASES BY DIFFERENT VOICES)
- TO DISCUSS THE ORGANIZATIONAL ASPECTS WITH THE HEALTH PERSONNEL
MEETINGS FOR HEALTH EDUCATION
WITH SMALL GROUPS OF ASYLUM SEEKERS ABOUT SEXUAL AWARENESS,
CONTRACEPTION, PREGNANCY ETC.
PARTECIPATION TO THE REGIONAL PROJECT «BEYOND THE ROAD»
goal of intercepting and drive to health Services Chinese prostitutes (even
from massage centers) to do health education, information, prevention and
early diagnosis
ACTIVITIES OF CULTURAL MEDIATORS AT CSFS
Since 2016 the high number of refugee arrivals
has required changes in the organization of
cultural mediation
Positive issues:
- Effective response to the need for uncommon languages
- Enlargement of the working group
- New ideas, point of views and experiences
Critical issues:
- lack of a “common language” (triage style, medical and not-medical
terms, not-verbal language etc)
- impossibility to ensure continuity between services
- low knowledge of some illnesses ad infections
These critical issues emerged mainly in
handling more delicate situations (that
occur often in our Service):
- mental illness
- victims of torture and abuse
- communication of seropositivity for HIV
- drug addiction
- ROM and SINTI population (gypsies)
TAKE HOME MESSAGES IN OUR EXPERIENCE
• The possibility to customize assistance on the basis of the single
situation guarantees better health result:
- Gender of cultural mediators
- The mother tongue of the patient
- Specific experience of cultural mediator
-Ensure the knowledge of
- Team Operators role
- Professional culture of colleagues
- "health cultures" of patients
• To clarify always the aims, purposes and objectives of cultural
mediation to patients who do not know this professional figure
TAKE HOME MESSAGES IN OUR EXPERIENCE
• Linguistic-cultural mediator in the team as a stable figure allows:
- To create a strong bridge between patient and healthcare staff
- To transmits culture and not just language
- To guarantee continuity between difference Services
- To increase patients’ empowerment in expressing health needs
- To increase the professional knowledge of the working group
… TO CREATE AND TO CARRY ON THE CULTURE OF MEDIATION …
OUR EXPERIENCE GAINED DURING TIME
THE ROLE OF THE LINGUISTIC-CULTURAL MEDIATOR ALSO WHEN THE
PATIENT HAS A SUFFICIENT LEVEL OF KNOWLEDGE OF ITALIAN LANGUAGE:
NOT ONLY WHAT TO SAY, BUT HOW TO SAY IT … TO BE EFFECTIVE
