migrants health v1

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PROTECTING IMMIGRANTS

HEALTH: RECENT PROGRESS

PANOS EFSTATHIOU, MD, Ph.D.

NATIONAL HEALTH OPERATIONSCENTRE COMMANDER


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The establishment of the migrants

detention centres was the best way to

reduce and gradually abate the

negative impacts of thousands illegalmigrants in Greece.
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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


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In our country live between 800,000 to1,000,000 foreign nationals amounting

to 7.3% of the total population.
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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


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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


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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


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CATEGORIES OFFOREIGNERS IN GREECE

Asylum seekers

Refugees who live and work in Greece

Repatriated Greeks of Greek origin

Unaccompanied underage migrants


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IMMIGRANTS HEALTHPROFILE

Tuberculosis1

2

3

Hepatitis

HIV/AIDS


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Scabies4

5

6

Suicide Attempts

Chronic Health problems


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IMMIGRANT

Stress Somatization

Emotional

disorders

Psychotic

disorders


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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


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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.


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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


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A special category comprises

of immigrants and asylum

seekers accommodated in

detention centers.


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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.
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Refugees and asylum seekers enjoy

equal rights and access to healthcare as

the Greek citizens


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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)


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For issues of detention, safety, hygiene, and

preservation of normality, it is necessary to

apply a serious, scientific and humanitarianappropriate program to address theproblem.


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In most cases, immigrants and especially

immigrants progenies, lack access tohealth services and education and areexposed to acts of violence against them.


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Detention Centres

must have:

Residency

Infirmary

Area of staff residence

Restrooms

Restaurant

Places of religion worship

Fire department

Sports field

Entertainment


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DETENTION CENTRESMUST HAVE

The installation must havetriple link fence (NATO type)

of 3 metres in height

Custody Cleaning


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The role of supportive social networksand non-governmental organizations(NGOs) is of great importance


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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.


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INSIDE

THE DETENTION CENTRES

Prevention

Hygiene

Information

Comprehensive immigration policy


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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


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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


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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.


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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


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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.


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HEALTH COVERAGE

LEVELS

1. Health Coverage in the detention centre

2. Health Coverage out of the detention centre

3. Special Health Coverage procedures


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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


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HEALTH COVERAGE

OUT OF THE CENTRE

Epidemiological surveillance

Medical transfer

Laboratory tests

Nursing


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SPECIAL HEALTH COVERAGE

PROCEDURES Psychological & Psychiatric

Support

Preventive medicine Vaccinations

Communicable diseases


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E.K.EP.Y Health Support

Management Team for DetentionCenters in Athens and Macedonia

and Thrace


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The whole project is financed

by the European Return Fund

migrants health v1

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