This paper explores the gaps in access to health for refugees and other migrant vulnerable individuals due to the discrimination and stereotypes in the host countries. A refugee is somebody forced to flee his home country with a strong justifiable fright of being oppressed and victimized on basis of ethnicity, race, religion, sexual orientation, nationality and a member of a specific societal assemblage or political ideology
By Michael Ssemakula
Health Rights Researcher & Advocate
Human Rights Research Documentation Center (HURIC) & PHM-Network, Uganda
Discrimination and Stereotype in the Global-North and -South Nation-States
The Major Interlope to Universal Health Coverage for Refugees and Other Vulnerable Immigrant Persons
The exponential paranormal jump-pace at which the present-day refugee crisis is exacerbating the back-and-forth unparalleled international migration, is acutely awe-inspiring and becoming a chief post-colonial era humanitarian integral complex anthem. This is intensely overshadowing the contemporary global and continental states managers’ comprehensive policy and plan frameworks on population planning. This has been allied with weighty-unrelenting challenges to get appropriate human rights-centric approaches to refugee discrimination, stigmatization and other dehumanizing human rights abuses against their dignity from dogmatic chauvinistic and xenophobic prejudist evacuee-host republics. Legions-upon-legions of refugees, asylum seekers and migrants arrived in the European Union state members in 2015. The sporadically skewed growing influx of susceptible populaces postures voluminous challenges to the host-foreign-fatherlands in the wave-length of preparedness and pliability of health systems and access to vital primary and emergency health care services.
This paper explores the gaps in access to health for refugees and other migrant vulnerable individuals due to the discrimination and stereotypes in the host countries. A refugee is somebody forced to flee his home country with a strong justifiable fright of being oppressed and victimized on basis of ethnicity, race, religion, sexual orientation, nationality and a member of a specific societal assemblage or political ideology. Here the refugee is assumed to be outside the country of his nationality, and due to fear, he is unwilling to avail himself to the jurisprudence protection of his State.
In regards to the report on ‘Refugees: towards better access to health-care services’ (Etienne V Langlois, 2016), the migration crisis is one of the most pressing global challenges, as worldwide displacement is now at the highest level ever recorded. Latest global estimates by the United Nations Commission for Refugees (UNHCR) show that 59.5 million people are forcibly displaced as a result of persecution, conflict, generalized violence, or human rights violations. The estimated refugee population reached an unprecedented 19.6 million individuals worldwide in 2015 – half of them being children and the number is steadily increasing, with Syria, Afghanistan and South Sudan as the leading countries of origin of refugees. A lengthy drought preceded the Syrian crisis that led to an enormous movement of people into cities and contributed to instability. Moreover, in South Sudan, due to the continued power hunger and political divide through coup d’état attempt accusations from President Salva Kiir against his former deputy Riek Machar, South Sudanese Civil War’s existence has been eminent between the government forces and the opposition forces which has claimed lives of over 300,000 people with over 2.1 million of those internally displaced, and over 1.5 million having fled to neighboring countries, especially to Kenya, Sudan, and Uganda, according to UNHCR (UNHCR, 2018) and World Vision reports on countries with the highest number of refugees (Vision, 2018). Furthermore, reports show Uganda was implicated in exiling hundreds of LGBTI populace to Kenya after passing the harsh Anti-homosexuality Bill in 2014, which made Kenya a safe haven for this key population till many were settled in Europe and North-America as asylum seekers to save their lives from inhumane and homophobic moralists’ persecution in Uganda.
Refugees experience conditions of societal exclusion and dementing stereotypes due to their feeble perceived status by society thus facing ostracism, vulnerability, marginalization, poverty, stigmatization and humiliation which heightens discrimination and heavy trauma of displacement (thereby extremely affecting their psychological health and emotion intelligence, including women, children, and older people). Research shows refugees frequently have severe psychological health complications and trauma symptoms, especially depression due to the status labelled on them, immense deportation fear and post-traumatic stress disorder (PTSD), related to prearranged violence, torture, human rights defilement, relocation, brutal torture, traumatic migration experience and other forms of violence. As such, refugees experience a range of bodily problems and disabilities, including malunited fractures, soft tissue wounds, neuropathies, head injuries, and epilepsy. Refugees also suffer from a heavyweight burden of undernourishment and anemia, curable Non-Communicable Diseases (NCDs) intensified by inadequate access to regular medication, and transmittable diseases. Right to free health care for refugees is typically constrained in host states with overwhelming divergence in entitlements between refugees or migrants and the host nation-citizenry which encumbers the refugees access to health care. Literally asylees are granted delimited health care accessibility, habitually with partial access to emergency medical care, pregnancy, childbearing, and vaccination services. The ostracization from health care is worsened by the illegal status of many undocumented refugees, information barrier and awareness about the obtainability of host country’s medical services due to insufficient provision of language translation services, limited transport access, traditionally insensitive care and financial constraints to access social security services such as insurance services.
Overall, these circumstances do represent a hindrance to a full-bodied approach to elevation of Universal Health Coverage (UHC) to refugees and other migrant vulnerable persons. Therefore, in a bid to stimulate UHC and promote the right to the highest attainable standards of health for all individuals (as enshrined in the article #12, of the International Covenant on Social Economic and Cultural Rights-ICSECR), some remedies are proposed in this article to narrow the gap in access to health for the refugees and other susceptible migrant persons:
-Strengthening regional unification of registration and anti-discrimination policies to dismantle health exclusion. In the long-run, this should become a robust appropriate measure to benchmark the success level of the drive to promote access to health for refugees, and trim down health service unreachability and bureaucratic propensities involved in documentation of refugees to ease their legal recognition and access to the host country’s health care services.
-Strong re-echoing of pre-onset orientation. Programmes that encompass effective and holistic pre-departure training for refugees should be redesigned to enlighten the refugees on the destination journeys they are yet to take; this should be backed by basic host country linguistic training with the help of language translators to streamline and abridge service accessibility.
-Reinforcing and widening social security coverage for all. This would include broadening of the insurance options, whereby newly inclusive well-streamlined insurance options support refugees and other vulnerable persons such as asylees and undocumented immigrants access to health care. This can be attained through resilient regional integrated states funded comprehensive health insurance frameworks through low-fee insurance plans with minimal stringent administrative procedures. Many insurance stratagems have often commended vulnerable immigrants to financially pay to some level in order to access health care related services. Unfortunately, that can’t be feasible to such vulnerable society stratas unless supported by the countries in region blocs as suggested above.
-Strengthening service providers training and preparation. Providers themselves need a further holistic capacity training to properly care for the refugees especially in regards to counseling and trauma management. The center of focus should be pointed towards cultural proficiency to better existing services as well as inventing new services. Some providers insufficiently understand the current policies on health care access and might turn refugees and other immigrants away based on false information. Henceforth, there’s a need for an additional training to keep providers upbeat to the legislation dynamics related to health access.
In conclusion, several barriers across-the-board that impede the drive to promote health care for refugees and other vulnerable immigrants are still eminent. These barriers are not only administrative and legal in nature but correspondingly incorporate challenges that inherently involve discrimination and stereotype due to the bigotry perceived status of the refugees. Barriers are worsened by exclusion and segregation health policies against non-citizenry strata in host countries as a result of the inadequate social and financial assets.
References
Etienne V Langlois, A. H. (2016). Refugees: towards better access to health-care services. London: The lancet.
UNHCR. (2018). FORCED DISPLACEMENT IN 2017. Geneva: UNHCR.
Vision, W. (2018, June 26). Forced to flee: Top countries refugees are coming from. Retrieved from World Vision: https://www.worldvision.org/refugees-news-stories/forced-to-flee-top-countries-refugees-coming-from