After Eugen Ghita arrived in Greece from his native Romania, he did not have a legal residency document, which meant that he did not have access to any kind of public services, including healthcare.

“The first two years health was equivalent to having money,” he recalls, sharing his experience during the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “For this reason, it was very difficult to stay healthy in the first six months because there was no program for us as economic refugees.”

Today Ghita serves as Human Rights Monitor and President of the Roma Lawyers Association.

One billion migrants

Lack of documentation, language and cultural barriers and the restrictive policies that more and more governments are implementing represent some of the biggest challenges for migrants and refugees to access healthcare, as Aslanyan discusses with his guest Reem Mussa, Humanitarian Advisor and Coordinator of the Forced Migration Team at Médecins Sans Frontières. Often, the consequences are very severe.

“The WHO World Report on health of refugees and migrants estimates that there are some 1 billion migrants globally,” says Aslanyan. “The report highlights migration and displacement as key influential determinants of health and well-being and urges for collective action to ensure that health is a reality for all refugees and migrants.”

Mussa emphasises that there are several types of migrants, including those who move countries for study or work purposes. However, those who are in the most vulnerable conditions are usually those who pay the highest price for lack of healthcare.

“We know that there’s a portion of migrants globally, particularly those that are forced migrants or undocumented migrants or labour migrants, particularly from the global south, that often are exposed to various poor health outcomes linked to the migration journey itself, but also linked to the policies and health systems in countries in which they arrive,” he says.

Separating border control and healthcare services

According to Mussa, in order to encourage those in need to seek care – especially those who lack proper documentation – one of the key elements is to maintain a strict separation between border control and healthcare services. Providing primary health care is also essential.

“If you exclude people from the health care system, you’re only going to see them when they end up in the emergency room and that becomes a challenge,” he notices.

Aslanyan and Mussa discuss how many governments are implementing increasingly restrictive policies, including policies that have proven to cause highly negative health outcomes, such as offshore processing.

On the other hand, Mussa emphasises how the way many countries have been willing to welcome and care for the influx of refugees from Ukraine is an example of what can be done for migrants and asylum seekers when there is the political will.

“People that arrived from Ukraine were able to apply for a temporary protection directive which also allowed them to have access to the health care system in the countries in which they arrived,” he says. “That’s very key.”

Image Credits: Global Health Matters, TDR, Global Health Matters Podcast, TDR.