Healthcare for refugees: a necessary symbiosis of medicine and politics

UNHCR Rohingya Refugees

Rohingya refugees live in overcrowded makeshift sites in Cox’s Bazar, Bangladesh, after fleeing across the border to escape the October 2016 violence in Myanmar. © UNHCR/Saiful Huq Omi.

This article was exclusively written for the Sting by Ms Janatana Karunakumar, a 3rd year medical student at Georg-August-University in Göttingen, Germany. Ms Karunakumar is affiliated to the International Federation of Medical Students Associations (IFMSA). The opinion expressed in this piece belongs to the writer and does not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

While some European politicians discuss about implementing quotas, which should reduce the influx of refugees in Italy, Greece and other European countries, it has not been sufficiently done to ensure a quality  healthcare for refugees in the host countries.

Refugee health care can only be delivered effectively if the specific needs of refugees are met. According to the Refugee Health Technical Assistance Center the refugee experience is divided into the categories: preflight, flight, and resettlement.

The preflight phase may include the death of relatives, air bombardments and witnessing of murder etc.  The quality of the flight itself has been viewable in the global press – despairing families standing closely together at railway stations, hardly seaworthy and overcrowded boats. Ongoing challenges like loss of culture, community and language and the uncertain access to food and water can continue in asylum camps. The health implications of all these phases can last for many years.

A study, presented in the International Journal of Social Psychiatry, also found out, that post-migration problems were markedly connected with emotional distress and post-traumatic stress disorder symptoms.[1] The Lancet study, an Oxford University research, shows that social supports in high-come host countries have got a positive effect on refugee child´s psychological functioning.[2] All in all, the most important factor of long-term well-being is the integration into the host country´s social and health system.

So, what should be done in order to improve the current health situation of refugees in the host countries? To say it in the words of Rudolf Virchow, a brilliant physician, politician and founder of social medicine: „Medicine is a social science, and politics is nothing else but medicine on a large scale.“

The clinical services should supply holistic interventions within a phased concept when working with refugees. At a structural level, it is obvious to reduce the post-migration problems of refugees and provide them enough social support and the opportunity for an effective integration.

Admittedly, the integration is harder to achieve in countries, which are already struggling to offer a high quality health system for their native citizens. But wasting resources into parallel substandard healthcare systems, which target only short-term social needs, is not the sustainable solution.

Expanding existing healthcare systems must be a central element of European humanitarian response to the  so-called migration crisis.

References

[1] http://journals.sagepub.com/doi/abs/10.1177/0020764009105699

[2]   http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60051-2/fulltext

About the author

Ms Janatana Karunakumar is a 21-year-old, 3rd year medical student at Georg-August-University in Göttingen, Germany. Her parents moved from Sri Lanka to Germany. She grew up in Detmold and moved to Göttingen for her studies. Besides medicine, social-political topics are one of her major interests. Her hobbies are playing volleyball and chess.

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