Century challenge: inclusion of immigrants in the health system

A young refugee from South Sudan at the Numanzi Transit Center where meals and temporary accommodation are provided by UNHCR in Adjumani, northern Uganda. © UNHCR /Will Swanson

This article was exclusively written for The European Sting by Ms. Amany Gonçalves Robaina, a 21 years old and medicine student at Universidade Regional de Blumenau (FURB), in Blumenau, Santa Catarina – Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Over the fifteenth and sixteenth centuries, it began in Europe in the period of the Great Navigations. It was during this period that the Portuguese arrived on the Brazilian coast and began their colonization. Soon, Brazil was born of immigrants and, over the years, gathered a number of initiatives in different periods of history. The current edition has not changed, due to the great flow of immigrants in the country. Thus, an inclusion of health experiences is one of the challenges of the Brazilian government.

According to article 196 of the 1988 Brazilian Constitution, health is everyone’s right and duty of the state, regardless of sex, age, religion, race, color, or national origin. Therefore, the Unified Health System (SUS) – Brazil’s public health system has as one of its principles of universality, related to the Universal Declaration of Human Rights.

In this scenario, not always the Basic Health Units meet immigrants, especially in cases of refugees, because they do not present a document of identification for registration or do not yet accept the provisional visa as an official document – regrattable act that hurts the Constitution. In addition, there is a contrast in the application of this law in the national territory. In Chapecó, Santa Catarina, in the south, there were prejudiced actions in health services, including racism and poor inclusion in the public health system. Already in states such as Roraima, in the north region, the Ministry of Health in conjunction with state and local governments, developed an integrated plan of action to meet the increased demand for health services due to the large Venezuelan migration and guiding, expand and qualify assistance in primary and hospital care.

Moreover, the process of integration into a new society, adapting to new customs and culture, often accompanied by marginalization and prejudice may reflect health problems. Considering the relationship between health and the socioeconomic and cultural conditions of the individual, understanding these factors are fundamental to improve the reception and care of these foreigners. Besides, the state government of Sao Paulo has hired community workers health nurse – members of SUS staff who make the exchange of information between medical staff and community – from countries of immigrant groups in order to facilitate the inclusion of such persons in system, allow greater knowledge of their culture and customs, and also improve communication between doctor and patient.

In addition to these measures, changes in the medical team approach, sponsoring a holistic medicine and create empowerment opportunities for the immigrant, as Portuguese classes, brochures in Portuguese and Spanish and allow access to information.

Therefore, the challenges faced by immigrants on a daily basis and their difficulties in accessing the basic health system of the nation are factors that directly influence their health and, therefore, should be taken into account in the anamnesis, as well as the measures taken by the Brazilian government in conjunction with the empathy and respect of the medical staff provide a greater inclusion of these people in the country’s public health.

References

Martin, Denise; Goldberg, Alejandro; Silveira, Cássio. Imigração, refúgio e saúde: perspectivas de análise sociocultural. Saúde e Sociedade, São Paulo, vol 27, n 1: 2018.

Link: http://www.scielo.br/pdf/sausoc/v27n1/1984-0470-sausoc-27-01-26.pdf

CREMESP. Atendimento a imigrantes sem cidadania é obrigatório por diretrizes legais e éticas. JORNAL DO CREMESP, São Paulo, ed 332, pg 15: 2015.

Link: https://www.cremesp.org.br/?siteAcao=Jornal&id=2127

Maciel, Victor; Valadares, Carolina. Roraima tem plano de ações para atendimento aos imigrantes. Ministério da Saúde, 2018.

Link: http://portalms.saude.gov.br/noticias/agencia-saude/42320-roraima-tem-plano-de-acoes-para-atendimento-aos-imigrantes

Mendes, Amanda; Maciel, Victor. Ministério da Saúde visita Roraima e acompanha assistência a venezuelanos. Ministério da Saúde, 2019.

Link: http://portalms.saude.gov.br/noticias/agencia-saude/45128-em-visita-a-roraima-ministro-acompanha-acolhida-a-venezuelanos

FASSI, D. O sentido da saúde: antropologia das políticas da vida. In: SAILANT. F; GENEST, S. Antropologia médica: ancoragens locais, desafios globais. Rio de janeiro: Fiocruz, 2012, p 375-390.

About the author 

Amany Gonçalves Robaina is 21 years old and a medicine student at Universidade Regional de Blumenau (FURB), in Blumenau, Santa Catarina – Brazil. She is in the second period of college and became a member of IFMSA during her first week there. She has a lot of interest in health and how it is affected. Besides, she really likes politics and social actions. So as a member of the IFMSA she took action in the university and in the community with the goal of improving my skills and learning as much as possible.