Inequalities are caused by problems that we can classify on three different levels:
- At the patient level: language, culture and social circumstances can inhibit access.
- At the provider level: the inability to communicate with patients makes physicians reluctant to deal with foreign patients.
- At the level of the care delivery system: legal restrictions and administrative complexities make it difficult to provide effective service for migrants.
These inequalities are also worsened by adopting a national view. Brian Gushulak, a migrant health specialist, emphasized the importance of a global perspective when dealing with the issue of access to health for migrants. According to this speaker, a national view of the problem at hand would limit the solutions and prevent them from being linked to development, economic and security matters. Indeed, all the participants agreed that migration was part of globalization and that it should be treated from a global point of view. "There are no local diseases and therefore there are no local solutions" Patricia Walker from the Department of Internal Medicine of the University of Minnesota, in the USA, pointed out.
One must not look upon the immigrant community as a homogenous group; its members have different social and cultural backgrounds. In order for the care delivery system to be effective, it has to be culturally competent and knowledgeable about both ethnic and social differences. This is illustrated by the fact that most patients from this community do not dare consult a physician due to language barriers and in turn 78% of the doctors do not like taking care of immigrants due to the complexity of the process.
However, the unequal access to health care was not the only point that was discussed. It was pointed out that providing better health services for migrants is in fact beneficial for host countries. We particularly have to focus on fast intervention because, not only does it prevent diseases like Tuberculosis from spreading, but also reduces the cost of treatments. Indeed, the further the illness is developed, the more complex and expensive it becomes for both patients and health care providers. Focusing on illegal immigrants, Dr. Francesco Castelli from the Infectious and Tropical Diseases Unit of the University of Brescia in Italy, pointed out that more than 70% of HIV infected people are unaware of their condition.
Thus, in order to ensure access to health for migrants, it is important to insist that health should be regarded as a human right and that all citizens, migrants or natives should be entitled to it.
Image: IOM helping Lebanese refugees in Syria 2006. Photo: Ranjitha Balasubramanyam, 2006.
