Access to Health Services for Irregular Migrants Living in Europe from the Perspective of the Right to Health

Öz

Migrants face many legal, social, cultural and economic problems during and after the migration process. Irregular migrants, a subgroup of immigrants, who are part of the “immigrant crisis” in the official discourse of the European countries,  face these problems much more intensively. Persons entering and working in their countries without legal permission are stigmatized as illegal or irregular. In this sense, irregular migrants are one of the groups most adversely affected by the migration policies of European countries. The aim of this study is to reveal the barriers that irregular migrants face in accessing health services in European countries. A literature search used a descriptive  analysis to create  themes and sub-categories. Access to health care for irregular migrants in European countries is no longer considered a basic human right as a result of the crisis of the welfare state.Our findings reveal that, due to the structural and individual barriers to access to health services, irregular migrants constitute the most disadvantaged group in accessing health services compared to the other groups of migrants. Furthermore, viewing irregular migrants as a national security issue has impeded creating policies that provide access to health care to this population. It is concluded that the access to health services for irregular migrants living in Europe needs to be revised from the perspective of the right to health.

Anahtar Kelimeler

• Undocumented migrants,migrant health,access to health care,crisis of the welfare state,European countries

Sağlık Hakkı Perspektifinde Avrupa’da Yaşayan Düzensiz Göçmenlerin Sağlık Hizmetlerine Erişimi

Öz

Göçmenler, göç sürecinde ve sonrasında yasal, sosyal, kültürel ve ekonomik, birçok sorunla karşı karşıya kalmaktadır. Avrupa ülkelerinin resmi söylemlerinde “göçmen krizi” olarak yer almaya başlayan düzensiz göçmenler ise, bu sorunları çok daha yoğun biçimde yaşamaktadırlar. Bulundukları ülkelere, yasal izne sahip olmadan giren ve çalışan kişiler yasa dışı ya da düzensiz olarak damgalanmaktadırlar. Bu anlamda düzensiz göçmenler, Avrupa ülkelerinin göç politikalarından en olumsuz şekilde etkilenen gruplardan biridir. Bu çalışmanın amacı, Avrupa ülkelerinde yaşayan düzensiz göçmenlerin sağlık hizmetlerine erişimde karşılaştıkları engelleri ortaya koymaktır. Bu amaçla, alanyazında bu konuda yer alan makaleler kategorik içerik analiz tekniği ile analiz edilip, tema ve alt kategoriler oluşturulmuştur. Çalışma boyunca hâkim olan yaklaşım, sağlığın bir insan hakkı olarak ele alınması gerekliliğidir. Refah devletinin yaşadığı krizin sonucunda, Avrupa ülkelerinde düzensiz göçmenlerin sağlık hizmetlerine erişimi artık temel bir insan hakkı olarak ele alınmamaktadır. Araştırma bulgularına göre, düzensiz göçmenler sağlık hizmetlerine erişimin önündeki yapısal ve bireysel engeller nedeniyle, diğer göçmen gruplarına kıyasla sağlık hizmetlerine erişimde en dezavantajlı konumda bulunan grubu oluşturmaktadır. Düzensiz göçmen sağlığı, birçok Avrupa ülkesinde, bir insan hakkı olmaktan ziyade, ulusal çıkarlar tarafından sınırlandırılmış bir politika alanı olarak ele alınmaktadır. Sonuç ve öneriler kısmında ise, Avrupa’da yaşayan düzensiz göçmenlerin sağlık hizmetlerine erişiminin sağlık hakkı perspektifinde yeniden gözden geçirilmesi gerektiği ortaya konmuştur.

Anahtar Kelimeler

• Düzensiz göçmenler,göçmen sağlığı,sağlık hizmetlerine erişim,refah devletinin krizi,Avrupa ülkeleri

Kaynakça

1. Adıgüzel, Y. (2018). Göç sosyolojisi. İstanbul: Nobel Akademik Yayıncılık.
2. André, J. M., & Azzedine, F. (2016). Access to healthcare for undocumented migrants in France: a critical examination of State Medical Assistance. Public Health Reviews. 37(1), 5.
3. Alkan, U. (2015). Avrupa’da Refah Devleti ve Göç İlişkisi: Refah Şovenizmi Örneği. Ankara Üniversitesi SBF Dergisi. 70(3), 751-768.
4. Anadolu Ajansı. (2019, 5 Ağustos). İtalya’da tartışmalı güvenlik paketi yasalaştı. https://www.aa.com.tr/tr/dunya/italyada-tartismali-guvenlik-paketi-yasalasti-/1550356. Erişim tarihi: 20 Ağustos 2019.
5. Avrupa Birliği Temel Haklar Bildirgesi. https://www.avrupa.info.tr/tr/avrupa-birligi-temel-haklar-bildirgesi-708. Erişim tarihi: 5 Ağustos 2019.
6. Avrupa Komisyonu. Definition of irregular migration. https://ec.europa.eu/home-affairs/content/irregular-migration-0_en. Erişim tarihi: 5 Ağustos 2019.
7. Avrupa Komisyonu. Definition of irregular migrant. https://ec.europa.eu/home-affairs/content/irregular-migrant-0_en. Erişim tarihi: 5 Ağustos 2019.
8. Avrupa Komisyonu. (2018). Rapport d'avancement sur la mise en oeuvre de l'agenda européen en matière de migration. Bruxelles.

9. Avrupa Komisyonu. (2019). Rapport d'avancement sur la mise en oeuvre de l'agenda européen en matière de migration. Bruxelles.
10. Barkensjö, M., Greenbrook, J. T., Rosenlundh, J., Ascher, H., & Elden, H. (2018). The need for trust and safety inducing encounters: a qualitative exploration of women’s experiences of seeking perinatal care when living as undocumented migrants in Sweden. BMC pregnancy and childbirth. 18(1), 217.
11. Bévière, B., & Duguet, A. M. (2011). Access to health care for illegal immigrants: a specific organisation in France. European journal of health law. 18(1), 27-35.
12. Castañeda, H. (2008). Paternity for sale: anxieties over “demographic theft” and undocumented migrant reproduction in Germany. Medical Anthropology Quarterly. 22(4), 340-359.
13. Castles, S., Miller, M. J., Bal, B. U., & Akbulut, İ. (2008). Göçler çağı: Modern dünyada uluslararası göç hareketleri. İstanbul: İstanbul Bilgi Üniversitesi.
14. Chappuis, M., Tomasino, A., & Didier, E. (2015). Observatoire de l’accès aux droits et aux soins de la mission France de Médecin du Monde. Rapport.
15. Chimienti, M., & Solomos, J. (2016). How do international human rights influence national healthcare provisions for irregular migrants?: A case study in France and the United Kingdom. Journal of Human Rights. 15(2), 208-228.
16. Comité pour la santé des exilés (COMEDE). (2016). Synthèse de l’activité 2015. Rapport. Kremlin Bicêtre: COMEDE.
17. Dauvrin, M., Lorant, V., Sandhu, S., Devillé, W., Dia, H., Dias, S., Gaddini, A., Ioannidis, E., Jensen, N.K., Kluge, U., Mertaniemi, R., Puigpinós i Riera, R., Sárváry, A., Straßmayr, C., Stankunas, M., Soares, J., Welbel, M., Priebe, S., & the EUGATE study group (2012). Health care for irregular migrants: pragmatism across Europe. A qualitative study. BMC research notes. 5(1), 99.
18. De Vito, E., De Waure, C., Specchia, M. L., Parente, P., Azzolini, E., Frisicale, E. M., ... & Ricciardi, W. (2016). Are undocumented migrants’ entitlements and barriers to healthcare a public health challenge for the European Union?. Public health reviews. 37(1), 13.
19. Defenseur des droits. (2019). Personnes malades étrangères : des droits fragilisés, des protections à renforcer. Rapport.Dias, S., Gama, A., Cortes, M., & de Sousa, B. (2011). Healthcare‐seeking patterns among immigrants in Portugal. Health & social care in the community. 19(5), 514-521.Dorn, T., Ceelen, M., Tang, M. J., Browne, J. L., de Keijzer, K. J., Buster, M. C., & Das, K. (2011). Health care seeking among detained undocumented migrants: a cross-sectional study. BMC Public Health. 11(1), 190.
20. Dünya Sağlık Örgütü (DSÖ). (2017). Santé et droits de l’homme. https://www.who.int/fr/news-room/fact-sheets/detail/human-rights-and-health. Erişim tarihi:26 Ağustos 2019.
21. European Union Agency for Fundamental Rights (FRA). (2011). L’accès aux soins de santé des migrants en situation irrégulière dans 10 États membres de l’Union européenne, Luxembourg : Office des publications de l’Union européenne.
22. Fransız Cumhuriyeti İçişleri Bakanlığı. L'admission au séjour - Les titres de séjour - visas (statistiques). https://www.immigration.interieur.gouv.fr/Immigration/L-admission-au-sejour-Les-titres-de-sejour-statistiques. Erişim tarihi: 15 Ağustos 2019.
23. Fransız Senatosu. Projet de loi de finances pour 2018: Santé. Le programme 183: Des évolutions positives pour le dispositif de l’aide médicale d’Etat. https://www.senat.fr/rap/a17-111-6/a17-111-65.html. Erişim tarihi: 2 Temmuz 2019.
24. Jackson, Y., Courvoisier, D. S., Duvoisin, A., Ferro-Luzzi, G., Bodenmann, P., Chauvin, P., Guessous, I., Wolf, H., Cullati, S., & Burton-Jeangros, C. (2019). Impact of legal status change on undocumented migrants’ health and well-being (Parchemins): protocol of a 4-year, prospective, mixed-methods study. BMJ open. 9(5), e028336.
25. Jensen, N. K., Norredam, M., Draebel, T., Bogic, M., Priebe, S., & Krasnik, A. (2011). Providing medical care for undocumented migrants in Denmark: what are the challenges for health professionals?. BMC Health Services Research. 11(1), 154.
26. Kadir, A., Battersby, A., Spencer, N., & Hjern, A. (2019). Children on the move in Europe: a narrative review of the evidence on the health risks, health needs and health policy for asylum seeking, refugee and undocumented children. BMJ paediatrics open. 3(1).
27. Kaoutar, B., Mathieu-Zahzam, L., Lebas, J., & Chauvin, P. (2012). the health of migrants consulting the Baudelaire polyclinic of the Saint-Antoine hospital in Paris, France. Bulletin of the Society of Exotic Pathology. 105 (2), 86-94.
28. Karl-Trummer, U., Novak-Zezula, S., & Metzler, B. (2010). Access to health care for undocumented migrants in the EU. Eurohealth. 16(1), 13-16.
29. Keygnaert, I., & Guieu, A. (2015). What the eye does not see: a critical interpretive synthesis of European Union policies addressing sexual violence in vulnerable migrants. Reproductive health matters. 23(46), 45-55.
30. Kuehne, A., Huschke, S., & Bullinger, M. (2015). Subjective health of undocumented migrants in Germany–a mixed methods approach. BMC public health. 15(1), 926.Myhrvold, T., & Småstuen, M. C. (2019). Undocumented migrants’ life situations: An exploratory analysis of quality of life and living conditions in a sample of undocumented migrants living in Norway. Journal of clinical nursing. 28(11-12), 2073-2087.
31. Mudde, Cas. (2019, 14 Mayıs). The Guardian. Why copying the populist right isn’t going to save the left. https://www.theguardian.com/news/2019/may/14/why-copying-the-populist-right-isnt-going-to-save-the-left. Erişim tarihi: 2 Haziran 2019.
32. Platform for International Cooperation on Undocumented Migrants (PICUM). Pourquoi utiliser les termes ‘sans papiers’ ou ‘irregulier’? http://picum.org/Documents/WordsMatter/Leaflet_FRENCH.pdf. Erişim tarihi: 4 Ağustos 2019.
33. Pottie, K., Martin, J. P., Cornish, S., Biorklund, L. M., Gayton, I., Doerner, F., & Schneider, F. (2015). Access to healthcare for the most vulnerable migrants: a humanitarian crisis. Conflict and health. 9(1), 16.
34. Rafighi, E., Poduval, S., Legido-Quigley, H., & Howard, N. (2016). National Health service principles as experienced by vulnerable London migrants in" austerity Britain": A qualitative study of rights, entitlements, and civil-society advocacy. International journal of health policy and management. 5(10), 589.
35. Simonnot, N., & Intrand, C. (2009). L’Europe et les sans-papiers. Politique de santé ou politique d’immigration?. Hommes & migrations. Revue française de référence sur les dynamiques migratoires. (1282), 108-121.
36. Sirkeci, I. (2017). Turkey’s refugees, Syrians and refugees from Turkey: a country of insecurity. Migration Letters. 14(1), 127-144.
37. Topcuoğlu, R. A. (2016). Göç Yazınındaki Düzenli ve Düzensiz Göç Kavramları: İnsan Hakları Temelinde Bir Kavramsal Sorgulama. İnsan Hakları Yıllığı. 34, 1-20.
38. Teunissen, E., Tsaparas, A., Saridaki, A., Trigoni, M., van Weel-Baumgarten, E., Van Weel, C., ... & Lionis, C. (2016). Reporting mental health problems of undocumented migrants in Greece: A qualitative exploration. European Journal of General Practice. 22(2), 119-125.
39. United Nations Department of Economic and Social Affairs (UN DESA).(2017). International Migration Stock. https://www.un.org/en/development/desa/population/migration/data/estimates2/estimates17.asp. Erişim tarihi: 18 Haziran 2019.
40. Vignier, N., du Lou, A. D., Pannetier, J., Ravalihasy, A., Gosselin, A., Lert, F., ... & PARCOURS Study Group. (2018). Access to health insurance coverage among sub-Saharan African migrants living in France: Results of the ANRS-PARCOURS study. PloS one. 13(2).
41. Woodward, A., Howard, N., & Wolffers, I. (2013). Health and access to care for undocumented migrants living in the European Union: a scoping review. Health policy and planning. 29(7), 818-830.