Sexual exploitation of unaccompanied migrant and refugee boys in Greece: Approaches to prevention.

In this essay, Julie Freccero and colleagues discuss resources to prevent the sexual exploitation of unaccompanied and separated refugee boys in Greece.

Undocumented migrants have diverse health problems.

INTRODUCTION: In 2008, 1.9-3.8 million undocumented migrants lived in Europe. We aimed to strengthen the evidence base on undocumented migrants' health problems by describing characteristics of undocumented migrant patients in a Danish non-governmental organisation (NGO) health clinic. MATERIAL AND METHODS: All patient files from the period from 24 August 2011 to 28 January 2013 were included in the study. Patient contacts were systematically analysed for age, sex, country of origin, medical referrals, symptoms and diagnoses. Contacts were classified by patient complaints or symptoms based on the International Classification of Primary Care, 2nd Edition (ICPC-2). RESULTS: A total of 830 patients (39.75% women and 60.25% men) visited the clinic, which led to a total of 2,088 visits and 1,384 ICPC-2 classifications. The patients seen had 94 different nationalities. The most common reasons for medical contact correspond well with the pattern seen in general practice and several chronic and severe cases were observed in the NGO clinic. Furthermore, a larger share of pregnant women presented (11.6%) compared with a Danish general practice (5.1%), and these were seen first in a late gestational age on average (16+ weeks). CONCLUSION: Undocumented migrants presented with diverse health problems. Some patients presented with critical disease, and an alarming number of pregnant women did not seek medical care until a late stage, and they did not return for infant care after giving birth. FUNDING: The study was funded by the Institute of Public Health, University of Copenhagen. TRIAL REGISTRATION: not relevant.

Access to health care for undocumented migrants from a human rights perspective: a comparative study of Denmark, Sweden, and The Netherlands.

BACKGROUND: Undocumented migrants' access to health care varies across Europe, and entitlements on national levels are often at odds with the rights stated in international human rights law. The aim of this study is to address undocumented migrants' access to health care in Denmark, Sweden, and the Netherlands from a human rights perspective. METHODS: Based on desk research in October 2011, we identified national laws, policies, peer-reviewed studies, and grey literature concerning undocumented migrants' access to health care in the three involved countries. Through treaties and related explanatory documents from the United Nations and the Council of Europe, we identified relevant international laws concerning the right to health and the rights of different groups of undocumented migrants. A synopsis of these laws is included in the analysis of the three countries. RESULTS: Undocumented migrants in Denmark have the right to emergency care, while additional care is restricted and may be subject to payment. Undocumented migrants in Sweden have the right to emergency care only. There is an exception made for former asylum-seeking children, who have the same rights as Swedish citizens. In the Netherlands, undocumented migrants have greater entitlements and have access to primary, secondary and tertiary care, although shortcomings remain. All three countries have ratified international human rights treaties that include right of access to health care services. We identified international treaties from the United Nations and the Council of Europe that recognize a right to health for undocumented migrants and embrace governmental obligations to ensure the availability, accessibility, acceptability, and quality of health services, in particular for specific groups such as women and children. CONCLUSION: In the Netherlands, undocumented migrants' right to health care is largely acknowledged, while in Denmark and Sweden, there are more restrictions on access. This reveals major discrepancies in relation to international human rights law.

Access to healthcare and alternative health-seeking strategies among undocumented migrants in Denmark.

BACKGROUND: As in many European countries, undocumented migrants in Denmark have restricted access to healthcare. The aim of this study is to describe and analyse undocumented migrants' experiences of access to healthcare, use of alternative health-seeking strategies; and ER nurses' experiences in encounters with undocumented migrants. METHODS: Qualitative design using semi-structured interviews and observations. The participants included ten undocumented South Asian migrants and eight ER nurses. RESULTS: Undocumented migrants reported difficulties accessing healthcare. The barriers to healthcare were: limited medical rights, arbitrariness in healthcare professionals' attitudes, fear of being reported to the police, poor language skills, lack of network with Danish citizens, lack of knowledge about the healthcare system and lack of knowledge about informal networks of healthcare professionals. These barriers induced alternative health-seeking strategies, such as self-medication, contacting doctors in home countries and borrowing health insurance cards from Danish citizens. ER nurses expressed willingness to treat all patients regardless of their migratory status, but also reported challenges in the encounters with undocumented migrants. The challenges for ER nurses were: language barriers, issues of false identification, insecurities about the correct standard procedures and not always being able to provide appropriate care. CONCLUSIONS: Undocumented migrants face formal and informal barriers to the Danish healthcare system, which lead to alternative health-seeking strategies that may have adverse effects on their health. This study shows the need for policies and guidelines, which in accordance with international human rights law, ensure access to healthcare for undocumented migrants and give clarity to healthcare professionals.