When it comes to going to the doctor, the list of difficulties for immigrants, especially those in an irregular situation and women who suffer gender violence, is endless. The fact that their conditions of legal access to public health services are more restricted, lack of knowledge about the language or their own fear of being punished or deported to their country are some of them.
The Professor of Nursing I of the UPV / EHU Iratxe Pérez Urdiales has carried out an investigation with the aim of recognizing these obstacles that take place in Basque health. “We wanted to analyze what are the difficulties faced by the immigrant population, especially those in an irregular administrative situation and immigrant women when it comes to accessing the health system in Euskadi,” says the researcher whose study includes an analysis of data from several years of the free clinic of the NGO Doctors of the World Euskadi.
Iratxe Pérez confesses that her classification includes some of those barriers, but that there may be more that she has not been able to detect in her study. “There are personal difficulties, a person who is Latin American is not the same as African, starting with the language or the culture they have and the approach they have in their countries to the health system. That is, the characteristics of each person. Then there are also those from the health system, since in Euskadi they attend to you in Basque and Spanish and the fact that someone can attend you in English, French, Swahili or any other language is a personal plus of the person who attends you, not from the health system, “he says.
There is a lack of knowledge of the access regulations for immigrants, which means that people who could access by law are left out
– Professor of Nursing at the UPV / EHU and researcher
Another barrier that this researcher has encountered is the fact that it is the same person who has to approach the health center in person to be treated and that no campaigns are carried out from health centers to get closer to them. “The fact that the care or information is only in the health center also makes it difficult for many people who are immigrants to access them, either out of fear or ignorance. The health system is not proactive looking for cases of people in which it is necessary for health that they go to him “, indicates Pérez.
Racism is also another factor that keeps these people away from health centers. “Immigrants when they go to the health system are not always well received by the professionals who work there, both administrative and health. Sometimes what happens is that there is a lack of knowledge of the access regulations for immigrants, which brings people who They could be allowed by law to be excluded and also in some cases there is a certain degree of racism, since the racism that exists structured in society, we health people also have it integrated. Sometimes there are also those kinds of problems “, the Mint.
Immigrant women have added barriers that make it more difficult for them to access healthcare
– Professor of Nursing I at the UPV / EHU and researcher
The study places special emphasis on immigrant women who have suffered gender violence and the opportunities they have to access healthcare given their situation and the danger they face. “Gender-based violence affects both local and non-local women, but immigrant women have added barriers that make it more difficult for them to access health care. They are based mainly on fear, fear on their part that health personnel discover their situation, fear caused by the abuser so that they do not come and all that mixed with other barriers they may have makes it really difficult to access “, says the researcher.
As an alternative, Pérez emphasizes the figure of mediator that exists in health systems such as Catalan or Andalusian, in which a person helps, accompanies and informs foreigners in the health process. “That helps a lot to make them feel integrated into the health system, not to miss appointments and at a given moment, when they need to go to the health system, they are not left out as happens on certain occasions,” he says.
Two decree laws that came into force in 2012, imposed stricter conditions on the right of migrants in an irregular administrative situation to access standardized health care. In this sense, Pérez has analyzed data from a free clinic run by the NGO Doctors of the World Euskadi. “The fact is not that the law is increasingly restrictive and does not allow them to enter, but that the changes in the law also produce a lot of ignorance both in migrants and in the people who work there and there are many people who have suffered more violations due to the fact that health personnel, especially administrative personnel, were unaware of the law and many people who had access were left out, “laments Pérez.
The free clinics, or ‘free clinics’ managed by social organizations such as Doctors of the World, which has one of the most important primary care consultations for the care of migrants who are outside the health system in the Basque Country. According to the researcher, these clinics, which serve people in an irregular administrative situation, but not exclusively, “are a good solution to get out of trouble and improve the health of the immigrant population, but they are not a definitive solution at all since they have to be it the health system that approaches or the one that provides solutions so that immigrants can access the health care they deserve and need “.