Littérature scientifique sur le sujet « Immigrants, irregular, care systems, rights »

- The legislative and operational measures recently adopted by Italy in order to prevent and repress clandestine immigration raise the problem of their consistency with Italy's international obligations conncerning the protection of human rights. With a view to assessing the actual terms of such a problem, contents and extent of the protection to be afforded to irregular migrants, under the international law of human rights, must be preliminarily determined. Considering the specific legal situation of Italy, in the light of its participation both to the European Convention of Human Rights and to the International Covenants on Human Rights, as well as to many other conventions dealing with the protection of human rights, it clearly turns out that Italy is internationally bound to respect and protect a number of basic rights of irregular migrants. Such rights include, at the very least, the right to life, the right not to be subjected to torture (or to cruel, inhuman, or degrading treatment), and the right not to be subjected to arbitrary arrest or detention. Respect for such rights also implies an absolute non-refoulement obligation, that is an obligation not to expel or return an irregular migrant to another State where there is an actual risk that his or her rights would be violated. Moreover, basic rights of clandestine immigrants include the right to family unity, the right not to be subjected to collective expulsion, and (closely linked with this latter right) the right to a fair and transparent procedure of expulsion or repatriation, implying a reasonable and objective examination of the particular case of each individual. Turning to economic, social and cultural rights, an internationally lawful treatment of irregular migrants requires compliance with international obligations protecting the right to health and medical care, the right to primary education, and some core labour rights. The principle of non discrimination plays obviously a crucial role in view of correctly implementing all these international obligations with respect to the specific situation of irregulars migrants. Lastly, special and stronger human rights protection is required when the irregular migrants are children, or victims of trafficking in persons. In the light of the international human rights obligations which are applicable to the peculiar situation of irregular migrants, some of the legislative and operational measures adopted by Italy to struggle against clandestine immigration seem indeed to be inconsistent not only with such obligations (and with the increasing international trend towards the "non criminalization" of clandestine immigrants by reason of their irregular position), but also - at least in part - with the EU legal standards provided for by the recent 2008/115/EC Directive on common standards and procedures for returning illegally staying third-country nationals. This seems to be true, for example, with regard both to the new Article 10 bis inserted in the Legislative Decree n. 286 on immigration, introducing the crime of clandestine immigration, and to the new paragraph 11 bis of Art. 61 of the Criminal Code, introducing a general aggravating circumstance consisting in the irregular status of the immigrant author of a crime. But this seems particularly true and blameworthy with regard to the practice of intercepting crumbling boats full of migrants on the high seas and coercively driving them back to Libya.

Recent decades have seen a strong trend among democratic countries to extend voting rights at subnational levels to non-naturalized immigrants, creating substantial variation across countries in terms of voting eligibility rules for non-naturalized immigrants. Our knowledge of the consequences of these different systems for immigrant political integration is, however, limited. This article seeks to shed new light on this important issue by using Swedish data to study whether immigrants who face shorter residency requirements for voting eligibility in local elections are more likely to integrate politically. We find little compelling evidence that such is the case. The results suggest that immigrants who became eligible to vote after six to seven years were as likely to naturalize and vote in future elections in both the short and long run as those who received the right to vote after only three years of residency. Thus, although expanded franchise can be of symbolic, as well as practical, value, it is unlikely to be a panacea for immigrant political inclusion. The argument that early voting rights for non-naturalized immigrants is desirable since it helps speed up immigrant political integration should, therefore, be used with some care by those advocating for such reforms.

Migration policies in recent years have turned to growing restrictions and tighter controls in most countries, not only at national level but often also at local level. But several actors from civil society have tried to counteract this trend, protesting, organizing advocacy actions, providing services and promoting networks. Italy is a case in point: from the beginning of the arrival of immigration flows in the ’80, the reception of the newcomers and the defence of their rights has been provided mainly by non-public actors: trade unions, voluntary associations, social movements, catholic institutions. In the last decade, Italian immigration policies have hardened, above all in the period 2008-2011, with the advent of a securitarian discourse. Many civil society organizations struggled against these policies. The article will present two case studies: 1) the Association “Avvocati per niente”, that defends the immigrants against local policies of exclusion; 2) NAGA and OSF, two Associations engaged in health care for irregular immigrants in Milan. The articles explore motivations, discourses, strategies, alliances and outcomes of their action.

<p><strong>BACKGROUND: </strong>One of the consequences of migration is cultural diversity in various communities. This has created challenges for healthcare systems.</p><p><strong>OBJECTIVES: </strong>The aim of this study is to explore the health care staffs’ experience of caring for Immigrants in Mashhad- Iran.</p><p><strong>SETTING:</strong> This study is done in Tollab area (wherein most immigrants live) of Mashhad. Clinics and hospitals that immigrants had more referral were selected.</p><p><strong>PARTICIPANTS:</strong> Data were collected through in-depth interviews with medical and nursing staffs. 15 participants (7 Doctors and 8 Nurses) who worked in the more referred immigrants’ clinics and hospitals were entered to the study.<strong> </strong></p><p><strong>DESIGN: </strong>This is a qualitative study with content analysis approach. Sampling method was purposive. The accuracy and consistency of data were confirmed. Interviews were conducted until no new data were emerged. Data were analyzed by using latent qualitative content analysis.</p><p><strong>RESULTS:</strong> The data analysis consisted of four main categories; (1) communication barrier, (2) irregular follow- up, (3) lack of trust, (4) cultural- personal trait.</p><p><strong>CONCLUSION:</strong> Result revealed that health workers are confronting with some trans- cultural issues in caring of immigrants. Some of these issues are related to immigration status and some related to cultural difference between health workers and immigrants. These issues indicate that there is transcultural care challenges in care of immigrants among health workers. Due to the fact that Iran is the context of various cultures, it is necessary to consider the transcultural care in medical staffs. The study indicates that training and development in the area of cultural competence is necessary.</p>

Migratory flows have a specific influence in the European and Portuguese demographic context. Societies’ commitment to ensure fundamental rights of all citizens and migrants includes the promotion of health. This study aims to describe migrants’ health policies and access to the health system in Portugal within the European framework. We carried out a mixed methods approach, analyzing health policies in European Union countries and public health key indicators from statistical secondary data collected from Eurostat and Migrant Integration Policy Index. This data was complemented with a survey applied to immigrants living in Portugal. Portugal is a European country known for its favorable immigrant integration policies and has developed access to the health care system. However, our study has shown that greater investment is needed to overcome limitations or social inequalities which inhibit migrants’ access. Additionally, we sought to present a comparative analysis between Portugal and European Union countries, which can contribute to improve health systems within the current crisis.

AbstractThis paper explores the key features of the emerging welfare mix for Syrian refugees in Turkey and identifies the modes of interaction between humanitarian assistance programmes, domestic policy responses and the Turkish welfare system. The welfare mix for Syrian refugees is a joint product of humanitarian assistance programmes implemented by international and domestic non-governmental organisations (NGOs) and domestic social policy programmes. Three policy domains are considered: social assistance schemes, employment and health care services. The paper suggests that granting of temporary protection status to Syrian migrants in Turkey and the agreement between Turkey and the EU shaped the welfare mix by empowering the public sector mandate vis-à-vis the humanitarian actors. As a result, the role of the public sector increases at the expense of NGOs, especially in social assistance and health care, while NGOs are increasingly specialised in protection work (especially in mental health support), where the Turkish welfare system has been weak. Employment has been essentially disregarded, in both humanitarian and social policy programmes, which casts doubt on the prospect of successful economic integration. Finally, this paper argues that the convergence of the rights of immigrants and citizens may well occur in mature components of less comprehensive welfare systems.

Purpose As long as migration is recognized as a public health concern, policies exist to address migrants’ health, and provide comprehensive information on how public and private health care system operates, health rights and what their health care plan does or does not cover. Thereby, responding to patients’ expectations significantly affects overall satisfaction with health care services because this dimension is most strongly associated with patient satisfaction. The purpose of this paper is to constitute the first quantitative large-scale study (n=1,512) in Cyprus and Greece exploring the level of satisfaction among third-country nationals (TCN) in relation to their health care needs. Design/methodology/approach The questionnaire used in this study has been developed and measured (Cronbach α =0.7) in a similar study in Greece (Galanis et al., 2013) and it has been used by other studies too (Vozikis, 2015). Findings The authors can conclude that participants’ knowledge of the health system is not good as 70.2 percent that they do not have a good knowledge. The findings suggest that nearly one in two TCN faced problems in accessing clinics or communicating due to various factors. Practical implications The findings of this study provide the context for further exploration of different means to improve cultural awareness amongst health and social care professionals, including multicultural training of health and social service providers and medical pluralist approaches that may be closer to migrants’ cultural and health background. Overall, types of interventions to improve cultural competency included training/workshops/programs for health practitioners (e.g. doctors, nurses and community health workers), culturally specific/tailored education or programs for patients/clients, interpreter services, peer education, patient navigators and exchange programs (Truong, 2014). To the above, practices can also be added as multicultural education to all health professionals in order to develop enthusiasm and be able to acknowledge immigrants’ difficulties. Adding to the above recommendation, interdisciplinary education with allied health professionals (psychologists, social workers and nurses) may lead to a more holistic approach of this group’s needs, especially in the forthcoming health system where primary care will play a vital role. Social implications Access to the health system may lead to social inclusion of TCN in the local society and improve their quality of life. It is also important for TCN to feel that the current health system is aware of issues related to their social and cultural background; thus, it will make the health system and those who work look more friendly and approachable. Originality/value In an era of crisis and of great debate around a forthcoming National Health System, these findings indicate that healthcare providers in Cyprus will need to address several challenges in managing care for migrants. In order for that to happen, assessing patient satisfaction is thereby important in the process of quality evaluation, especially when dealing with population subgroups at higher risk of inequalities such as immigrants or ethnic minorities. Such studies help systems to develop by measuring their weaknesses and enhancing their strengths. Voicing clients/patients feedback is always helpful to minimize risks.

Background and context: In Senegal, pediatric oncology patients arrive at the hospital at advanced stages of disease. Their large tumors, as well as the side effects of chemotherapy make children experience intense pain. In this low-resource setting, morphine supply was quite irregular. Doctors don´t prescribe morphine due to shortages; but few prescriptions also lead to limited orders. A vicious circle with only 1 victim: the patient. Hearing children in pain was agonizing for everyone: patients, caregivers and healthcare practitioners. Aim: This advocacy narrative illustrates how the fight for access to morphine in pediatric oncology has led to both positive and negative externalities. We will highlight ways in which this fight for morphine has provoked political tensions moving the issue forward, but has also affected the careers of health workers involved. Strategy/Tactics: Morphine is a cheap drug, yet it is extremely regulated by international laws. It takes political will to influence national morphine orders. This advocacy strategy was built on raising awareness and setting morphine shortage on the political agenda. Not providing morphine in oncology goes against international standards of care. But most importantly, letting patients suffer without “existing” relief is a breach of basic human right to live - and also die - in dignity. Program/Policy process: Conversations began within the pediatric oncology department. Focus groups highlighted caregivers' feelings of powerlessness before their suffering child. Interviews with key informants (doctor and nurses) were instrumental to a widely diffused Human Rights Watch report exploring the medical and political causes to morphine supply shortages, as well as its psychological repercussions on patient care. A BBC documentary was broadcasted soon after. Subsequently, meetings were held between the Ministry of Health, the National Supply Pharmacy and leading local oncologists. Outcomes: Morphine orders were multiplied by 10, leading to much improved pain management for patients. However, Senegal was portrayed negatively on the international scenes, much to the Health Minister´s dismay. The consequences were incurred by the health workers who contributed to the international publications/reports. What was learned: Health practices can inform policy just like policy can inform health practices. It is a cyclical process. Creating advocacy coalitions and rallying the help of the international community are effective strategies. However, in the political arena, health workers need more than commitment to human rights and quality care. Even in democratic republics, systems can penalise outspoken activists. We have learned that health care practitioners (especially working in public settings) who wish improvement for their patients must learn to be tactical and diplomatic. International partners will return to their home countries, but local actors will pay the high cost of advocacy.

The complex interactions and ruptures between contemporary settler colonialism, environmental ethics, and Indigenous rights and worldviews often emerge in projects of civil engineering. The continued capture, control and burial of natural water courses in Aotearoa-New Zealand is a case in point, and exemplifies a failure to stay abreast of evolving understandings and renewed relationships we seek with our waterways, our ancestors. Wai-Horotiu stream used to run down what is now Queen Street, the main road in Auckland, Aotearoa-New Zealand’s largest city. Treasured by Māori as a source of wai (water) and mahinga kai (food), it is also the home of Horotiu, a taniwha or ancestral guardian—a literal ‘freshwater body’. However, as Tāmaki-Makaurau transitioned into Auckland city, Wai-Horotiu became denigrated; used as an open sewer by early settlers before being buried alive in the colonial process. How, now, can we know this buried waterway? Te Awa Tupua Act 2017 that affords the Whanganui River juristic personality and moral considerability offers one possible solution. It acknowledges that waterways, incorporating all their physical and metaphysical elements, exist in existential interlinks with Māori as part of their whakapapa (genealogical networks). This paper asks, can a corresponding and appropriate ethics of association and care be fostered in and expressed by the political descendants of British settlers (Pākehā) and later immigrants who live here under the auspices established by Te Tiriti o Waitangi in 1840? Here is a conversation between a Māori earth systems scientist and a Pākehā interdisciplinary scholar. Where Hikuroa speaks from and to direct whakapapa connections, beginning with pepeha, Lythberg’s narrative springboards from public art projects that facilitate more ways of knowing Wai-Horotiu. Together, we contend that a regard for Indigenous relationships with water can guide best practice for us all, and propose that creative practices can play a role in attaching people to place, and to waterways.

Over the past two decades, the creation of the European border regime has increasingly sparked acts of protest and resistance by immigrants and led to the creation of initiatives to defend immigrant rights. This activism has provoked many European states to formalize what is known in the literature as ‘crimes of solidarity’ in their legal systems. Taking the Spanish case as an example, the objective of this article is to analyse the ‘crimmigration’ of protest and activism defending the rights of irregular immigrants at Europe’s southern border. This analysis describes the development and implementation of the repressive tactics employed by the state against activists, including forms of police control of protests, informal and formal dissuasion techniques, and the use of administrative and criminal sanctions. This work provides valuable insight into the practical impact of these crimmigration processes, particularly how they have affected activists, social organizations and immigrants, as well as how they have extended beyond the territory of the state (externalizing punishment).

My research is about the possibility for irregular immigrant, to have medical care in health care systems. Their practices and problems dealing with human rights. Starting from their sick condition, using the special lent of legal analysis takes from european and italian laws, I study constraction's processes of this particular contemporary subjgectivity, always in balance from regular and irregular condition. These analysis show legal limits with their porositity and “gray zone” used by institutional systems in order to have immigrants in the state of 'irregularity' and easly to manipulate.

The aim of this paper is to analyze the effects that recent health reforms adopted in Spain because of the economic crisis have had on the National Health System. It is not only a matter of mere budgetary cuts or measures of saving in the public expense. Reforms are looking for the efficiency and financial sustainability of health care services. However, a «mutation» in the public service has taken place. Reforms have affected the basic principles of the public system: the insurance model, its universality, the financing of the system and the principles of equity and cohesion of the public service.
El objeto de este trabajo es analizar los efectos que las reformas adoptadas recientemente en España con motivo de la crisis económica han tenido en el servicio público sanitario. No se trata solo de meros recortes presupuestarios y de medidas de ahorro en el gasto público. Las reformas buscan la eficiencia y la sostenibilidad económica del sistema sanitario. Sin embargo, han producido una importante «mutación» del servicio público que ha afectado a los principios básicos inspiradores del modelo, al modelo de aseguramiento, a su universalidad, a su financiación y, con ello, a los principios de equidad y cohesión del sistema.

Milena Andrea Melo’s chapter examines the impact of the lack of health insurance coverage for low-income, undocumented immigrants who required regular dialysis to stay alive. Undocumented immigrants are deemed undeserving of most publicly funded health care services by virtue of their “illegal” status. Those with chronic, debilitating illness struggled to navigate public and private health care institutions as indigent patients in order to locate life-saving but substandard treatment. Since they were uninsured, irregular and costly dialysis treatments in hospital emergency rooms, paid by Emergency Medicaid, was their only option. The chapter demonstrates that the health system itself exacerbated health risks for dialysis patients by requiring that they come close to death before emergency services were offered. This chapter raises questions concerning belonging, deservingness of care, and American notions of human rights in cases where those with nothing more than “bare life” are excluded.