Rapport   Access to health care and human rights of asylum seekers in Malta.


Accès aux soins et aux droits des migrants à Maltes - Rapport en anglais novembre 2007 - synthèse en français

1. Summary

Background:

After an exploratory mission in September 2006, Médecins du Monde (MdM) France decided to plan and to implement an international humanitarian mission concerning the access to healthcare of asylum seekers in Malta for a duration of 5 months starting from April 2007.Médecins du Monde (MdM) is an international humanitarian aid organisation with 11 country offices inEurope. MdM provides health care in situations of acute and chronic crisis and intervenes in issues ofaccess to health care of vulnerable persons in more than 50 countries around the world. It has, since itsfoundation in 19801, been focusing on issues of health care among asylum seekers and refugees whocertainly belong to one of the most vulnerable populations, especially with regard to their right to accessadequate health care

Objective and activities:

The main objective of the mission was to foster the right to access health care among the migrants living in detention and in the Open Centres. The humanitarian mission in Malta was started on April 18th 2007. The MdM team – consisting of a nurse and a medical doctor (with a Master of Science in Public Health) - offered medical consultations between June 1st and August 30th in the two biggest Open Centres. The consultations were held twice weekly in Marsa Open Center (consultations offered on Thursdays from 5pm to 8pm, and on Sundays from 12am to 5 pm) and Hal Far Tent Village (consultations were offered here on Wednesdays and Fridays between 5pm and 8pm). The MdM team offered moreover preventive workshops for women on sexual and reproductive health and rights in several Open Centres, distributed information material and male condoms during their medical consultations and trained - in collaboration with UNHCR and JRS - cultural mediators on health related issues.
Through its work, MdM was able to cure, orientate and guide patients to complementary services and support the vulnerable asylum seeker population. The project guaranteed as well an improved detection
mechanism for diseases of great importance to public health, including Tuberculosis, HIV/AIDS and
psychiatric disorders. Moreover, providing medical services in close proximity to the refugee population
was shown to significantly reduce the pressures on the main policlinics in Floriana and Paola and
ambulance services. During its work MdM registered 410 medical consultations and 325 new clinical cases.
The field team conducted in total 167 structured face-to-face interviews on questions of access to health
care and 59 on issues of psychosocial health.



Access to health care and human rights of asylum seekers in Malta. Experiences, results and recommendations. MdM France survey and final report of the humanitarian mission in Malta 2007.

Rapport_Malte.pdf 659.96 kB

Accès aux soins et droits des migrants à Maltes - Rapport novembre 2007. Synthèse en français.

synthese_rapportMalte.pdf 412.41 kB

Table of content

  • 1. Summary
  • 2 Introduction
    • 2.1. Context
    • 2.2 The collaborating local partners during the MdM mission.
    • 2.3. Arrival of asylum seekers in Malta and detention policy
    • 2.3.1. Arrival in Malta 8
    • 2.3.2. Detention policy and procedure
    • 2.4. The Open Centres
    • 2.4.1 Basic facts and living conditions
    • 2.4.2. Living conditions in Marsa and Hal Far tent Village
    • 2.5. The Maltese health care system and the control of communicable diseases: a short overview
    • 2.5.1. Short overview of the Maltese health care system
    • 2.5.2. Entitlement to health care of asylum seekers.
    • 2.5.3. The control of communicable diseases
    • 2.5.3.1 Tuberculosis
    • 2.5.3.2 HIV/AIDS and Sexual Transmitted Diseases (STD)
  • 3 The MdM-project: Concrete action and collection of evidence
    • 3.1. Objectives
    • 3.2. Activities
  • 4. Health care and prevention in detention and the Open Centres: Methodology,observations, findings and recommendations
    • 4.1. Detention
    • 4.1.1. The MdM visit to Hal Safi and Hal Far Detention Centre
    • 4.1.2. The living conditions in the detention centres. A short summary
    • 4.1.3. Access to health care
    • 4.1.4. Vulnerabilities
    • 4.1.4.1 The policy paper: An incomplete framework
    • 4.1.4.2 The identification and handling of vulnerable persons
    • 4.2. Recommendations: Detention in Malta, an inhuman practice
    • 4.3. The Open Centres: The MdM survey, daily experiences and prevention
    • 4.3.1. The MdM survey
    • 4.3.1.1. Methodology of the survey in the Open Centres
    • 4.3.1.1.1. The first step: Medical diagnosis, referrals and chronic diseases
    • 4.3.1.1.2. The second step: Questionnaires on access to health care and psychosocial health
    • 4.3.1.2. Results of the MdM survey
    • 4.3.1.2.1. Medical diagnosis, referrals and hospitalisation
    • 4.3.1.2.1.1. Medical diagnosis
    • 4.3.1.2.1.2. Start of Symptoms:
    • 4.3.1.2.1.3. Referrals
    • 4.3.1.2.1.4. Hospitalisation
    • 4.3.1.2.1.5. Chronic diseases
    • 4.3.1.2.2. The questionnaires: access to health care and psychosocial health of asylum seekers in Malta
    • 4.3.1.2.2.1. The Questionnaires on Access to Health Care: the asylum seekers’ perspective
    • 4.3.1.2.2.2. The Questionnaires on Psychosocial Health
    • 4.3.1.3. Discussion of the findings of the MdM survey
    • 4.3.2. Prevention
    • 4.3.2.1. Sexual reproductive health: workshops with female asylum seekers
    • 4.3.2.2. Prevention in the Open Centres: Distribution of leaflets and male condoms
    • 4.3.3. Accompaniments of asylum seekers to hospitals and policlinics
    • 4.3.4 Additional experiences and observation regarding access to health care
    • 4.4 Health care of asylum seekers in the Open Centres: Conclusions and recommendations
    • 4.5 Final conclusion

Access to health care and human rights of asylum seekers in Malta. Experiences, results and recommendations.

All migrants who arrive at the shores of Malta are sytematically detained. Malta applies a policy of administrative detention with a maximum length of 18 months. In reality, a certain amount of vulnerable persons - including children and pregnant women - are realesed within a months time, but the vast majority is released only after 10 to 12 months. After detention, the migrants live in different open centres on the island.