National staff: 45
Many people in Spain, and in particular a vulnerable, excluded often immigrant population, do not make use of the country's General Social Service, which covers basic necessities such as health care. Since 1994, MSF has been working to improve the access to health care and social services of this "fourth world" population.
4th World Barcelona
MSF has a socio-medical dispensary for Barcelona's marginalized population next to the main MSF office in the city. The focus is on increasing access to the existing health network. In addition to providing medical care at the dispensary, MSF raises awareness of HIV/AIDS and offers general health information. In an area of the city frequented by heroin addicts, MSF mobile clinics exchange needles with drug users and offer basic care. Teams also visit parts of the city where homeless people live, to talk to them, encourage them to visit the clinic if necessary, and help them learn how to access existing health and social services.
To better understand the social, health, educational and housing rights of disadvantaged people in Barcelona, MSF is conducting a legal review of relevant national and regional laws. This work is focused initially on the laws regarding creating a space for drug users to inject heroine safely, because a plan to create such a space was refused by the authorities after extensive pressure from people in the surrounding neighborhood.
4th World Madrid
In April 2000, MSF began work in Madrid. The program is twofold. Medical work is done through the Madrid-area tuberculosis control (TBC) program. The legal/social part of the program focuses on immigrants and asylum seekers, who often live in difficult conditions because of their lack of papers.
MSF works to detect and treat tuberculosis, with special priority given to often undocumented immigrants. People receive information on administrative and judiciary procedures necessary for legalizing their stay in Spain. MSF also guides immigrants and asylum seekers to various general services, such as social and health services, educational and cultural services, professional training and career guidance.
The project has recently begun offering psychological assistance to those in need, who often suffer from depression, anxiety, alcoholism, drug addiction, and stress. These problems have a variety of causes: difficulty adapting to Spain, distance from families, limited networks of social support, unemployment, or physical or psychological mistreatment undergone prior to arrival in Spain.
To open a public dialogue about the problems faced by the "fourth world" population in Spain, MSF is interested in participating in civic platforms supporting immigrants, cooperating with human rights organizations, campaigning to change public opinion, and denouncing Spanish government actions which violate the rights of asylum seekers and other immigrants.