Undocumented migrants in Sweden among the most vulnerable in Europe

Roughly six out of every seven people who turn to the MSF project quote fear as the primary reason for not seeking care in regular health structures. They are afraid of being treated badly or being turned in to immigration authorities or the police.
Stockholm - A Médecins Sans Frontières (MSF) project for undocumented migrants in Sweden that has been running for the past year has shown that financial, judicial and administrative barriers add to the de-facto exclusion of undocumented migrants of health care in Sweden. The MSF project provided 502 medical consultations over 2004. The vast majority of the 168 patients involved (87%) say they have turned to MSF because they are afraid of going to a hospital directly. "The project has been running for over a year now," said MSF's Head of Mission, Mattias Ohlson. "The sheer number of people who contact us illustrates how serious the problem of the undocumented migrants is in terms of seeing a doctor and receiving treatment when needed. We hope that decision makers and health workers will work together to remove the barriers that stand between these people and the care they are entitled to." MSF decided to organise consultations for undocumented migrants after the organisation had found, in 2003, that many of them only seek medical care when in a very late stage of illness, or not at all. The mission set up a phone number for undocumented migrants to call if they needed care but felt unable to go to regular health services. Simultaneously, MSF built a network of doctors who are willing to see and treat people outside their normal practice hours for free. A nurse, employed by MSF on full-time basis, answers the phone and mediates between the undocumented migrants and both the MSF network and hospitals. In comparison with other West European counties where MSF has projects aimed at facilitating access to health services for undocumented migrants, Sweden has far worse legislation, according to Ohlson. "The Swedish legislation on health care for undocumented migrants are one of the strictest, and Sweden is one of the few countries that actually charge them for emergency care," he said. "For example, a delivery costs over 3,000 Euro, if there are no complications. This makes undocumented migrants tremendously vulnerable. In terms of legal entitlement, countries such as Italy, Spain and Belgium take much better care of undocumented migrants than Sweden." Roughly six out of every seven people who turn to the MSF project quote fear as the primary reason for not seeking care in regular health structures. They are afraid of being treated badly or being turned in to immigration authorities or the police. MSF has heard from several health workers that they assume treating undocumented migrants is illegal and may cost them their medical or nursing license. Such misconceptions should be corrected urgently and publicly, says MSF, in order for undocumented migrants to regain confidence that they can visit a doctor when needed. In addition to the fear and the high costs, undocumented migrants' access to health care is restricted by administrative routines. "Many administrators in hospitals think they can either not allow people in who do not have proper ID or only after they have paid all costs for the consultation or treatment in advance," says Ohlson. MSF is continuing its mission in Sweden in 2005. The organisation will seek solutions for individual patients on a daily basis as well as alert decision makers to the structural blockages that undocumented migrants seeking health care face.