NowHereLand – Improving Services for Undocumented Migrants (UDM) in the EU

The issue of undocumented migrants (UDM) in the EU has been gaining increasing attention. Estimated at between 1.9 and 3.8 million people in the EU in 2008 (7-13 % of the foreign population), this is a vulnerable group, exposed to high levels of health risks. Although all EU Member States have ratified the human right to health care, heterogeneous national public health policies have different frameworks for health care provision which in many cases severely restrict UDM access to health care. Accordingly, practice models of how to ensure the human right to health follow different logics.

Undocumented Migrants are vulnerable groups at high risk of health threats (e.g. HIV, TBC, etc.). Service provision for UDM is precarious due to various reasons such as late contact with services, language barriers, lack of entitlement, and uncertain legal/financial frameworks. Health policy has to deal with contradictory aims and criteria from public health, human rights, security and law enforcement policies.

Project aims

The project aimed to improve knowledge to manage these complex problems by collecting existing practice in health policy and health services in the EU. It identified transferable good practices optimising between criteria of quality of care, stress reduction for providers, and avoidance of attraction for clandestine migration. The perspectives of policy, providers and clients were included in assessments of needs, strategies and problems.

Project findings

Based on the evidence collected and research experience within the framework of the NowHereland Project, preliminary recommendations can be formulated that address the policy frameworks and the practice level of health care provision itself as well as further research. These are:

Increased awareness about the issue of undocumented migration is required, so that policies are based more on evidence and less on emotions/myths. This requires a more systematic use of knowledge collected in various projects and initiatives, both on practical level and on a research level.
UDM are the most flexible and exploitable work force and undocumented migration is closely connected to informal labour market demands. Policies to shape labour markets should be included in discussions concerning UDM issues.
The debate on how to ensure the human right to health care is undoubtedly highly relevant. Furthermore, economic conditions should be considered, which might show that the costs of excluding UDM from health care until they end up in emergency care are considerably higher than allowing (at least) partial access to mainstream services.
The development of partnerships between public health services and NGO initiatives has proven to be a factor for successful practice. GOs and NGOs should find a way to discuss and develop frameworks for joint service provision.
UDM are a heterogeneous group, and there are vast differences between and within UDM communities. Differences are related to working and living situations as well as social networks. On a practice level, this means that there is no standard, ‘one-size-fi ts-all’ solution. Research and practice approaches have to be aware of the dangers of stereotyping.
In most cases, UDM leave their countries of origin because they cannot have a ‘humane’ life there. They are willing to work, to take care of their families and themselves in order to succeed in life, and they survive under extreme hardship. They could also be seen as a resource for Europe and not a threat. Maybe such a shift in perspective could open up new grounds for discussion.

Download a copy of the report here.

Research team

Caroline Hall

Glynis Flood

Output

Danube University, Krems (with contribution from all partners, including University of Brighton) (2010) Health Care in NowhereLand – Improving Services for Undocumented Migrants in the EU. Final Report to the European Commission. Krems, Austria; University of Krems.

Partners

Danube University Krems

Azienda Unità Sanitaria Locale di Reggio Emilia

Centro de Investigacao e Estudos de Sociologia

Malmö Institue for Studies of Migration

Platform for International Cooperation on Undocumented Migrants