PROTECTING IMMIGRANTS

HEALTH: RECENT PROGRESS

PANOS EFSTATHIOU, MD, Ph.D.
NATIONAL HEALTH OPERATIONS
CENTRE COMMANDER

The establishment of the migrants
detention centres was the best way to
reduce and gradually abate the
negative impacts of thousands illegal
migrants in Greece.
IMMIGRANTS IN GREECE
The vast majority of immigrants in Greece
remained undocumented until the first
legalization process in 1997-1998.

The main features of this migration period
were:
informality
temporariness
employment in the "informal" economy and
mass deportations



IMMIGRANTS IN GREECE

In our country live between 800,000 to
1,000,000 foreign nationals amounting
to 7.3% of the total population.



IMMIGRANTS IN GREECE

More than half are coming from Albania
and an additional 16.2% from Central and
Eastern Europe and the former Soviet
Union.

In recent years we have seen a large
influx of immigrants from Asian countries
and the Middle East



IMMIGRANTS IN GREECE

In Greece, the legal term foreign"
refers to all those who do not have the
Greek nationality, but essentially it is
used only for third countries nationals
excluding EU citizens


CATEGORIES OF
FOREIGNERS IN GREECE

Foreign citizens who live and work in Greece and
have residence permits

Foreign citizens who live and work in Greece and
DONT have residence permits



CATEGORIES OF
FOREIGNERS IN GREECE

Asylum seekers
Refugees who live and work in Greece
Repatriated Greeks of Greek origin
Unaccompanied underage migrants


IMMIGRANTS HEALTH
PROFILE



Tuberculosis
1
2
3
Hepatitis
HIV/AIDS
IMMIGRANTS HEALTH
PROFILE




Scabies

4
5
6
Suicide Attempts
Chronic Health problems
IMMIGRANTS HEALTH
PROFILE



IMMIGRANT
Stress Somatization
Emotional
disorders
Psychotic
disorders
PROBLEMS SOURCE
1. Detention of unaccompanied minors - often in the
same places as adults.

2. Detention of people from war zones - such as
Syrians - with serious psychological burden, such as
post-traumatic stress syndrome.

3. Failure of the State to provide the continuity of
ongoing health interventions with many months
discontinuance that causes immigrants limited
access to health care
PROBLEMS SOURCE

4. Serious obstacles to interface with local health units.

5. Lack of procedures for the initial assessment of the
medical situation of newcomers immigrants.

6. Lack of provision for the immediate lifting of the
detention process for serious medical incidents.
PROBLEMS SOURCE
7. Lack of a monitoring system from the appropriate
local health authorities (Regional Directorates of
Public Health) with on-site visits in order to
safeguard public health.

8. Lack of proper interpretation services resulting
inadequate provision of psychosocial and other
services, such as information services.

9. Big detention time
IMMIGRANTS IN GREECE



A special category comprises
of immigrants and asylum
seekers accommodated in
detention centers.

NATIONAL HEALTH SYSTEM (NHS)
Access of immigrants to the NHS, is a key aspect of their
integration in Greek society.

Immigrants of Greek origin (expatriates), can benefit from
public health services if they provide the necessary
documents.



NATIONAL HEALTH SYSTEM (NHS)
Refugees and asylum seekers enjoy
equal rights and access to healthcare as
the Greek citizens


NATIONAL HEALTH SYSTEM (NHS)



Access to the NHS
Is not allowed
When it comes to minors and foreigners imported
urgently for hospitalization there is an exception to the
rule (Law 3386/2005/Article 84)
IMMIGRANTS IN GREECE



For issues of detention, safety, hygiene, and
preservation of normality, it is necessary to
apply a serious, scientific and humanitarian
appropriate program to address the
problem.
IMMIGRANTS IN GREECE




In most cases, immigrants and especially
immigrants progenies, lack access to
health services and education and are
exposed to acts of violence against them.
Detention Centres
must have:
Residency
Infirmary
Area of staff residence
Restrooms
Restaurant
Places of religion worship
Fire department
Sports field
Entertainment
DETENTION CENTRES
MUST HAVE



The installation must have
triple link fence (NATO type)
of 3 metres in height
Custody
Cleaning



The role of supportive social networks
and non-governmental organizations
(NGOs) is of great importance



Following a request from the Ministry of
Public Order and Citizen Protection, the
National Health Operations Centre
(EKEPY) of the Ministry of Health,
undertook the health coverage of
migrants detentions centres.
INSIDE
THE DETENTION CENTRES
Prevention
Hygiene
Information
Comprehensive immigration policy
MAIN PURPOSE




The purpose of the EKEPY Operational Plan
is the recording of actions (interoperability)
for Integrated Healthcare support at the
detention centres which are under the
jurisdiction of the Police
ASSUMPTIONS
1. The immigrants detention centres within
the Greek territory are in specific areas
(former military camps and other
buildings), and they can provide
accommodation and safety facilities.
2. The security of these centres is under
the responsibility of the Police

ASSUMPTIONS
3. In Immigrants Detention Centres
there are facilities of water and
electricity without major technical
problems.
4. The Detention centers have telephone
lines and alternative communication
options.

ASSUMPTIONS
5. Feeding of immigrants is provided seamlessly
under Polices care.

6. The transportation to and from the centres is
under the responsibility of the Police

7. With concern of the Police there is a
translator in each detention centre

OPERATIONAL PLAN BASIC PRINCIPLES
Health coverage of immigrants is under
the responsibility of the State and is one
of the main principles concerning human
rights as laid down by the World Health
Organization.


HEALTH COVERAGE
LEVELS

1. Health Coverage in the detention centre

2. Health Coverage out of the detention centre

3. Special Health Coverage procedures


HEALTH COVERAGE
IN THE CENTRE
Medical station A Type
Medical station B Type
Medical station C Type
Medicines and other health products
for each station type
HEALTH COVERAGE
OUT OF THE CENTRE
Epidemiological surveillance
Medical transfer
Laboratory tests
Nursing


SPECIAL HEALTH COVERAGE
PROCEDURES
Psychological & Psychiatric
Support
Preventive medicine
Vaccinations
Communicable diseases


E.K.EP.Y Health Support
Management Team for Detention
Centers in Athens and Macedonia
and Thrace


The whole project is financed
by the European Return Fund