This resulted in an almost immediate improvement of the medical situation and marked a starting point of an inclusive and culturally sensitive health care immediately after arrival in the refugee center.

Regional Office for Europe: Migration And Health: Key Issues. - The burden of hosting large populations of displaced people requires improved coordination and cooperation by European countries. 0000229646 00000 n

(+1) 202-419-4372 | Media Inquiries. Altogether, 5 refugees in very severe medical conditions were treated at our ICU from the summer of 2015 until the spring of 2016.

The World Health Organization (WHO) does not recommend compulsory mass screening of refugees. The average TB rate in the EU is 39 per 100,000 inhabitants [27]. 0000007127 00000 n 0000178972 00000 n Thus, access to vaccination is of prime importance. liver cirrhosis, lymphoma, AIDS) aggravated by common infections, which were acquired during the long and troublesome journey. Similar shares in Germany and Sweden which saw large influxes of migrants seeking refugee status in 2015 and 2016 back taking in refugees. 0000245141 00000 n In 2015 the number of displaced people reached an unprecedented level, with more than one million crossing into Europe. As the need for medical care was only very high at the beginning, i.e. Nearly all of these migrants arrive on the Mediterranean shores of Greece, Italy or Spain; more than 2 million migrants have entered Europe this way since 2009. Tobias Schilling and Stephan Rauscher share first authorship. Rev.

0000017948 00000 n Department of Economic and Social Affairs, United Nations: International Migration Report 2015. 0000066809 00000 n 0000241230 00000 n

2015.

Those who obtain refugee status receive permission to stay in the country a year or longer, and many receive help to integrate. Many of the patients needed mechanical ventilation and/or the use of vasopressors to maintain circulation.

0000049056 00000 n In a population-based cross-sectional study, Aldridge et al. 0000011064 00000 n Frontex, the European border and coast guard agency, helps to guard the EUs external borders. Furthermore, communication with the patients in the refugee center was much easier because other refugees - in addition to the interpreters in our team - volunteered to translate from the mother tongue of the patient to English. PloS One 2012;7:e44611. 0000005797 00000 n The government wants to maintain public support for the reception of genuine refugees. A further important challenge is due to gender-specific problems, such as maternal, reproductive issues and access to contraception. They often mislead people into thinking they can easily get asylum or a job in Europe. 0000067202 00000 n Greenaway C, Thu Ma A, Kloda LA, et al: The seroprevalence of hepatitis C antibodies in immigrants and refugees from intermediate and high endemic countries: a systematic review and meta-analysis. Vandenheede H, Deboosere P, Stirbu I, et al: Migrant mortality from diabetes mellitus across Europe: the importance of socio-economic change.

0000023273 00000 n However, vulnerable groups (children and elderly), considering that they spent long periods on their journey, are prone to respiratory and gastrointestinal infections and dermatological diseases (scabies) due to poor hygienic as well as living conditions [12,16].

0000059491 00000 n 0000002955 00000 n The task as well as challenge for the future is the integration of refugees and migrants into the existing health care systems in Europe. Cochrane Colloquium Abstracts. During the autumn of 2015, several other refugee centers were established in Stuttgart to accommodate up to 2,500 people. We describe our experiences from a large community hospital in Stuttgart, Germany, in the summer and autumn of 2015. 0000017473 00000 n In conclusion, intersectoral collaboration is important to meet the different needs of this special patient population, multidisciplinary teams have to be formed, and newly arrived migrants should receive an immediate health reception or welcome in the refugee center. - The number of displaced people reached an unprecedented level at a total of 60 million people worldwide in 2015. 0000008838 00000 n 0000050816 00000 n We realized soon that health care for refugees and asylum seekers should be based on a holistic approach, including early health assessment and management of communicable and non-communicable diseases, such as chronic diseases as well as mental and social problems, including the provision of ongoing care. About two-thirds or more of people in Mexico, Canada, Australia, the United States and Japan say they support taking refugees from countries where people are fleeing violence or war. Of these almost 700 lone refugee minors are excluded from institutional child protection services without access to basic care, social welfare, or any information about their rights. 0000219492 00000 n The most common health problems may be related to problems in their home countries and the journey, representing a variety of diseases including accidental injuries, gynecological and obstetric complications, dermatological diseases, cardiovascular events, gastrointestinal and respiratory problems, and mental illness [10,11]. For these conditions, knowledge of the prevalence of the infection in the country of origin is mandatory. NEXT. 0000050290 00000 n - TB: Refugees and asylum seekers are at higher risk of getting infected or developing TB, depending on the TB incidence in their country of origin and poor access to health services during migration. Furthermore, female refugees are at high risk of sexual abuse and pregnancy due to poor access to contraception [17]. All interventions should be based on evidence, global disease patterns, and medical needs during the migration process. 0000166684 00000 n UNHCR Master Glossary of Terms. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. PLoS One 2015;10:e0141715. Health care should be provided by a multidisciplinary team in coordination with the local health care systems and other organizations. Different aspects need to be considered when analyzing the migration process regarding infectious diseases, e.g. Kimbrough W, Saliba V, Dahab M, Haskew C, Checchi F: The burden of tuberculosis in crisis-affected populations: a systematic review.

Note: See full topline results(PDF) and methodology. All relatives of the patients were closely involved in the treatment by our interprofessional team of the ICU. trailer <<6776773064EF45ECAD4D90CE181C5C3D>]/Prev 410869>> startxref 0 %%EOF 177 0 obj <>stream

0000050988 00000 n About half in Poland (49%) voice support, and only about a third (32%) say the same in Hungary, where thousands of migrants sought asylum in 2015. In this review, we focus on specific aspects of medical care for newly arrived migrants and refugees in Europe. 0000050071 00000 n Although the likelihood is low that certain infectious diseases will occur among migrants, they should still be considered in order to make sure that infectious diseases are diagnosed timely to control the risk of disease spread [6,7,8,9].

Eur J Epidemiol 2012;27:109-117. A very recent work from Germany assessed the health status of 214 asylum seekers, and the main health problem was psychological illness while the prevalence of infectious and chronic diseases was low [15]. Morais S, Costa AR, Ferro A, Lunet N, Peleteiro B: Contemporary migration patterns in the prevalence of, Schulz TR, McBryde ES, Leder K, Biggs B-A: Using stool antigen to screen for. Available evidence underlines that infectious diseases are not a health priority at first arrival [12,13,14]. Refugees and immigrants from developing countries settling in industrialized countries have a high prevalence of H. pylori and therefore an increased risk for the development of H. pylori-associated complications such as peptic ulcer disease and gastric cancer [34].

Notably, all of the patients suffered from previously undiagnosed chronic diseases (e.g.

Registering such detailed information means that at a later date, authorities can establish when and where a refugee entered the EU. In this article we describe our experiences and contribution in providing medical care for refugees who have newly arrived in Stuttgart, Baden-Wuerttemberg, Germany. According to the WHO, vaccinations may include: measles, mumps, and rubella (for children below 15 years); poliomyelitis for children and adults from countries exporting poliovirus; meningococcal disease; tetanus, pertussis, and diphtheria; and influenza depending on the season [22]. 0000245038 00000 n Issue release date: August 2017, Number of Print Pages: 6

As stated above, most refugees with very serious diseases were identified in reception centers near the border between Bavaria and Austria. - Prescribing medications as usual was impossible as most refugees could not obtain the medication with a prescription from local pharmacies due to a lack of health insurance and money. Arnold F, Katona C, Cohen J, Jones L, McCoy D: Responding to the needs of refugees.

Krki T, Napoli C, Riccardo F, et al: Screening for infectious diseases among newly arrived migrants in EU/EEA countries - varying practices but consensus on the utility of screening. On the other hand, as with our patients on the intensive care ward, the diagnosis of chronic, non-communicable disease had not been established due to lack of access or decimation of health care systems in their country of origin.

Rossi C, Shrier I, Marshall L, et al: Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refugees: a systematic review and meta-analysis. This was probably due to the fact that refugees who started the long journey to Europe were generally in a good medical condition and those who acquired serious diseases or trauma during the journey had already been identified and had received medical treatment in Austria or in Bavaria close to the Austrian border. The EU respects the human rights of refugees, both when dealing with their applications and with regard to return. Working with countries of origin and transit is also very important. 0000201075 00000 n This is particularly important when the recommended agent is a new and/or infrequently employed drug. - After having received treatment, patients that had arrived by ambulance did not know how to return to the refugee center as they had neither money nor knowledge of the place to use public transport systems. De Vito E, De Waure C, Specchia ML, Ricciardi W: Public Health Aspects of Migrant Health: A Review of the Evidence on Health Status for Undocumented Migrants in the European Region. 0000007172 00000 n 0000011915 00000 n 0000051802 00000 n - Skin conditions (including impetigo, scabies, and cellulitis): Skin infections are common among those forcibly displaced, as they have to endure inadequate shelter and sanitation while travelling or in crowded reception centers. 0000017388 00000 n In fact, across all 10 EU countries surveyed, majorities disapprove of how the EU is dealing with the refugee issue. Regional Office for the Eastern Mediterranean: Eastern Mediterranean Region.

They must do this in the country where they enter the EU. Support for taking in refugees varies around the world. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). We were confronted with airway infections, small wounds, pain caused by old battlefield injuries as well as scabies and lice. The EU also seeks to create employment opportunities in countries large numbers of economic refugees come from.

hb``0c`ZT @1v+si Gd}{wO>0 T[t59iii@$Lt6EXU*`0fQq02232bejqsp,`akWVa?Q.0`0`0dpghfTcebap}QqxS&^b^d61 y9m8m&|99OKyprJUe3822( o32Z{6e @o0 Tw endstream endobj 68 0 obj <>>> endobj 69 0 obj <> endobj 70 0 obj >/PageWidthList<0 595.276>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/Tabs/W/Trans<>/TrimBox[0.0 0.0 595.276 841.89]/Type/Page>> endobj 71 0 obj [72 0 R 73 0 R] endobj 72 0 obj <>/Border[0 0 0]/H/N/Rect[265.031 184.159 445.488 173.149]/Subtype/Link/Type/Annot>> endobj 73 0 obj <>/Border[0 0 0]/H/N/Rect[209.792 170.159 335.53 159.149]/Subtype/Link/Type/Annot>> endobj 74 0 obj <> endobj 75 0 obj <> endobj 76 0 obj <> endobj 77 0 obj <> endobj 78 0 obj <>stream People smugglers cause a great deal of misery. }4E>p|+o=Y,4kBk2>d1il]A1^,Nx]ZxQD|b&vrwG#rgY#$0dW[[bR{}9'>0+9+_EyO4f7Mn4ivMf7Mn49'4. directly after the arrival of the refugees in Germany, and decreased during the following weeks and as the number of refugees in the camps declined, it was possible to integrate the refugees into our public health system. BMC Public Health 2015;15:561. In conclusion, migrants with non-communicable diseases may be more vulnerable as a result of the difficult conditions during their journey. The other two homes have been set up to accommodate teenage boys also aged 13 to 18 years old. The relation between migration and infectious disease is complicated', is stated in an editorial in The Lancet Infectious Diseases from 2016, and there is no systematic association between migration and importation of infectious diseases' [19]. 0000007001 00000 n World Health Organization.

0000005079 00000 n These bodies support the member states, for instance by identifying smuggling networks and providing information for investigations.