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«Ministério da Saúde PORTUGAL: ASSESSING HEALTH-SYSTEM CAPACITY TO MANAGE SUDDEN LARGE INFLUXES OF MIGRANTS B PORTUGAL: ASSESSING HEALTH-SYSTEM ...»

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Portugal’s migrant detention infrastructure also includes several CITs located at airports, which are used for the short-term detention of undocumented migrants and asylum seekers entering the country. During the mission, it was possible to visit the CIT in Lisbon airport, which has capacity for 56, distributed across two wings. The hygienic conditions appeared to be in line with minimum standards, but there was a lack of windows in the dormitory area and a shortage of space when fully occupied. The main concern relates to length of detention, which could reach 60 days. The airport health post – run by the Portuguese Red Cross – provides initial medical assistance to the migrants detained in the CIT, but when necessary, migrants are escorted to the referral health centre or hospital.

CNAIs and CLAIIs provide information to documented and undocumented migrants about access to the NHS. Civil society organizations, NGOs and religious institutions have established parallel medical services whereby, alongside basic health care, medicines, food and clothes are provided. Some of them pay the bills when undocumented migrants need special treatment or diagnosis. The JRS and the CPR are particularly active in this respect. Through a 2006 Memorandum of Understanding between the Ministry of Internal Affairs, the IOM and the JRS, JRS-Portugal provides social and psychological services, as well as legal counsel to detainees. The Bobadela Reception Centre for asylum seekers is located near Lisbon and is run by the CPR.

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Recommendation 1 The ACIDI should consider mapping sites that can be used as shelters, and nongovernmental resources that can be mobilized in case of sudden, massive influxes of migrants.

Testing the assessment tool Findings T he overall structure of the assessment tool – based on the WHO health systems framework – is adequate to assess the situation even in a country never affected by a sudden, massive influx of migrants.

However, the number of questions could be reduced and questions could be regrouped to assess the situation in countries in which such influxes are considered to be unlikely.

Conclusions In several aspects, Portugal could be used as a model for immigrant integration. However, during assessment interviews it was reported that current legislation may limit undocumented migrants’ full access to basic health care services. Emergency management structures are in place, but sudden, massive influxes of migrants are not considered a possibility.

The assessment mission represented an opportunity to further stimulate dialogue and collaboration between the Ministry of Health and the Ministry of Internal Affairs.

Although Portugal would be unprepared to respond to sudden, massive influxes of migrants, the willingness to further improve the migrant integration process, coupled with the already existing interministerial collaboration and coordination mechanisms, represent fertile ground for enhancing the capacity for preparing for and responding to such (albeit so far unlikely) events.

References

1. Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M. Migration and health in an increasingly diverse Europe. Lancet 2013;381(9873):1235–1245. doi:10.1016/S0140-6736(12)62086-8.

2. Dias P. Machado R, Estrela J, Ramos Bento A. Relatório de Imigração, Fronteiras e Asilo – 2012 [Report on immigration, borders and asylum 2012]. Lisbon: Immigration and Borders Service (SEF); 2013 (http://sefstat.sef.

pt/Docs/Rifa%202012.pdf, accessed 27 February 2014).

3. MIPEX. Portugal [web page]. Brussels: British Council and Migration Policy Group; 2014 (http://www.mipex.eu/ portugal, accessed 24 April 2014).

4. Björngren Cuadra C, Cattacin S. Health care in NowHereland. Improving services for undocumented migrants in the EU. Policies on health care for undocumented migrants in the EU27: towards a comparative framework.

Summary report. Malmö: Malmö University; 2010 (http://files.nowhereland.info/698.pdf, accessed 16 May 2014).

5. Glossary on migration. Geneva: International Organization for Migration (IOM); 2004 (http://publications.iom.int/ bookstore/free/IML_1_EN.pdf, accessed 19 May 2014).

6. Dias SF, Severo M, Barros H. Determinants of health care utilization by immigrants in Portugal. BMC Health Serv Res. 2008;8:207. doi:10.1186/1472-6963-8-207.

PORTUGAL: ASSESSING HEALTH-SYSTEM CAPACITY TO MANAGE SUDDEN LARGE INFLUXES OF MIGRANTS

7. Barros P, Machado S, Simões J. Portugal: health system review. Health Systems in Transition. Copenhagen:

WHO Regional Office for Europe; 2011.

8. Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D et al. Financial crisis, austerity, and health in Europe. Lancet 2013;381(9874):1323–1331. doi:10.1016/S0140-6736(13)60102-6.

9. Gonçalves G, Castro L, Correia AM, Queirós L. Infectious diseases surveillance activities in the north of Portugal, during the EURO 2004 football tournament. Euro Surveill. 2005;10(4):ii–532.

10. Dengue outbreak in Madeira, Portugal, October–November 2012. Stockholm: European Centre for Disease Prevention and Control; 2013. doi 10.2900/75830.

11. The Immigration Observatory. Who we are [website]. Lisbon: High Commission for Immigration and Intercultural Dialogue; 2014 (http://www.oi.acidi.gov.pt/modules.php?name=Content&pa=showpage&pid=21&newlang=engli sh, accessed 24 April 2014).

12. Portugal health system performance assessment. Copenhagen: WHO Regional Office for Europe; 2010 (http:// www.euro.who.int/__data/assets/pdf_file/0006/131766/E94518.pdf, accessed 24 April 2014).

PORTUGAL: ASSESSING HEALTH-SYSTEM CAPACITY TO MANAGE SUDDEN LARGE INFLUXES OF MIGRANTS

PORTUGAL: ASSESSING HEALTH-SYSTEM CAPACITY TO MANAGE SUDDEN LARGE INFLUXES OF MIGRANTS

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