k. lack of use of the health structures and policies in the destination countries

In Germany at least there appears to be a gap between what is proposed by the European authorities and what is nationally implemented, especially when it comes to drug abuse (i.e. tobacco) among migrant subgroups (who in general have a higher prevalence of drug abuse).

Dear Colleague,

Thank you very much for your answer.

Best regards,

Parmena Olimid

d. lack of system information on migrant health

Honestly, the health history of all migrants are unknown by the European authorities. No system provides information on the current health status of migrant. This is one of the problem currently faced by the European authorities. Migrant population that travel across the Mediterranean Sea contact different diseases and majority end up sick as a result of many factors, as they enter into European countries.

In order to solve the many problems in existence, besides the need  to test, treat and provide adequate healthcare for these migrants, European authorities will have to set-up an efficient and effective health record system to capture the data of these migrants and keep an up-to-date information about individual migrant health status. 

This will help the European authorities better manage the migrant population trooping into European countries.

Hope this answer helps.

Kind regards

 Olugbenga

m - Other answer

This is not a case where the european authorities can take the initiative. Health care is the exclusive competence of the individial Member States. It is up to the Council of Ministers to provide a common position and devise the policies the european authorities must execute, but exclusively as a collaborator, in the pursuit of an equitable solution, and acting as honest broker. The european authorities can only coordinate the efforts of the states, and provide relief in trans-border situations, such as communicable disease risks etc. And there are numerous initiatives taken by the institutions and the Agencies to deal with the emergency.

In fact the other answer is a combination of all of the above, and in each specific case, by which the issue is the situation in each European member state faced with the problem. The first impact states, for example, suffer in variable proportions, of  a),d), and e) and are overwhelmed by the sheer numbers.

Second impact countries, are confronted with a), c), f), h), i), k), and l), in also variable percentages. There is a very different attitude and political will to confront the issue, the response capacity is saturated, but there is communication problems as well.

In the countries of final destination, there are mainly combinations of b), c), d), and l). as these member states are generally well provided with services.

Having said this, the European authorities are confronted with a series of problems when dealing with a transfrontier phenomenon such as this, and can only respond in close partnership with the Member States. The EU has no competence in direct health care to citizens or migrants, as that is an exclusive competence of the individual Member states. The directives dealing with health care provision are transcribed into national legislations, precisely to allow each state a latitude of interpretation and adaptation to national peculiarities and cultural choices. The Member States have to deal with this crisis while the EU can only provide general guidelines, and offer to organize cooperation between the states and mitigate cross-border situations and to attempt to divide the burden as equitably as possible.

 Dear Mrs. Namorado,

Thank you for your answer.

Best regards,

Assoc. Prof. Parmena Olimid, Ph.d.

The answer L seems to me the main issue. The cultural gap is huge and help seems to be a right for the migrants, and lack thereof induce violent responses. the issue is borderline on public health and may be considered as state privilege. we'll have to watch out !

Dear All, Greetings.

As a researcher and a nurse, I do appreciate that you address this sensitive issue. Reaching out for immigrants is crucial for the stability as well as for the integration and enrichment of the host country with new cultural backgrounds. I suggest that host countries, especially universities and research centers, seek collaboration with researcher from stable countries in the region that have similar cultural heritage, like Jordan, in order to establish courses and workshops that can be conducted in the host countries explaining different issues concerning cultural beliefs and practices about the immigrants. These academic and research activities may be directed toward students, key individual in the society and the public.

I urge you to consider this suggestions as it would help all partners understand immigrant sensitive needs from the perspective of the people influenced by the decisions of the authorities, either local or European.

All the very best in your efforts.

Cheers.  

Dear Colleagues,

Thank you all for your answer. In addition, we can also consider the provisions of the Article 4 of the THE TREATY ON THE FUNCTIONING OF THE EUROPEAN UNION available at http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:12012E/TXT&from=EN 

that specifies  the "shared competence between the Union and the Member States applies in the following principal areas:  (a) internal market; (b) social policy, for the aspects defined in this Treaty;..."

Best regards

Assoc. Prof. Parmena Olimid, Ph.d.

I consider the main difficullty of the European authorites while addresing the public health measures of the migrant populations to be:

-te lack of knowledge of their health status

- organize continous care program for long-term medical conditions

- finding a resolution for malnutrition

- realistic expactations of the whole program

- effective conversation between famillies and medical staff (non- English speaking patients)

Dear Mrs. Bralic,

I received your message. Thank you very for your contribution to this research.

Best regards

Assoc. prof. Parmena Olimid ph.d.

This is a very complicated yet crucial public health environment that needs attention. Thank you for raising the question. I would suggest that your item (d) - lack of system information on migrant health - could be addressed by researchers outside the EU in the following manner. As far as specific country or regional data are available on the most prevalent communicable diseases suffered in the origin countries of the immigrants, wherever possible there should be [simple if possible] screening methods identified and applied to make sure immigrants carrying those diseases are treated and isolated as soon as possible to facilitate their recovery and mitigation of pandemic transmission to others. Treatment for non-communicable illnesses can also be planned and implemented via specific screening methods, but isolation would not be appropriate for these immigrants. Public Health research for the first recommendation herein could be funded and accomplished just as easily in North America or Asia to support medical care on the ground in the destination EU countries and allow local health care staff there o screen and treat patients rather than worry about first doing the demographic research.

Article 4 (2), (4) there is a specific mention to health and social policies, but the Health concerns in this alinea mean emerging risks that affect more than one Member State (for example a health risk due to emerging epidemics, and the EU only has coordination competences. Health risks action planning and monitoring is attributed to the relevant agency, (in Stockholm) but the actual health delivery is the competence of the Member State. Social policies is the same.

There are dedicated articles to these chapters that define and modulate the competence, and if taken in context, with the preamble also, to define with precision what each concept means, you will have a more accurate panorama. The Treaty you mention, by the way, is not the only fount of EU law, so it has to be taken in conjunction with the Charter( Constitution), and the specific Legislation.

The colleague who suggests that third states do the research on Public Health issues should understand the EU already does a lot of research on Public Health through its Research policy, The issue is still the exclusive competence of the Member States in Health provision. This means that any EU structure, be it the Commission or the Agencies, can only suggest a plan of action, it is up to the MS to carry them out.

All Member States have Public Health structures which actually carry out a public health coverage and a universal access to health is the practise throughout the EU; tending to free at the point of delivery, and health care is a policy that is provided  directly to citizen, without private intermediaries, to different degrees in each Member State, but available nonetheless. There is even provision for the European Citizen to receive care free at delivery, and a method of compensation devised between MS. However, this mechanism is not open to third country nationals, and in this case, there is no competence for mediation by the EU.

It is therefore up to each Member State to apply the common solutions provided by the EU structure in charge, and to the degree it choses, which means zero to 100%.

So, again, the solution exists, but it is up to the MS to apply it, as a sovereign state.

The EU is deliberately not a federation, and in all but certain policies, has no competence in Health provision and social relief.

Dear Colleagues,

Thank you very much for your contributions.

Best regards

Assoc. Prof. Parmena Olimid, Ph.d.

I would suggest item (a) migrant population sensitive health policies. Public health measures for migrant population are shaped by policies that would direct and orient these measure. These policies are not essentially health policies per se but rather a wider set of policies that recognize migrants' right to health and health care as one of the non-negotiable human rights. EU countries and others would not reach such a recognition unless they stop denying their responsibility for creating the conditions for migrations especially in the Middle East. Neoliberalism succeeded to create different forms of indirect neocolonialism through unfair (and colonial) trade agreements and massive support of privatization and directly by military actions. Those measure continued to produce dictatorships and fundamentalism.

Dear Colleague,

Thank you very much for your contributions.

Best regards

Assoc. Prof. Parmena Olimid, Ph.d.

Dear colleague,

I wrote an editorial on this topic. I send to you the link:

http://journalhss.com/wp-content/uploads/JHHS13_165-172.pdf

Francesco