Managing the migration/refugee crisis-Balkan route through provision of health care
Submitted by: Andrijana Vojnovic, Project Officer, Catholic Relief Services (CRS)
Email: [email protected]
Introduction to the project
Republic of Serbia and North Macedonia
The project began 1st March 2017. The project will be completed on 15th December 2019.
The government will take over provision of health services upon the project completion. It is expected that service provision will continue uninterruptedly and with the same composition of medical teams that accumulated experience and expertise during the intervention.
Provision of health care to refugees and migrants in nine locations across Serbia as well as delivery of essential medicines to the affected population.
*A project of Catholic Relief Services and the International Organization for Migration with the support of EU MADAD RTF.
The goal of the project was to facilitate access to basic medical care for migrants, asylum seekers and refugees in Serbia. In order to meet the project objective CRS deployed nine medical teams across Serbia to meet the essential health needs of incoming migrants through health assessments and tests conducted by CRS-contracted doctors and nurses. In addition to basic health services covered, CRS facilitated the provision of secondary medical protection by referring and later accompanying the migrants to government run health centers and hospitals in cases when further treatment was necessary. Medical teams had the support of 9 CRS interpreters for Arabic and Farsi to enable effective communication between medical personnel and migrants in languages understandable to them (predominantly Arabic, Farsi and/or Pashto).
Local laws that enabled CRS to take part in the response, to hire medical teams through the existing system and local Health Centers. The project was also in line with several key government documents such as (but not limited to) Migration Management Strategy, Law on migration management, Law on social welfare etc.
The implementation of the project was facilitated by dedicated funds from the EU MADAD Regional Trust Fund.
Main activities of the Good Practice
Objective 1: Ease the pressures on host countries
The project served not only to address the immediate health protection needs of the migrants/refugees transiting or accommodated in Serbia but also to extend support to the government and fill in the gap in the area where the local communities did not have the capacity to address the issue. Within the scope of the ongoing crisis, refugees and migrants have been stranded in the country for several months, now years, leading to overcrowding at the existing centres, which were in the beginning of the crisis deemed insufficient for addressing protection needs of the most vulnerable persons. At the time the project was initiated government of Serbia was implementing the fiscal consolidation measures that included hiring freeze in most public administration entities. The resources that health center had were too scarce to serve both local population and increasing number of migrants and refugees. CRS was able to bridge this gap and help increase the capacities at the local level by hiring local unemployed licensed doctors and nurses from the local community and also equipping the small clinics inside the reception centers where the health care was provided with necessary medical equipment that will later be transferred to local health centers to be used by host community as well. All of this led to increased involvement of local community through cooperation with the local Health Centres and increased capacity of the local community to deal with the migration/refugee crisis. CRS medical coordinator was travelling regularly to the field monitoring the needs and medical condition of all especially vulnerable and chronic patients and reporting regularly to the project management team and the Ministry of Health ensuring that all needs are met timely without additional pressure on the local health centers.
Objective 2: Enhance refugee self-reliance
Within the health component of the project from March 2017 to December 2019 CRS was able to provide medical protection to more than 14.000 migrants - including male and female. More than 1.500 vulnerable patients were provided with medical examinations and essential medicines. Some of the patients had chronic conditions that CRS medical teams were able to adequately treat, some had acute conditions, injuries that required immediate attention. Due to the fact that migrants and refugees had very high-quality health protection provided at all times their health condition improved significantly over time. As a result, many of them were able to live their lives in dignity and be successfully integrated into the local communities. Many children started going to school as the Government of Serbia and other stakeholders facilitated that all school aged children receive the compulsory primary education. All of this led to enhanced refugee self-reliance and CRS is proud to be able to contribute to this objective of the GCR.
- IOM - International Organization for Migration
- EU Delegation in Serbia
- Ministry of Health of the Republic of Serbia
- Commissariat for Refugees and Migration of the Republic of Serbia
Challenges and how they were overcome
Challenges encountered in delivering the project included medical teams from other organizations relocating their medical teams suddenly and/or ending medical protection due to lack of funding. This led to the situation in which not all government run refugee centers had medical protection at all times. Also, one of the challenges was sudden increase in numbers that occasionally happened during the project cycle that led to shifts that are not covered.
How they were overcome:
The challenges were successfully overcome by preparation and coordination with all relevant stakeholders to make sure that number of medical teams is adequate and covers all centers where medical services are needed. Deployment of medical teams was closely coordinated with IOM, Ministry of Health and Serbian Commissariat for Refugees and Migration.
In order to facilitate exchange of information and coordination the Steering Committee was meeting regularly to monitor the migration flows and address any possible problems in implementation. The SC consisted of the following representatives: IOM, The EU Delegation, CRS and relevant government institutions.
Results of the Good Practice
- As a result of the project health service provision to refugees based on principles of non-stigmatization and non-discrimination was ensured.
- In addition to health services CRS also facilitated communication between refugees and medical personnel through interpreters/cultural mediators. This was especially important for vulnerable patients as well as refugees with chronic conditions who did not have any kind of medical documentation with them
- When it comes to benefits for the host community CRS provided medical care to refugees by engaging unemployed, licensed local doctors and nurses through local Health Centres in each town where the project was being implemented.
The project lasted from 01 March 2017 to 15 December 2019. After December 2019 provision of health care to migrant/refugees accommodated in Serbia is handed over fully to the competent Serbian Ministry of Health. Hand over activities and meetings were held to ensure smooth and uninterrupted service provision.