PHM-Exch> Access to health for refugees and displaced populations in urban settings Online discussion on Global Access to Health Platform, starting Monday 2nd November 2009

[Slim SLAMA]

Dear PHM colleagues,

I am pleased to invite you to join the upcoming online discussion
"Access to health for refugees and displaced populations in urban
settings?" to be held on the Global Access to Health Platform, an online
extension of the Geneva Health Forum:

To register go to http://www.globalaccesstohealth.net and choose the 
GHF - Access to Health at Times of Crisis group.

The discussion will be open for contributions for two weeks, from Monday
2 November 9am CET and close Sunday Nov 15 at 6pm CET.  

We are happy to have already over 50 members from 19 countries;
Bangladesh, Belgium, France, India, Iraq, Italy, Laos, Lithuania,
Mexico, Myanmar, Niger, Rwanda, Singapore, South Africa, Switzerland,
Sudan, Tanzania, United Kingdom and the United States.  

We also welcome the participation of experts from different
international organizations to give their insights and comments.
We are looking forward to an interesting round of sharing experiences
and ideas on this very current topic. There is a possibility to attach
documents that you think could be of interest for the discussion.

Some house rules:
* In order to get to know each other please indentify yourself ( name,
organization, country) the first time you contribute.
* Please try to not exceed 500 words per contribution.
* Should you have any problem making a posting to the discussion, log in
or any other technical issue please email: (Didier Wernli)
didier.wernli at hcuge.ch

Discussion will be moderated by Dr Atti-La Dahlgren, from the Geneva
Health Forum

Background, case study and questions to be discussed:

A common conception is that refugees are hosted in camps. With increased
urbanization (currently over 50% of the world?Ts population live in
cities) a major shift is observed with more refugees and displaced
persons taking refuge in cities - living with friends or relatives, or
in slums. The fact that these people are generally not affiliated to the
local health system can be detrimental to their health. Paradoxically,
however, some receive better care than the local population (in case of
official refugee status). These examples of inequalities in access to
health in cities can lead not only to consequences for the individuals
and the families, but also to problems in the community and even civil
unrest.  
 
An example of this problem is the situation of the Iraqi refugees in
Syria:
In 2007, an estimated number of two million displaced Iraqis were living
in neighbouring countries, 1.5 million Iraqis in Syria, 750 000 in
Jordan, and up to 70 000 in Egypt. In Syria, most of the Iraqi refugees
settled in urban areas, not in camps. A rapid assessment revealed that
the majority of families (72%) lived in shared accommodations with
Syrian or Iraqi families, often in overcrowded conditions. The policy of
the Syrian government has been to provide access to health services for
displaced Iraqis on the same basis as for the local population. The
reality is that there are huge difficulties in meeting this commitment
and severe problems of access in practice. The displaced Iraqis have
placed a major additional burden on national health services. In
particular, those with chronic diseases incur substantial additional
costs. Furthermore, refugee populations often have increased needs, for
instance requiring increased mental health care and psycho-social
support.   

This paradigm shift in search for refuge in urban areas is being
observed in several other recent humanitarian crises.  
In Pakistan 90% of the 1.5 million displaced persons - due to the recent
military operations in the northern part of the country - are hosted in
local communities and only 10% in camps.  
In Cameroon, refugees are staying in villages rather than camps, which
increased the burden on the local population.


**We invite you to share your experience with similar situations
involving refugees/displaced persons in urban settings.**

Questions:  
How can refugees/displaced persons be identified?  
How can localshould a parallel system be created or should the local system be
reinforced?  
What are the most important challenges?  
What innovative approaches have worked?


Click [here]( http://globalaccesstohealth.net/?v02jpcpb ) to read
online.

warm regards

Slim Slama
Geneva Health Forum


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Dr Slim Slama
Chief resident
FMH Internal Medicine
Programme Director of the Geneva Health Forum
Division of International and Humanitarian Medicine,
Department of Community 
Medicine and Primary Care 
Geneva University Hospitals
24, rue Micheli-du-Crest
1211 Geneva 14
Switzerland
----------------------------------------------
Chef de Clinique
FMH de Médecine Interne
Hôpitaux Universitaires de Genève
Service de Médecine Internationale et Humanitaire
Dpt de Médecine Communautaire et de Premier Recours
Directeur scientifique du Geneva Health Forum
Rue Micheli-du-Crest 24
1211 Genève 14
tel : +41 22 372 96 58
mobile: +41 79 446 70 86
fax: +41 22 372 96 26
email: slim.slama at hcuge.ch