EMERGENCY Italian Programme Giulia Chiarenza An Overview of the Emergency experience on unaccompanied minors Favignana, 29 giugno 2015

Emergency provides - high level, free health care assistance; - health care to everybody in need, without discrimination ; - training for local staff.

Emergency

Programme based in Italy

Target population Migrants, people in need, seasonal workers, sex workers, migrants on landings, unaccompained minors, people affected by natural disasters, Romani people…

Main Objectives To foster social inclusion and integration of vulnerable segments of population. To provide foreigners and people in need with basic medical care in accordance with an individual’s right to healthcare as stated in the Constitution of Italian Republic. To identify and decrease the barriers of NHS which hinder the access of vulnerable persons to socio-medical service.

Main Objectives To assess the needs of community through the collection of clinical and social-demographic data. To enhance general awareness of public health issues, with special focus on concerns related to the plight of the most vulnerable segments of the population. To advocate for the improvement of access to NHS for migrants and people in need

Good Practices  Basic medical services respond to a fundamental right of individuals and reduce the need for referral to secondary care, consequently reducing the costs for the NHS. i.e.: Mobile Clinics Consultation outcomes: 10% of patients sent to second level consultations at NHS 0,7% of patients referred to NHS Emergency Dept 0,1% of patients sent to NHS through the NHS Emergency number  Cultural mediators are essential as permanent staff of the NHS to facilitate the access to healthcare services

Data courtesy of Prefecture of Siracusa

UNACCOMPAINED MINORS First Reception Camp “ Papa Francesco ” – Priolo Gargallo (SR) Since August rooms, 9 toilets and 6 showers. No medical assistance. Guests on average: 80 Emergency activities: Once a week social-sanitary assistance by means of our mobile clinic Polibus Partnership with other NGOs concerning critical issues and vulnerabilities Support to guardians in order to enroll minors to NHS Staff: coordinator, two cultural mediators, two nurses, one doctor, one logistician

MAIN CRITICAL ISSUES Lack of sanitary conditions according to international standards Long staying period (6 months or even more) Lack of coordination among actors (Social Service Office, Camp management, NHS, NGOs)

ACHIEVED OUTCOMES Powerful network with guardians Enrollments in NHS Good management of minors’ follow-up and orientation to NHS services Low voluntary disappearence

OVERALL DIAGNOSES Overall number of med. examin and consultations as 920 First reception camp in Priolo: 253 patients

UNACCOMPAINED MINORS “Scuole Verdi” – Augusta (SR) Since April rooms with camp beds, 6 toilets and 2 showers. Managed by Augusta municipality. Lack of supervision during the night. Lack of both cultural mediators and well trained workers. Guests on average: 120 Emergency activities: Cultural mediators support to NHS doctors Promotion of coordination between actors involved in the hospitality of minors (Augusta Municipality, Social Service Office, local health care system) Partnership among NGOs concerning minors’ vulnerabilities Support for the guardians in order to enroll minors to NHS Staff: coordinator, two cultural mediators, one nurse

MAIN CRITICAL ISSUES Serious lack of sanitary conditions according to international standards* Long staying period Lack of attention to vulnerable cases High level of voluntary disapperances and involvement in criminal activities (exploitment, human trafficking and prostitution) Lack of legal guardians Low enrollment in NHS** Difficulties in orienting minors in NHS system Lack of coordination among actors * Sphere Project ** L’art. 30 della L.R. n. 5/2009 Regione Sicilia The Sphere Handbook 2011, Decreto regionale – Ass. Salute della Regione Siciliana del 01/03/2012 Humanitarian Charter and Minimum Standards Decreto regionale – Ass. Salute della Regione Siciliana del 06/03/2014 con DA 326/2014 in Humanitarian Response

ACHIEVED OUTCOMES Permanently closed on October 21st, 2014 according to Prefettura decision Transfer of all the unaccompanied minors to another, appropriate camp

Thanks