Abstract
BackgroundCroatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. They had to optimize health care delivery in the special circumstances in refugee camps and transit centres. Little is known about health care provision in border camps where a large number of migrants stay for only couple of hours. Previous studies emphasize that language barriers and cultural differences play a central part in the relationship between health workers and migrants inside the transit zone. The aim of the study was to identify specific characteristics of health care provision experienced by primary healthcare providers in order to prepare solutions on how to organise health care in refugee settings.MethodsTwelve thematic interviews were conducted in the middle of the most intense migration movements to the North-West Europe between November and December 2015 with health workers from Croatia and Slovenia. Interview transcripts were read, coded, reviewed, and labelled. We used qualitative content analysis.ResultsFour themes about the health service provision for refugees at Schengen border were identified. The circumstance when mutual understanding is poor and the consultation not successful, cultural differences represent a central barrier. Participants highlighted that the importance of respecting human dignity is crucial for the provision of basic medical care for migrants in transit.ConclusionSuccessful overcoming language barriers, respecting cultural differences, humanity, susceptibility to social deprivation and traumatic experiences are the key factors important for organisation of health care in transit centers and camps. This article gives some useful tips for healthcare workers and policy makers who are participating in health services provision for migrants and other refugees. Health workers should be prepared to work in special working conditions with a lack of resources. Their work would require timely planning and reflection on the organization of more transit camps.Trial registrationEthical Committee of the Republic of Slovenia approved the study as a project number 112/02/16.
Highlights
Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016
Four themes referring to Croatian and Slovenian health workers experiences with health service provision for migrants on Schengen border were formed
The unwillingness of the countries refers to the number of migrants who were accepted in some border centers and significantly exceeded the planned number and its capabilities
Summary
Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. Studies conducted between general practitioners [5,6,7] showed achievement of mutual understanding with migrant patients required additional efforts by health workers They mostly had to undertake an individual approach (each patient is treated as a unique or sui generis case), because of the differences in their characteristics, educational level, urban or rural upbringing etc. The problem occurs when professional interpreters as less respectful (e.g. religion of the patient), less friendly, less concerned for the patient as a person, and less likely to make the patient comfortable In these cases healthcare workers’ role could be contra productive for the development of trust and a genuine relationship between the health worker and migrant patient [12]
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