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MSF in Belgium, 2005
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Belgium's sophisticated health system includes provisions for providing care to all, yet vulnerable groups within the country often face obstacles to obtaining needed medical care. A complex bureaucracy, long and difficult administrative procedures, fee-based services and misinformation about current laws all contribute to keeping some groups out of the system.
MSF is focusing on ways to improve access to health care for the most disadvantaged groups in Belgium including asylum seekers, undocumented migrants and the very poor. While undocumented migrants and asylum seekers have the right to receive health care services, in practice, access is very complicated. In response, MSF staff run three clinics in Brussels, the capital, and in Liège and Antwerp, that provide free care to disadvantaged people. During 2004, MSF's medical team carried out 10,000 consultations for approximately 4,500 patients. Based on its experience, MSF and other organizations are lobbying government officials to develop a structural solution to health care gaps within the current system.
In response to requests from seriously ill refugees who receive care in Belgium, the organization provides information about the availability of quality health care in various countries of origin. This type of information can be crucial to refugees seeking to avoid repatriation to countries where their health needs will not be met. In the first half of 2005, MSF staff received and fulfilled approximately 80 requests for information each month.
In Brussels, MSF operates the Elisa center, which provides free, anonymous HIV testing. Voluntary counseling is also provided to anyone who requests the test, and more extensive psychological support is available to those who want it. For the past 15 years, MSF has been advocating for free, anonymous testing to be integrated into the country's health system. The organization hopes that this goal will be achieved by the end of 2005 and plans to close the center at that time.
In 2004-5, MSF staff also continued to provide psychological support to Belgium's Rwandan refugees, who fled the 1994 genocide in which an estimated 800,000 people were massacred. Management of the program — which offers group and individual therapy — is gradually being turned over to the Rwandan community involved in the work. The project will become completely independent and supported by an external donor by the end of 2005.
MSF has worked in Belgium since 1987.