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MSF in France, 2010
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Many asylum seekers in France do not receive a residence permit or their asylum applications are denied. Not having any legal status has serious social consequences – no home, no social assistance, no right to work – which in turn cause problems in accessing healthcare.
In 2007, MSF established a centre for asylum seekers in need of psychological support in Paris. The patients are mainly Afghans, Chechens, Guineans, Eritreans or Sri Lankans who have escaped armed conflict or persecution. MSF staff assess the patients’ condition and ensure that they get the necessary medical and psychological care. The programme focuses on assisting those whose distress is the most severe, who do not speak French or who do not have a residence permit, as these people find accessing healthcare especially difficult. In 2010, 210 patients received psychological care.
Anxiety levels are extremely high among patients: 40 per cent speak of having suicidal thoughts. Many have had traumatic experiences in their home country, on their journey, or in Europe. The vulnerability and uncertainty of the migrant’s or asylum seeker’s current situation can exacerbate stress.
Conditions for such migrants are likely to get even worse, as at the end of 2010 restrictions were placed on access to healthcare for vulnerable foreigners – undocumented migrants and foreigners with serious illnesses that cannot be treated in their home country.
An outbreak of scabies in mid-2009, when local hospitals were overstretched, led MSF staff to begin medical consultations for migrants living in the streets of the 10th district of Paris. The team continued its work in 2010, holding more than 1,900 consultations for around 400 patients.
Healthcare in Mayotte
In May 2009, MSF opened a health centre in a shanty town in Mamoudzou, the capital of the French island of Mayotte, in the Indian Ocean. Many of the people living in the shanty town do not have a clear legal status, despite around half of them having been born in Mayotte. Increasingly repressive policies toward those with irregular status (in 2010 more than 21,000 people were expelled to the Comoros Islands) make accessing healthcare very difficult. MSF staff provided basic healthcare and carried out more than 20,000 consultations for 7,500 patients between May 2009 and September 2010. In September 2010 MSF decided to halt activities. The objective had been to provide access to healthcare for marginalised people by bringing it directly to them. It became clear over the course of the project that critically ill people could obtain treatment, especially in emergencies, and that the main obstacles to medical care were linked to legal issues and fear of arrest, which are beyond MSF’s mission.
MSF has had operational activities in France since 1987.