petek, 17. avgust 2018

DIAGNOSIS OF HEALTH POLICY TOWARD REFUGEES AND MIGRANTS IN BOSNIA AND HERZEGOVINA

HEALTHCARE LAW OF FB&H REGARDING REFUGEES AND MIGRANTS ILLEGALLY SUSPENDED BY THE EU - MASSIVE VIOLATION OF HUMAN RIGHTS IN B&H

A short draft of Diagnosis of Health Policy Towards Refugees in Bosnia and Herzegovina, August 2018


Dimitar Anakiev, MD
spec. Global Health

Refugees and migrants reached Federation of Bosnia and Herzegovina in the beginning of 2018. From January to June 2018 they solved all their health problems using the healthcare system of FB&H. As reported on 4th June by the Head of Health Center Velika Kladuša, Dr. Senad Okanović, they have average visit of 30 migrants per day – that is less than 10% of visit prevalence regarding total number of refugees and migrants in Velika Kladuša (1). Dr. Okanović also said that they very successfully solved all clinical cases and also epidemiological-hygiene control but they have financing problems because they received only support from local actors. Not a single cent from 1,5 million euros donated by the EU to the government of B&H in June 2018 went to support legal institutions of healthcare in FB&H. Healthcare Law of Federation Bosnia and Herzegovina strictly understand and respect health as a human right, including primary health care: articles 3, 12, 26 and 27 legitimated healthcare rights very specifically for foreigners, refugees and migrants(2) what is totally opposite to the EU legislature.
Even more, article 76. of Asylum Act of Bosnia and Herzegovina grants right to primary health care to all asylum seekers.
Refugees and migrants, now temporary settled in wild camps in Bosnian Frontier, including families with small children, were brutally deprived for asylum right in the EU. They were pushed back, shot, kidnapped, beaten, sexually humiliated and looted by the EU officials in their attempt to ask for asylum in the EU (3). The result is stuck of more then 10.000 people in B&H among them about 4.000 in Bosnia Frontier (Una-Sana Canton)(5)
Even Bosnian & Herzegovina government officially never declared a state of emergency the official Healthcare Law in Federation of B&H was put out of power for the refugees and migrants. What way this group of people were deprived for the legal rights we do not know but obviously this way was not legal, not public and not democratic. Three months (June-August) all actors: state officials and Doctors without Borders (MSF) are acting illegally in attempt to exclude refugees from legal rights to healthcare legitimated by the FB&H legislation. Especially the role of MSF is obscure. They appear visible in the streets of Bosnian Frontier in June 2018 as a symbol of “emergency” and deprivation of refugees and migrants for the legal rights. It seems they took part in the political show of the European Union... MSF officially has not permission to work in B&H but they act as a kind of taxi service to local doctors occasionally delivering health care to refugees and migrants beyond the legal procedure. In that way MSF is used for public shield in the process of depriving refugees & migrants for healthcare rights.
When in July 2018 I arrived for the first time at Temporary Refugee Camp “Trnovi” in Velika Kladuša the situation was catastrophic: prevalence of visiting doctor was 25% with alarming morbidity: 66% refugees had all kind of skin infection, wounded about 30%, scabies 15%, a lot of stomachache and diarrhea, (some of them more then 10 times by night), pharyngitis and flu along with headaches, anxiety, sleeplessness and psychological problems. As described in my short draft of NARA document (6) especially hygienic-epidemiological situation was alarming. Contrary to the report of dr. Okanović, just one month ago, refugees and migrants taken out of the official legislation into the hands of MSF & EU show picture of heavy and massive violation of human rights regarding the healthcare.
MSF mobile unit -without official permission to work – to whom is joined local doctor, visits refugee & migrants camp Trnovi three times a week for three hours (main camp with about 350 people is visited two times and once a week they visit dislocated group). So the main part of the camp has availability of doctor six hours a week. MSF vehicle is parked not in the camp but at the parking lot on the other side of the river Kladušnica. That means doctor cannot see the situation in the camp, perhaps they (MSF & doctor) are not interested in it. Not to mention distance between doctor and patient so important in humanitarian context and also standardized by professional standards for medical work in humanitarian context. In one word: refugees and migrants in FB&H are not only illegally deprived for healthcare they also receive substandard humanitarian medical help. They are beaten, humiliated and left alone - just in public, thanks to presence of MSF, it appears they have “regular” (humanitarian) medical care. To this picture let me add that state officials does not allow medical preventive departments to visit refugee and migrant camps. That is why, if you visit for example web-site of Institute for Public Health FB&H, you will not find the information about hygienic-epidemiological situation in camp Trnovi. It is not registered that on 10th August one third of refugees and migrants had diarrhea and two-third was not able to eat lunch and dinner. There are numerous information that local health centers stopped delivering medical care to refugees and migrants, only life threatening conditions is considered for treatment. That is EU standard for refugees and migrants.
To complete the picture of massive violation of human rights regarding medical care of refugees and migrants in FB&H it is interesting to note local police judge that volunteer medical help in camp Trnovi is “illegal”...(!)
In the end of the day, as we know from praxis, the question of deprivation of human right is never isolated on deprived people but it affects people of the area in general. Because there are not two medicines: one for them and one for us. The Medicine is only one as history of colonialism gave lesson to humanity long time ago.


NOTES:

(2)Službene novine Federacije BiH, broj 46/10 iz 2010.
(3)Numerous reports, from Slovenian Delo Daily News from 11th July, Amnesty International Slovenia, RTV SLO MMP, to many locals portals and media in different countries

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