Improvement of the sanitary help desk of Associazione Cittadini del Mondo in Palazzo Selam, Rome - Italy

Project location: ITALY, Rome
Project start date: April 2017 - Project end date: April 2018
Project number: 2017-068
Beneficiary: Associazione Cittadini del Mondo

This project, which received a grant from the Nando and Elsa Peretti Foundation, aims to improve health assistance for international protection holders and asylum seekers and to facilitate their access to the National Health System. The direct beneficiaries of the project are the 1,200 inhabitants of Selam Palace - an occupied building in the outskirts of Rome, inhabited by political refugees - as well as the foreign nationals who attend the Association President’s surgery, most of whom are entitled to humanitarian protection.
According to the project, started in November 2017, volunteers and the project staff are implementing the following activities:

  • Once a week the health help desk is open ‐ on Thursday night ‐ at Selam Palace. The project staff, the cultural mediators and the volunteers, both medical doctors and social workers, attend the help desk.
  • Two days weekly the medical doctor is available for consultation by the beneficiaries of this project at the Association President’s surgery.
  • During all the activities on the field volunteers and the project staff collected data in order to monitor their health and social situation. The coordinator helps the medical doctors to develop a very effective methodology to collect data, which can easily be used by volunteers. All the volunteers have a form to collect the most significant information about the beneficiaries: gender, age, nationality, the number of years in Italy, type of residency permit, place of official residence, the place where they live, the reason of the access to the help desk. The classification of the main pathologies found during the surgery was carried out through the ICD9-CM system.
  • During the help desk activities, volunteers (both medical doctors and social workers) identifies beneficiaries that need further assistance, for example because they can’t speak Italian or because the bureaucratic process is complex. These people are accompanied by volunteers or mediators to the public structures and are followed in all the steps of the request.  
  • All the data collected were described in a report presented on the occasion of the World Refugee Day on 20 June, at the Red Hall of the VII Municipality of Rome, in the presence of journalists, representatives of the institutions and members of other humanitarian associations active in the Roman territory. In addition to social and sanitary data, the publication collects stories and direct testimonies of the inhabitants of Selam Palace. A special contribution was given by Nils Muiznieks, Commissioner for Human Rights at the Council of Europe from April 2012 to March 2018, who already in 2012, after a visit to the Palace, had denounced the conditions to the Council.

From the beginning of the project the number of accesses to the sanitary help desk has been 269, of which almost the 50% attends the association president’s surgery. Among the beneficiaries of the sanitary desk, the most common nationalities are the Eritrean and Somalian ones, almost all users are beneficiaries of international protection and the majority owns the refugee status. It is very interesting that more than half of the help desk users are in Italy from more than 5 years, which is the evidence of an insufficient integration and of a lack of knowledge about the access of the National Health System.

The most frequent conditions observed during the sanitary desk are the following:

  • articular pathologies (14%), mainly due to working conditions and sleeping on inadequate bedding, and respiratory conditions exacerbated by protracted permanence in poorly‐aired environments such as Selam Palace;
  • infectious and parasitic diseases (12%), especially the ones related to overcrowding and poor hygiene, such as scabies and dermatological fungal diseases;
  • diseases of the gastrointestinal system (9%), often due to stress or irregular food rhythms.

To avoid an excess of dependency, the project staff and the volunteers decide which cases can be accompanied to the public structures, and these cases are selected considering the gravity of the situation and the vulnerability of the beneficiary. For this reason, since the beginning of this project, 6% of the beneficiaries needed the presence of a volunteer, especially for the procedures related to the virtual address, required for the access to the National Health System for the inhabitants of the occupied buildings.

Thanks to the coordinators and to the expert volunteers, both medical doctors and social workers, 7 new volunteers have been trained on specific issues related to immigration and to the most frequent pathologies spread among them, which has increased the quality of the work. Volunteers are able to give all the basic information regarding access to public services, create informative material and they are able to accompany people to the public structures.

The methodology used for collecting data gives the Association the possibility to communicate the facts observed, in particular through a report of the activities held in Selam Palace.

The project is following the timeline scheduled by coordinators, the activities at the sanitary desk will follow as described, the number of accesses is expected to increase to 500 people, and the number of registrations to the National Health System is expected to increase to 200 people.

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