La rivista The Lancet pubblica lettera di MSF:
  • Italia

Roma – The Lancet, una delle più prestigiose riviste medico-scientifiche al mondo, pubblica questa settimana una lettera di Medici Senza Frontiere che denuncia il crescente rischio di esclusione dall’accesso alle cure corso dai migranti irregolari in Italia.

La lettera si sofferma in particolare sulle conseguenze dell’eventuale introduzione del reato di immigrazione clandestina che, se approvato dal Senato della Repubblica, obbligherebbe tutti i pubblici ufficiali a denunciare gli immigrati irregolari alle autorità. Gli operatori della sanità pubblica sono pubblici ufficiali. E nonostante in Italia esista il divieto di segnalazione degli immigrati irregolari da parte del personale sanitario, l’introduzione del reato di immigrazione clandestina rischia di creare un clima di paura tra i migranti, ostacolando ulteriormente il loro accesso alle strutture sanitarie, aumentando così i rischi per la salute dei migranti stessi e della comunità.

La lettera segnala inoltre il preoccupante atteggiamento dei politici italiani di afftrontare l’immigrazione come una questione di ordine pubblico e non come una questione umanitaria, come dimostrato recentemente dalla decisione di rimpatriare forzatamente oltre 200 migranti verso la Libia senza verificare l’eventuale presenza di minori, categorie vulnerabili o richiedenti asilo.


Riportiamo il testo della lettera (disponibile anche sul sito della rivista)

The Lancet, Volume 373, Issue 9681, Pages 2111 – 2112, 20 June 2009

Access to health care for undocumented migrants in Italy

R Ravinetto (a), C Lodesani (a), U D’Alessandro (b), L De Filippi (c), A Pontiroli (a)

In Italy, since 1998, undocumented migrants have had the right to receive health care under national law, without being reported to immigration authorities. This aspect of the legislation is in line with Article 32 of the Italian Constitution, which states that health is a fundamental right of the individual (not only of the citizen) and statutes free health care for the poor.

An amendment to the law concerning public order measures, approved on May 14, 2009, by the Chamber of Deputies and now to be approved by the Senate, introduces the crime of illegal immigration, and consequently obliges by law all civil servants to report undocumented migrants. Public health workers are civil servants. Notwithstanding previous legislation forbidding them to report undocumented migrants, this new legislation risks creating fear among migrants, preventing them from attending health facilities and exposing both migrants and the whole community to higher health hazards.

Since 2003, Médecins Sans Frontières has been working in Italy, offering assistance at landings, and in public health centres for undocumented migrants. Migrants often present with disorders related to the hardships of the journey (trauma, dehydration, etc), the difficult working and living conditions (eg, osteoarticular diseases), and the stress caused by social exclusion, uncertainty of income, and changes in eating habits (gastritis and duodenal ulcers). Women mainly attend for gynaecological problems. Cross-cultural mediation services and outreach activities, aimed among other things at raising awareness about the availability of health care without the risk of being reported, have proven to be key factors for achieving effective access to health care.1

If the Senate approves the current proposal, the obligation for civil servants to report undocumented migrants would undermine any confidence they might have had in the public health system. This will increase exclusion and worsen their already unacceptable living and working conditions,2, 3 with serious health consequences for the whole community.
Italian policymakers tend to treat immigration as a public order issue rather than a humanitarian issue, as shown recently by the decision to send migrants back to Libya without checking for minors, vulnerable groups, and asylum seekers. This is alarming when considering that migrants are often fleeing situations of conflict and extreme poverty so dramatic that they do not hesitate about embarking on a long and perilous journey. Assisting them and ensuring the respect of the principles of the Italian Constitution is a public health and an ethical obligation.

We declare that we have no conflicts of interest.

1 Virgilio A, Defilippi L, Moschochoritis K, Ravinetto R. Right to health for vulnerable migrants. Lancet 2007; 370: 827-828. Full Text | PDF(44KB) | CrossRef | PubMed
2 Médecins Sans Frontières. The fruits of hypocrisy: history of who makes the agriculture? hidden. Survey on life and health conditions of foreign workers employed in the Italian agriculture. (accessed June 3, 2009).
3 Médecins Sans Frontières. A season in hell: MSF report on the conditions of migrants employed in the agricultural sector in southern Italy. (accessed June 3, 2009).

(a) Médecins Sans Frontières Italy, via Volturno 58, 00185 Rome, Italy
(b) Institute of Tropical Medicine, Antwerp, Belgium
(c) Médecins Sans Frontières, Operational Centre, Brussels, Belgium

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