Exile, Exit? Life as an undocumented migrant in Europe

, by Karina Andres

Exile, Exit? Life as an undocumented migrant in Europe

In order to highlight the obstacles which undocumented migrants face in trying to access the different European health systems, the European Observatory on Access to Healthcare survey collects personal testimonies conveying an objective vision of the alarming situations in relation to the key determinants of health. Based on this data, the “Exile, Exit?” exhibition by Médecins du Monde bears witness on the living conditions, health status and access to healthcare faced by undocumented migrants in Europe - people among the poorest, most excluded and most discriminated against.

The focus of the “Exile, Exit?” exhibition is on reception conditions and everyday experience of people living without residence permits, better known as "undocumented migrants” and often denied healthcare on the grounds of their immigration status. The data gathered by the European Observatory on Access to Healthcare survey and presented by the Médecins du Monde exhibition is most revealing:

72% of the health problems receive little or no treatment

70% are faced with barriers when seeking healthcare

41% have abandoned attempts to obtain healthcare

14% have been denied treatment by healthcare providers and have been victims of discrimination, prejudice and ignorance

Only 6% give health as their reason for their emigration. This is a clear indication that the myth, often quoted by politicians, that people come to Europe for healthcare, does not stand.

Aggravating factors

59% of migrants have suffered of violence in their lives and 25% report being victims of violence since their arrival in Europe. Before, during, after: violence is omnipresent in the lives of most migrants. Indifferent from their painful pasts, host countries offer no protection from future violence.

More than half of the migrants interviewed say they are lonely. Loneliness, social isolation and fear are additional risk factors for the health of these people, already weakened by their migration and their past experiences. 52% of the migrants is roofless or in insecure accommodation and 86% of the families live in overcrowded houses. Over half of them work more than 10 hours a day, a workforce that doesn’t refuse to be underpaid overtime.

Insecure, overcrowded and unsanitary housing, difficult working conditions and night work put the health of undocumented migrants at risk. The combination of previous trauma, pathogenic living conditions and the absence of effective rights makes undocumented migrants three times more likely to fall ill than citizens of the European Union.

Children without protection

59% of parents of young children live apart from their children. 18% of migrant mothers were refused care during their pregnancy, whereas appropriate pre-natal and post-natal healthcare should be ensured for these high-risk pregnancies.

The children of undocumented migrants share the worst of what their parents endure: insecure living conditions, the anguish of separation, no access to healthcare. Common sense dictates that children cannot be considered undocumented migrants as they do not choose where they live. And yet certain countries offer no specific protection to children and refuse them access to the health system, sometimes requiring that they be reported, although child protection is a cause common to all countries in Europe.

Limited access to healthcare

Complex administrative procedures, bureaucratic requirements and linguistic barriers limit access to healthcare for undocumented migrants as well as restrictive and disparate laws in Europe, financial discrimination and a lack of information. Improving the medical case-management of vulnerable populations is one of most European countries’ public health goals, and is a stated priority for the EU and World Health Organisations.

Conditions of access to healthcare for people without residence permits are increasingly dictated by immigration control policies. Europe’s immigration policy has become so restrictive that it is turning back huge numbers of those attempting to flee misery or war and find elsewhere what their own country is unable to offer them: security, decent living conditions, work. Fleeing one’s country is not a crime and yet the main concern of the EU countries is to keep foreigners out. In doing so, they condemn to their fates a multitude of desperate people in search of safety and humanity. The closure of Europe’s borders does not dissuade these migrants who take ever more dangerous routes.

Free and equal access to preventive healthcare and treatment for anyone living in Europe, without discrimination on the basis of immigration status or financial means.

Access to healthcare is still not recognised as a fundamental right in Europe. What undocumented migrants are experiencing also concerns EU citizens living in vulnerable situations. Today, economically-weak European citizens who have no health insurance and aren’t nationals of the EU country in which they are living loose the right to residence and find themselves in the same situation as undocumented migrants from outside Europe. This is a further restriction on the free movement of persons. Belgium and France have therefore extended the medical assistance system for undocumented migrants from outside Europe to Europeans without a residence permit.

Médecins du Monde is fighting for free and equal access to preventive healthcare and treatment for anyone living in Europe, without discrimination on the basis of immigration status or financial means. Health policy must remain independent of immigration policy.

The “Exile, Exit?” exhibition is a manifesto that calls on political leaders to ensure real access to healthcare for everyone living without documents in Europe and raise awareness to what is both, an ethical and public health issue: undocumented migrants do not come to Europe to take advantage of its healthcare systems; their health is damaged by their living conditions.

Three demands for ensuring the right to healthcare for everyone is respected in Europe:

- No requirement to report undocumented people seeking healthcare. Safeguards on medical confidentiality and a strict ban on any kind of reporting or arrest.

- Protection for mothers and children. Treatment for children (under 18) and pregnant women, including appropriate ante-natal monitoring

- No expulsion of sick people. Protection for seriously ill foreign nationals who cannot effectively access healthcare in their home country


1 Médecins du Monde is an international humanitarian organisation providing medical care to vulnerable populations affected by war, natural disasters, disease, famine, poverty or exclusion. Originally established in France in 1980, the international network of this independent organisation now extends to 16 countries in Europe, Asia and the Americas.

2 Statistics revealed by the second European Observatory on Access to Healthcare survey (launched in 2009), based on data gathered in the 11 European countries in which Médecins du Monde is present (Germany, Belgium, Spain, France, Greece, Italy, Netherlands, Portugal, United Kingdom, Sweden and Switzerland) among 1,218 people of 97 different nationalities.

Image: Olivier Jobard SIPA


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