World AIDS Day – a Day to Dissect an Inhuman Health Care Law
It is the 1st of December which means the World AIDS Day. The exclusion of undocumented migrants in the Swedish health care law is intact. The good news is that the access for undocumented migrants to get information and help in HIV/AIDS-related issues is getting better.
“It has happened a lot during the last year”, says one of the volunteers of Médecins du Monde in Sweden. She has just explained how things have improved concerning the possibility for the undocumented migrants in Stockholm to be tested for HIV/AIDS and get information about the disease.
But let us get one thing clear : it isn’t the legislative process that has gone through any big changes since last World AIDS Day. The Swedish law doesn’t handle undocumented migrants with HIV/AIDS in any particular way – these persons right to treatment is just as bad as any other undocumented migrant’s access to medical treatment in Sweden. Undocumented migrants don’t have any right to treatment here, unless it is absolutely urgent. HIV/AIDS isn’t absolutely urgent, according to this, in fact, capricious law.
Important cooperations
Doing an HIV-test in Sweden doesn’t cost anything and the result is kept secret between the doctor and the patient. The doctor and the patient discuss how to inform other persons that the patient might have infected, and hopefully they can reach these concerned persons that also need to do a HIV-test. Undocumented migrants have never been excluded from this principle – everyone that fears to be infected is encouraged to do leave a blood-sample. But thereafter, the legislative discrimination begins.
What my colleague – who has been working in Médecins du Monde for six years – had explained was how the cooperation between different clinics and NGOs has made it possible for undocumented migrants to do a HIV-test and get the result within 15 minutes. This clinic is situated in the central part of Stockholm and is specialized on HIV/AIDS. Of course, most blood-samples are negative but if there is an undocumented migrant who get the response that the test is positive, then there is doctors and nurses available to help and support with professional advices.
Regional progress
It is worth noting that much of the situation being described is just in Stockholm and some other towns and counties. Without a law, it’s up to each county council to decide whether they want a policy decision that gives undocumented migrants more access to an open health care that might not treat the patients with HIV/AIDS, but still integrate them into the health care system. For example, the county council in Stockholm has given undocumented migrants the same access to maternity welfare, which also includes a HIV-test on the mother. If the expecting mother is HIV-positive, it is important to give her treatment after the 20th week of the pregnancy as a preventive measure for the child.
Motivation and communication
The question surrounding HIV/AIDS and undocumented migrants has so many different angles of approach. One problem is in fact to motivate an undocumented migrant to do a HIV-test if this person suspects to be infected. For some migrants, to be infected could be seen as a result of shameful behaviour. Others don’t want to go to a clinic because of linguistic barriers. To have a meaningful discussion with a doctor, an interpreter is needed which in some cases could only be someone close that knows the two languages. For personal reasons it’s a hard thing to ask your relatives or friends to communicate in these questions. Also, to be an undocumented migrant in Sweden is tough even without knowing anything about an eventual sad response to the blood-sample. To motivate yourself to get a test that might make your situation even more precarious isn’t an easy thing to do. If the test is positive, then you still won’t have access to healthcare and medication. So to motivate undocumented migrants to have a HIV-test, the Swedish state should include them in the legislative system and give them access to health care.
Parallel processes
Thus, there are two parallel processes in Sweden concerning undocumented migrants’ access to healthcare. The legislative process that doesn’t change is the first one. Secondly, the good progress that actually gives undocumented migrants some opportunities to get information about HIV/AIDS and support after a sad and overwhelming response. Hopefully, on World AIDS Day 2010, someone can summarize that after pressure from civil society, the Swedish government decides to change the law so undocumented migrants have the same access to health care and HIV-treatment as nationals.
By Arvid Hedeborg, Läkare i världen
“It has happened a lot during the last year”, says one of the volunteers of Médecins du Monde in Sweden. She has just explained how things have improved concerning the possibility for the undocumented migrants in Stockholm to be tested for HIV/AIDS and get information about the disease.
But let us get one thing clear : it isn’t the legislative process that has gone through any big changes since last World AIDS Day. The Swedish law doesn’t handle undocumented migrants with HIV/AIDS in any particular way – these persons right to treatment is just as bad as any other undocumented migrant’s access to medical treatment in Sweden. Undocumented migrants don’t have any right to treatment here, unless it is absolutely urgent. HIV/AIDS isn’t absolutely urgent, according to this, in fact, capricious law.
Important cooperations
Doing an HIV-test in Sweden doesn’t cost anything and the result is kept secret between the doctor and the patient. The doctor and the patient discuss how to inform other persons that the patient might have infected, and hopefully they can reach these concerned persons that also need to do a HIV-test. Undocumented migrants have never been excluded from this principle – everyone that fears to be infected is encouraged to do leave a blood-sample. But thereafter, the legislative discrimination begins.
What my colleague – who has been working in Médecins du Monde for six years – had explained was how the cooperation between different clinics and NGOs has made it possible for undocumented migrants to do a HIV-test and get the result within 15 minutes. This clinic is situated in the central part of Stockholm and is specialized on HIV/AIDS. Of course, most blood-samples are negative but if there is an undocumented migrant who get the response that the test is positive, then there is doctors and nurses available to help and support with professional advices.
Regional progress
It is worth noting that much of the situation being described is just in Stockholm and some other towns and counties. Without a law, it’s up to each county council to decide whether they want a policy decision that gives undocumented migrants more access to an open health care that might not treat the patients with HIV/AIDS, but still integrate them into the health care system. For example, the county council in Stockholm has given undocumented migrants the same access to maternity welfare, which also includes a HIV-test on the mother. If the expecting mother is HIV-positive, it is important to give her treatment after the 20th week of the pregnancy as a preventive measure for the child.
Motivation and communication
The question surrounding HIV/AIDS and undocumented migrants has so many different angles of approach. One problem is in fact to motivate an undocumented migrant to do a HIV-test if this person suspects to be infected. For some migrants, to be infected could be seen as a result of shameful behaviour. Others don’t want to go to a clinic because of linguistic barriers. To have a meaningful discussion with a doctor, an interpreter is needed which in some cases could only be someone close that knows the two languages. For personal reasons it’s a hard thing to ask your relatives or friends to communicate in these questions. Also, to be an undocumented migrant in Sweden is tough even without knowing anything about an eventual sad response to the blood-sample. To motivate yourself to get a test that might make your situation even more precarious isn’t an easy thing to do. If the test is positive, then you still won’t have access to healthcare and medication. So to motivate undocumented migrants to have a HIV-test, the Swedish state should include them in the legislative system and give them access to health care.
Parallel processes
Thus, there are two parallel processes in Sweden concerning undocumented migrants’ access to healthcare. The legislative process that doesn’t change is the first one. Secondly, the good progress that actually gives undocumented migrants some opportunities to get information about HIV/AIDS and support after a sad and overwhelming response. Hopefully, on World AIDS Day 2010, someone can summarize that after pressure from civil society, the Swedish government decides to change the law so undocumented migrants have the same access to health care and HIV-treatment as nationals.
By Arvid Hedeborg, Läkare i världen