Un ambulatorio per migranti: un’opportunità di Medicina Transculturale

Migration is a complex, dynamic, multifactorial and structural phenomenon. The promotion and defense of human and social rights for migrant populations must necessarily consider the promotion and care of health for individuals and communities. Moreover, recent assessments show migration’s start in good clinically conditions, developing sick and tired during the journey or staying in the country destination due to the poor living conditions. Global migration from regions where strongyloidiasis, schistosomiasis, viralhepatitis and tuberculosis are endemic, has increased the potential individual and public health effect of these infectious diseases. The real rate in non-endemic countries is still a challenge. Therefore, screening for these conditions is necessary to prevent clinical complications and economic effects of Sanitary National System, but also ensure safe and right taking care to these patients. In the cultural and social perspective desired and carried forward by WHO, all UN Member States have agreed to try to achieve Universal Health Coverage (UHC) by 2030. Objectives Analyze the taking care process, clinical involvement and the health promotion with migrant population in our reality, in order to improve and guarantee the access to health care system. Underline the value of (a)symptomatic acute and chronic diseases, especially in infectious and tropical field, in order to promptly manage them. Methods We adopted a mixed methods approach. We performed a retrospective observational study of the prevalence of (a)symptomatic acute and chronic diseases in migrants at a single center in Negrar (VR) from January to December 2017. Furthermore, social and cultural patterns were also considered by a narrative ethics approach. Results We collected clinical and social data of 559 migrants, comparing them based on different origin centers. We valuated these data with statistical analysis. After that, we described clinical and social characteristics of UNIVERSITÀ DEGLI STUDI DELL'INSUBRIA Dottorato di Ricerca in Medicina Clinica e Sperimentale e Medical Humanities Segreteria: Centro di Ricerca in Farmacologia Medica, Via Monte Generoso n. 71, 21100 Varese VA Tel. (+39) 0332 217401, Fax (+39) 0332 217409 - E-mail farmacologia.medica@uninsubria.it 214 migrants leading to a public Hospital in Lombardia. We developed also a medical booklet for collecting clinical data of migrant patients, aimed at providing care and follow-up during their migration route. We made 42 organized-interviews, focused on tortures and other aspects of forced migration (persecution, discrimination, war-conflict, etc). Conclusion Access to care for migrants is a public health issue and an ethical duty alike. All the actors involved in migrants’ social, health care and political spheres will have to face these challenges. Migration journey and a long stay in Libya is associated to tuberculosis and other infectious diseases development. Therefore, accurate collection of migrant’s health and migration history and clinical needs is necessary. In order for UHC goals to be achieved into practice, the development of a targeted health pathway is needed. Our example of medical booklet is simple, well accepted and, given the double language, could be used even far from Italy along the migration route; it will contribute to rationalize the choice of medical investigations that need to be done and it will allow to sum up a detailed medical history that can be consulted at every visit everywhere.