Migrant people who reach Spain in a small boat are young and healthy, and when they are in the best state of health is just at the moment of arrival; however, it deteriorates as their stay in our country lengthens due to the conditions in which they must live.
"What makes them sick is their living situation here," Carlos Ramírez, from the migration and health working group of the Canary Society of Family and Community Medicine (SOCAMFyC), settles in a conversation with EFE.
Ramírez is one of the participants in the pre-congressional table of the XLIII Annual Meeting of the Spanish Society of Epidemiology (SEE) in which prominent experts are addressing this afternoon the challenges of healthcare for migrant people and dismantling the hoaxes that are repeated on this matter.
Some of them are precisely that migrants are carriers of diseases or abuse the health system.
"In the health centers of tourist areas we also attend to other foreign people who are never talked about, such as Europeans -Italians and British, fundamentally- who retire in the south of the Peninsula and the Canary Islands, who are older people and make greater use of resources," he points out.
Likewise, the islands also receive a significant number of migrants arriving by plane from Colombia, Venezuela and Cuba, who have already accumulated several generations in the Canary Islands, also older people who go to the health system more often.
Diabetes or hypertension
Originally, those who get on a small boat "are usually the most fit", young and healthy people who survive increasingly violent journeys and who leave from increasingly distant points.
"The moment of greatest health of a migrant person who arrives in a small boat is the moment of arrival, regardless of whether they may have suffered trauma or pathologies typical of the journey," says this family doctor.
Upon disembarking, many of them "apparently have a state of health that I would not say is optimal, but they walk on their own feet," he continues; it is the hours afterwards that begin to reflect that they were actually suffering a 'shock' due to dehydration, hypothermia or infections. This is what has been described as "small boat syndrome".
The health services, in coordination with the Red Cross and the Police, work in coordination from the first second to provide them with the necessary assistance in these first moments.
After a few months there would be a kind of "normalized life", and it is there where health professionals see that their state of health is deteriorating: situations of poverty, difficulties in accessing housing, precarious working conditions and widespread abuse.
Although it is true that in the first months diseases such as tuberculosis or malaria that they contract in their countries of origin may emerge, as their stay in Spain lengthens, migrants begin to develop pathologies typical of these stressful situations, such as diabetes or hypertension that, if they do not have adequate treatment, are complicated towards other cardiac, hepatic or renal diseases.
Promote cultural mediators
The problem is that, far from what hate speech promotes, these people use the health system to a much lesser extent than the rest of the population and, when they do, it is limited to emergency services.
"Accessibility to the health system is not as simple as people might think: obtaining the health card is complicated, although attempts are being made to enable instruments so that these people can exercise a right that belongs to everyone to universal health care," he adds.
For this it will be necessary to eliminate many other barriers, from the language to the culture itself, for which greater training is needed among health professionals: "We have to be humble and understand that the person in front of us comes from another context and that the skills we may have learned in our training do not include cultural competences," he says.
He thus demands that the figure of the cultural mediator be promoted, of which there are "interesting experiences" in the Basque Country, Madrid or Andalusia, but which is little developed at the national level.
It is not a mere translator, as there are in some hospitals, but someone capable of understanding the culture from which the other person comes, "how they manifest their symptoms or what their relationship is with health, illness and death, which does not have to be similar to ours."
Because in addition, in the conditions of extreme vulnerability in which they find themselves, "they need to find a person who understands them and trust in what they are saying," he concludes.
