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Blog post
19 May 2021
Frontline social workers provide vital support to improve health
https://www.unicef.org/eca/stories/frontline-social-workers-provide-vital-support-improve-health
Yura has been a social worker for many years. “When I started working in social services, I was mainly interested in family therapy,” she says . “In time, I found out that supporting communities to become resilient and self-reliant is an extremely rewarding experience.” A year ago, she joined the Council of Refugee Women in Bulgaria (CRWB) – a civil society organization created in 2003 to support the integration of refugees and migrants. “Guiding through people from refugee and migrant backgrounds on health-related procedures in their host country is a way to empower them to find solutions to health issues,” explains Yura. And this is particularly vital for those fleeing from armed conflicts and humanitarian crises. As they search for safety and better life opportunities, both adults and children go through many traumatic experiences as a result of often prolonged stays in refugee camps, limited access to health care, and the dangers they face as they travel through volatile areas. By the time they finally reach a safe destination, they are often in very bad physical and psychological shape. “In Bulgaria, refugee children arrive with their parents or – in some cases – unaccompanied. Psychological problems, infectious diseases, medically unobserved pregnancies and, in particular, a lack of immunization, are common problems that have a negative impact on their health and wellbeing.” Radostina Belcheva, Project Coordinator and Deputy-Chair of CRWB The CRWB partners with UNICEF Bulgaria to provide general health checks and referrals, as well as life-saving vaccines in line with children’s immunization schedules, and equips parents with information on health risks, entitlements and how to access medical services. “As part of the ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South-Eastern Europe’ (RM Child-Health) project co-funded by the European Union’s Health Programme, we work with our partners to ensure that children can follow immunization plans and that their vaccination status is updated in their immunization documents. These are crucial steps in ensuring good health . ” Diana Yovcheva, Programme Officer with UNICEF Bulgaria Working directly with refugees, Yura consults families that want to access health services. “Some cases are easier than others”, she says, recalling a consultation with Ahmed*, a 45-year-old father of six children, who fled Syria in 2020 and received humanitarian status in Bulgaria. A chef by profession, Ahmed settled quite well in the host country, found a job in a restaurant and, after some time, managed to reunite with his wife, his four sons and two daughters. “Ahmed was referred to the CRWB by friends and he came in for a consultation on the immunization process with his youngest baby girl, Yasmina, only one year old” explains Yura. During their meeting, the social worker provided information about the health system in Bulgaria, the role of a general practitioner, and how people with refugee status can access medical services including vaccinations for their children. Although Ahmed’s baby girl had been vaccinated before her arrival in Bulgaria and had an immunization passport, the father urgently needed to update her vaccination status to synchronize her vaccinations with the recommendations of the national immunization calendar. “I contacted the Regional Health Inspectorate and helped Ahmed to provide the necessary documents and find a translator, as the documents were in Turkish”, says Yura. Subsequently, she helped Ahmed schedule an appointment with a medical doctor and Yasmina received her next vaccine. Parents often lack the necessary vaccination documents. According to Yura, “Sometimes children have not had any vaccinations, or they have been vaccinated in their country of origin, but their immunization cards have been lost or destroyed.”    Such cases require additional consultations, research and coordination, as well as testing for antibodies and immune responses when it is not clear whether the child has been vaccinated. “By empowering parents to familiarize themselves with the immunization plans and procedures we help them become proactive in following up on their children’s health." Yura, Social worker To address the COVID-19 restrictions and keep active communication with refugees and migrants, the CRWB and UNICEF developed leaflets in Bulgarian, Arabic and Farsi with details about the health system in Bulgaria and the importance of vaccinations, and regularly provide health-related information via social media. “The role of communication in immunization is essential.  Our frontline staff interact on a daily basis with beneficiaries, but we have also used other means [such as a Facebook group dedicated to health-related topics] to keep the information flow going, particularly during the COVID-19 pandemic . ” Radostina Belcheva, Project Coordinator and Deputy-Chair of CRWB Logo - Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe This story is part of the Project Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe, co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative). The content of this story represents the views of the author only and is her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the European Health and Digital Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains .
Blog post
23 March 2022
Inside the journey of Ukrainian refugee children and families
https://www.unicef.org/eca/stories/inside-journey-ukrainian-refugee-children-and-families
In the past three weeks Moldova’s southern border has seen crowds that one could hardly imagine here even several weeks ago. With thousands waiting to flee war-torn Ukraine, the life of both communities has changed irremediably. Armed violence has not spared civilians for weeks and millions of Ukrainian families were forced to leave their homes in a matter of days or, in some instances, hours. Now they are arriving in Moldova and neighbouring countries in pursuit of safety.  Since the first day of the war waged against Ukraine, UNICEF's teams have been on the ground, providing life-saving aid to the most vulnerable children both in Ukraine and outside of its borders. Together with a group of first-responders in Moldova, I arrived at the border crossing point of Palanca that has already seen thousands of Ukrainians seeking refuge in the past weeks. The first thing that catches your eye as you look at the people traveling through Palanca is that there are almost no men among them. The vast majority of those fleeing the hostilities in Ukraine are women and children as men between 18 to 60 are banned from leaving the country. According to UNICEF’s estimates, at least one child is crossing Ukraine’s border every single minute. The total number of children seeking asylum in Moldova and the European Union has already gone beyond 1.5 million. As for those children who have been displaced within Ukraine, a comprehensive count could not be done yet due to the rapidly changing situation. The second observation that you can hardly miss at Palanca is the profound exhaustion on the faces of those who walk across the border. Many women and children we meet started traveling days ago. Roads, trains, buses, queues, shelters – families lost the count of those on the way to Palanca. The journey’s logistical hardships are coupled with many dangers, ranging from gunfire to air strikes. Ukrainian refugees, some with children, arrive at the Palanca border crossing in Moldova Ukrainian refugees, some with children, arrive on March 08, 2022 at the Palanca border crossing in Moldova, on the Moldova-Ukraine border after they fled war in their country. Once they reach the crossing point, families have yet to face another challenge. In the bitter cold, children and their mothers form lines stretching many kilometres away from the border. There are two separate queues. The first one, for cars, is so long that some mistakenly confuse it for a traffic jam on the way. The second one, for pedestrians, is somewhat shorter, although probably more exhausting. Mothers are clutching their children and hurriedly packed suitcases – the only remnants of their safe, pre-war lives. Some are trundling pushchairs or prams; others have three or even four children to look after. After crossing the border, Ukrainian mothers and children receive, along with long-awaited safety, an immediate aid from the Moldovan government, working together with UNICEF. Welcomed at Blue Dots placed by UNICEF along the road, families get what some of them described as “a much-needed moment to breathe”. Designed to provide a safe space for children and their families, the Blue Dots offer mothers and children vital services, play, protection and counselling in a single location. As mothers crossed the border, I could hear them say: “Hold my hand, hold my hand. Whatever you do, do not let go of my hand!”. What would seem a generic comment in any other circumstances was truly essential in this context. In the past three weeks, UNICEF has received many reports about missing or unaccompanied children traveling through Ukraine and across its western borders. We now work with the Moldovan government to increase the capacity of their social protection systems to screen, track and account for unaccompanied children. They then attempt reuniting the children with their families or provide temporary protection to shield them from risks of trafficking and abuse. The Blue Dots serve as a platform to identify unaccompanied children, as trained workers activate a screening mechanism during the art programme held at these safe spaces. In less than three weeks, Moldova has welcomed 200,000 refugees. It is at least half the size of the population of the country’s capital, Chisinau.The others opt to continue traveling to Romania or further into the European Union. Regardless of their choice, asylum seekers can receive immediate support from the local authorities in Moldova, including food, lodging and transportation. A child therapist and social worker assists families at a UNICEF-UNHCR Blue Dot centre A child therapist and social worker (right) assists families on March 16, 2022 at a UNICEF-UNHCR Blue Dot centre at a refugee reception centre close to the Palanca border crossing in Moldova, near the Moldova-Ukraine border. The Moldovan government has built more than one effective partnership to house Ukrainian mothers and children: both local hotels and university dorms have opened their doors. Many others are hosted in temporary shelters: theatres, gyms, sports stadiums, basketball courts and many other premises have been rapidly turned into accommodation. MoldExpo Exhibition Center, a location for trade fairs, has also found a new purpose. Structured cubicles used for commercial events have become tiny homes with beds, mattresses and pillows for the centre’s new residents. As our team arrived at the MoldExpo Exhibition Center, we immediately noticed the difference between the atmosphere here and at Palanca. Most of the families seemed calm and rested. They now had access to hot meals, electricity and running water. With a variety of food available in the centre’s kitchen areas, one would also assume that nutrition is no longer a concern. However, for many mothers with small children, finding the right nutrients, continuing breastfeeding or preventing infants’ diarrhoea remains a challenge. Another invisible danger that looms in almost every collective centre these days is a high risk of an infectious disease outbreak. In the past five years, Ukraine has faced more than one outbreak of vaccine-preventable diseases. In fact, a polio outbreak continues in the country to this day, and the latest case of polio-induced paralysis was confirmed in February. As this crippling disease recognises no borders, it now threatens every unvaccinated child in the region. With many Ukrainian children missing their compulsory vaccination doses due the war-related disruption of the healthcare system, we must ensure they have access to immunization as soon as they arrive in the host countries. UNICEF is already working with the Moldovan government to roll-out immunization services for the youngest refugees and their families. Having spent some time at the MoldExpo Exhibition Center, we had a chance to observe how it is being transformed from empty premises with beds and pillows into a structured child-friendly space. Blue Dots have been set up and first children joined the art programme. Moldova has already opened their educational and day-care centres to Ukrainian asylum seekers, and, as of today, 191 children have enrolled. Access to quality pre-school and school education marks the start of a new beginning both for them and their parents. Meanwhile, there are thousands of children back in Ukraine who are robbed of the chance to learn, as their families are still trapped on the roads or bomb shelters. We are still far from understanding every layer of the unprecedented influence that the war in Ukraine has on our communities. Although, something has become clear to me after visiting Moldova last week. The war in Ukraine is not just any crisis. It is, first and foremost, a child protection crisis. A child protection crisis that will have an impact on the entire region. Afshan Khan is a UNICEF Regional Director Europe and Central Asia, UNICEF Representative to the UN in Geneva, Special Coordinator, Refugee and Migrant Response in Europe. She has spent 25 years in the United Nations, primarily with UNICEF, responding to some of the biggest humanitarian crises of our time, from the Indian Ocean earthquake and tsunami to war and conflict affected countries.
Article
13 May 2021
Safeguarding the health of refugee and migrant children during COVID-19
https://www.unicef.org/eca/stories/safeguarding-health-refugee-and-migrant-children-during-covid-19
"When COVID arrived here, I thought: ‘It's over, it will spread throughout the building’. I didn't think it was possible to avoid the spread of the outbreak. Instead, we have had very few cases and we owe this, above all, to the support we received from INTERSOS and UNICEF."  Josehaly (Josy), a refugee living in Rome A field worker from Intersos fastens a mask for a young refugee girl in Rome. A field worker from Intersos fastens a mask for a young refugee girl in Rome. The ‘RM Child-Health’ initiative is funding work across five European countries to keep refugee and migrant children connected to health services. While the COVID-19 pandemic was not foreseen when the initiative was first launched, the strategic principles underpinning the ‘RM Child-Health’ initiative – flexibility, responsiveness to real needs, and building on what works – meant that UNICEF and partners could swing into action to safeguard the health and wellbeing of refugee and migrant children and overcome intensified and unprecedented challenges. Since the launch of the 27-month ‘RM Child-Health’ initiative in January 2020, activities were adapted quickly to address access to health services during the COVID-19 crisis in Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia. This €4.3 million initiative, co-funded by the European Union Directorate-General for Health and Food Safety, has shown refugee and migrant children and families how to protect themselves and others, and that they have every right to health care – even in a pandemic. The rapid escalation of the COVID-19 pandemic in Europe in 2020 exacerbated the already worrying state of health and wellbeing of the region’s most vulnerable people, including refugee and migrant children, and has had a protracted impact on their access to health and other vital services. The situation has been particularly dire for refugees and migrants who are not in formal reception sites, and who are, therefore, harder to reach and monitor. Refugee and migrant families living in over-crowded conditions with limited access to sanitation are at high risk of infection. These communities have often had to face a ‘double lockdown’, confined to their settlements and camps and having little or no access to accurate information on protecting themselves and others.  The additional pressures have been severe. UNICEF and its partners in Bulgaria have seen appeals for support double from 30 to 60 cases per day. Far more refugees and asylum-seekers have been in urgent need of financial and material support, having lost their incomes because of the pandemic. There have been increased requests for support to meet the cost of medical care for children, which is not covered by the state budget, and more requests for psychosocial support. This increase in demand has, of course, coincided with serious challenges for service delivery. Restrictions on movement have curtailed in-person services, and partners have had to adapt the way in which they connect with refugees and migrants. The pandemic has had a direct impact on the provision of group sessions to share health-related information, as well as on the timely identification of children and women suffering from or at risk of health-related issues. The impact on vital services for timely and quality maternal and child health care, psychosocial support, recreational and non-formal services, and on services to prevent and respond to gender-based violence (GBV) has been profound. In Bulgaria, UNICEF and its partners were able to take immediate measures with support from the ‘RM Child-Health’ initiative to alleviate the impact, including online awareness raising and information sessions and the use of different channels for communication, including social media. UNICEF’s partners, the Council of Refugee Women in Bulgaria (CRWB) and the Mission Wings Foundation (MWF) adapted service delivery to allow both face-to-face interaction (while maintaining social distancing for safety) as well as assistance online and by telephone. Partners were able to continue to provide direct social services support while also delivering online consultations to refugees and migrants on cases of violence, as well as referral to specialized services. In Greece, the initiative supported the development of child-friendly information posters and stickers for refugee and migrant children and their families on critical preventive measures and on what to do and where to go if they experience any COVID-19 symptoms. In Italy, the initiative has supported outreach teams and community mobilization, providing refugee and migrant families with the information and resources they need to keep the pandemic at bay. In Rome, for example, health promoters from Intersos continued to work directly with refugee and migrant communities in informal settlements, not only to prevent infection but also to keep their spirits high, as one health promoter explained: "We have organized housing modules that are not only designed to keep the community safe, but also to stop loneliness overwhelming the people forced into isolation. The entire community has assisted people affected by the virus by cooking, washing clothes and offering all possible support, particularly to the children."  UNICEF and its partners in Italy, as in other countries, have aimed to maintain continuity and unimpeded access to key services. Child protection, for example, has been mainstreamed into all project activities, and additional measures have been introduced, with a ramping up of activities to raise awareness and share information. UNICEF partners adapted quickly to the pandemic, with Médecins du Monde (MdM) activating a hotline number to provide remote counselling and psychological first aid (PFA). Centro Penc shifted to remote case management and individual psychological support, strengthening the capacity of cultural mediators to support GBV survivors, with UNICEF’s support. Young people were consulted and engaged through UNICEF’s online platform U-Report on the Move, with young U-reporters sharing information on the increased risks of GBV, as well as on available services. In Serbia, the initiative has supported UNICEF’s efforts to improve the immunization process for refugee children and migrants by strengthening the assessment and monitoring process. As a result of such efforts, refugees and migrants have been included in the national COVID-19 Immunization Plan.  
Press release
04 May 2020
With financial support from the European Union UNICEF launches the ‘RM Child-Health’ project to strengthen vulnerable refugee and migrant children’s health
https://www.unicef.org/eca/press-releases/financial-support-european-union-unicef-launches-rm-child-health-project-strengthen
Logo Logo   BRUSSELS, GENEVA, 5 May 2020 – Under the Health Programme of the European Union, the Directorate General for Health and Food Safety has committed a project grant to  UNICEF to support work ensuring refugee and migrant children and their families have access to quality health care and accurate health information in Bulgaria, Greece, Italy, Spain, Bosnia Herzegovina and Serbia. Refugee and migrant children and their families often have more health-related risks and face a number of barriers accessing quality health care. Many children and families also live with severe emotional distress due to the trauma of fleeing home, undertaking dangerous journeys and experiencing abuse and exploitation, including sexual and gender-based violence. The global COVID19 pandemic further exacerbates these health challenges.  “With the ongoing pandemic, protecting every child and adult’s right to health care and accurate heath information is paramount. This collaboration with the EU Health Programme will help ensure the most vulnerable refugee and migrant children will have better access to primary healthcare services, psychosocial support as well as violence prevention and response services,” said UNICEF Regional Director for Europe and Central Asia and Special Coordinator for the Refuge and Migrant Response in Europe, Ms. Afshan Khan. The project ‘RM Child-Health’ will help improve the health of refugee and migrant children by improving their access to life-saving immunizations, mental health and psychosocial support, gender-based violence prevention and response activities as well as maternal and newborn health care and nutrition support. Information materials on health-related risks and services available for refugee and migrant populations will be created and shared. Medical interpreters and cultural mediators will be deployed to support communication between children and families and health care providers. The project ‘RM Child-Health’ will also support training programmes so frontline health care workers can better respond to the specific needs of refugee and migrant children and their families. In parallel, national health authorities will benefit from technical support to develop, update and improve the implementation of health policies and address bottlenecks in national health systems that currently prevent refugee and migrant children from accessing services. Refugee mother feeding her baby at ADRA community centre in Belgrade. UNICEF/UNI220342/Pancic
Article
01 February 2021
Strengthening the implementation of health policies
https://www.unicef.org/eca/stories/strengthening-implementation-health-policies
The initiative also promotes and supports multi-disciplinary approaches and teams to address the complex causes of health problems among refugee and migrant children – from trauma, anxiety and over-crowded conditions, to lack of hygiene facilities and immunization. As a result, support from the ‘RM Child-health’ initiative builds trust between refugee and migrant families and health providers. At the Centre for refugees and migrants near Bela Palanka in south-eastern Serbia, for example, the needs of refugee and migrant women have shaped the development of the Community Centre run by ADRA, with its Mother and Baby Corner for women with infants. Here, women can take part in language classes, sports activities and, crucially, in workshops about their own health and rights. “ The most important thing is that all the advice from our doctor is in line with their economic circumstances and current living situation [in Reception centres],” explains social worker Andja Petrovic. “The advice is tailored to their life and I think they particularly like that, because they can see that their situation is acknowledged. Because when they go to a doctor [in other facilities], they get advice that they can’t follow because they don’t have the living conditions for it.” Also in Serbia, funding from the ‘RM Child-health Initiative’ supports work by UNICEF and the Institute of Mental Health that looks beyond the provision of basic health care to assess the scale and nature of substance abuse among refugee and migrant communities. This cutting-edge field research will guide the development of materials and capacity building specifically for health and community workers who are in regular contact with young refugees and migrants, helping these workers to identify and tackle substance abuse by connecting children and youth to support services. As one researcher involved in the research commented: “Most of those children have spent several years without a home or any sense of stability. They can't make a single plan about the future since everything in their life is so uncertain. I can't begin to imagine how frightening that is.” By building greater rapport between frontline workers and children, and by equipping those workers with the support, skills and resources they need, the ‘RM Child-health’ initiative is helping to transform health policies into health practice. This vital work has been particularly crucial in 2020, as frontline workers have had to confront – and adapt to – the greatest public health crisis in living memory: the COVID-19 pandemic. Logo This story is part of the Project ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe’, Co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative).It represents the views of the author only and is her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.

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