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Article
02 Июль 2020
Going for a vaccination with my cousin Emina
https://www.unicef.org/eca/stories/going-vaccination-my-cousin-emina
“Don’t worry, it doesn’t hurt, it just stings a little. It’s easier if you look the other way,” says Emina to Irma as they fix each other’s hair. This is an important day for Irma Fafulić, who has already prepared a clothing combination to wear and asks us to wait for her while she changes in another room. Both girls soon return to the living room of Irma’s humble home, dressed up and with their hair done to their liking, but now they are faced with another dilemma: they are not sure if their protective facemasks will match the rest of their outfits so they deliberate on which one to wear to the vaccination point. The atmosphere in the living room of the Fafulić family in the village of Varda near Kakanj is almost festive: they are visited by Edin Sejdić, mediator from the Kakanj-based Roma Support Centre “Romalen”. Six-year-old Emina and her mother Fatima Dedić from Visoko are currently visiting the Fafulić family, so the girls have been inseparable for days. “I call her sister even though we’re actually cousins, and I’m a little older than Emina,” says Irma with a smile full of crooked milk teeth and explains that she has completed her second grade online due to the COVID-19 situation. Now, she says, she is deservedly enjoying her school holidays after a very challenging period when she had to compete with other relatives for access to a single shared mobile device so that she could attend her online classes. When asked what she liked most about school this year, she retorts right off the bat: “My teacher Dženita!” The rest of the Fafulić-Dedić household listens attentively to Edin, whom they have known for a long time, and who has stopped by today to escort their Irma to the local health centre for a vaccination. Statistics show that only four percent of Roma children in BiH are vaccinated Roma girl UNICEF/ Majda Balić Raising awareness about the importance and effectiveness of immunization in Roma communities is one of the regular activities implemented by the Kakanj-based Roma Support Centre “Romalen” Edin is kind of a link between the health-care system and the residents of this small community, and as a true man of the people, he explains the advantages of immunization, dispelling misconceptions and rebutting arguments of even the most fervent opponents of vaccination in the audience. He is one of the 16 mediators trained to do outreach work and help Roma communities with vaccination procedures in four cantons with sizeable Roma population (Zenica-Doboj, Sarajevo, Central Bosnia and Tuzla). Raising awareness of the importance and effectiveness of immunization in Roma communities is one of the regular activities implemented by the Kakanj-based Roma Support Centre “Romalen” under the project Immunization for Every Child in Bosnia and Herzegovina (BiH), in cooperation with UNICEF BiH. Edin is a link between the health-care system and the residents of this small community. Edin is a link between the health-care system and the residents of this small community. He admits that doing outreach work is not always easy, adding that people often confuse going to the doctor for an injection for receiving vaccines, and that there are still those who remain unconvinced of the benefits of immunization. But Edin has a way with people, patiently walking them through the entire process, emphasizing benefits and dispelling fears. By the end of the project, as many as almost 1500 families in the four cantons will have been informed about the benefits and effectiveness of immunization, as well as vaccination procedures and options. Mediators like Edin also provide assistance by escorting the youngest members of the community to vaccination points. “Thanks to this project, you can also retroactively receive the vaccines you missed,” says Edin, adding that many Roma are not at all aware of what needs to be done, or when. Mediators are therefore an invaluable asset to the community as they motivate, inform and mobilize people, and prepare the ground for the child’s immunization. Each mediator has a vaccination schedule for every child, and reminds parents when it is time to go to a health facility. Mediators are carefully selected from among their communities, they are persons of trust, and are usually involved in supporting the community through other projects – so they are familiar to the people they interact with and have already gained trust of the local residents. The same is true of the Fafulić family, who are now ready to have their Irma vaccinated after receiving relevant information from Edin. Mujo Fafulić Mujo Fafulić, president of the Kakanj-based Roma Support Centre “Romalen” “Roma mediators have a vital role to play in Roma communities. Statistics show that only four percent of Roma children in BiH are vaccinated. This project aims to raise this immunization rate, even using statistics on the mortality of unvaccinated children as one of the arguments,” explains Mujo Fafulić, president of the Kakanj-based Roma Support Centre “Romalen”, the organization implementing the project. “These are one-on-one conversations, with mediators visiting communities to check on the spot what the vaccination rates are and whether children are vaccinated at all, as well as which vaccines they have received, while also motivating parents to have their children immunized if they have not done so before.  "By the time they reach adulthood, children should complete the vaccination cycle, and mediators are doing outreach work to explain the benefits of on-schedule immunization, as well as the adverse consequences of failing to do so." Mujo Fafulić Emina has already received the vaccines scheduled for her age, and she confidently shares her last words of advice with her cousin Irma before they leave, so that there are two parallel conversations going on in the living room – adults talk about the benefits of immunization and health care, and the little girls, holding hands, have their own conversation about what the needle looks like and where on the hand the nurse will give Irma a jab. Rubbing their hands with disinfectant, with their facemasks on, the girls extend their hands to the mediator, ready to go – Emina, being more experienced, will escort Irma to help her go through this whole experience as painlessly as possible. Irma’s parents Jasmina and Nermin are staying at home and waving to the girls from the window. Holding hands, with their fingers intertwined in a clasp that shows care and love, the children set out together on their trip to the health centre. The trip they are taking is one that is recommended to everyone as it promises better health and protection against diseases that are still lurking about and are far from being eradicated. Dr. Rownak Khan, UNICEF Representative in BIH confirms that by saying: “Vaccination is the best protection from communicable diseases. Unfortunately, Bosnia and Herzegovina’s low immunization rates, 68% full immunization and only 4% among Roma children, mean that children in this country are at high risk of getting vaccine preventable diseases resulting in outbreaks, particularly measles outbreaks. Currently, UNICEF is working with two Roma NGOs, Kali Sara and Romalen, to raise awareness on the importance of vaccination in Roma communities, by connecting with health institutions, Public Health Institutes and ministries with Roma communities through Roma health mediators to reach the most vulnerable children. This will also reduce equity gaps and will protect all children in BiH from vaccine-preventable diseases.” All children, regardless of the country or circumstances in which they live, have the right to develop and thrive. As a key component of the human right to health, immunization saves millions of lives and protects children against vaccine-preventable diseases. Immunization saves two to three million lives each year. Vaccines now protect more children than ever before, but nearly one in five infants miss out on the basic vaccines they need to stay alive and healthy. Low immunization levels among poor and marginalized children compromise gains made in all other areas of maternal and child health.   This material is produced within the initiative Increase awareness on the importance of vaccination with special focus on Roma communities - Immunization for every child! UNICEF Country Office in Bosnia and Herzegovina’s programme on immunization, funded by the Centers for Disease Control and Prevention (CDC) through UNICEF Headquarters. We would also like to thank UNICEF Europe and Central Asia Regional Office for their support.
Programme
29 Январь 2021
Improving health literacy among refugee and migrant children
https://www.unicef.org/eca/stories-region/improving-health-literacy-among-refugee-and-migrant-children
UNICEF has worked with partners and with young refugees and migrants on the ground to identify information gaps – work that has, in turn, guided the development of health literacy packages across all five countries on a range of crucial health issues, from immunization and nutrition to sexual and reproductive health (SRH) and gender-based violence (GBV). The assessment has shaped the development of detailed plans on how to ensure that health messages reach their audience and have an impact. The health literacy packages have also drawn on existing materials, including Facts for Life , My Safety and Resilience Girls Pocket Guide and an adapted version of the UNFPA curriculum: ‘Boys on the Move’. Refugees and migrants face a chronic lack of health information in their own languages, and a lack of information that reaches them through the channels or people they trust health navigation Some common priorities have been identified by refugees and migrants across all five countries, including access to immunization and other primary health care services, breastfeeding and young child feeding, and the prevention of GBV. They have also flagged up the pressing need for more mental health and psychological services. Other issues have emerged as priorities in specific countries, including cyberbullying and online safety in Italy, and substance abuse among young people In Serbia – the focus of a new in-depth UNICEF study. Not surprisingly, the COVID-19 pandemic is a new and urgent priority for refugee and migrant communities – and one that has heightened the health risks they already face by curtailing their movements and their access to health services. A consultation with refugee and migrant adolescents and young people living in Italy has revealed major gaps in their knowledge about sexual and reproductive health, drawing on an online survey, a U-Report poll and a series of focus group discussions. It has highlighted some common misunderstandings, such as the myth that masturbation causes infertility, and continued perceptions around the importance of a woman’s virginity at marriage, as well as knowledge gaps around menstruation, pregnancy and sexually transmitted infections. The consultation also found, however, that the young participants want to know far more about this crucial area of health. As one young man from Guinea noted during a focus group discussion: “often young people do not want to know if they have an infection, also because they are not aware that these can be treated. It is so critical to raise awareness on STIs tests and treatment options.”  
Article
01 Февраль 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.
Article
29 Январь 2021
Strengthening national health capacity for refugee and migrant children
https://www.unicef.org/eca/stories/strengthening-national-health-capacity-refugee-and-migrant-children
“This collaboration is helping to stimulate public demand for strong national health systems that work for everybody and that rise to new challenges, such as disease outbreaks.” Afshan Khan, UNICEF Regional Director The ‘RM Child-Health’ initiative has supported work across five European countries to enhance and strengthen the capacity of national health systems to meet the health needs of refugee and migrant children. This work recognizes that a health system that works for such vulnerable children is a health system that works for every child. At first glance, helping a 10-year girl from Iran, now living in Bosnia and Herzegovina, get a new pair of glasses might seem a simple thing. For Maisa, however, this is the end result of a continuum of intensive support, from identifying a girl who struggles with an eye condition, to connecting her to a skilled ophthalmologist. And now Maisa stands in front of a mirror, trying on the glasses that will enhance her life, learning and play. Such a momentous day is only possible when an established health system is equipped to accommodate and respond to the complex needs of refugee and migrant children. Support from the ‘RM Child-Health’ initiative aims to reinforce and enhance health systems across five European countries (Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia) so that these systems can deliver the high-quality services that are the right of every child – and that every child needs, regardless of their origins. The aim: to ensure that health systems catch every refugee and migrant child who is in danger of slipping through the gaps. And there are additional benefits: a health system that works for these vulnerable and excluded children is a health system that works for every child, and that can reach those who are so often the very hardest to reach. This 24-month, €4.3 million initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, aims to strengthen the capacity of health systems to deliver health care to refugee and migrant children. That means ensuring access to life-saving immunization, to mental health and psycho-social support, and services to prevent and respond to gender-based violence, as well as maternal and new-born health care and nutrition. Stronger health systems are needed to overcome the bottlenecks that confront so many refugee and migrant families when they try to access health care. “ The profound challenges that often confront populations – especially children – on the move can include cultural and language barriers, stigma and discrimination on the part of health providers, and a lack of detailed medical records or paperwork,” says Dr. Basil Rodriques, UNICEF Regional Health Advisor. “They may also have their own reasons to distrust state-provided services, including fears of deportation.”

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