Frontline social workers provide vital support to 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 .
"During crisis we realized, health is the most important thing."
For thousands of pregnant women in Kazakhstan, pregnancy coincided with the pandemic and the introduction of quarantine measures, which can vary from week to week. UNICEF estimates that around 116,000,000 children will be born worldwide during the pandemic.1 During the pandemic, 498,367 children were born in Kazakhstan (March 2020 - April 2021)2. From the very first months of pregnancy, a woman's life changes dramatically, and quarantine, self-isolation and additional precautions can limit access to medical services or add stress to women in labor. Aigerim is 40 years old; during the pandemic she was pregnant with her fifth child. Aigerim wanted to plan the birth the following year, but in early September 2020, she found out that she was expecting a baby. From the first days of pregnancy, Aigerim was registered at the district polyclinic at her place of residence in Nur-Sultan. 2021_Newborn_Family_Karaganda Aigerim with her newborn son ”I had constant access and contact with gynecologists and midwives. I got all my tests on time and I went to my routine check-ups," she says. Until the seventh month of pregnancy, Aigerim and her family lived in Nur-Sultan, and then moved to Karaganda, where she was transferred to the city polyclinic No. 1. Aigerim planned to give birth at her place of residence in the Karaganda Regional Perinatal Center. She didn't need to take a PCR test before giving birth. When frequent contractions occur or amniotic fluid is released, the woman in labour will have to call an ambulance or go to the hospital on her own. The PCR test will already be taken at perinatal centers. ”I was told that if a woman has any symptoms, she is taken to a separate quarantine zone. If not, then she gives birth and waits for the test results, " says Aigerim. The quarantine zone is a separate ward where a woman will give birth alone and will not have contact with other women in labor. If doctors do not detect COVID-19, then the woman in labor goes to the general ward. According to UNFPA Kazakhstan , in the event of a confirmed infection or suspected infection with COVID-19, health care workers should take appropriate precautions to reduce the risk of their own infection and that of others, including by wearing protective clothing. Aigerim herself had COVID-19 in June 2020, three months before the start of pregnancy, but did not feel any significant changes in her health or the possibility of becoming pregnant. According to Aigerim, this pregnancy went the same way as the previous ones, and she hardly noticed any changes in the situation and the new reality of quarantine measures. 2021_Newborn_Family_Karaganda Aigerim with her children The only difference Aigerim observed is in the work schedule and the timetable of the clinics. In the past, pregnant women had to wait 2-3 hours in a queue at the polyclinics; now, the reception is conducted strictly by appointment and there are no queues in the corridors. “I guess I was doing so well because I was prioritizing my health. It is very important for a woman," she says. "In the current time of crisis, we all realized that the most important thing is health and only a strong immune system can cope with the virus." Aigerim, being a nutritionist, always carefully monitors her well-being, so she did not worry about the upcoming birth. ”I had no concerns about my health, " says Aigerim. "I’m constantly checking my thyroid, haemoglobin, taking vitamins and eating right". In addition to maintaining immune function, Aigerim followed the necessary precautions to avoid contracting the virus. She avoided public places, shopping centres and other crowded places, and washed her hands frequently and thoroughly throughout the day. 2021_Newborn_Family_Karaganda Aigerim and her children reading a book Due to the pandemic, she was forced to go for walks only on the streets or in parks, in order to have minimal contact with passers-by. And masks and sanitizers have already become essential items when leaving the house. Aigerim already had four children. Her fifth pregnancy was going well, and in April she gave birth to a baby boy. "The birth went well. I am very happy and glad that my child was born healthy. I finally have him in my arms” " says Aigerim. Aigerim was discharged two days later, and her recovery is proceeding calmly and with her family. “I would also like to thank the doctors in the polyclinics. Despite the introduction of quarantine measures, they handled stressful situations perfectly and dealt with issues quickly, correctly and in a timely manner,” says Aigerim. Cooperation with the European Union allowed UNICEF to support the healthcare system of Kazakhstan during the COVID-19 pandemic by equipping it with the medicines and diagnostic devices necessary to effectively combat the coronavirus. Funded by the European Union Humanitarian Aid. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union. European Union cannot be held responsible for them.
With financial support from the European Union UNICEF launches the ‘RM Child-Health’ project to strengthen vulnerable refugee and migrant children’s health
– 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
Safeguarding the health of refugee and migrant children during COVID-19
, 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.
Strengthening the implementation of 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.