After Gothenburg, my next stop was Berlin for a few days. A few days in Berlin was never going to be enough: the city has so much to offer (both in terms of contacts for my project, and sightseeing!) I’m already thinking about when I can next go back. Despite being short on time, I managed to fit in some really thought-provoking meetings with academics and researchers involved in refugees’ and asylum seekers’ access to healthcare. Whist many of the people I spoke to had a clinical background, their involvement in academia and research gave them an ‘outsider’s’ perspective, in some ways, and it was fascinating to hear their thoughts on how Germany is (or isn’t) meeting the needs of these patient groups. It was also great to spend time with fellow researchers and hear their experiences of recruitment strategies, ethics, and methods.
The starting point for most of my conversations in Berlin was the refugee crisis: back in 2015, Germany accepted over 1 million asylum seekers, many of whom were seeking refuge having fled Syria. There was a feeling amongst those I spoke to that Germany, and the health system in particular, hadn’t been prepared. In the void that was created, bands of enthusiastic volunteers stepped in and a host of groups and organisations emerged to try and meet the health needs of Germany’s new arrivals.
Three years on, the numbers of asylum seekers entering Germany has subsided considerably. And there have been other changes, too. The academics and researchers I met with in Berlin described how, in immediate response to the crisis, the government had invested significant funds in research relating to refugee and asylum seeker issues (for example, this study into refugee women’s experiences). But this is no longer the case: some of those I met felt that the government is now less willing to fund refugee-focused research and projects due to a change in public mood towards refugees. At the extreme, this has manifested as xenophobic rioting in Chemnitz.
I also heard how there was a risk of fatigue amongst the voluntary groups that sprung up in response to the crisis. Furthermore, many groups had been formed so quickly that not much thought had been given to their sustainability; for example, the need to recruit new volunteers. In response to this, two of the people I met in Berlin, Prof. Sabine Oretelt-Prigione and Jenny Jesuthasan, are involved in developing a tool-kit for voluntary groups working with refugees.
Given this context (the lack of government funding / appetite for refugee-focused projects, and the recognition that the voluntary sector can only do so much), the role of local health systems, including General Practice, in meeting the needs of refugees and asylum seekers seems vital. I’m looking forward to seeing how this challenge is being responded to in my next stop: Leipzig.