It’s the last week of my four-week trip and my final stop: Italy. Data from the UN show that 20,885 migrants have arrived in Italy, via the Mediterranean Sea, since the beginning of the year; more one thousand migrants have died or are missing at sea. Migration is, of course, a contentious issue in Italy. The general election earlier this year resulted in a hung parliament with the populist League party emerging as the main political force. Matteo Salvini, Interior Minister and leader of the League, has had approved a series of hard-line measures to reduce the protection provided to migrants and make deportations easier, whilst ships rescuing migrants from the Mediterranean Sea have been blocked from Italy’s ports. Whilst Sweden and Germany are both, seemingly, experiencing a rise in far-right populism, the rhetoric and the reality of anti-migrant sentiment in Italy is perhaps the most extreme of the counties I have visited as part of my Fellowship. Arriving in Italy, I was interested in finding out what this context means for refugees’ and asylum seekers’ access to primary healthcare.
My first meeting of the week was at the National Institute for Health, Migration, and Poverty in Rome. The Institute was established 15 years by the Ministry of Health to support and respond to the needs of migrants. It does this both directly via a drop-in health clinic, and indirectly via training and support to a network of health professionals across the country. On a tour of the clinic, I soon realised how many specialisms were under one roof: dermatology, gynaecology, ENT, paediatrics, infectious diseases… and the list went on. All services are accessible without charge to refugees and asylum seekers.
But what is so fascinating about the Institute (at least to me, with a Social Science -background) is that alongside the wide-range of medical professionals, the Institute has employed – for many years – two Anthropologists. The role of the Anthropologist (one of whom I had the pleasure of meeting: Maria Concetta Segneri) is to negotiate the cross-cultural encounter between the patient and the medical professionals which so many of the health professionals I have met in Sweden and Germany so far have remarked upon; such as during my visit the Transcultural Centre in Stockholm.
The Anthropologists achieve this by talking in depth with the patients about their experience of, and attitudes towards, health and illnesses / diseases; from this, the Anthropologists communicate their findings to the medical professionals, enabling them to better understand their patients’ needs and perspectives. The Anthropologists are also supported by 20 Cultural Mediators, directly employed by the Institute, who provide interpretation; both during the clinical consultations and during the Anthropologists’ in-depth conversations with patients, if needed. The Institute also employs Social Workers and has links with services and NGOs across the city; the Anthropologists explore each patient’s particular circumstances (including housing, social relationships, and practical problems – such as inability to contact relatives) and draw on the Institute’s network to try and improve the patient’s well-being beyond just their physical and mental health.
It was so inspiring to hear how anthropology was embedded in the Institute’s work and, as Maria explained, a key feature of the Institute is the way in which professionals from such a wide range of disciplines work together as part of a truly multi-disciplinary team. She described how each professional’s individual skills and knowledge are valued and drawn upon with the shared aim of improving the health and well-being of refugees and asylum seekers. Looking to the future, Maria, Angelo, and Cecilia were unsure what the future held regarding refugees’ and asylum seekers’ access to primary healthcare, given the current political climate, but I left the meeting with a great deal of optimism: it was really inspirational to hear about the Institute’s work. Thank you to Maria and Angelo Barbato (the Institute’s Health Care and Preventive Medicine Director) and Cecilia Fazioli (who leads the Institute’s external communications) for their time in meeting me.