venerdì 4 Novembre 2016

The role of Parliament in addressing women’s, children’s and adolescents’ health needs of migrants.

Intervento alla conferenza internazionale sulla salute materna e dei bambini organizzata dall’OMS.

Firenze 4-11-16

Let me begin by quoting the words of Pope Francis a few days ago, after returning from Sweden where he had been to celebrate the 500^th anniversary of the Protestant Reformation. Talking to journalists, he said that it is not humane to close the doors against immigrants, but added that prudence must be shown in order to integrate them well… It is not humane to close the doors, just as it is not humane to close our hearts to them, and in the long term we shall pay a political price for it, just as we have to pay the price for having failed to prudently calculate how many more we can settle above and beyond the numbers who can become integrated.

I believe that few of us have really grasped the tribute the Pope intended to pay Sweden, a country with a population of fewer than 10 million people, but which has welcomed and above all integrated many thousands of migrants (and I am speaking of migrants in the broad sense, as people on the move, without distinguishing between refugees, asylum-seekers, economic migrants, etc).

Sweden has now reined in its willingness to welcome any more migrants, because it is no longer able to provide them with homes, schools, jobs, services, education and training…. And the Pope intended to show his understanding, because Sweden has already proved that it is a welcoming host country. And it is only fair that the “burdens” should be shared.

Italy is also a welcoming host country, and I will be talking about this in a moment. But on the subject of burden-sharing, allow me to recall my feeling of discomfort a few days ago when I found myself speaking about the numbers of migrants Italy has accepted, in comparison with the numbers being hosted by Lebanon. According to the figures published on September 6 by the United Nations High Commissioner for Refugees, Lebanon has taken in 1,033,513 migrants, which is the highest number of all countries, accounting for roughly 25 percent of the Lebanese population as a whole. Comparatively speaking, it would be like saying that of Italy’s population of 60 million people, 15 million are refugees.

But Italy is also playing her part in the matter of providing migrants with healthcare for everyone. And I am also proud to say that we have designed the SPRAR reception system – the Italian acronym for the System for the Protection of Refugees and Asylum-Seekers – as a network of “second reception” centres, to be used for asylum seekers and persons entitled to international protection, to foster their social and economic integration. These centres differ from the “first reception” centres that provide immediate assistance to those arriving on Italian soil.

The figures for Italy.

Just to give you some idea of the magnitude of the phenomenon of migration in Italy, in 2015, 153,842 people arrived by sea: 70,000 applied for international protection, 60,000 were “illegal”, while the remaining 24,000 were either children (12,360) or people in need of urgent medical treatment. In 2014, 13,026 children arrived, while by mid-October this year, 19,429 have arrived already.

More than 11,000 people arriving by sea last year were given medical assistance before they were identified, because health and the right to health come first.

They are also entitled to be rescued from the sea, after being sent out by unscrupulous people-traffickers (smugglers) who place their lives in jeopardy. Just under 4,000 people drowned in the Mediterranean last year. This year, we are once again expecting to reach the 4,000 threshold. And last night 239 people drowned because of the bad conditions of the boat which they were compelled to board.

And I cannot but help wondering whether these figures might perhaps have been different had we managed to continue to operate the Mare Nostrum mission. For Mare Nostrum was the outcome of an initiative taken by a small group of parliamentarians at the time of the first (of several) great tragedy involving hundreds of migrants, during the night between October 2 and 3, 2013, when a boat carrying about 500 migrants was shipwrecked off the Isola dei Conigli, near Lampedusa, killing 366 people.

Seven or eight of us immediately set out for Lampedusa after hearing the news of the shipwreck, accompanied by the President of the Chamber of Deputies, Laura Boldrini, and when we saw the bodies lying in plastic bags in rows in the hangar in the small island airport, and the look of despair on the faces of the survivors grieving over the dead who had been trapped in the hold of the boat, we decided to take action. The Mare Nostrum mission came about as a result of our report on the tragedy, which we delivered to the Prime Minister Enrico Letta on our return.

The decision was taken on 14 October and the Mare Nostro mission was launched on the 18^th. This action is one of the most intense, significant and effective I have ever seen in my parliamentary experience.

We wanted, and were obliged, to save the lives of people crossing the Mediterranean after entrusting their lives to unscrupulous people-smugglers, in search of a better life, fleeing from war, persecution and, in the case of the young Eritreans for an indefinite period of compulsory military service, or simply from atrocious living conditions.

Mare Nostrum was tasked with saving human lives at sea and bringing the illegal migrant traffickers to justice.

The mission lasted one year, when it was said Italy could no longer sustain it alone and it was shared with the European Union. We expected that sharing the mission would broaden the range of the coastguard patrols in the Mediterranean, but it was reduced instead, and people continued to die. This has been one of the most bitter disappointments I have ever known in my parliamentary experience.

I believe that the European dimension, and Europe’s co-responsibility for the problem, are crucial for managing migration in the Mediterranean region. Italy is Europe’s southern border: this is an undeniable fact, both geographically and in the minds of many migrants, many of whom used to see Italy as a transit country, particularly in past years, hoping to be reunited with their family members in other European Union Member States. Now Italy has also become a country of destination, but the arrival channels, which are always illegal, have not changed, with people crossing on unseaworthy boats, partly because of the closure of the Balkans route.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RIGHT TO HEALTH AND TO HELATH CARE

Italy has every good reason to say that she is playing her part in the matter of migration, in two main ways. The first refers to a measure which makes Italy a special country: the right to health, the right of everyone within the territory of Italy to receive health care. Our policies on health are inclusive not only for Italian citizens, but for all persons who happen to be in Italy, including migrants, all migrants, whether regular or irregular, on Italian territory.

These health policies relating to the health of migrants, all migrants, were taken up in legislation dating back to the late Nineties. The “philosophy” of these purposefully “inclusive” health policies can be summarised in terms of two major areas: 1) the complete equality of rights and obligations, regarding both health and the right to health care, between Italian citizens and foreign nationals legally present (with a residence document), with full health care coverage from the public health system; 2) the broad availability of health protection and health care also for undocumented immigrants, especially women and children, including, but not limited to, transmissible diseases.

This is why people rescued at sea and in need of health care are assisted even before being identified.

 

Even though “irregular” migrants cannot register with the National Health Service they nevertheless have access to “urgent or at all events essential” care. In particular, foreign nationals without a residence document are guaranteed essential care to give them a full course of treatment or rehabilitation until they are well again, including the possibility of receiving transplants.

“Irregular” migrants can therefore go to any A&E Department (Pronto soccorso) for “urgent care”. But they are also eligible for “essential” treatments: preventive care, vaccinations, care for expectant mothers, continuing treatments, hospital admissions and surgery. Virtually everything, in short.

 

However, an “inclusive” health policy needs to be accompanied by a real willingness to collaborate on the part of the local authorities, which over time have been given a crucial role in the provision of social and health services for foreign nationals, in terms of implementation and maintaining effectiveness.

 

Only three weeks ago (on 12 October, to be exact) the Associazione Nazionale Comuni Italiani (ANCI) – National Association of Italian Municipalities – agreed to increase the number of municipalities (to 2300 out of 8000) to create a fair and sustainable system for the reception and integration of migrants.

And so all have the right to health care, a right enshrined in art. 32 of our Constitution: “The Republic safeguards health as a fundamental right of the individual and as a collective interest, and guarantees free medical care to the destitute”.

UNACCOMPANIED MINORS

Another example of the important role that parliamentarians can play is the law that was approved last week by the Chamber of Deputies (now waiting to be laid before the Senate) on unaccompanied minors, of whom there are already 20,000 this year. The law bears the name of Sandra Zampa as first signatory.

The law sets out a kind of charter of rights of unaccompanied minors to ensure respect for their dignity and to facilitate responsible autonomy. We take in these children, and by acknowledging their rights, we help them to grow up into free and responsible adults.

They have the right to be taken in and treated consistently with their ages and circumstances, recognising their specific features: the right to be recognised as individuals, the right to a family, the right to schooling the right to health, the right to education and training, and the right to be heard whenever any decisions are taken regarding them. And the right to special protection in the case of vulnerable children, namely those who have been trafficked, and have been subjected to the experience of being introduced to prostitution, who have been abused and in order to make them repay the cost of their journey: they have not only been abused but also traded like commodities, because only by selling their primary asset – their own body – can they find the necessary resources to aspire to a better life and future for themselves and for their families.

We know that when many of these children land in Italy, the first thing they are forced to do, if they have been recruited by criminal gangs of this type, is to return the money that had been given them to send them to Italy. And this is why many of them disappear without trace. I hope that the Senate will rapidly approve this law in its final form.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WOMEN

Women arriving in Italy are in a different situation, and in numerical terms they are anomalous in view of their small numbers (I refer to their percentage on the total arrivals).

In less than 10 months, 132,000 migrants have set foot in Italy, of whom just under 21,000 have been women. The main countries of origin of these migrants are 9 and cover the broad area of Sub-sahara Africa: Nigeria, Eritrea, The Gambia, Ivory Coast, Guinea, Sudan, Mali, Senegal, and Somalia, accounting for about 100,000 migrants, of whom 15,000 have been women. And of these, over one-half come from Nigeria.

These statistical anomalies should send alarm bells ringing, and this is the case of the Nigerian women, of whom two-thirds, or even three-quarters, according to the International Organization for Migration (IOM) are reckoned to be victims of people-trafficking. Their numbers have rapidly soared from 433 in 2013, to 1,454 in 2014, to about 5,000 in 2015, and to 7,500 today.

The IOM’s 2015 Report says that the girls being groomed for prostitution always come from the poorest parts of Nigeria, from destitute families, often orphans or girls brought up by relatives a long way from their families of origin. In other cases, they are the first-borns, which in Nigerian tradition and culture, imposes the moral obligation on them to look after and maintain their surviving parents, and their underage siblings.

Recently, the OIM has recorded a sharp increase in the number of trafficked minors, of girls who are more easy to manipulate and are incapable of seeking help to be rescued from exploitation and violence.

A few months ago, a number of parliamentarians had been alerted by certain NGOs concerned with monitoring the movements of these migrants, with the warning that obvious victims of trafficking were being repatriated.

We visited the Centre at Ponte Galeria and tabled questions to the Government about this superficial policy; we asked the government to quickly identify the victims of trafficking, to take care of them and protect them, before they end up in the prostitution business. We know how difficult it is to identify actual, or potential, victims of trafficking in view of the huge numbers of migrants at the difficult moments of arrival, and of the so-called “mixed” migrant flows (economic migrants, and asylum seekers, children, vulnerable cases, etc.). But we have to act. And only a few months ago (on 26-2-16) the Council of Ministers adopted the first National Action Plan against People Trafficking and Serious Exploitation. This marks a stride forward. It is also a question of the right to health: WOMEN’S global health and rights.

 

 

 

ALL PARTY-GROUP WOMEN’S global health and rights

I have used these words on purpose, because they are the “name” of the group I want to mention as I come to end of this speech. I would like in particular to speak of the initiative to be held in May next year that we are organising as the all-party Parliamentary Group on “Women’s Global Health and Human Rights”, of which I am the chair.

This group is made up of women members of the Chamber of Deputies and the Senate committed to giving prominence to women’s comprehensive, sexual and reproductive health and rights on Italy’s agenda. The group forms part of a network which comprises other similar groups in various European countries, the European Parliamentary Forum – EPF. Each group works with an NGO from their own country, and in Italy’s case we work with AIDOS, Associazione Italiana Donne per lo Sviluppo (the Italian Association of Women in Development).

At the annual G7 meeting, the Working Group of the country hosting the Summit organises a Conference of parliamentarians to foster the international cooperation agenda, in cooperation with the local NGO and EPF, referring in particular to women’s health and rights, according to the agenda of the rotating Presidency. Next year, Italy will be hosting the G7 Summit under the Italian Presidency.

Due to its geographic position – Italy is one of the main landing places for thousands of migrants seeking a better life and fleeing conflicts and crises – and in view of its importance in the current global landscape, migration will be one of the major agenda items on the next G7 Summit of Heads of State and Government.

As occurred for the Berlin Summit in 2014 and this year’s in Tokyo, the network’s Italian group, “Women’s global health and rights” will be organising a conference attended by about 140 parliamentarians, observers, panellists and speakers, in order to bring influence to bear on the G7 agenda.

The focus of the Conference we are launching will be on migration from a human rights – and, in particular, from a women’s right to health –perspective, and with a gender-based approach.

The aim of the initiative is to enlist MPs from the G7, G20 and Southern and emerging countries, to get their governments to renew their commitment to international cooperation and global health, building upon their previous obligations in favour of gender equality and sexual and reproductive health and rights, and in the framework of the Sustainable Development Goals and the 2030 Agenda.

The Conference will conclude with the adoption of an appeal or a declaration by the participants to be delivered to the G7 leaders, as was done in Berlin and Tokyo, to promote the support of the governments attending the Summit for the issues raised by the Conference, and to influence their agenda.