Public Health

Question 1

Define Refugee.

Answer 1

Someone that has an asylum status and is protected by the law in terms of Section 34 of the Refugee Act of 1998.

Question 2

Define asylum seeker.

Answer 2

Someone who fled their country in hope of protection and recognition as a refugee in SA,
The application is still under consideration

Question 3

Define irregular migration

Answer 3

“Movement of persons that takes place outside the laws, regulations, or international agreements governing the entry into or exit from the State of origin, transit or destination.” (IOM)

Question 4

Define undocumented people.

Answer 4

SA/non- that does not have appropriate documentation to leave or enter south africa

Question 5

Name and explain the rights that allow access to health care in South Africa, ACTS.

Answer 5

The Constitution- Regardless of status/nationality have, no one should refuse emergency medical treatment
The National Health Act- access to primary health care, Pregnant and babies have access to free health care
The Refugee Act- Same access to, includes asylum seekers
Department of Health Circular- R and AS, with/ without permits can access the same as South Africans, even HIV
The Immigration Act-Must find out the patient’s legal status before providing healthcare

Question 6

As a health professional, how can you adapt the consultation and care to patients such as immigrants?

Answer 6

Find a translator
Change plans- medications to ones avail at PHC
Ensure the patient knows where the referral facility is, address phone numbers
Much more detailed referral letter
be honest about the cost
Advocate for patients

Question 7

What is the role of the health professional in mitigating barriers?

Answer 7

Understand and protect patient rights
Attitude: courtesy, respect for human dignity, patience, empathy, and tolerance (patient rights charter).
Understanding the context of migrant patients and providing consultation and care plans appropriate to these needs
Orient/educate on other available social service departments (housing, social welfare) OR specific NGOs for psycho-social services (legal aid, food, nutrition, counseling, information…)in order to deliver a holistic patient-centered approach.
May require more time, effort, and advocacy than a regular consult: do your best within the limitations of the system around you.

Question 8

List the Patient’s Right Charter.

Answer 8

Access to health care in public facilities
Choice of health services
Confidentiality and privacy
Informed consent
Continuity of care
Healthy and safe environment
Participation in decision-making
Treated by a named health care provider
Refusal of treatment
A second opinion
Complaints about health services

Question 9

What are the key barriers to accessing Health care?

Answer 9

Structural/ Health System Related
NB at the tertiary level
Documentation requirements
Inequitable and unclear payment and access policies
Contradict other health legislation that protects the right to access care e.g. Unclear Gauteng DoH circular
Discrimination, anti-migrant sentiment in health facilities
General access issues - Poorly resourced systems e.g. overburdened mental health system – many can’t access timeous care for significant mental health needs - PTSD, re-victimisation during procedures, anxiety, depression, difficulties with daily life, asylum-claim, loss of human dignity.

Contextual
Cultural and communication barriers e.g. language
Discrimination, xenophobic climate e.g. Increasing activity of Operation Dudula, communities protesting and giving PHCs ultimatum to favour South Africans etc