Meeting the health care needs of the millions of the refugee population through the mobile clinics approach

It is a very well-known fact that national health strategies and welfare programs fail to reach the marginalized populations, such as refugees and migrants.^[1] The current global estimates reflect that more than 60 million refugees are living worldwide, who have been exposed to numerous unique barriers which prevent them from availing essential health care services.^[1],[2] There is no doubt that once a person becomes a refugee, many facets of the life changes, but even then it does not compromise the human right to attain the maximum possible standard of health and well-being regardless of any sociodemographic determinants.^[2],[3]

Moreover, irrespective of the age, gender, and country of origin, people do have health needs and are vulnerable to specific conditions, the risk of which enormously increases when people are displaced.^[1] Such displacement makes people vulnerable to infectious diseases (due to interruption in routine immunization or drinking water supply or sanitation services, personal hygiene), mental trauma, exacerbation of chronic illnesses owing to lack of adherence to the therapy or limited medical attention, exposure to life-threatening circumstances, and different age-group-specific problems.^[3],[4]

According to the Goal 3 of the Sustainable Development Goals, the target is to ensure universal access to sexual and reproductive health care services and integrate them with other national strategies.^[1] As women and girls are extremely vulnerable to poor short and long-term health outcomes, due to the lack of family planning or antenatal care or childbirth (including the presence of a skilled birth attendant), or postnatal services, it is important to protect them from all ill-effects.^[1],[2] Further, the risk enormously increases in cases of refugee women, who are often exposed to sexual violence and also have to deal with pregnancy and childbirth in sub-standard situations.^[2],[3]

Thus, there is an immense need to improve the access to health care and extend protection to the girls and women.^[2] However, it can happen only if the international stakeholders and the nations which have to deal with the refugee people understand their responsibilities and obligations under humanitarian laws, and subsequently transforms those into political commitment; ensure provision of minimum initial service package for reproductive health care (like childbirth care, supply of condoms or dignity kit, care for survivors of women with sexual harassment, etc.) during emergencies; and strengthen the nation’s health system and make it flexible enough to allow refugee populations to access the same.^{[1],[3],[4],[5]} In fact, a toolkit has also been developed to help nations to check for their preparedness of their health systems, but its universal implementation is still pending.^[1]

In European region, more than 1 million refugees have entered in last 1 year and the number is further going to increase as extensive unrest has been reported among the Middle East nations.^[3],[5],[6] Considering the reluctance of the refugee people to avail health care from the health facilities, the international stakeholders have advocated for the decentralization – extending the health care services on the road.^[5],[6] Also, the approach to meet the refugees where they are is vital as pregnant women are often exposed to the risk of complications during their travel, and the problem is huge, mainly because of the massive number of refugees, due to which health facilities have been overburdened.^[1],[2],[3]

In fact, both United Nations Population Fund and World Health Organization are supporting the national health authorities in different nations affected by the incoming of refugee population by providing assistance through mobile clinics.^[5],[6] These mobile clinics are offering aid to improve the health outcomes and quality of life through the provision of direct medical and health care services, sexual and reproductive health services, health promotion and disease prevention activities, social support, and referral to the higher centers.^[5],[6]

To conclude, realizing the special needs of the refugee population groups, their enormous number, and hesitancy to approach health care establishments, it is the need of the hour to implement measures to reach the refugee population wherever they are and thus give them an opportunity to lead a normal life.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.222667