Health care

Croatia

Author

Croatian Law Centre

About text

Applicants are entitled to health care. However, the LITP which entered into force in July 2015 prescribes that health care includes emergency care and necessary treatment of illnesses and serious mental disorders.1

Medical assistance is available in the Reception Centre for Asylum Seekers in Zagreb, and when needed also in the Reception Centre in Kutina.

Many organisations, including UNICEF, Doctors of the World (MdM), the Rehabilitation Centre for Stress and Trauma, the Croatian Red Cross, the Society for Psychological Assistance (SPA) and the Centre for Peace Studies, have reported great problems and major deficiencies in the health care system. Due to deficiencies in the system, many organisations have targeted their activities in that direction.

In the first eight months of 2016, organised health care in the Reception Centre in Zagreb did not adequately respond to the needs of asylum seekers,2 as a doctor was available two times per week but could not efficiently address the needs of all accommodated persons. As observed by the Croatian Red Cross staff, initial medical check-ups during that time were not always done in a timely manner. In the last few months of 2016, the situation improved, especially with engagement of MdM.

According to the Ministry of Interior, the doctor from the Health Centre is available daily from Monday to Friday in the Reception Centre in Zagreb from 1:30pm until 3:30pm.3

In relation to the Reception Centre in Kutina, Croatian Red Cross staff reported that, after working hours, asylum seekers have to go to emergency care if there is any health care need. Problems were also reported in relation to dentist’s services, as for asylum seekers accommodated in Kutina a dentist from Glina offered his services on voluntary basis, which is evidently not a sustainable practice. In addition, according to information provided by Croatian Red Cross staff, a doctor comes to Kutina on call or when a certain number of asylum seekers need medical services.

 

Complementary services by non-governmental organisations

In mid-August 2016, an MdM team consisting of 2 doctors and nurse started work in both Reception Centres and were present in Zagreb from Monday to Friday and in Kutina few times a week.4 Besides the medical team, 2 psychologists were also employed by MdM for the implementation of activities of psychosocial support and individual counselling.

In the period between 18 August 2016 and 21 December 2016, the MdM medical team carried out 1,311 medical consultations and health checks and more than 200 initial medical check-ups as prescribed by relevant legislation. In the same period, MdM psychologists conducted 215 individual psychological counselling sessions, out of which 67 initial check-ups.5

MdM identified three key priorities and needs which have not yet been systematically resolved:

  1. Medical monitoring of pregnancy and regular gynaecological examinations of women


  2. Vaccination of children and regular paediatric examinations


  3. Mental health and lack of availability of psychiatric services

From the beginning of 2017 until the end of March 2017, MdM team has a reduced team of only a doctor and nurse, but no psychologist, and is present only in Zagreb, not in Kutina. At this point, it is not known whether they will have opportunities to continue the implementation of their activities beyond that date.

The lack of interpretation services when accessing medical services is still a problem. MdM provided interpreters while providing their services, but asylum seekers who approached doctors through the “regular” system have encountered this problem.

Other organisations have provided complementary support to health care activities. JRS reported that during 2016 their staff assisted daily to general practitioner present in the Reception Centre in Zagreb, through interpreters at his disposal and assistance in record-keeping keeping.6 JRS supplied the necessary medicines and distributed them to patients. It also organised and paid for specialist examinations for asylum seekers, purchased orthopaedic equipment, glasses and other medical supplies and necessities. In addition JRS coordinated communication between doctors of the Health Centre and the MdM. On a daily basis, JRS staff assisted approximately 20 asylum seekers in need of medical attention.

As regards psychological support during 2016, the huge increase in the numbers of asylum seekers in Croatia led to needs for additional psychological support. In that respect, psychological counselling and support were also provided by several other organisations during 2016:

  • The Society for Psychological Assistance (SPA) provided psychological counselling in Russian, Turkish, Arabic and French. Counselling was mainly organised in their premises and included 17 persons in psychological counselling.7 Information on their activities for clients are also available online.8 SPA plans to continue providing counselling in 2017.


  • The Croatian Law Centre provided psychological counselling through two projects to potential and recognised victims of torture among asylum seekers, discussed below.


  • The Rehabilitation Centre for Stress and Trauma also provided psychological support through psychosocial workshops and group sessions. Within that period, 11 persons were included in individual psychological counselling, which were organised in total 34 times.9

 

Special health needs

Applicants who need special reception and/or procedural guarantees, especially victims of torture, rape or other serious forms of psychological, physical or sexual violence, shall be provided with the appropriate health care related to their specific condition or the consequences resulting from the mentioned acts.10 However in practice this type of “extra” health care is not accessible on regular basis for those who have special needs. During 2016 many asylum seekers who came to Croatia were in need of special guarantees but have not received appropriate health care and were simply referred to doctor present in the Reception Centre, as a system and mechanism for addressing special needs of asylum seekers has not been established.

MdM was informed by the Ministry of Health via letter that for asylum seekers accommodated in Kutina who are victims of torture, rape or other violence, as well as for asylum seekers with special needs, psychosocial support is made available at Neuropsychiatric hospital in Popovača.11 The Ministry of Health also informed MdM that a contract was concluded with the aforementioned hospital for 2016, specifying that a psychiatrist would provide services 4 times a month in the Reception Centre in Kutina to mentioned categories of asylum seekers. However, employees of the Reception Centre in Kutina informed the Croatian Law Centre that due to lack of capacities, the psychiatrist would not be able to come to the Reception Centre in Kutina, but asylum seekers would be referred directly to hospital when needed.

Since 2010 the Croatian Law Centre has implemented the project “Protection of Victims of Torture among Vulnerable Groups of Migrants” (Zaštita žrtava mučenja među ranjivim skupinama migranata) funded by the UN Voluntary Fund for Victims of Torture (UNVFVT). The project will continue in 2017, but funding will not be enough to cover the needs which have increased with the growing numbers of asylum seekers in 2016. Through the project, legal assistance provided by the Croatian Law Centre, psychosocial support provided by the Croatian Red Cross and psychological counselling provided by external experts – psychologists) are available to asylum seekers and refugees.

During 2016 within the project “Access to early protection and rehabilitation services right on arrival in the EU” (ACESO),12 psychological counselling was also organised for torture victims among asylum seekers, however the project will end in March 2017.

During 2016, 28 persons were assisted and psychological 140 counselling sessions were organised by the Croatian Law Centre in total. As specified above, many NGOs were present in the Reception Centres during 2016, yet project-based activities could not cover all the needs which were much greater than available capacity. It also not clear how many NGOs would continue their activities in 2017.

JRS reported that due to the culturally oppressed position of women from certain countries, access to medical, psychological and legal assistance is often deprived to a certain number of women which is why they created special workshop aiming to support and empower women.13

  • 1. Article 57(1) LITP.
  • 2. Information provided by the Croatian Red Cross, 13 February 2017.
  • 3. Information provided by the Ministry of Interior, 2 March 2017.
  • 4. Information provided by MdM, 31 January 2017.
  • 5. Ibid.
  • 6. Information provided by JRS, 16 February 2017.
  • 7. Information provided by SPA, 8 and 14 February 2017.
  • 8. See: http://bit.ly/2lr77E4, http://www.srcro.eu/, http://bit.ly/2m2IRVO.
  • 9. Information provided by the Rehabilitation Centre for Stress and Trauma, 15 February 2017.
  • 10. Article 57(2) LITP.
  • 11. Letter from the Ministry of Health to MdM, dated 4 October 2016. This is also mentioned by the Croatian Dublin Unit in guarantees provided to other Member States prior to transfers: ECRE, Balkan route reversed, December 2016, Annex IV.
  • 12. The Croatian Law Centre implemented Project “Protection of Victims of Torture among Vulnerable Groups of Migrants” funded by UNVFVT and “Access to early protection and rehabilitation services right on arrival in the EU” (ACESO) led by Hungarian Helsinki Committee and funded by the European Commission.
  • 13. Information provided by JRS, 16 February 2017.

About AIDA

The Asylum Information Database (AIDA) is a database managed by the European Council on Refugees and Exiles (ECRE), containing information on asylum procedures, reception conditions, detenti