New Publication: Report on the Health Care for Asylum-seeking Children in the Netherlands (in Dutch)

By Veronika Flegar, University of Groningen, v.l.b.flegar(at)rug.nl

The report titled “Quickscan Gezondheidszorg asielzoekerskinderen in Nederland” was commissioned and published by the UNICEF-led Working Group on Children in Asylum Seeker Centres (Werkgroep Kind in azc). The central question of this research is how the access to and quality of health care and youth care for asylum-seeking children is organized and functions in the Netherlands. The report is based on desk research and qualitative semi-structured interviews with persons involved in the provision of health care to asylum-seeking children at the policy and practical level. The report highlights central aspects of the legal framework, the responsibilities of different organizations and the financing of health care, relevant supervision and monitoring mechanisms as well as the implementation of health policies and the collaboration of health care providers and other organizations concerned with asylum-seeking children in the Netherlands. The research points to the crucial importance of timely information provision, clear standards and a systematic process of transferal and relocation as well as to the role of schools in the prevention of health issues, to the necessity of preventive health care for the mental health of asylum-seeking children and to the importance of a constructive relationship between the parents of asylum-seeking children and health care providers. It ends with recommendations for improving the current situation and questions for future research on this issue.

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Insights from the OHCHR Expert Meeting on Non-Refoulement in International Human Rights Law

By Veronika Flegar, University of Groningen, v.l.b.flegar(at)rug.nl

On 2 June 2016, the Office of the High Commissioner for Human Rights (OHCHR) organized an expert meeting titled “Non-refoulement in International Human Rights Law” in Geneva. During the meeting, representatives from academia, the International Organization for Migration (IOM), the United Nations High Commissioner for Refugees (UNHCR), OHCHR, the EU Fundamental Rights Agency (FRA), the United Nations Children’s Fund (UNICEF), human rights treaty bodies and courts as well as members of non-governmental organizations voiced their ideas on this matter. The meeting aimed to clarify the scope and future of the principle of non-refoulement as well as to highlight possible legal and policy avenues and challenges. One of our GHLG members, Veronika Flegar was invited to speak about her research on extreme poverty, vulnerability and non-refoulement.

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Event: Empowerment of Refugee Women and Girls

Interactive event about the Empowerment of Refugee Women and Girls on 24 May 2016 at 3.30pm in Groningen. Interesting speakers, such as a former refugee and a women’s rights expert will debate issues of medical health for pregnant women, violence, hygiene and other struggles that refugee women and girls encounter. Free entrance. Limited spots, so sign up soon!

Towards Individualized Vulnerability in Migration Policies

By Veronika Flegar, University of Groningen, v.l.b.flegar(at)rug.nl

The Dutch parliament recently pledged for separate reception centres for vulnerable asylum seekers. In a reaction, the Dutch State Secretary of Security and Justice Klaas Dijkhoff objected to this claim, arguing that placing “vulnerable groups” into separate reception centres is stigmatizing. Instead, he calls for a tailored approach. He certainly has a point, but one should be aware of the fact that talking about “vulnerable groups” in itself already has a stigmatizing effect – even without physically placing them into separate centres. In his statement, Dijkhoff varies between referring to “vulnerable individuals” and “vulnerable groups” which reveals insufficient awareness about the difference between these approaches. I would therefore like to draw attention to the need for a more nuanced approach towards vulnerability. There should be more emphasis on an individual assessment of the needs of persons who might be particularly susceptible to harm.

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Human Rights in a Downward Spiral?

By Veronika Flegar, University of Groningen, v.l.b.flegar@rug.nl

With the high number of asylum seekers arriving in Europe, states increasingly struggle to simultaneously accommodate the interests of their citizens and abide by their human rights obligations. Particularly in light of the increasing fear of terrorism in Europe tensions may arise between security concerns and human rights. I suggest that anyone interested in human rights should think about these developments as the current number of people requesting asylum in Europe is not only a test case for the integration capacity of Germany or for the functioning of the European Union, but also for the perseverance and strength of human rights. The goal of this post is not to provide a legal analysis of the issue but rather to raise awareness for the role of human rights in this context.

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Get involved in GHLG: ‘Vulnerability and Migration in International Human Rights Law’

Do you want to find out more about human rights in the context of migration? Are you interested in learning about social scientific research methods and qualitative content analysis programmes and their application in the legal field? Join the project ‘Vulnerability and Migration in International Human Rights Law’ as a research assistant or thesis student!

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The Right to Health – An Empty Promise?

Three perspectives presented at the University of Erlangen-Nuremberg EFI Conference in Berlin, 14-16 September 2016

Lucía Berro Pizzarossa presented a research conducted in collaboration with Katrina Perehudoff about the constitutionalization of sexual and reproductive health and rights. Veronika Flegar discussed the existence of a right to preventive health care for asylum-seeking and undocumented migrant children under international law. Brigit Toebes keynote lecture took a more general approach towards the relevance of progressive realization and the AAAQ and identified some of the possible solution for such practical problems as identified with regard to both reproductive rights and undocumented migrants.

Lucía Berro Pizzarossa: Despite over three decades of discussing sexual and reproductive health and rights, we have seen very little progress in reducing their health inequalities and poor health outcomes. There is the need for a framework that can translate the international rights discussions into action. Standards in international law can only be made a reality by committed governments applying and enforcing global norms domestically. To this end, domestic constitutions are an important affirmation of State duties and individual entitlements. Constitutional rights can help shape national laws, policies and programs, or they may even be enforceable before domestic courts. The findings are based on the GHLG project Constitutional Health Commitments, where we analyzed constitutional commitments to sexual and reproductive rights and health to 1) develop an understanding of existing State commitments and 2) identify the building blocks of a model constitutional text using a human rights framework. The research we presented shows that very few jurisdictions have enshrined sexual and reproductive health and rights in their constitutions and the provisions differ widely on emphasis, approach and scope. However, our results demonstrate the political will of some countries to incorporate them in their national constitutions and provides examples of constitutional commitments to willing governments, policy makers and health and human rights advocates who seek to introduce similar text into their law, thereby providing individuals with a top-down (i.e. from laws and policies to programs) and bottom-up (i.e. enforcement through courts) framework to enjoy their right to sexual and reproductive health and rights.

Veronika Flegar: There is a need for increased attention to some of the aspects that are easily neglected in the current refugee and asylum crisis. Especially preventive health care and the rights of undocumented migrant children do not yet receive sufficient attention. My doctrinal analysis of the principle of the preventive health care rights of children showed that non-discrimination under the Convention on the Rights of the Child (CRC) could largely be labelled as an empty promise for the health rights of undocumented migrant children. While asylum-seeking children are entitled to far-reaching rights under the right to health of children, the extent to which also undocumented migrant children explicitly enjoy these rights is less clear. While terms such as ‘all children’, ‘all sections of the child population’ or ‘all children within [the states’] jurisdiction’ suggest that the rights of the CRC apply equally to national, asylum-seeking and undocumented migrant children, the fact that extensive reference in the CRC framework is made to asylum-seeking but not to undocumented migrant children undermines this conclusion. This is not the only aspect that needs further clarification in order to ensure the effective implementation of the right to preventive health care of all children. Also the right itself needs to be further clarified and delimitated. While it is promising that the right to preventive health care is explicitly and separately mentioned in Article 24 CRC, the exact content is spread throughout various documents. The CRC would benefit greatly from an additional General Comment on non-discrimination that could emphasize the scope of non-discrimination as truly encompassing all children and would pay particular attention to the relevance of non-discrimination under the right to health.

Brigit Toebes: There is no reason to be skeptical about the right to health, let alone sarcastic. Yet our research into various dimensions of the right to health reveals the need for a stronger and more refined legal framework. What requires improvement, refinement and elaboration are the concepts that we work with under the right to health. Progressive realisation in the context of the right to health is an open-ended concept and as such it forms the Achilles’ heel of the right to health. One could say that progressive realization begins where the minimum core ends. Once the core has been realised, States need to gradually or progressively realise the remaining part of the right. Progressive realization recognizes the reality that the full realization of economic and social rights may not be possible immediately or in a short period of time. In this sense, progressive realization differs significantly from the obligation contained in Article 2 of the International Covenant on Civil and Political Rights which contains the immediate obligation to respect and ensure all the rights. Several sources including the Limburg principles have stressed that progressive realization is not just about making more resources available:  it is more about making effective use, optimally prioritizing available resources, and about careful planning. So it is about setting concrete priorities and targets, whilst avoiding inefficiency and corruption. To give one example: in many countries the poor are deprived of primary healthcare while specialized hospitals are built providing expensive care. Such outcomes go against the principles of progressive realization. A possible solution for making the right more concrete is working with the AAAQ in combination with the setting of indicators and benchmarks. The AAAQ is a comprehensive tool and it draws the attention to equitable access to healthcare where priorities in healthcare have to be set. The AAAQ is universally applicable and allows for comparison across countries. As such, for instance, the physical or geographic accessibility of primary healthcare is a problem in many nations, varying from Ethiopia, to Brazil, to Iceland. It has been suggested that the AAAQ is particularly useful in a policy setting; yet there are also interesting examples from domestic law and international and domestic case law showing an increasing use of the AAAQ in a legal context. In order to ensure that the right to health is not an empty promise, the primary concepts, such as the minimum core, the AAAQ, progressive realization and the definition of legal obligations must be refined. To come to a better understanding of these concepts, the insights from experts in public health, medicine, health economics as well as from civil society are most needed.

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Some of the GHLG members at the Right to Health conference in Berlin. From left to right: Milan Markovic, Veronika Flegar, Lucía Berro Pizzarossa and María Dalli.