‘I Was Afraid To Seek Help At The Health Centres’
Health solutions often fail to connect with migration. This has a damaging effect not only on the health of individuals on the move but also on the communities with whom they interact through their migration journey. A woman recounts the impact of her migration on her health; both in the host country and as a returnee.
By Maria* as told to Samuel Hall Staff
As supported by the EU-IOM Knowledge Management Hub, based on the Samuel Hall-IOM Study on Health and Reintegration
TW*: Mentions and descriptions of triggering physical and mental health ailments and procedures
‘I left the country for the first time in 2020. My sister was in a city in Switzerland, and she suggested I try something there. So, my husband and I sold everything in Brazil and travelled there with our baby boy. Everything was fine during the first year, but then the Swiss Government found out that my husband was working without permission — we did not have a visa or any documentation.
In less than a month, we received an expulsion letter. I had been doing informal jobs, like cleaning and babysitting, and my son was with me the whole time. We decided to go to Spain, but then we received this letter from the Swiss Government saying we had to leave the Schengen Area. We had no option anymore but to go back to Brazil. As we did not have money for that, we asked the International Organization for Migration (IOM) for help.
In June 2020, while we were still in Switzerland, I was doing an extra job in a restaurant, and I fell and a heavy box collapsed on me. My knee was dislocated, and my colleague brought me to the emergency unit. The doctors did an X-ray and gave me medication and crutches. Then, my sister arrived, and she spoke French. They gave me medicines, intravenous therapy, and tests. They were discreet [about my status].
I could not pay for physiotherapy and did not return to the doctor for my knee anymore. I was constantly stressed because of the distressing letter my husband had received from the Swiss government and the Covid-19 pandemic too, as my son has asthma, and I was so afraid for him. In winter, he started to have respiratory crises, as he was not used to those temperatures. I looked for social assistance at a religious unit, and I received some medical security, so my son had a regular paediatrician in the city I lived in.
I was also overweight. I used to eat the whole day because of my anxiety. I was suffering from hypertension and had a stroke in January 2022. Before moving to Switzerland, I did not have hypertension — the stress and anxiety were caused by the insecurity and instability we faced there. I was afraid to seek help at the health centres because I was irregular.
Finally, we returned to Brazil with some support from the IOM. I could also have surgery and physiotherapy back home with the money they gave me. However, the stroke affected the same knee, so I lost a bit of mobility.
After I came back to Brazil, I also started having headaches. I would often feel dizzy and tremble. One day I was washing some clothes and suddenly felt very dizzy. Then I called my father, and he said my nose and mouth were bleeding. By the time my mother came, I was already unconscious. They called an ambulance to bring me to the emergency care unit. I started to vomit blood, my blood pressure was too high. Then they gave me medicines in the vein, but it was hard to stabilise it. I was in the hospital for one week. After that, I lost partial control of my right leg. I am taking medicine for high blood pressure and anxiety — I got all this for free at the unit.
My mother has been here with me — she helped me pay for a tomography privately as there were two thousand people ahead of me in public health care. I am naturally feeling less anxious; my humour is also way better. Earlier [in Switzerland], I often went into the shower to cry without any reason. I never knew why I was crying. It was all because of the insecure situation. I thought we would have a better future for my family and myself. We never thought of the challenges and obstacles, let alone how we would deal with them.
Thankfully, my health is currently fine. I am on medication and I have regular appointments with my neurologist. So, my living standards are improving. My blood pressure and anxiety, which were high, are under control as the uncertain situation no longer exists. I am dealing way better with my knee too. My son is happy, my family is around, and my business is running.
I make an edible bouquet of strawberries and chocolate and some party snacks to sell. When I got back to Brazil, my mom offered half of her house, and we reformed and acclimatised the space to suit the chocolate business. And it has been just fine; the business is growing and expanding.’
This interview was part of Samuel Hall’s research on the ‘Impact Of Health-Related Needs On Sustainable Reintegration Outcomes’ for the IOM. It has only been edited for the purpose of brevity and clarity. The study took a life-course approach and followed a mixed methods approach, conducting fieldwork in Brazil, Ethiopia, the Gambia, Georgia, Pakistan, and Senegal. The study found that health and reintegration mutually impact each other over time — and its negative repercussions are felt more by some than others.’
How can we move forward?
- Considering the implications of how gender and identity play a huge role in determining access to equitable healthcare, it is important to develop an individual care plan for migrants. For example, timely testing and sharing of information should take into account differences in languages and names for pharmaceuticals and procedures.
- Mental health screenings upon return facilitated by a trained person of the same gender are also essential to providing psychosocial support to returnees, especially women who are more likely to take the burden of keeping their domestic life afloat in their families.
- Strengthening follow-up support for returnees who have long-term health needs would help create sustainable health outcomes and stronger reintegration processes within the migration cycle. There is also a need to align reintegration and health programming.
- Finally, migrant awareness should be mainstreamed into health systems policies at national, regional, and international levels. This would further require a longitudinal study with insights on how returnees’ health and reintegration outcomes, especially those from vulnerable communities, continue to interact to manifest either deteriorations or improvements over time.
Found this story insightful? Read more about the topic in our first insight piece from the study: The Gendered Reality of Returnees’ Health Outcomes
*Names have been changed to protect identity.
