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"Migrant-friendly" handbook helps hospitals

At Bern University Hospital, every fifth patient is a migrant


A handbook and accompanying film aim to help Swiss hospitals communicate better with immigrants and deal with their specific needs.

The Federal Health Office said that if people from different cultures and linguistic backgrounds received better treatment, overall costs would go down.

Thomas Spang, head of equal opportunities and health at the Federal Health Office, said on Monday that migrants do not have the same opportunities regarding health as locals.

He said migrants were overrepresented in lower socio-economic groups and poorer jobs and that they often lived with heightened health risks. He added that this was not only because of linguistic reasons, but because socio-cultural barriers prevented them from accessing the healthcare system.

Preventative health campaigns and general information were not getting through to migrants satisfactorily, Spang said.


The handbook, "Diversity and equal opportunities", and accompanying film "Understanding can heal", were produced by the Swiss Hospital Association and the Federal Health Office and aim to remedy the situation.

They use examples from the "Migrant-friendly Hospitals" project – part of the government's "Migration and Health" strategy – and are targeted at the boards of hospitals, clinics and care homes.

When it comes to communication, for example, the patient, friends and relatives could be provided with interpreters or multilingual staff. Further aids could include pictograms and dictionaries.

Training should give staff the necessary information to deal with patients from a variety of social and linguistic backgrounds and religions, thereby avoiding misunderstandings and stress.

This in turn, it was claimed, would lead to better efficiency and lower treatment costs.


A study by the Geneva-based International Centre for Migration and Health (ICMH), published two years ago, found that nearly a quarter of clandestine migrants felt their health had deteriorated since arriving in Switzerland.

Four out of five said they were depressed and many reported problems of a psychosomatic nature such as ulcers, back pains, chronic headaches, loss of appetite and sleep disorders.

The report's authors, who interviewed 235 unofficial migrants in Geneva, found that knowledge about certain health matters was limited and that they were often poorly informed about contraception and family planning.

Most were not covered by any form of health insurance and those that sought it were generally refused policies by insurance companies.

More than 60 per cent could not name one hospital in Geneva and most were unaware that special health services were available to clandestine migrants.

More than three-quarters of those questioned feared they would be denounced if they approached social services for help. The ICMH estimates there are 15,000 clandestine migrants in Geneva.

The study concluded that more needed to be done to promote and protect the well-being of illegal migrants to prevent long-term social and health problems.

swissinfo with agencies

In brief

Health policy is formulated at a federal level but Switzerland's 26 cantons enjoy a high degree of autonomy in health matters.

The government's "Migration and Health" strategy was launched in 2002 and encompasses research, education, prevention, support and therapy for traumatised asylum-seekers.

The five-year project has a total budget of SFr25.8 million ($20.4 million).

The cabinet is set to discuss a follow-on strategy in the new year.

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Key facts

The Swiss health system cost SFr51.7 billion ($40.6 billion) in 2004.
This represents 11.5% of Swiss Gross Domestic Product.
Only the United States spends more – 15% of GDP.
In 2003, drugs accounted for 10.5%, or SFr5.2 billion, of health costs in Switzerland.

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