Interpreting the health service for refugees and migrants

When Junyu Wang first arrived in Ireland as an English language student, he went straight to a hospital when he was sick with a fever. "I didn't know anything about GPs because in China, we go to the hospital for everything," he explains.

After waiting a long time in A&E, he was given some medicines and told to go to a family doctor next time. “I then found a doctor in Dublin city centre and brought a friend with me to help explain things.”

Now in Ireland for 18 years, Wang met his wife here, with whom he has two children. He became an Irish citizen five years ago. Over time, he has noticed that interpreting services for those who can’t speak English can be provided if needed in hospitals. However, he says most Chinese people in Dublin prefer to go to one of a small number of Mandarin-speaking GPs here.

“I understand the system now and that it’s free if you wait for a long time, but some people still go back to China to pay for operations because you can get it done quickly. Many Chinese people still bring Chinese medicines back with them to Ireland because, in China, you can buy what you want without prescriptions”

Hospital trolley diary – I'm beyond exhaustion and find myself crying

---

The farm that helps drug addicts: ‘It’s calm here. When everything is hectic, that helps’

---

In praise of playgrounds: for kids each one is a new city to be explored

---

. . .

Juljia came to Ireland from Lithuania in 2006, initially for three months, and then stayed. "I came without any English, but I used to be a teacher so I taught myself how to speak English. I met my husband here and we have two children now, although I was told I'd never have children when I was in Lithuania," she explains.

She discovered she was pregnant with her first child when she went to a Polish clinic (where the doctor also spoke Russian, which is Juljia's first language) with strong pains. "It was the happiest day of my life," she says. Juljia has had a positive experience of the Irish maternity services – even though her second child required heart surgery when he was four days old. "I almost lived in the intensive care unit at the Children's Hospital in Crumlin for the 2½ months he was there, but we got huge support," she explains.

Juljia has sometimes returned to Lithuania for treatment for her own health problems because it’s faster and cheaper than in Ireland. “We also notice that often Irish doctors don’t do physical examinations. To pay €50 just for advice without the doctor even looking at you is very strange for people from Lithuania,” she explains. She says that a lot of Lithuanians and Russians in Ireland will seek out doctors who speak their native language.

. . .

Fidaa is a Syrian dentist who came to Ireland as part of the EU relocation scheme in 2017. While living in direct provision at Mosney, he asked to see a psychologist. "I first saw a nurse who booked me an appointment with the GP. I was stressed and depressed and not sleeping well. I went back week after week without seeing a psychologist. In Syria, I would be able to go to see a psychologist directly," he explains.

He eventually moved out of direct provision and is now renting a room in a house and working as a dental nurse, while hoping to sit exams to qualify as a dentist here. However, he still hasn’t managed to see a psychologist. “Since I moved to Dublin, I’ve had the opportunity to improve my life, but I still don’t feel fully myself,” he explains. He contacted Cairde, the health advocacy organisation who put him in contact with a local GP who he hopes will refer him for counselling soon.

. . .

Emilia Marchelewska, the health advocacy officer with Cairde says that Syrian refugees have long waits for many health services here. "It's hugely frustrating for them. And people coming here from post-Communist countries aren't used to organising appointments for themselves because in those countries, everything is arranged for you. Some people fly back to their own countries because the Irish public health system here is so slow," she says. Interpreting services are available to GPs who see asylum seekers but not to other migrants.

Burundi native Alphonse Basogaomba, who has been in Ireland since 2004, spoke at a seminar on migrants' health at the University of Limerick in May. At that event, he said some refugees and migrants are fearful of accessing healthcare when they become unwell in the host country because they are afraid that being sick will affect their application for legal status.

“Some people fear that if they find they have a disease they won’t get their status. So, they hold on until it is too late,” he said. He added that languages difficulties and cultural differences add a further layer of complexity and can be a barrier for refugees to accessing healthcare.

Cairde has recently launched a new website, healthconnect.ie, which introduces the different Irish health services to newcomers to this country. Available in Arabic, Chinese, Russian and Polish as well as English, the health connect website explains how GPs/family doctors are the first port of call if you are sick. It also explains the different services available in primary care centres and maternity care.

It also explains how GPs write referral letters for visits to the A&E departments, counselling services, specialist outpatients clinics and for tests/X-rays. Such information is essential to people coming from countries where the health systems operate differently. The healthconnect website was funded by the HSE Social Inclusion office.

“People are sometimes living here for years and they still don’t know where their local GP is,” says Tonya Myles, the general manager at Cairde. She tells the story of how one client told her she didn’t have any GP nearby – not realising that the “surgery” three doors down from her was a family doctor’s practice.

Cairde also offers assistance to people applying for medical cards, GP visit cards and the drugs payment scheme. “We tell people not to go to A&E with minor illnesses and we explain to them what out-of-hours GP services are because many of them don’t know about these services,” says Myles.