Civil Society Organisations and the Healthcare of Irregular Migrants

Chair:

• Ester Gallo - Università di Trento

In many countries around the world, individuals who reside and/or work without regular authorisation find it difficult to access public medical services beyond emergency treatment. Civil society organisations (CSOs) often fill this gap by providing healthcare to vulnerable populations, including irregular migrants. What, if any, are the dilemmas that arise for CSOs when delivering such services? We answer this question using 40 semi-structured interviews with CSO staff working in two European countries with high levels of irregularity among their immigrant population, universal healthcare provisions on paper, and significant differences in approaches and availability of public services for irregular migrants in practice: Italy and Spain. We show that CSOs providing health services to irregular migrants are faced with a fundamental dilemma between humanitarianism and equity.

CSO staff respond to the ethical imperative to immediately aid those in need, thus promoting a decent quality of life that includes access to both emergency and non-emergency care. By doing so, however, they run the risk of substituting rather than complementing public provision, thus alleviating governments from assuming responsibility for those services in the long run. This is a hard conflict between two independent morally worthy goals. Our argument is that CSOs involved in the provision of healthcare to irregular migrants are not simply giving services: they also play an inherently political role. This is regardless of whether and how they deal with the dilemma: If they ignore it, this too is a political choice. The presumed neutrality and impartiality of humanitarianism is – at least in this case – an illusion.