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Migrant children in transit: health profile and social needs of unaccompanied and accompanied children visiting the MSF clinic in Belgrade, Serbia

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Tijana Topalovic, Maria Episkopou, Erin Schillberg, Jelena Brcanski and Milica Jocic

Background

Thousands of people migrate to Europe each year in search of safety and the promise of a better life. In 2018, around 30,000 of these people were children. During migration children find themselves “in transit”, on the move or staying only temporarily in one or more countries along their journey towards the final destination. Children can journey unaccompanied or along with their family members or caregivers. Daily challenges during migratory travel, affect their physical and mental health, making them extremely vulnerable. Migrant children in transit, particularly if unaccompanied, are less likely to have access to health and social services of the hosting country. In such setting children are hard-to-reach and often isolated, hence meeting their complex needs and problems is challenging. In addition, it is in the context of transit migration when child protection services are the weakest. Child’s health is generally affected by lack of support, protection and substandard living conditions. Uncertainty about continuation of the journey, problems in communication due to cultural and language differences add to the potential of unfavorable outcomes.

Serbia is one of the central transit countries along the so-called Balkan migration route. In December 2018, 1140 migrant children were present in Serbia. Many of these children were unaccompanied or separated from their families. Although there is no official registry publicly available to establish the exact number of unaccompanied migrant children (UMC) in the country, it was estimated that around 500 were accommodated in the asylum and transit-reception facilities run by the government. At the same time, government centers struggled to address the health and social needs of accompanied migrant children (AMC) and UMC and they provided limited to no access to social, education activities or tailored integration programs.

To address the health and social needs of migrants in transit, in early 2017, Médecins sans Frontières (MSF) established an outpatient fixed clinic, in Belgrade city center. Approximately 35% of 23,901 patients who presented to the clinic in 2017 and 2018 were children, of which over 50% were unaccompanied. MSF recognizes children and UMC in particular, as a vulnerable group that requires specialized health and social care and has adapted its services to address the needs of this population.

So far, there have been several studies describing health profile of migrants, refugees and asylum seekers either upon arrival to Europe (mainly Greece and Italy) or after reaching destination countries such as Belgium, Germany and Switzerland. UMC and AMC have been studied with regards to development and treatment of mental health symptoms, however there is a gap in comprehensive description of medical, mental health and social care in the context of transit migration.

The aim of the study is to describe the demographic and health profile of all children who received medical, mental or social care at the MSF clinic in Belgrade from January 2018 to January 2019, divided in two groups, UMC and AMC, to understand the health and social needs of these vulnerable populations. In addition, we described the package of care offered at the Clinic to identify gaps and opportunities for improved services provision.