Mi-Health HIV Partnership Wins 2 Awards!

27th November 2023

We are honoured and deeply grateful to have won the awards for both Impact and People’s Choice during the Gilead Community Awards 2023 on 8-9 November 2023 in Madrid, Spain. We were chosen by our colleagues from across Australia, Europe, and Canada working in the areas of HIV, liver diseases, and oncology.

The Impact category highlighted how we have achieved measurable social impact and positive change by engaging 2,402 key population migrants that others dismiss as “hard to reach” in HIV testing and care. Through our targeted HIV testing, we managed to collect detailed data that reveals the levels of disparities that migrants experience across the HIV continuum of care and the social determinants of health for migrants in precarious circumstances. We have leveraged these findings to advance health equity by engaging in data-driven advocacy, launching a position paper calling to include migrants more fully in universal healthcare, and presenting our work at three international conferences.

We are proud to have been recognised by independent judges from the Charities Aid Foundation for this award – it speaks to the collective power of our Partnership and demonstrates the need for a more coherent approach to addressing the HIV-related needs and health outcomes of migrants across Europe. The health of migrants is inherently a transboundary issue that requires involvement of those most impacted, and our Partnership is rooted in the belief that agile community-led and community-based networks that cross borders and unite diverse groups can advance solutions to the common concerns that impact key migrant populations.

The People’s Choice award was voted for by attendees at the event in Spain, who selected us from amongst 16 finalists across four award categories. We are deeply grateful to be recognised for our achievements, impact, and contribution to migrant communities across 10 European countries. Receiving this award from our peers is especially meaningful, as it acknowledges the challenges involved and the effort that it takes to successfully deliver culturally sensitive services for diverse and usually marginalised key migrant populations. It also demonstrates that empowered and resourced communities, armed with expertise, competencies and lived experiences, can lead on and have influence over their HIV-related health outcomes.

Our Mi-Health HIV Partnership said in a joint statement:

“We are thrilled to have won the Impact and People’s Choice awards for our work as the Mi-Health HIV Partnership. These awards represent the efforts of our Partnership, working in 10 diverse communities across Europe as a strong and collaborative network, to reduce the barriers that migrants and other marginalised groups face in accessing HIV and other health services. We are grateful to Gilead for their continued support, commitment to health equity, and for giving us this opportunity to collaborate in a first-of-its-kind network, leverage the expertise of community-led organisations, and to address the common challenges facing migrants in Europe.”

Judges noted the multi-pronged approach of our Mi-Health HIV Partnership to addressing the issues facing migrants at risk of or living with HIV, the development of relationships with local organisations across the European region, and the collection of both outcome and programme monitoring data from the very start of our work.

To find out more about our Mi-Health HIV Partnership and Gilead Science’s Zeroing In Fund, please see below:

Gilead Sciences:

• Zeroing In: Ending the HIV Epidemic

Mi-Health HIV Partnership:

• Learn more

Partnership members:

• Africa Advocacy Foundation (AAF, England, lead organisation)
• Afrikaherz (Germany)
• The AIDS Solidarity Movement (Cyprus)
• Association PASTT (France)
• LHIVE Diritti e Prevenzione (Italy)
• Noaks Ark Mosaik (Sweden)
• Open Paths Athens (Greece)
• Plateforme Prevention SIDA (Belgium)
• Portuguese Foundation “A Community Against AIDS” (FPCCSida, Portugal)
• Stichting African Foundation Against AIDS (Stichting AFAA, Netherlands)

Migrant Health Training Toolkit

9th October 2023

This toolkit offers resources and practical information for migrant health advocates working to improve the HIV-related health outcomes of migrants in precarious circumstances across the European region. These materials can be used when working directly with migrants or when engaging in HIV-, healthcare- and/or immigration-related advocacy. This toolkit draws on content from AAF and Mi-Health Europe’s annual training programme for migrant health advocates, Mi-Care.

HIV, migrant health, and immigration and healthcare policy are complex, evolving topics. Though these materials are accurate as of the dates below, this is not an exhaustive resource.

Module 1: Health Inequalities

This module covers health inequalities and the social determinants of health relevant to migrant populations, with a focus on xenophobia and discrimination.

Materials are accurate as of 2021.

Health Inequalities for Migrant Individuals

Social Determinants of Health: Medical

Social Determinants of Health: Non-medical

Impact of Xenophobia and Discrimination on Migration and Migrant Health Outcomes

Module 2: HIV Science for Communities

This module covers HIV testing, treatment and care, including explanations of ARVs, U=U, treatment for key populations and future research directions.

Materials are accurate as of 2022.

HIV Science for the Community

Module 3: Viral Hepatitis

This module covers viral hepatitis prevention, testing and treatment in the context of migration.

Materials are accurate as of 2022.

Viral Hepatitis Elimination: Reaching the People

Module 4: An Overview of HIV Epidemiology

This module covers ECDC data for migrants on HIV epidemiology, testing and treatment.

Materials are accurate as of 2022.

ECDC Data on HIV Epidemiology, Testing and Treatment: Focus on Migrant Health

Module 5: Healthcare Policy and Systems

This module covers the main international laws and frameworks governing migrant access to healthcare in Europe.

Materials are accurate as of 2021.

Healthcare Policy, Systems and International Frameworks

Module 6: Strategic Health Agendas

This module covers global healthy policy and agendas, including financing the response to HIV and strategic agendas.

Materials are accurate as of 2022.

Policy: Directions and Current Topics at the National and International Levels for HIV, Healthcare and Health Systems

Module 7: Migrant Health Research

This module covers HIV research on migrants and ethnic minorities in Europe, including gaps in the literature and data-driven advocacy.

Materials are accurate as of 2022.

Migrants and Ethnic Minorities and HIV in Europe: Research and Data Driven Responses

Module 8: Migrant-led Advocacy

This module covers community-led initiatives and migrant patient empowerment.

Materials on community-led initiatives are accurate as of 2021 and materials on patient empowerment are accurate as of 2022.

What Makes for a Successful Community-led Initiative?

From “Do To” to “Do With”: Achieving Patient Empowerment through Advocacy

Module 9: Justice and Advocacy for Change

This module covers human rights, types of justice, and advocacy frameworks and techniques for change.

Materials on advocacy frameworks are accurate as of 2022 and materials on human rights, justice and social change are accurate as of 2021.

Advocacy

From Social Service to Social Change: Locating Human Rights Advocacy in Our Work

Transformative Advocacy Approaches: It’s about Justice

Module 10: Digital Campaigning

This module covers communications, social media and the use of digital platforms and campaigning.

Materials are accurate as of 2021.

Communications, Digital Campaigning and Social Media

U = U

30th March 2023

Undetectable = Untransmittable

This is not a mathematical equation. It is science.

Having an undetectable HIV status means that the amount of HIV in a person’s blood is so low that it cannot be detected by standard HIV tests (see here for more information). Untransmittable means that, when taking antiretroviral drugs as prescribed by your doctor, you cannot pass HIV on to sexual partners. This status is only possible by staying on regular treatment with the use of antiretroviral drugs (ART) – treatment available, for example, in the UK for free to all migrant communities regardless of their immigration status.

Migrant communities in Europe are more likely to be diagnosed with HIV later than non-migrants[1], an inequity reflecting lower rates of testing and the many barriers to accessing ART faced by migrants. Without access to ART and other healthcare services, it is difficult for many migrants to maintain an undetectable viral load.

So, what could be possibly behind this issue?

Several factors are pointed to, such as:

1. Lack of access to healthcare services due to immigration status. Not all countries in Europe offer free (sexual) health services. Not only that, but many migrants that may not have legal status yet in the country they are living in are hesitant to access medical care for fear of being deported, because of past experiences of discrimination by healthcare providers and/or due to stigma.
2. Linguistic and cultural barriers. Translators may be unavailable or worse yet, not even provided by the healthcare system at all. Additionally, migrants may not speak the language of the country they are living in, may have a hard time understanding or navigating the healthcare system, and/or the available information about HIV treatment and care may not be appropriate for or relevant to them. Additionally, some may come from a cultural background of heavy HIV stigma, making it challenging to seek testing and treatment.

How can this situation be improved?

To address these challenges, there are several steps that can be taken to improve HIV care for migrant groups in Europe:

1. Providing language assistance and cultural competency training for healthcare providers to better serve migrant patients – this may include hiring interpreters or providing targeted co-produced and translated materials about HIV care. It may also involve addressing the biased attitudes of some healthcare providers so that an equitable standard of care is applied to migrant and non-migrant patients alike.
2. Tailored and targeted outreach and education to migrant communities about HIV testing and treatment. This may happen through community-based organizations that migrants trust or through partnerships with migrant-led organizations. Providing reassurance about the confidentiality of HIV testing and treatment (and about any limitations of that confidentiality, as required by law) is also important as it can help reduce the stigma associated with HIV and encourage more people to feel comfortable enough get tested.
3. Addressing the legal barriers to healthcare access for migrants is crucial in improving HIV care for this population. As many European countries determine eligibility for healthcare services based on immigration status, regularizing migrants’ status is a form of HIV prevention. Additionally, providing legal assistance to migrants who are wrongly denied healthcare and implementing policies that protect the confidentiality of HIV-positive individuals may also prevent discrimination.

Migrant populations everywhere face unique challenges in accessing HIV care and in maintaining an undetectable HIV status. By addressing their challenges, it would be possible to improve HIV care for diverse migrant communities and ultimately reduce the burden of HIV everywhere.

Watch this space for updates on our Mi-Health HIV Partnership. Would your organization be interested in partnering with us?

We would love to hear from you. Feel free to reach out at mihealth@africadvocacy.org.

[1] European Centre for Disease Prevention and Control. HIV and migrants. Monitoring implementation of the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia: 2017 progress report Stockholm: ECDC; 2017.

World Aids Day: This is how to reduce your risk of getting HIV (a WHO guide)

20th April 2022

On World Aids Day, designated on the 1st of December each year, the WHO released a brief guide with 5 recommendations on how one can reduce their risk of contracting HIV.

We have explained these recommendations in more depth below, and hope that they can be helpful for anyone curious about how to engage in safer sex and reduce their risk of getting HIV.

Using condoms

The use of condoms is considered as one of the safest ways to prevent HIV and other sexually transmitted infections. Condoms are cheap, effective and easy to access. Although they do not completely eliminate the risk of contracting HIV, condoms are highly effective in most cases as they prevent the passing of fluids between partners and thus highly limit the risk of infection. There are both men and women condoms, wherein the former are worn on the penis and the latter are worn inside the vagina.

Ensuring that your partners who are living with HIV are taking treatment

Although there isn’t any medicine yet that can eradicate HIV, the virus can be managed with the use of antiviral medications. These medications help lower the level of HIV found in the blood (called viral load) and in other bodily fluids such as semen, anal and vaginal fluids. If taken correctly and consistently, such levels can become undetectable. According to the CDC, an undetectable viral load is considered to be fewer than 200 copies per milliliter (mL) of blood. If your partner is HIV positive, it is important to ensure that they take their medications correctly and consistently. The support you provide to an HIV positive partner is particularly crucial as it motivates them to stay on track with their health while at the same time reducing your risk of transmission.

Using PrEP to prevent getting HIV if you have ongoing risk, including during pregnancy

PrEP, or pre-exposure prophylaxis, is a preventative medication used to prevent the contraction of HIV. For women who are pregnant, trying to get pregnant, or breastfeeding, PrEP can also be an effective method to protect them and their baby from getting HIV. Taken once per day, this medication stops HIV from infecting cells in the immune system. It reduces the risk of getting HIV through sex by more than 90%, and 70% for those who inject drugs. This medication is particularly useful for people who do not have HIV but are at risk of contracting it, such as people having sex with HIV positive partners with detectable loads, or whose statuses are unknown.

In order to ensure an effective PrEP regimen, it is essential to get screened for HIV before starting the medications, and every three months after.

It is important to note however that PrEP:

• Becomes effective one to three weeks after starting the medication
• Isn’t as effective for anal sex as it is for vaginal sex
• Doesn’t protect against all STIs

Therefore, it is highly recommended to still use a condom in order to more effectively reduce the risk of contracting HIV and STIs.

Using sterile needles and syringes for all injections

Whether it is for a medical injection or for the injection of drugs, it is crucial to avoid sharing needles and syringes with anyone as this increases the risk of contracting HIV and other infections found in the blood.

Sharing needles, or using unsterilised needles is highly unrecommended as through injection, there can be residues of blood in the needles or syringes. If the same needles or syringes have been used by an HIV infected person, there is a high risk to inject HIV infected blood into the bloodstream, and transmit the infection as a result.

For anyone having a difficulty accessing new needles or syringes, please note that it is possible in some countries to get your used needles exchanged for new ones at no cost in pharmacies.

Getting tested and treated for sexually transmitted infections

In order to keep track of your health and avoid the spread of HIV and STIs, it is crucial to get tested regularly. For people who are sexually active, it is recommended to get tested every 3 months and/or between each partner. This helps ensure that if there is infection, treatment can be pursued on time, which prevents the condition from getting more serious and reduces risks of transmission.

Barriers to undocumented migrants’ access to COVID-19 vaccines

20th April 2022

As of 11 February 2022, 70.8% of the population in EU/EEA countries received their primary course of the COVID-19 vaccine, as reveals data from the ECDC. From a global perspective, it is undeniable that countries across Europe have done an outstanding job at attaining high rates of vaccination amongst their populations, which represents a crucial step in reducing the spread of COVID-19.

However, challenges still remain in terms of the ability of all groups to access vaccines, in particular for undocumented migrants. In fact, these groups continue in many countries to be excluded from national vaccination programmes as a result of harmful policies fuelled by anti-immigration rhetoric. This is counter-effective to the vaccination goals of many European countries as it puts undocumented migrants at a further risk of contracting the virus, which in turn makes them more likely to pass the virus to others and thus become a bigger threat to public health. This is all the more alarming given that migrants (including undocumented migrants) represent a significant part of the population of many European countries, such as in Germany where they amount to about 12 million people.

Low rates of vaccination among undocumented migrant groups can be attributed to a number of reasons, both direct and indirect. This includes but is not limited to: a lack of transparency on vaccine policies, identification and residency requirements, the exclusion of undocumented migrants from vaccination policies, a lack of guarantee of data privacy, as well as existing social, geographical and linguistic barriers.

Taking the example of Poland, the vaccination environment of undocumented appears rather exclusionary due to a number of factors. First and foremost, undocumented migrants are explicitly excluded from official vaccination documents, wherein “only citizens, legal residents, work permit holders, [and] official asylum seekers” can get vaccinated through national healthcare programs. Furthermore, in order to get vaccinated, all patients must generally show proof of an ID, of their right to stay in Poland and/or a PESEL number, all of which undocumented migrants, by reason of their irregular status, often lack.

In the case of Italy, despite the fact that official vaccination documents clearly state that “everyone in the country, independent of legal status” can be vaccinated by public health authorities, the latter may still be discouraged from accessing vaccines by reason of a lack of clarity as to whether they can access vaccines without an ID. Additionally, there is no guarantee as to whether medical staff won’t inform the police or immigration enforcement authorities of their status prior to/during COVID-19 vaccination. Fearful of their status being revealed to the police and being deported as a result, many undocumented migrants are forced to remain in the shadows. This is counter-effective to the vaccination goals of many countries given that it places these groups at a further risk of contracting the virus, and experiencing health complications which could potentially lead to death.

In an effort to reassure its undocumented migrant population, which possibly amounts to 1.3 million people, the British government has made it publicly clear to NHS officials and other public healthcare services that no one being vaccinated shall be subjected to ID verifications, nor immigration status checks of any sort. Furthermore, the British government declared that vaccination for all populations is free for anyone living under British territory, regardless of their immigration status. Such strategies are likely to increase vaccination rates among undocumented migrants, given that they foster an environment of trust where the latter may access vaccines and other healthcare services safely, and without any fear that they may be detained or deported as a result of such. Furthermore, making all vaccines free removes important financial barriers for these groups, who in many cases can’t get vaccinated due to exorbitant healthcare costs.

Another important but often neglected barrier to undocumented migrants’ ability to access vaccines is language. Taking the example of Poland, where the vast majority of migrants come from Ukraine, Germany and Belarus, vaccine resources are only available in Polish, the country’s official national language. This represents a significant barrier to the vaccination of undocumented migrants, given that the vast majority of these groups are not fluent in the local languages of the countries in which they reside, and thus unable to understand crucial information about vaccines. One way to solve this issue is to provide translation of healthcare material in languages that correspond to the majority of migrant populations, as well as provide the option to have translators at the time of vaccination for those who lack fluency in a local language.

If governments wish to increase rates of vaccination among undocumented migrants and their populations more generally, it is primordial that they adopt policies that are inclusive, transparent, trustworthy, and remedy significant barriers that continue to deter undocumented migrants from accessing healthcare. Most importantly, there needs to be a clear divide between the work of public health services and that of immigration enforcement authorities, if governments wish to fight COVID-19 more effectively and create more trust among their populations.

What is the legal framework around COVID-19 vaccination in your country? Do you find it to be inclusive of all migrants ? If not, what sort of barriers or legal loopholes can be identified?

With regards to the administration of vaccines by health officials, are there any challenges or setbacks that could deter undocumented migrants from getting vaccinated ? If so, which ones?

We would like to hear your thoughts !

Escape, Racism, Health, and Solidarity in the Russia-Ukraine war

20th April 2022

On the 24th of February 2022 Russia’s invasion of Ukraine started and is forcing millions of people to leave their country. A lot of people migrating in a short time increases the risk of infectious diseases, especially during the Covid-19 pandemic. Since the start of the war covid infections in the Ukraine increased 555% according to an UN report. Being forced in small quarters and bomb shelter puts people at higher risk of getting infected with Covid, tuberculosis, measles, chickenpox, or even polio. Hospitals are full will trauma patients and access to medicine has decreased. (Global News) Humanitarian aid is in place and host countries have now the responsibilities of keeping the people fleeing from the Ukraine safe and healthy. However, humanitarian assistance is not available for everybody.

(TW Racism)

While EU countries are opening borders and welcoming Ukrainian refugees, Black international students are left outside. Videos are circulating on social media showing that Black people are not allowed on buses and trains and cannot cross the border. Articles and speeches by politicians underline the racist behavior by expressing their emotions with statements such as ‘European people with blue eyes and blonde hair being killed everyday’ (Metro UK, Ukraine’s deputy chief prosecutor David Sakvarelidze, on BBC News) .

Experts are talking about hypothermia, dangerously low body temperature, among refugees at the borders. Ukrainians are free to enter the EU countries, even without possessing the legally required passport. This however does not apply to third-country passport holders with visas for Ukraine. Ukrainians are legally allowed to stay up to three years in the EU and a goal is to make healthcare accessible for at least a year without going through the asylum process. The solidarity with the Ukraine is inspiring and important but is influenced by racial bias. People from African ancestry, living in the Ukraine face racism at the borders. Additionally, the current EU migration policy shows a double standard. Where white people from the Ukraine are welcomed with open arms, this solidarity was/is lacking for people from Iraq, Syria, Palestine, Afghanistan, and counting.

The war is displacing people and puts them at risk of infectious diseases and hypothermia. Additionally, it shows the differences that are being made between different ethnic groups. The migration policy is changing and making it easier for people to enter the EU. The war shows that it is possible to make the EU and its services easily accessible to refugees. Hopefully, this will also be made possible for refugees from outside Europe in the future. Solidarity should not be racist.

For additional reading:

‘Short supply’ of medical products in Ukraine – WHO | Express & Star (expressandstar.com)

Europe’s different approach to Ukrainian and Syrian refugees draws accusations of racism | CBC News

https://abcnews.go.com/International/europes-unified-ukrainian-refugees-exposes-double-standard-nonwhite/story?id=83251970

https://www.icmpd.org/blog/2022/integration-of-ukrainian-refugees-the-road-ahead

Ukraine migrants given right to reside and work in EU for three years amid Russian attack (republicworld.com)

Ukraine refugees: Racism still exists during war and can’t be ignored | Metro News

Ukraine-Russia war forces EU refugee policy reversal – InfoMigrants

Intimate Partner Violence, Antiretroviral Therapy adherence and Women’s Health

22nd November 2021

Earlier this year, my colleagues and I published a paper on how experiencing intimate partner violence (IPV) negatively affects the ability to maintain high rates of antiretroviral therapy (ART) adherence. For this study, 410 HIV positive women who had been on ART for at least six months were sampled from 12 public hospitals in Kenya. After their routine check-up, women who agreed to participate in the study were asked whether their current partner had ever been physically, sexually, or emotionally abusive to them (as defined by Demographic Health Survey module on Domestic Violence). They were also asked if their partners had ever exhibited controlling behaviour such as limiting her contact to friends and family.

IPV has long been identified and proven as a risk factor for HIV infection among women. This is because women who experience it are more likely to be exposed to risky sexual behaviour, violent sexual acts, forced sex a

re rarely in a position to negotiate for condom use. They also seldom access healthcare services. Recent literature also suggests that in countries with high HIV prevalence, violent men are more likely to be HIV positive therefore increasing the risk for the women. It was therefore, unfortunately, not surprising to find that 76% of the women interviewed had experienced some form of IPV from their current partner. This prevalence rate is higher than Kenya’s national average, 46%.

When compared to their ART adherence rate in the last 30 days, women who had experienced physical IPV, sexual IPV or controlling behaviour were more likely to report taking between 0- 94% of their ARV doses. Those who had never experienced IPV mostly reported 100% adherence

rates. The healthcare providers who interviewed the women offered some explanations for this. One is that during violent encounters, some women are chased or forced to flee their homes and therefore may not be able to carry their medication with them. Additionally, that their newfound refuge may make it difficult for them to maintain their medication schedule or clinic appointments because of distance or fear of disclosure. Our rationale, which was also the foundation of our research hypothesis, is that living in an environment where IPV occurs (whether past or ongoing) affects a woman’s ability to adhere to treatment. Research has a

lready shown that living in such an environment can lead to psychological distress, depression and poor mental health, which are also predictors of lower ART adherence. Additionally, our study revealed that controlling behaviour, which is often simply dismissed as overprotective or jealous behaviour, may be psychologically more detrimental than previously estimated.

One of the reason behind conducting this study was to contribute to the growing scientific evidence of the adverse e

ffects IPV has on women’s health. Specifically, that IPV should not only be viewed as a social or legal issue, but rather a public health problem, even when it does not end in femicide. Studies by the World Health Organisation (WHO) have established forms of IPV as underlying causes of physical injury (morbidity), ill mental health which led to emotional distress and suicide, chronic health problems (pain syndrome, severe headaches, coronary heart disease, stomach ulcers) and mortality among women globally. An analysis I did for UNFPA Swaziland a few years back revealed a significantly higher rate of IPV among women with unwanted pregnancies, women who had ever had an abortion or miscarriage, and pregnant women who attended antenatal care clinics less frequently.

With regards to migration, IPV is not necessarily significantly higher among migrant groups as compared to the general native population. IPV occurs at all social, economic, racial, cultural, and religious realms. However, the process of migrating or migration status can aggravate the vulnerability and experiences of IPV among women. There are different levels at which this occurs. First, from a practical level, migrant women who experience IPV may lack access to helpful resources because they may not know of their existence or how to get to them. Even when they do, they may lack the finances or language skills to engage with the services providers or may face discrimination.

From a social aspect, migrant women may lack the social support that helps to overcome an abusive relationship because they left their friends and families back in their home countries. This social isolation gives their abusive partner even more power to control them especially if the woman does not have contact to the host population through work, education e.t.c. In this case, the informal communities

which migrants usually form in foreign lands may help to mitigate this isolation and may also act as a source of support and information about rights and resources. However, depending on the social and cultural norms of the community, some women may fear leaving their abusive relationship because they would not want to be ostracized and lose the only social connection, they have in the host country.

From a legal aspect, for many migrant women, their legal status is linked to their partners’ e.g., family reunification laws. Most

immigration laws require that the pair remain together for a certain period for the partnership to be legally recognised and before separation or divorce can be filed. Therefore, women would endure the abuse in silence because they are afraid to jeopardize the process. For

those with partners who are citizens or have legal residency, this dependency may be used in blackmailing them into staying in the abusive relationship.

Nevertheless, there are good examples which show that given the proper interventions and support, both at government level and from local programs in host countries, migrant women experiencing IPV can remove themselves and their children from abusive thus dangerous situations. An example being Syrian refugees in Germany and Sweden who used the laws in the host countries to separate from their abusive partners and build independent lives for themselves and their children.

Introducing the Mi-Health Team: Get to know us!

13th October 2021

Denis Onyango 

Denis is the Programmes Director at Africa Advocacy Foundation. He has over 20 years experience of grassroots community health promotion work focusing on HIV/STIs prevention, testing and treatment access within marginalised and underserved communities, primarily black migrant communities across Europe He has served on a number of advisory boards including WHO RCC on HIV, Hepatitis and TB, NHS England CRG on PrEP, UK HIV Commission, He is passionate about improving health service provision for Europe’s most underserved communities, including LGTBI, homeless, migrants, people who inject drugs, sex workers and prisoners. Denis’ background is in education, voluntary sector management, policy and public health. 

For Denis, Mi-Health Europe means that we can finally involve migrant communities who are underserved or barred from accessing healthcare by unjust laws and practices in conversations and campaigns to ensure healthy equity. 

Anne Flaherty-Gupta

Anne Flaherty-Gupta is a social worker with over 10 years experience providing direct services and developing and managing programmes in both clinical and community settings. Originally from the United States, she has mainly worked with adults who have experienced and/or committed interpersonal and community violence and who are re-entering the community after incarceration. She holds a Masters in Social Work with a concentration in Mental Health and a Certificate in Violence Studies from the University of Illinois at Chicago and has provided individual and group therapy to migrant and criminal legal system-involved teens and adults in Chicago. A licensed social worker in the US and a registered social worker in England, she now resides in London with her husband.

One of the aspects of Mi-Health that Anne thinks is so impactful and unique is that it helps re-balance power — both by putting knowledge of one’s rights and resources into the hands of those who need it and by providing a platform for frontline organisations to pool knowledge and practice. 

Juliette Emmanuel

Juliette Emmanuel is originally from the Republic of the Congo, and has been a part of the Mi-Health team since January 2021. She holds a B.A. in Political Science, French Literature and Race and Ethnic Studies from St. Olaf College, in Minnesota, along with a Master of Laws in International Criminal Justice and Human Rights Law from the University of Kent. Juliette has worked and volunteered with several NGOs from across the globe, advocating for the rights of vulnerable and underrepresented groups. Some of her relevant experience includes working with the Immigrant Law Center of Minnesota and lobbying in favour of laws that protect and advance the rights of migrant communities in the state of Minnesota. She has also acquired knowledge and experience in providing support for victims of gender-based violence and assisted survivors of sexual trafficking in their rehabilitation journey. 

Juliette believes that the Mi-Health mission is so empowering because by equipping migrants with all the right tools, knowledge and resources, it gives them a chance to lead autonomous lives and integrate more confidently into their new country.

We Are Live !

8th July 2021

After several months of brainstorming, research, hard work, and collaboration, the Mi-Health Europe platform is finally live!

What a great pleasure it is to finally bring this platform to life! It is a major step towards improving migrant health outcomes and access to justice and equality across the WHO European region.

For those who were able to attend our launch last Friday, 18 June 2021, we would like to say thank you! It was a sincere pleasure to have you be a part of our discussion, ask thoughtful questions to our panelists, and hear from our diverse group of experienced speakers on the urgent need for healthcare equality, overcoming challenges, and of the importance of dialogue, policy-making, research and collaboration in improving the healthcare rights of migrant, asylum seeker and refugee populations.

After open remarks from Debra Allcock Tyler, who reminded us that it is “time to fight again”, our host Bernadette N. Kumar, co-chair of Lancet Migration, passed the mic to Lord Boateng.

Member of the House of Lords and the first speaker of the launch, Lord Boateng gave us a brief overview of the legal framework with regards to equal access to healthcare rights within the EU. He identified existing legal loopholes that may hinder the EU’s ability to deliver equal healthcare rights to EU citizens, along with the ways in which EU laws are applied distinctly at national levels. Lord Boateng particularly emphasised how important it is for constituents and civil societies to write and speak directly to legislators and MPs on issues that matter to them, in order to actively contribute to the making of policies.

Moro Yapha, radio host and founding member of Wearebornfree!, gave us insight into his personal experience as a migrant in Germany and the importance of speaking out on inequalities and barriers that migrants face when navigating new socio-cultural and legal systems. Moro’s experience rooted the rest of our launch in Mi-Health’s purpose as a platform for migrants and allies to share experiences and knowledge and ultimately enhance migrant health.

HIV expert at the European Centre for Disease Prevention and Control Teymur Noori then gave us an overview of the HIV response in Europe as it relates to screening, prevention and treatment. He particularly stressed the importance of data in monitoring the scale of and finding better responses to HIV. Furthermore, he warned us about the negative impact of stigma and stereotypes attached to migrants and how they can limit the ability of the latter to get tested and obtain treatment if needed.

Dr. Kanokporn Kaojaroen, Country Support and Partner Coordinator at the World Health Organization, then gave an overview of the WHO’s goals and responses as it relates to healthcare access for migrants. Similarly to Noori, Dr. Kaojaroen stressed the serious need for comprehensive, multidimensional and credible data in order to better respond to modern healthcare challenges, and specifically the healthcare needs of migrant communities.

Next we heard from Melody Lewdon, Program Officer at Open Society Foundations. She talked about the importance of supporting small scale organisations advocating for equal access to healthcare for migrant populations. As Program Officer at Open Society Foundations, she also discussed how social outreach and an adequate sharing of knowledge and information can ensure stronger health equity, which is particularly important for those who are socially excluded and live in more precarious conditions.

Finally Jeffrey Lazarus, Associate Research Professor at ISGlobal Institute, shared insight into the state of healthcare policy and systems within the EU. He highlighted the health and socio-economic challenges brought by the spread of the Covid-19 virus and their impact on migrant communities and movement.

We want to thank our speakers, once again, for their rich and varied contributions and hope that you were able to learn a lot from them.

Taking to heart Moro’s call to use our voices to speak out, Lord Boateng’s appeal for civic participation in policy making, and the repeated request for data and research on migrant health, not to mention a reduction in stigma, coming from our panelists, in the coming months we will be holding the first meetings of our steering committee, and discuss how we can achieve these goals as a team. Additionally, we will continue to grow our database of migrant-led and migrant-focused supportive services on www.mihealtheurope.org and open applications for our working groups and independent advisory board.

If you’re interested in getting involved, please email us at mihealth@africadvocacy.org. If you are part of or know of any organisations that could be a part of our database, kindly complete this consent form and we will gladly post information on our website. Otherwise, follow us on social media and check out our website, mihealtheurope.org! We look forward to collaborating with you as Mi-Health grows!

Thank you again!

The Mi-Health Team

Telemedicine during COVID-19 and the power of adaptation

25th June 2021

One of the lessons we have learned this year is that everything is unpredictable. From surviving almost two years of a pandemic to working from home, seeing our loved ones pass, homeschooling our kids, or graduating virtually, it is certain that none of us would have expected any of this to happen.

However, despite all the changes that have taken place, here we are, progressively adapting to our new lives. There is a popular saying which states that “when life throws you lemons, you make lemonade”. And that is exactly what we did, we made our own personally crafted lemonade and adaptation was the perfect ingredient to cope with every challenge that was thrown at us.

One of the ways that we have adapted has been through the use of telemedicine, which has allowed many health specialists from across the world to find new ways to deliver quality services to their patients, even from a distance.

For those who are unfamiliar with this term, telemedicine consists of using communication platforms such as Zoom, Facetime, or Whatsapp to allow doctors to virtually track down the health and needs of their patients, provide diagnosis, and even prescribe medicines when needed.

Although telemedicine isn’t a totally new practice, it has gained immense popularity since the start of the pandemic, and for a large number of reasons. In fact, not only it has helped reduce,exposure to the Covid-19 virus by limiting patients’ visits to hospitals to strict necessity, but it has also helped cut down long waiting times , compensate for the shortage of hospital staff and material due to an overcrowding of Covid-19 positive patients, and allow those living in more disadvantaged and deserted locations to access healthcare services without having to incur outstanding travel costs.

One particular way I found telemedicine to be extremely helpful has been through the delivering of mental care services from afar. For many of us, the challenges that we have experienced this year were like no other, which unfortunately may have taken a big toll on our mental health, and affected the way in which we interact with colleagues, children, romantic partners, and even ourselves. Finding ways to stay grounded, develop stronger self awareness, and remain sane and positive has been a major prerequisite to our adaptation.

While for some of us, maintaining sanity was achieved individually, by doing activities such as meditation, sports or baking, for others this required the help of a professional. What makes this the most exciting is that with only one single link, an electronic device and a great internet connection, anyone could get the help they needed in a fraction of a second.

Telemedicine is a perfect example of the power of adaptation, and how it can allow us to better respond to our constantly changing world and diverging needs as humans.

Whether that means finding ways of cutting down long waiting times, limiting chances of exposure to a virus, or providing mental support and assistance to those in need, the biggest lesson we can learn from this is that as with everything in life, healthcare too requires ADAPTATION. Adaptation to the varied needs of patients, adaptation to the changes of our times, and adaptation to possibly anything that could undermine its efficiency and accessibility. And this is what Mi-Health is about!

Confusing and conflicting blood donation rules obstruct Black blood donors in England

17th June 2021

I scroll through Instagram, my feed alternating between pictures of my friends and adverts for makeup, clothes and natural hair products “especially formulated” for Afro-Caribbean textured hair.

My eye is drawn to the next advert: this time, it’s an appeal with a grinning man in a medical chair, donating blood. “We need more black donors to donate blood” the caption reads, urging readers to visit the website to sign up.

NHS Blood Service campaign, 2020

I’m a healthy and fit 29 year old woman and a universal blood donor too. I care immensely about blood donation so I clicked the link and was taken through a list of questions to determine my eligibility.

What I found surprised and confused me. According to one part of the NHS Blood Donation Service, I was ineligible to donate because I had travelled to an African country in the past few months. What is more, my black British partner may also be denied to donate because as his partner, I classified as a person who “has, or you think may have been, sexually active in parts of the world where HIV/ AIDS is very common. This includes most countries in Africa.”

I work in HIV prevention in England so I was shocked that this would constitute as adequate grounds for refusal. As an individual, I test for HIV every year, and every time I have a new partner. I know that when I travelled I had no exposure to HIV.

I decided to look deeper into it. I visited a different part of the NHS blood donation website and completed their eligibility tool, and it informed me that based on visiting a certain city within Kenya that I would only need to wait 4 weeks, not 4 months. Confused by the information discrepancy, I called the service on the telephone and they confirmed that the rules had changed in response to the FAIR evidence review on blood donation eligibility, so I could now donate after only a 4 week wait. They registered me over the phone without any other issue and gave me an appointment to donate.

However, my doubts still remain. Will I turn up to the appointment and still be turned away? After going to all the effort for the good of my community? Will I ever bother to try registering again? Will other people in the community assume they cannot donate and never bother to register? Particularly in COVID times, very few people are actively seeking to go to healthcare centres to access services they may see as ‘non-essential’ to them – although they certainly are classed as essential to the NHS.

Black donors are ten times more likely to have the Ro and B positive blood types urgently needed to treat the 15,000 people in the UK suffering from sickle cell disease, a debilitating condition that is especially prevalent in people with an African or Caribbean background. Only 1% of current blood donors are black, yet while they are running urgent appeals to get more black donors through mass media advertising campaigns, they are simultaneously denying potentially thousands of willing donors on an outdated and discriminatory rule that is not individualised, not evidence-based, and vague and difficult to interpret. And while the website and telephone helpline send mixed messages, there has also been no indication from the government that their policy has changed.

I recently found out that the NHS blood service is set to overturn the blanket ban on gay men donating blood, which was banned on similar grounds as those which would affect me or my partner based on the thin possibility of HIV. This is fantastic news and needs to be similarly applied to all groups. It is disappointing to see such progress made for some marginalised groups, while failing to do so for others when there are no clear obstacles for doing so.

In fact, the discriminatory question around ‘partners of’ those from ‘many African countries’ has already been removed from both Scotland and Wales, leading to questions to why England alone is going firmly against the scientific advice of FAIR and declining to remove the discriminatory question, especially at a time when the blood service actively encouraging Black communities to donate blood and blood products due to shortages.

We need the Blood Service and the government to take an individualised approach to blood donation from people from Black backgrounds who are more likely to be affected by the discriminatory blanket ban than other groups.