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Q&A: Can a Divided Europe Handle the Refugee Crisis?
Deaths at sea and a chaotic refugee influx reflect the failure of European Union leaders to settle on a common immigration policy, one of Italy’s top elected officials tells ProPublica 
 
Laura Boldrini, the president of Italy’s Chamber of Deputies, has unusually strong credentials to discuss the immigration crisis gripping Europe. She worked for a quarter century at United Nations humanitarian agencies, serving as spokeswoman in southern Europe for the U.N. High Commission on Refugees.
 
Boldrini, 54, saw global migration at the front lines: the Italian island of Lampedusa, where seagoing migrants and refugees wash up, dead and alive, on the tides of despair and poverty; the refugee centers in Sicily where human traffickers exploit teenage Nigerian girls forced into prostitution; and the Greek coasts that are beachheads for an unprecedented wave of refugees from Syria and Afghanistan.
 
In 2013, she was elected to Italy’s Parliament as a candidate of today’s governing center-left coalition. Two days after she took office, she was catapulted into the presidency of lower house of the Legislature, the equivalent of the U.S. Speaker of the House of Representatives. 
 
Boldrini recently was in New York City and spoke with ProPublica about the immigration drama. European Union leaders have since moved closer to approving a plan to accept 160,000 refugees, though many see it as insufficient. This interview has been translated from Italian and edited for brevity. 
 

Q. What are the roots of Europe’s immigration crisis and what are the solutions?

I am not surprised that these migratory flows have increased. Last year, we attained the terrible record of 60 million refugees in the world, the highest number since World War II, because conflicts have increased. Sadly, solutions are not in sight. There is intense donor fatigue, which reduces the level of aid in the refugee camps, and this pushes people to travel further and risk their lives. There are protracted crises such as Syria. In the refugee camps, whoever has some savings left decides to attempt the big leap. We have to understand that during these past five years, nations such as Turkey, Jordan and Lebanon have accepted millions of refugees in their nations.
 
Immigration is the offspring of unresolved crises, the first collateral effect and the most visible one. In Europe, we are surrounded by instability. We have a nation like Libya a hundred miles away from us. A nation divided with a government in Tobruk, another in Tripoli, and then the tribes. We also have Syria, Iraq, the Horn of Africa. Somalia, still a hostage to al-Shabaab (the Islamic terrorist group). Eritrea, which has a dictator named Afwerki who forces young men and women to do indefinite military service and does not permit any freedom of expression.
 
Europe right now is not succeeding in responding to the challenges it confronts. We have to take advantage of this moment of difficulty and the opportunity it presents. In 70 years we have done a lot to construct our European identity. In a short time, we have undertaken an extraordinary journey. We have freedom of movement. When I was a girl, there were internal European borders. Our young people can study in any country. We have judicial cooperation. So this is positive, but it is no longer enough.
 
Now we have gone halfway, we have reached a ford in the river. Because today without a strong Europe, we don’t count for anything compared to the rising global giants. We have to cross the ford and restart the motor of European integration, a motor that has stopped. But that means we have to give up something. We have to give up power to the European institutions. We have to share sovereignty. We need a single economic policy. A single European industrial policy. And an immigration policy
 
It’s not possible that only Italy and Greece receive migrants and that Germany is the only place where people go to request asylum. Or Sweden. If we are a union, we have to cooperate.
 

Q. What are some concrete responses to the migration crisis that Europe should implement?

We have to develop a coordinated asylum system. And have the same standard in all countries: European teams that manage the asylum issue. The same thing in Greece as in Norway as in Sweden as in other nations. If an Eritrean comes and asks me for asylum in Italy, he gets the same treatment as he would in Sweden. Today, on the other hand, if the same person requests asylum in one country he gets a certain response; if that person makes the request in another country, he gets a different response. So it’s clear that they all want to go where they have the best chance of getting asylum. This leads to asylum-shopping in the EU. 
 
We have to act on several levels. We have to continue to save human lives at sea. Not everyone agrees with this. But it’s inhuman to think that if you have a passport, you get saved, and if you don’t, you drown. But there are people who say that. I am proud that my country has taken the lead on this issue. We did Mare Nostrum (an Italian rescue operation in the Mediterranean) alone for a year at a cost of 9 million euros a month. Then it became European. Today we have Operation Triton
 
Next: How do we reduce the number of people who risk human life at sea? We have to give an alternative, because if people know there is an alternative they won’t risk their lives. The most concrete idea is to act in transit countries with a certain level of stability. You could create centers where international agencies do work – which, in fact, they are doing now, but with very limited resources. They do the screening… Continue Reading…
 
Courtesy: ProPublica 

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COMMENTS

J Pinto

1 year ago

Refugees will go to the country which offers:

1 Best chance of asylum
2 Best unemployment and child welfare cash benefits

It seems Denmark has fallen out of favour after cutting cash benefits by 50%

There is a need to unify both the above attractions.

Prime Minister as the real Health Minister
What surprises me more is the capacity of our PM to understand the complexities of health care
 
I was thrilled to hear Prime Minister Narendra Modi asking doctors last week to try to be human and humane. It sounded like the lectures I used to take in the medical schools while I was in active teaching. The latest research shows what I used to teach for decades that healing is not due to our interventions with drugs and surgery but through the placebo effect, that underlies all interventions. (Science Translational Medicine 2013; 3: 70) If so, the doctor should earn (command) the respect and faith of his/her patients. As Oliver Wendell Holmes, a Harvard trained medical doctor who left medical practice to be a writer and poet, writes the following lines, which now have been proven scientifically right. “The two most powerful medicines doctors ever invented were the two kind words of a good doctor.” How true.
 
That being said what about the state of health care in India? Are doctors the only factor in health care? That is another unscientific myth that makes the round especially in political circles. Mac Furlane Burnet said something like this. “Doctors and hospitals do not keep society healthy.” When you talk to any politician worth his salt s/he thinks that India lacks in numbers of doctors to plug the doctor-patient ratio. There seems to be an obsession with the numbers game in the medical field that most politicians think that India needs more doctors! In fact, India has surplus doctors and the so called doctor-patient ratio is the best here if we consider all castes of doctors in the healing field as one bunch. If we take the MBBS doctors alone it might not be as good as some of the advanced countries. What is important is not the number of doctors but the number of humane doctors in any country. Several scientific studies have shown that even in the advanced west those countries with too many doctors per capita and when more number of the former are specialists, the health of the population was the worst and disease numbers were the highest compared to those countries whose doctor patient ratio was poor and most of their doctors were only family doctors. Japan with the worst doctor patient ratio was one of the best countries in the world for health statistics while US and Germany with the best ratios were the worst among the fourteen industrialised countries! (JAMA 2000; 284: 483). A very recent study done over a period of 10 years prospectively in thirty hospitals in the Massachusetts area showed that when senior interventionalists were away attending conferences, the death and disability rates among seriously ill patients admitted to their ICUs did better and death rates fell down significantly. (JAMA Internal Medicine 2015; 185: 237) Similar was the experience when doctors went on strike for longer than three months. (BMJ 2000; 320: 1561)
 
India does not have to worry about their doctor numbers; we could do well to reduce the numbers if needed. If some rationalists have doubts about the ability of the non-MBBS doctors to be effective one only has to look at that large study done in Thailand by the WHO some years ago where five different systems of healing arts are in vogue including quackery. This study did show that all doctors were equally effective in society in general. So we have to count all health care providers even in villages in India for our statistics.  Even if all Indian doctors abroad come back to their homeland, they will not go to our far-flung villages where the service will have to be provided by traditional practitioners only.
 
The PM almost echoes the sentiments expressed by the United Nations Industrial Development Organization (UNIDO), in 1998 that a country needs following basic needs for good health. Clean drinking water for the masses tops the list. Next comes three meals a day uncontaminated by human and/or animal excreta. Sanitary facilities like toilets, underground drainage systems, and environmental cleanliness come next. Cooking smoke, especially which emanates from burning dry leaves and twigs and some of our villages they even use cow dung cake, is the best stimulant of cancer and childhood pneumonia. Economic empowerment of village women will help remove her distress from seeing her children go to bed on an empty stomach, if the husband does not bring his earnings home, after spending most of it to drink alcohol and feed himself. Girl child education is a vital area for reducing the fertility rate, as girls above the age of 25 at marriage will have only half the usual rate. This is an indirect method of family planning. For some unexplained reasons our PM looks into all these areas and he is the true health minister. He could command the resources from all those concerned government departments that our conventional health ministers cannot muster. In short our conventional health ministers are just disease ministers. They are concerned about sicknesses and their management. Thank God, we have a thinking Prime Minister who works overtime to make is country healthy and prosperous. Health is the best wealth for any nation. Sick nation will be economically also sick. I have another thought for village health care. We could convert our village primary schools into health care centres! 
 

Primary schools double up as health centres:

 
In this new concept, the village school teacher is trained for 6-12 months with a teaching diploma in school health promotion (TDHP) to replace the village doctor. Every medical school could be made to train certain number of selected bright village teachers, free of charge, with a special curriculum to equip them with enough know how to look after the holistic health of the children and their parents in the village. They should be provided with communication facilities to inform the taluka hospital about any sick child or adult in the village to be shifted there for treatment. They should be trained to spot trouble and inform the doctor and the hospital to do the needful. They are never trained to handle drugs or treat any one. The money being spent for the PHCs could be diverted to develop this new concept along with the village school. 
 
The teacher/health promoter would look after sanitary needs in the village like toilets for every household, clean drinking water, smokeless houses, and clean meals for all, and assist the villagers to live like a large family in the village. In due course, people would look up to them for all kinds of guidance. The idea is to develop a cadre of village teachers who become the friend, philosopher, and guide of the villagers. In the school, these teachers have added responsibility to see that children get proper nutritious meals; they develop healthy habits, clean dress and are made to wash hands before eating. Children should be trained to use the toilet and teach their parents in turn at home. Children should be taught to respect all life on this planet as we are all inter-dependent. 
 
These teachers are responsible to see that children get proper immunization at the right time. They could help children to develop a healthy social outlook with universal compassion, sharing and caring. Healthy living should be one of the important subjects in the curriculum but without the conventional end year examination. However, those who excel should be given a special certificate as also some incentive by way of a prize or so. Children could be encouraged to think for themselves to develop curious healthy citizens for science training in later life. Catch them young should be the motto. My friend, Late Dr. Solomon Victor, a famous cardiac surgeon of Chennai, had a model for teaching school health. That could be supplemented to make a special curriculum for the subject of health promotion in school. I know that the vested interests will block these ideas as there is no business interest in this. Would some Godly person see that this message reaches our Hon. Prime Minister please? 
 
“The 1 to 2 billion poorest in the world, who don't have food for the day, suffer from the worst disease: globalization deficiency. The way globalization is occurring could be much better, but the worst thing is not being part of it. For those people, we need to support good civil societies and governments.” — Hans Rosling
 
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)
 

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COMMENTS

Prakash Bhate

1 year ago

Someone (Moneylife?) should arrange a talk by Dr Hegde in a company on his idea of utilizing village schools. Use of the company's CSR funds for initiating such an activity will be a natural outcome.

A S Bhat

1 year ago

As always, Dr. Hegde is right. Very well said sir! Thank you.

A.S. Bhat

D S Ranga Rao

1 year ago

Very practicable idea. But as Dr. Hegde rightly concluded:"I know that the vested interests will block these ideas as there is no business interest in this", will the medical mafia comprising the doctors, all sorts of health care professionals, hospitals, diagnostic centres, chemists, pharmas(merchants of death), the ministers, etc., be willing to forego their kickbacks, commissions and what not, so easily?

Narendra Doshi

1 year ago

Extremely well said, worth total or more applicable. Hegde sir, your thoughts are reborn for action. Moneylife and your contacts should continue their efforts in this direction, THIS REFORM IS A MUST.

REPLY

Shirish Sadanand Shanbhag

In Reply to Narendra Doshi 1 year ago

I full agree with Narendra Doshi's views on this article on health care.

Shirish Sadanand Shanbhag

In Reply to Narendra Doshi 1 year ago

I full agree with Narendra Doshi's views on this article on health care.

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