Bridging the gap - a multi-dimensional program for the integration of refugees in the Netherlands

Puenteando el desfiladero - un programa multidimensional de integración de refugiados en los Países Bajos

With the financial support of the European Commission, a multidimensional project "Networking for the integration of refugees" was carried out in the Netherlands in 1998 and 1999 to advance the integration of refugees. Part of that project formed a health and welfare programme which aimed at the promotion of access to main stream health care for refugees. For this aim, a study was made of the health problems and the accessibility of health care as perceived by the refugees. As could be expected, the refugees presented with many and a diversity of psychosocial problems, which they related to their experiences before, during and after their forced migration. Moreover, many refugees experienced a serious communication gap between themselves and mainstream health care providers. The care provided does not meet the expectations of refugees, due to language barriers, differences in explanations for the health problems and other forms of miscommunication.

For the majority of refugees in the Netherlands, the possibilities for integration and participation in Dutch society are limited. Illness can be an expression of social distress, but at the same time can be the cause of impaired social functioning. For that reason health care should identify and give adequate attention to the consequences of the pre- and post migration experiences on refugees in time to prevent later major problems. Furthermore, mainstream health care provisions play an important role in the integration of refugees. Therefore, it is essential that refugees' experiences with the health care system be positive.

To improve the accessibility of Dutch health care for refugees, but also to advance their participation in Dutch society, various activities based on the outcome of the study were undertaken in the context of the project. The project showed that combined action in the various sectors, important for integration possibilities, can be successful in a relatively short time. Nevertheless, as will be argued in the presentation, asylum seekers and the host society would be better off if these sort of programmes would be started directly after asylum seekers have entered the host country.