Closing the gap in universal health coverage

WHO

Even in countries with robust health-care systems there are undocumented individuals who are not able to access routine care or basic prescription medicines.

To support these people and close the gap in universal health coverage, the Danish Red Cross runs clinics in Copenhagen and Århus for undocumented individuals across Denmark. Rikke Dalsted is a nurse and sociologist who volunteers at the clinic in Copenhagen. Here, she shares her experiences:

“While I was doing my PhD in public health, I worked together with a network of general practitioners who, at the time, provided unofficial care for undocumented migrants in their homes. Then the Red Cross and the General Practitioners Association got together with the Danish Refugee Council to launch the first clinic and I have been a volunteer there since the beginning.

There are different reasons why people have to come to our clinic, but it boils down to not having the right documents. In the Danish system the personal registration number is everything. There are lots of EU citizens who are here legally but don’t have the needed documents. And then there are people who overstay their visa. There are sex-workers who might be here illegally. Then there are women who have been here as au pairs and stayed.”

If you are undocumented, getting a prescription is a challenge

“We see everything from itchy shoulders to cancer. A lot of people need prescriptions for noncommunicable diseases like asthma, diabetes, high blood pressure and heart problems. For undocumented individuals, getting a prescription is a challenge.

Then there are pregnant women. When we started it was only nurses and doctors who provided health services, but then we realized there were a lot of women or couples here illegally who were expecting a child. So we have midwives and family nurses who provide the same care as people with access to the Danish health care system get. You get antenatal and postnatal care, vaccinations and follow-ups.

When needed we can also provide specialized care like psychiatrists or urologists, for example. Each week we have dentists as well. It’s always packed on the days when we have dental care and they’re queuing outside the door before we open.

It depends on the day but typically there are 2 or 3 nurses, 1 or 2 doctors and/or a dentist. There’s a lab technician and often a student in the reception area. Some days there are midwives or physiotherapists. We have 6 or 7 people and we never know how many patients will come, but generally we see 100 patients per month. Very often we can’t see everyone inside the shift and we have to send people home. We are open from 5–8pm, 3 times a week and then we have extra times for specialized care. There are more than 300 volunteers with various professional backgrounds.”

It brings me joy because I get things done

“This is a wealthy part of the world; there shouldn’t be anyone here who doesn’t have access to health care. For me as a health-care professional, and as a person, it’s just what I can do. I can give my time and skills for a few hours a month. It brings me joy because I get things done, but it’s just a tiny contribution. We have to find a way globally to fix this.

Our clinic is a brilliant example of interprofessional collaboration. All of us just step in and do the job. It is patient-centred and we provide far better care because of it. Just in this tiny little room we are the perfect example of a polyclinic.”