Paradoxes of Healthcare Entitlements in the Covid-19 Pandemic: Crisis Response and Hostile Environments

Datum
17. Juni – 18. Juni 2021 

Indi­vidu­elles Textfeld

From the ear­ly days of the Covid-19 pan­dem­ic, pol­i­cy­mak­ers acknowl­edged what has long been known to prac­ti­tion­ers, name­ly that bar­ri­ers to health­care for peo­ple with­out fixed legal sta­tus and/or res­i­dence are detri­men­tal to pub­lic health. Ear­ly respons­es to the coro­n­avirus out­breaks across the Euro­pean con­ti­nent and beyond involved emer­gency leg­is­la­tion that sought to remove those bar­ri­ers by extend­ing these groups’ eli­gi­bil­i­ty for health­care and oth­er ser­vices. These tem­po­rary inter­ven­tions addressed some imme­di­ate prob­lems, such as pro­vid­ing emer­gency shel­ter and access to health­care (and lat­er vac­ci­na­tion) for Covid-19 regard­less of cit­i­zen­ship or res­i­den­tial sta­tus. As lock­downs evolved, some of these mea­sures were with­drawn while the imple­men­ta­tion of oth­ers remains uneven, reflect­ing bar­ri­ers to health­care encoun­tered by mar­gin­al­ized pop­u­la­tions before the pan­dem­ic. Ques­tions of how mem­bers of mar­gin­al­ized pop­u­la­tions have expe­ri­enced these poli­cies are the sub­ject of devel­op­ing research. More broad­ly, such expe­ri­ences car­ry twofold lessons, which this work­shop seeks to explore.

First­ly, they offer insight into the log­ics of cri­sis response as they apply to groups that are made vul­ner­a­ble through the inter­sect­ing effects of their immi­gra­tion sta­tus, their socio-eco­nom­ic sta­tus and their posi­tion as eth­nic minori­ties. When gov­ern­ments extend a help­ing hand, is that dri­ven by a strict pub­lic health imper­a­tive to lim­it con­ta­gion and pro­tect the major­i­ty pop­u­la­tion? Or do oppor­tu­ni­ties for more durable soci­etal inclu­sion also emerge, even as an unin­tend­ed consequence?

Sec­ond­ly, Covid-19 reversed the con­ven­tion­al dynam­ics of cri­sis. We are accus­tomed to emer­gen­cies which pro­duce move­ment, pro­pelling peo­ple (migrants and refugees) to flee and seek safe­ty else­where. In this cri­sis, the osten­si­ble imper­a­tive of safe­ty demand­ed that peo­ple be immo­bi­lized at var­i­ous stages of their migra­to­ry jour­neys. They were pre­vent­ed from mov­ing by trav­el bans, quar­an­tines and oth­er pub­lic health mea­sures enact­ed at bor­ders, in addi­tion to the pre-exist­ing deter­rents of bor­der con­trol. This begs the ques­tion whether the empha­sis on bor­ders as a key site of infec­tion con­trol will fur­ther entrench the hos­tile envi­ron­ments which in many coun­tries were delib­er­ate­ly cre­at­ed to dis­in­cen­tivize arrivals and set­tle­ment. To what extent have pub­lic health con­sid­er­a­tions now become a cen­tral facet of the nor­mal oper­a­tion of bor­der con­trol systems?

The design of this work­shop is informed by the aware­ness that the pan­dem­ic has had a sig­nif­i­cant impact on research activ­i­ties, from the time avail­able to issues of access. In addi­tion to empir­i­cal research at any stage of progress, we wel­come con­tri­bu­tions that are con­cep­tu­al, spec­u­la­tive, agen­da-set­ting or which reflect on oth­er pan­demics (e.g. HIV/AIDS, H1N1) and dis­as­ters. Some spe­cif­ic ques­tions we seek to explore include:

* What log­ic informed the waiv­ing of some health­care access restric­tions ear­ly in the pan­dem­ic? If nation­al health­care sys­tems are closed sys­tems that rou­tine­ly exclude cer­tain groups, how have cur­rent and past crises chal­lenged this? Can those pre­vi­ous­ly out­side these enti­tle­ments be includ­ed on a more per­ma­nent basis?
* How does pub­lic health data cir­cu­late? What types of data are pro­duced? How do they move? Which ‚at risk’ groups are made vis­i­ble by this cir­cu­la­tion and which remain non-visible?
* How has the prac­tice of migrant health advo­ca­cy and activism shift­ed, when the very con­di­tions for resis­tance are premised upon free­dom of move­ment? Like research meth­ods, advo­ca­cy meth­ods were forced into a read­just­ment, with what effects?
* What can we learn from past crises (pan­demics, but also oth­er dis­as­ters such as floods, earth­quakes and con­t­a­m­i­na­tion)? How do we under­stand the role of crises in shap­ing pol­i­cy and prac­tice around access to health for marginalized/irregularized populations?
* Which method­olog­i­cal approach­es best equip us for assess­ing the effects of cri­sis response and the dynam­ics of hos­tile envi­ron­ments? Mobile meth­ods pro­vide a heuris­tic frame­work for under­stand­ing health­care ser­vices from migrant patient per­spec­tives. This cri­sis has demand­ed immo­bil­i­ty. What might mobile meth­ods look like while we remain com­pelled to social­ly distance?

How to sub­mit: To express your inter­est in par­tic­i­pat­ing, please send a 150–200 word abstract sum­ma­riz­ing your con­tri­bu­tion to k.follis@lancaster.ac.uk by 30 April 2021. More info here: http://wp.lancs.ac.uk/doctors-within-borders/2021/03/22/workshops‑2–3/
We have some mod­est funds to sup­port the par­tic­i­pa­tion of health­care, advo­ca­cy or activist orga­ni­za­tions, so please be sure to let us know if you are in this category.

We expect that the con­tri­bu­tions to the work­shop will take the form for short online pre­sen­ta­tions of 10–12 min­utes, linked by facil­i­tat­ed dis­cus­sion. We will also wel­come par­tic­i­pa­tion of non-pre­sent­ing audi­ence mem­bers. We will pub­lish details on how to reg­is­ter for the work­shop as an audi­ence mem­ber along­side the final­ized program.