(Pro-Access) Promoting migrant access to sexual and reproductive health services for sexual gender based violence (SGBV) prevention and response ...

Promoting migrant access to sexual and
reproductive health services for sexual gender
based violence (SGBV) prevention and response

                 (Pro-Access)

                                   Maria Di Benedetto
                                                    LILA Catania

                                                   5-7 Giugno 2019
                                    Università degli Studi di Milano

I hereby declare that
I have no conflict of interest

Background
Economic refugees and asylum seekers (People of Concern - PoCs) face sexual
violence, murder, torture and religious persecution in their Countries of origin and
during their attempt to reach Italy.

The number of women, girls, men and boys victims of trafficking and sexual
exploitation has increased drastically over the last years.

PoCs continue to be victims of trafficking and sexual exploitation even after
reaching Europe.

These events have led to an increase in unwanted pregnancies, acquiring and
spread of sexually transmitted diseases, including HIV infection.

Objectives
Pro-access is a programme addressed to PoCs with the objectives of
ensuring and increasing:

i.   diagnoses and treatment of sexual and reproductive STIs, HIV, HCV;

ii. early identification and support of SGVB survivors;

iii. timely access to health care services;

iv. recovery and reduction of long-term consequences of SGBV;

v. empowerment of migrants to encourage self-determination.

Material and Methods

The target population of this program are refugees and asylum seekers,
with special focus on Sexual and Gender Based Violence (SGBV), in
these areas:

1) “Sistema di protezione per richiedenti asilo e rifugiati” (SPRAR/
   SIPROIMI);
2) “Centri di Accoglienza per Richiedenti Asilo” (CARA) and “Centri di
   Accoglienza Straordinari” (CAS);
3) others reception centres (centres for minors);
4) urban refugee population in Catania and other urban areas of Sicily.

Material and Methods

The project, carried out by LILA-CT and funded by UNHCR, started in
September 2017 and is still ongoing.

The activities are implemented by a multi-disciplinary team (doctors,
psychologists, social workers, cultural mediators, a coordinator and
outreach operators) supported by volunteers, volunteers with medical
background and two problem-solving supervisors (one for ongoing
strategical matters and the other for technical issues).

Material and Methods

Three visit sessions are delivered to the reception facility.

The first session imparts medical information, the second offers socio-
psychological information, and the third session verifies PoCs feedback,
and creates a stronger link between PoCs and staff to favor the
emergence of psychological discomfort deriving possible SGBV.

During the third session HIV and HCV tests are offered.

Material and Methods
A Drop-in Centre, low-threshold access, has been organized for PoCs,
once a week, at LILA-CT, offering:

a)   medical consultation;
b)   individual and group psychological support;
c)   Help centre/Social services;
d)   HIV/HCV quick oral test;
e)   pregnancy test.

Outreach activities are performed at least twice weekly in key locations
involving distribution of IEC materials for PoCs engagement and
information.

Table 1: Activities performed at reception facilities from September 2017 to December 2018
                                            Activity                       Number                             Notes

    Results
                                Reception facilities visited      82 reception facilities   Hauses/flats, (SPRAR)
                                                                                            Centri per richiedenti asilo (CARA)
                                                                                            Centres for minors

                                Individuals receiving information 2185 PoCs                 Hauses/flats, (SPRAR)
                                on sexual and reproductive                                  Centri per richiedenti asilo (CARA)
The data are preliminary,       health, prevention of STIs and
                                access to services
                                                                                            Centres for minors

the project is still ongoing    Testing services provided         2019 tests                HIV tests: 534 at reception facilities,
                                (pregnancy, HIV, others)                                    141 at Drop-in, 332 at CARA;
                                                                                            HCV tests: 534 at reception facilities,
                                                                                            141 at Drop-in, 332 at CARA;
                                                                                            5 pregnancy tests at Drop-in

                                Reported SGBV incidents for       50 PoCs
                                which survivors received
                                psychosocial counselling

                                Reported SGBV incidents for      60 PoCs
                                which survivors received medical
                                assistance

                                Referral to public clinics/services 137 PoCs                HIV clinics, Family Planning Clinics,
                                                                                            Gynaecological clinics, Drug User
                                                                                            Clinics, Social services of City Council,
                                                                                            Infectious Disease Department
                                IEC materials on sexual and       11.665                    Urban areas
                                reproductive health developed
                                and distributed

                                Condoms distributed               4445                      Houses/flats, (SPRAR)
                                                                  3895 male condoms         Centri per Richiedenti Asilo (CARA)
                                                                  550 female condoms        Centres for minors
                                                                                            Urban areas

Conclusions

The Project demonstrated that sexually transmitted diseases are not
highly prevalent in the migrant population (no case of HIV infection;
only 5 cases of HCV infection).

Conclusions
In the province of Catania, Lila activities, both independently and
within the UNHCR project, can confirm that PoCs outside the reception
system are at high risk of sexual exploitation, criminal activity (such as
drug dealing, petty crime or worse) and unregulated labour
exploitation.

Even residents within the reception system are not immune to these
risks, as confirmed both by Lila activities on visits to the area
surrounding the CARA Mineo, through anecdotal testimony gathered,
and by the criminal investigations into PoCs labour exploitation.

Conclusions

The project is well received by the PoCs and over time has managed to
resolve many situations of physical and/or mental health, which in the
absence of the project would have been difficult to achieve.

THANK YOU
ProAccess Team
K. Ceesay, D. Di Dio, S.B. Dhiab, G. Floridia, M.C. Longo, M .
Manuli, D. Matheson, G. Petrelli, S.Reale, S.Scalzo, A.A.
Sleemankhel, F. Bellissimo and L. Nigro

ProAccess/LILA Volunteer Group:
J. Alieu, S. Bruno, G. Cacciatore, A. De Cristofaro, A. Leo, M.
Maresca, S. Maccarrone, S. Timpanaro

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