Care providers about criminalization help with illegality: ‘Our work continues, if necessary underground’

Maryam (82) carefully washes her silver teapot. She comes from Morocco, has been living in the Netherlands for fifteen years and only a week in the daycare for people without papers. In recent years she worked with an older woman in the house, as a household help and caregiver. When Maryam moved to the Netherlands from Morocco, she never considered ‘papers’. The woman recently died. Maryam was on the street.

The intermediate facility in Utrecht offers people without papers, such as Maryam, shelter and helps them with the care they need. Maryam – pink slippers, flower dress – points to her right breast. Cancer. The chest is amputated, she still gets radiation and medicines. What if that couldn’t be done anymore? She pulls an eyebrow. “Then I wouldn’t make it.”

At the beginning of this month, a narrow majority in the Lower House voted for a PVV proposal to make illegal residence punishable, as well as ‘help’ with that. If the proposal is indeed implemented – the Senate still votes – this means that the shelter and care for Maryam are no longer sure. Because, says coordinator of the Luuk Haagen reception location, “With that our reception loses its right to exist. We cannot do work that is in the basic illegal.”

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In the Lower House there is actually no majority for criminalizing people without papers. Nevertheless, the amendment, which became part of the ‘asylum measurement measures’ law, could be adopted with 72 votes because of blunders around the ‘pairing’ system. They were absent parliamentarians who had been striping against that of a supporter against those of a supporter against those of a supporter.

At least sixty social organizations, from Refugee work to it Salvation Armyspoke out against criminalizing (help to) people without residence papers. The police fear stigmatization of people without papers, social unrest in the actual introduction of the amendment and the criminalization of their own agents Giving help to people from this group. Municipal officials become according to The VNG Brought into an impossible position because on the one hand the government is obliged to provide basic assistance to undocumented people, and this help on the other is in danger of being criminalized.

Coalition party NSC and opposition party SGP Drongen with outgoing minister David van Weel (Justice/Asylum, VVD) on commitments about the spare of care providers. He couldn’t give it. After all, the Public Prosecution Service is the enforcer of criminal law. “The law is the law,” said Van Weel. But he said he could not imagine that the prosecution of volunteers at the church or the Salvation Army is “quickly discussed.” According to him, prosecuting care providers would also have “no priority.”

A Jewish doctor who still worked during WWII has taught me: be afraid of a government that forbids people to take care of people

‘Paternalistic Gesus’

“Paternalistic Gesus,” Straatarts Marcel Slockers calls that statement. “We, as doctors, have nothing to do with that.” In the 1980s, Slockers worked with a now deceased Jewish doctor who had worked during the Second World War. “He has always taught me: be afraid of a government that forbids people to take care of people.” He has to think of his undocumented 85-year-old patient who sleeps outside. “I don’t have to expect me to no longer give him his medication. Do those MPs want him to be dead on the street?”

Professor of Health Law at the University of Groningen Brigit Toebes also says that Van Weel’s statement is worth little. “You can fall back on the law, less on oral tolerance agreements.” In the debate, Van Weel did promise the Council of State to request advice on criminalization.

Toebes, previously working at the council, expects a negative opinion from that advisory body. “This proposal is contrary to human rights and other existing legislation. Everyone, including undocumented people, has the right to care according to all kinds of treaties.” The question is how much such a negative judgment picks up. The Council also ruled very negatively about the asylum laws of former asylum minister Marjolein Faber (PVV), who were nevertheless submitted to the Lower House without adjustments. “Crumbling our democratic foundations,” says Toebes.

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Whether or not the proposal is being introduced, that it is at all on the table calls a ‘moral abyss’. “I hope that we will balance along it and eventually back to our moral starting points by our democratic processes. But then we have to respect them.”

Jurriaan Penders, doctor and chairman of Doctor’s Federation KNMG, calls the proposal “morally unacceptable” and points out that it also goes against international human rights treaties. “People must have access to medical care, not facilitating it comes down to inhuman and humiliating treatment.”

“With this we only make health differences between people bigger, says Shakib Sana, who works as a general practitioner in Rotterdam.” While we have to reduce it. Politics is breaking down everything we have built up in recent decades. “

The doctors are above all for us

Penders cannot remember that the indignation among doctors (street doctors, general practitioners and psychiatrists) has been so great. Doctors who do not come into contact with undocumented patients in their daily work also experience it as “an attack on their professional integrity,” says Penders. The fact that the parliament agreed to criminalizing help (with a maximum prison sentence of six months) touches their doctors and the professional obligation that results from this, also ten doctors from different disciplines – emergency care, general practitioners, pediatricians, microbiologists, midwifery – NRC spoke.

Doctors are therefore standing between their doctors and the law. The oath is not anchored in the law, but “enormously authoritative,” says Toebes. “It’s a moral dilemma,” says Penders. “But the outcome is not complicated: the oath is above all for us.” That is what pediatrician Albertine Baauw says. “I am not behind this legislation, but I am behind my oath. I would help Geert Wilders myself.”

Afraid of sharing address

The doctors who spoke to NRC all say they will continue to follow their oath, regardless of legislation. But, they also say: criminalizing (assistance to) undocumented foreigners is disastrous for the relationship of trust between doctor and patient. All his healthcare providers are busy explaining that they have a professional secrecy, and that a patient can therefore trust that their residence address will not be passed on to the authorities.

The consequences of that breach of trust are great, says Lisa Vliegenthart, midwife at Doctors of the World, an organization for ‘medical human rights’ with mainly patients without papers. She had a patient who had gynecological complaints but did not dare to report to a doctor, for fear that he would report that she had no papers. As a result, her cervical cancer was found too late. “Three months later she was dead.”

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That fear now only gets bigger, sees director of Doctors of the World Jasper Kuipers. “We have office hours in all kinds of neighborhood centers and since the submission of this proposal we are always asked: can I still go to the doctor?” A few days after the submission he had finally found a doctor for a woman who had been without a long time. “Eventually she did not dare to give her home address and we could not register her. Without this proposal, she would have just had a doctor.”

Avoiding or postponing medical care not only has negative consequences for the patient, but also for society as a whole. Deferred care is more expensive care, says pediatrician Baauw. Only she saw a four -year -old, undocumented girl in intensive care, with asthma. Her parents did not dare to pick up the prescribed medication. “If they had done that, the IC recording would have been prevented.” Apart from the costs, there are still the consequences for public health, says microbiologist Jan Sinnige. “You never have infectious diseases alone. It is in the interest of society that treats everyone. Bacteria don’t look at papers.”

The care providers of the interim provision do have the trust of the target group, says Coordinator Haagen. The threshold is to turn to them lower than with ‘official authorities’ such as the doctor. “People report here, we can then guide them to the required care.” For example, he has already guided several residents with cancer to a doctor. “It is unthinkable for me that such a person will soon have to die under a bridge from a disease that is treatable. And that society must watch.”

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At the registration counter of the intermediate facility (and Four other social foundations For people without papers) people report every day looking for help. Sometimes that is food, sometimes a bed (then they come, if they meet the criteria, on the long waiting list of the daycare), and sometimes medical care. This Thursday a man from North Africa is reporting. Where he slept last night? He laughs ashamed. “Opposite the station, just like the night before.” He does have acquaintances with whom he can knock on, but he dares and does not want. He has been suffering from his teeth for a while, but has not been able to find a dentist for treatment. “I don’t want them to see me like that, with a teeth full of teeth.”

No words, but tears

Our work continues anyway, says Merlijn Verstraeten, team leader of the registration counter (via Vluchtelingenwerk). “If necessary underground.” Whether the PVV proposal hits her? She has no words, but tears. “Sorry,” is all she says.

In addition to the shared bedrooms on the upper floor, the shelter consists of a small living room with two benches and a table football table, a garden that also serves as a bicycle rack and a kitchen – the ‘beating heart’ of the shelter, where, according to Haagen, “cooking twenty times a day”. On the counter is a rice cooker filled with freshly boiled yellow rice.

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Twenty people, ten men and ten women live there. Some stay a few weeks, others for a few years. An asylum procedure can take years, says Haagen. All the while someone is ‘undocumented’. That does not mean that the person has no right to be here – it just takes a long time before that right is granted. Almost two -thirds of the people who get help from this location of the intermediate provision will eventually receive a permit, says the coordinator. “People who shout that all ‘illegal immigrants’ have to leave the country therefore have wrong information.”

Whether she slept well, he asks the 82-year-old Maryam. Yes, she says, just a little trouble with the stairs. As soon as a bed is released below, that is for her, Haagen says. “Shokran,” she answers smiling, thanks. She puts her shiny Moroccan teapot in the corner of the counter.

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