Paradoxes of Healthcare Entitlements in the Covid-19 Pandemic: Crisis Response and Hostile Environments
Online Workshop 2, 17-18 June 2021

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 As the crisis evolved, some of these measures were withdrawn while the implementation of others remains uneven, reflecting barriers to healthcare encountered by marginalised populations before the pandemic. Questions of how members of marginalised 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?

Topics

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, but 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 marginalised/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?

This is the second workshop of the Doctors Within Borders: Networking Initiative on Mobile Populations in Contemporary Health Systems project funded by the Wellcome Trust. To express your interest in participating, please send a 150-200 word abstract summarising your contribution to [log in to unmask] by 30 April 2021.

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 a non-presenting participant along with the finalised program.

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