Hacia un cuidado ético en residencias sanitarias durante la pandemia de COVID-19: estudio cualitativo con migrantes internacionales en Chile

Abstract

Migrantes internacionales han sido reconocidos como población de riesgo en el contexto de la pandemia de COVID-19. A nivel mundial se han desplegado diversas estrategias para la protección de esta población, como la habilitación de centros de recepción y cuarentena o aislamiento. El artículo da cuenta de los resultados de un estudio que exploró las experiencias de migrantes internacionales en residencias sanitarias dispuestas en Chile para la realización de cuarentenas seguras en el marco de la pandemia COVID-19, desde un enfoque de condiciones éticas para el cuidado. Se realizó un estudio cualitativo entre los años 2020-2021. Se efectuaron 30 entrevistas individuales semi-estructuradas en línea en las ciudades de Arica, Iquique, Antofagasta y Santiago a migrantes internacionales con experiencia de uso de residencias sanitarias; equipos de salud de residencias sanitarias; mánagers de dichos recintos; autoridades locales; y expertos nacionales. Se realizó análisis temático de la información. El estudio concluye que para migrantes internacionales, si bien la experiencia en residencias sanitarias ha significado un apoyo sanitario significativo, es imprescindible que el cuidado proporcionado, además de la exigencia que se enmarque en un enfoque de derechos y de respeto a la dignidad de cada persona, incorpore la perspectiva de la interculturalidad en su quehacer, es decir, asegurando el derecho a servicios de salud culturalmente pertinentes, respetuosos de la cultura de las personas, las minorías, los pueblos y las comunidades.

Perceptions of Health Needs among Venezuelan Women Crossing the Border in Northern Chile during the COVID-19 Pandemic

“…Although Decree 67 guarantees access to public healthcare regardless of migratory status, barriers related to additional administrative requirements, active discrimination, and a lack of knowledge impose important limitations on achieving this right. This finding is consistent with the existing evidence on access to healthcare among international migrants in Chile, produced before and during the COVID-19 pandemic, suggesting that the situation has not improved in the last few years and may have worsened during the pandemic [ 28 , 30 , 87 , 88 , 89 ]. Additionally, participants reported facing important barriers to accessing healthcare while transiting through other countries, wherein access to healthcare for international migrants, especially those with an irregular migratory status, is not guaranteed [ 90 ].…”

“…Venezuelan migrants in Chile are a diverse group who experience social vulnerability to different degrees, depending on their migratory and life trajectories, including pre-departure context, year of migration, and reason for migrating [ 29 ]. Considering the tightening of migratory regulations specifically targeting Venezuelan nationals and border closures during the COVID-19 pandemic, as well as the worsening of social and economic conditions in Venezuela, recently arrived migrants have been experiencing increased social vulnerability, as reported in previous research conducted in the northern regions of Chile [ 12 , 28 , 30 ]. This poses important challenges in terms of health outcomes, the social determinants of health, access to healthcare, and the wider humanitarian response to migration fluxes in the context of the COVID-19 pandemic.…”

“…Although its poverty rate is lower than the national poverty rate, it grew from 5.1% to 9.3% between 2017 and 2020, and 5.7% of people living in Antofagasta experience overcrowding [ 25 ]. The region has historically received international migrants from Peru, Bolivia, and Colombia [ 27 ]; however, migrants from Venezuela have become an important part of the migrant population in the region, considering that after crossing into Chile in the northernmost regions of Arica y Parinacota and Tarapacá, they usually transit through, and sometimes settle in, Antofagasta on their way south to the capital city of Santiago [ 28 ]. In this context, the current study focuses specifically on Venezuelan migrants in the Antofagasta region.…”

“If I get sick here, I will never see my children again”: The mental health of international migrants during the COVID-19 pandemic in Chile

“…Finally, In Chile, in the first month of the pandemic, according to an opinion poll conducted with 1650 international migrants, 90% reported feeling anxious and 73% sad or depressed because of the pandemic [ 20 ]. Another, qualitative, study highlighted that international migrants from Venezuela entering Chile via unauthorized crossing-points after travelling by foot for several weeks presented mental health issues [ 21 ]. The factors identified for increased mental health issues during the pandemic are the following: precarious or worsening socioeconomic conditions, pre-existing mental health issues, migratory status, unemployment, loss or decrease of income, food and housing insecurity, uncertainties around access to healthcare, fear of infection, knowing someone infected, misinformation and social isolation [ 16 – 18 , 20 , 22 – 24 ].…”

“…However, the social and political context has grown increasingly hostile to migrants in recent months, adding to the already adverse conditions brought by 2019 social unrest and COVID-19 pandemic. The exodus from Venezuela coupled with the visa requirement for Venezuelan nationals to enter Chile and the closing of the border in the context of the pandemic, has led to an increasing number of Venezuelans entering the country through unauthorised crossing points in Northern Chile, with little option to obtain a residency permit and work in the formal labour market [ 21 , 40 ]. This migratory and subsequent humanitarian crisis has been instrumentalised in the context of the 2021 presidential elections and violent demonstrations of xenophobia have taken place [ 41 ].…”