Seeking Health below the Radar: Undocumented People’s access to healthcare in Two Dutch Cities

This study sought answers to a puzzling paradox. Generally, formal legal health care rights for undocumented people in The Netherlands are relatively good, with some exceptions (like dentistry and mental health). Despite this, many undocumented people were found only to access health care services in the case of an emergency, and sometimes not even then. Why were undocumented people not fully making use of their legal rights to access health care? Was it due to discrimination? A lack of information? Or some other deterrents? This article presents findings from a project entitled: “Count Us In”: Towards Realising Health Rights among Undocumented People in Two Dutch Global Cities”, funded by the Rotterdam Global Health Initiative (RGHI). Using the Participatory Ethnographic Evaluation and Research (PEER) methodology, research was conducted in The Hague and Rotterdam between 2012 and 2015. The study found that those in work or socially embedded in support networks or NGOs, were more likely to claim their health rights in practice. Rejected asylum seekers, more isolated on the whole, tended to access health care only in extreme situations or emergencies. Both groups reported self-medication, which was found to be quite common. We also found that undocumented people exclude themselves from health care services, for fear of being detected, detained and even deported. We conclude with some modest suggests to ensure that the basic health rights of undocumented people are better protected in these and other Dutch cities in future.