'Almost impossible to halt spread of coronavirus in migrant shelters'

Since the evacuation of the makeshift Aubervilliers camp in northern Paris on March 24, dozens of migrants have found themselves on the streets. Others have been accommodated in sporting halls and other open surface facilities. Sanitary conditions in these locations are often less than adequate.

Due to the fast spread of the coronavirus, and France’s nationwide lockdown, the migrants’ regular access to healthcare services has more or less vanished, and so have the aid groups that used to assist them on the ground.   

Doctors without Borders (MSF) continues to operate. Offering migrants medical assistance in "this era of uncertainty" has become a priority for the organization. 

InfoMigrants spoke to Aneliese Coury, coordinatior of MSF’s Urgence COVID-19 project in Île-de-France about the group’s work.

InfoMigrants: MSF is one of few aid groups still assisting people on the ground, how do you work?

Anneliese Coury: Just like everyone else, we’ve been heavily affected by staffing problems: Some of our nursing colleagues have been deployed to hospitals, while others can’t carry out field work due to various reasons. But because of the current situation, MSF decided to roll out a new scheme in France, and in particular, in the Île-de-France region [which is the region most affected by Covid-19 in France, editor’s note]. The idea is to support healthcare workers, and not to replace the health system in any way. We focus on vulnerable groups and people: migrants, homeless people, and unaccompanied minors.

We’ve set up a team and recruited new staff, including doctors, nurses, logistic specialists and project coordinators. We’re also planning to hire social workers. Over the past week, we have recruited 15 people [for a team that would normally count around 30 employees, editor's note].

On March 31, we also reactivated our mobile clinics, which we were no longer running.

How safe are migrants at the shelters includings sports halls and other large complexes that were set up to house migrants following the March 24 evacuation of the Aubervilliers camp? 

Unfortunately, sports halls are not ideal in the current situation.

These type of facilities often lack separations, which sometimes makes it impossible to isolate suspected coronavirus cases. Those who have been infected with the virus need to be isolated, in a separate room, to allow for sufficient social distancing.

In total, we operate at nine accommodation sites in the Seine-et-Marne region [west of Paris], in the Val d'Oise region [northwest of Paris] and in Paris itself, including hotels and sports halls. At each site, we try to implement simple health guidelines to ensure that both residents and staff stay safe.

Can you give us an example of what these guidelines entail?

Some are very simple: we recommend people to wash their hands on a regular basis, to avoid wearing jewelry, and to keep their nails short because it makes it easier to keep their hands clean and decrease the risks of catching the virus. We’re also working on recommendations on how to handle dirty laundry. Changing bed sheets, for example, increases the risk of spreading the virus, and so we recommend each and every one to change their own bed sheets and immediately put the dirty sheets in a laundry bag without carrying it so that it touches the body and then wash the sheets at 60 degrees Celsius. The same recommendation goes for clothes.

In some places, where washing machines aren’t available, we recommend people to do their laundry by hand and to air dry it.

But again, this might not always be possible: In sports halls for example, everything that has to do with hygiene is done in shared spaces … These are some of the challenges we face.

How many coronavirus cases have you registered among migrants?

It’s not easy to get hold of tests. Since last week, we have only been able to carry out 26. Sixteen of them were positive, three were deemed unreadable, and three were negative. We’re still waiting for the results of four of the tests.

Eight out of the 16 confirmed coronavirus cases are unaccompanied minors that we monitor and who were not among the migrants evacuated from the Aubervilliers camp. They are currently being accommodated in hotels. Four were transferred to a COVID-19 center [a center set up for homeless people contaminated with the coronavirus but whose conditions does not require hospitalisation, editor's note].

The other eight minors are being sheltered by authorities since the March 24 camp evacuation. Three of them are in hotels and five have been placed in four different sports halls. Only one of the [adult] migrants has been transferred to a COVID-19 center because he was staying in a sports hall in Seine-Saint-Denis which was particularly unsuitable for isolation: there were no separate rooms there.

So the other seven coronavirus cases have been placed in isolation in the shelters they were already staying in?

Yes, as best as possible, but it’s sometimes difficult for them to respect the isolation rules in these places, especially if there are no separate toilets or if the catering areas are located in a shared space. Inevitably, the virus spreads in these cases ... In this type of shared living space, as well as in shared hotel rooms, it is almost impossible to stop the virus from spreading.

For most people, the consequences of catching the virus are not that serious. But what is important is that the people who are most at risk aren’t exposed to it.

Aside from the risk of catching the coronavirus, what are the main health issues among the migrants you meet?

Sometimes migrants come to see us for other reasons than COVID-19, simply because the healthcare facilities they would usually go to are no longer open. They may have dental, or dermatological problems, or wounds, which need to be treated if they live on the street and don’t have access to basic sanitary facilities. Scabies is also a problem, especially in accommodation centers where it can spread easily.

There is also a need for mental healthcare services. We are currently recruiting a psychologist to join our team next week. For many migrants who have experienced trauma, both the pandemic and the lockdown can add to their anxiety.

In addition to that, a lot of processes have been suspended during this time, including asylum requests or demands for appeal, and it negatively impacts the migrants psychologically. Some have no income at all.

All these factors destabilise these people even more. The lockdown, and the fact that their access to healthcare has been reduced, impact the migrants’ mental health, and make their problems even more visible.