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When access to vaccination means access to the future

The 1951 Convention stipulates that “the Contracting States shall accord to refugees lawfully staying in their territory the same treatment with respect to public relief and assistance as is accorded to their nationals”. This includes, inter alia, relief and assistance to persons in need due to illness, age, physical or mental impairment, or other circumstances, as well as medical care. This means that refugees shall be equally entitled to the same conditions as nationals to social and medical assistance. The Law of the Republic of Kazakhstan on Refugees recognizes the right of refugees and asylum-seekers to benefit from health services. In practice, however, the access of refugees and asylum-seekers to health services remains a challenge.

Fleeing persecution, conflicts and human rights violation in their countries of origin, asylum-seekers find refuge in the Republic of Kazakhstan. The majority of refugees have been residing for more than ten years. Similarly, Mr. Hamid Aidari, a farther of three children, fled Afghanistan  more than ten years ago to find protection in Kazakhstan. He proudly tells that his only son was born in Kazakhstan.  “Kazakhstan accepted us on its territory and we were granted refugee status. It was not easy to survive in a new country where I had to look for a job, rent a house and feed my family. At that time, however, we did not need to pay for health care services and it helped us a lot,” – sadly says Mr. Aidari. With the change of the health care system in Kazakhstan, Mr Aidari’s family faces new challenges. Mr Aidari’s six-year old son may be not admitted to school, because he will not able to be vaccinated in a due time.  

“We cannot afford paying for health services in a private clinic, but even there vaccinations are not available to foreigners. They refer us to the State-run clinics where we cannot get vaccinations because refugees are considered to be temporarily staying foreigners and are not entitled to free health care,” – says Mr. Aidari. 

Since the entry into force of the Unified National Healthcare System in 2011, access to free health for foreigners, including refugees and asylum-seekers has been limited to emergency aid and several acute diseases presenting a threat to public health. Under the mentioned system, vaccinations are not provided to refugee children on a free of charge basis. This is of particular concern as a lack of access to vaccinations can result in an increase of the child mortality rate, as well as in a risk of transmission of diseases that can impact negatively public health.  

 “Vaccination is the most effective method to prevent the spread of serious diseases and ensure the health of people,” – says Anara, Medical Coordinator of the Kazakhstan Red Crescent Society with which UNHCR works in close partnership to ensure refugees and asylum-seekers access to health care, – “When trying to engage in partnerships with private clinics we realized that such clinics are reluctant to deal with vaccination as the procedures are very complex and very expensive.  At the moment, we have 15 refugee children who are in need of vaccination and we are struggling to help them, otherwise they may not be accepted to schools.”

UNHCR office in Kazakhstan aims to ensure refugees and asylum-seekers  access to quality health services at a level similar to that of nationals. UNHCR engages with a wide range of actors, including government bodies, UN sister agencies, NGOs and refugees themselves to advocate for refugees rights as guaranteed by the 1951 Convention and the national legislation.  

During 2014 UNHCR submitted to the Ministry of Health and Social Protection of Kazakhstan a proposal for amendments to the Health Code, the purpose of which was to ensure access of refugee children to vaccination on free of charge basis. Unfortunately, the proposed amendments were not approved, but UNHCR hopes that this issue will be addressed by the Government of Kazakhstan.