Italy: revolt for life and dignity 2
Posted by clandestina on 13 January 2010
More texts on the situation in Southern Italy.
“We Are Not Animals!” Italy’s Racial Riots and Their Aftermath
MARIA RITA LATTO (January 11, 2010)
Rage and fear. This is what comes out of the images from Rosarno, a small town near the western coast of Calabria, where violent clashes broke out after two African immigrants were wounded by a pellet gun attack by white youths in a car.
“Those guys were firing at us as if it was a fairground,” one of the men told La Repubblica newspaper. “They were laughing, I was screaming, other cars were passing by but nobody stopped them.”
The reaction to the events was furious. More than 2,000 African immigrants, most of whom employed illegally as farm laborers, blamed the episode on racism and gathered in the town centre to demonstrate against the shooting and their living and working conditions. Some chanted “We are not animals”, others carried placards saying “Italians here are racist.” Their protest continued leading to violence in the streets of Rosarno; the crowd set cars on fire, stoned the police, attacked residents and smashed shop windows. Police said that at least 60 people were wounded, including immigrants themselves, locals and policemen.
This situation lasted three days. Some Italian residents, armed with iron bars and wooden staves, erected roadblocks next to buildings where immigrant farm workers live. Some local people occupied the City Council building demanding that the police cleared the immigrants out of the town. Domenico Ventre, the former head of civil protection department of Rosarno’s council, condemned the rioting. “In Rosarno the immigrants are well cared of, and their reaction to this isolated episode is disproportionate,” he said. “We cannot accept that they destroy our town and scare the citizens.” Other citizens, afraid to venture into the streets, holed up in their homes, the media reported. “You would step out and buy some bread only because you have to eat, but if I could choose I wouldn’t go out for an evening walk,” said Renato Cortese, a top police official interviewed for the evening news.
The Minister of Interior, Roberto Maroni, in charge of State Police, sent over 200 police officers because of the highly inflamed situation; schools and shops were closed. Those who were injuried more seriously were three immigrants: two were beaten up with metal bars, doctors at the emergency room in a hospital near Rosarno said. One had kidney surgery and the other was treated for an eye socket fracture. A third was taken to Reggio Calabria for brain surgery.
Several immigrants were arrested together with some Italians including two who tried to hit the demonstrators with their vehicles. Calm was generally restored on Saturday 9, with barricades erected by locals dismantled and shops open.
Authorities, applauded by the locals, transferred more than 1,000 people, mostly illegal temporary workers from sub-Saharan Africa, to immigrant centres around Italy in an operation that lasted throughout Sunday. Even workers with regular residence permits left the town to escape a situation that a political commentator compared to the Ku Klux Klan racial violence in the United States in the 1960s. Immigrants without regular papers risk expulsion to their country of origin as the authorities began demolishing their former makeshift homes in Rosarno. Minister Maroni said the government had “brilliantly restored public order” and thanked the police for organizing the exodus “in an exemplary way.”
A protest of such size was never seen in Italy before, despite frequent episodes of intolerance against immigrants—some reported by the media and many, too many, remaining untold for fear or humiliation.
This time, though, something new happened. Hunger exploded. Immigrants had camped out in tents and cardboard shelters within an abandoned cheese factory with no heating, running water or electricity on the outskirts of Rosarno. Human rights groups add that they are easily exploited by organized crime. Rosarno’s priest, Don Carmelo Ascone, described their living conditions as “something similar to Dante’s Inferno”.
According to the CGIL public sector union, about 26,400 immigrants were employed in Calabria’s agriculture sector in 2007; fewer than 7,000 of them held regular working permits, a situation which is common all over Italy. And immigrants in Calabria add they earn illegally low wages, as little as 20 euros ($30) for a 12-hour day picking citrus fruit and other crops. Despite chronically high unemployment rates in Italy’s underdeveloped South, many residents refuse to do the backbreaking seasonal farm work. This, coupled with frequent episodes of racism and intolerance, eventually sparked the riots in Rosarno.
This spiral of violence stirred many reactions in the country. Opposition politicians accused Premier Silvio Berlusconi’s coalition, which includes an openly xenophobic party, the Lega Nord, of failing to allow the immigrants to find proper housing and jobs, which are necessary to get regular residence permits. Minister Maroni, a member of the Lega Nord party, replied by suggesting that the violence resuted from a general failure to address the issue of illegal workers in the country. “The situation in Rosarno, like in other places, is difficult because illegal immigration—which feeds criminal activities—has been tolerated for years and nothing effective was never done about it,” he told La Repubblica newspaper. But the leader of the centre-left Democratic Party Pierluigi Bersani commented that it is Berlusconi and the right-wing that have been governing the country for most of the past decade: “Maroni is passing the buck … We have to go to the roots of the problem: mafia, exploitation, xenophobia, and racism.”
The right-wing daily Il Giornale, owned by the family of Prime Minister Silvio Berlusconi, agreed that illegal immigrants should be kept out of the country. However, it added: “Once they are here, they cannot be shamefully exploited and shot at while they accept jobs that our unemployed sneer at.”
Father Luigi Ciotti, founder of the anti-mafia association Libera, pointed the finger at the ‘Ndrangheta, the local criminal organization that dominates Calabria. “The mafia, which controls the region, cynically and pitilessly exploits the immigrants,” he told the daily La Stampa. “The criminal bosses know that illegal immigrants cannot even try to rebel because they have no identity documents and therefore no protection from the state.” According to Italy’s main trade union CGIL, about 50,000 immigrant workers in Italy live in poor conditions similar to those in Rosarno. The union also accused the mafia of controlling the “industry” of illegal labor saying that immigrants are paid “miserable salaries and have terrible hours, similar to slavery”.
Agazio Loiero, the governor of the Calabria region and a member of the Democratic Party, told Sky TV that the violence was “unacceptable” but that the migrants had been “strongly provoked.”
Pope Benedict departed from the prepared text of his weekly Angelus blessing to appeal for tolerance. “An immigrant is a human being, different in origin, culture and tradition but he is a person with rights and duties who must be respected,” he told the crowd in Saint Peter’s Square.
These words peace seem so far from the nightmare of Rosarno where tolerance was a mere word, a mirage in a desert of resentment, in a war of poor against poor. It is impossible to forget the images of the riots on television, the rage of exasperated locals, or those mothers holding their children, protesting under the windows of the Town Hall, yelling “Bastards! Shame on you!” against those who fed the immigrants after hours of absurd, surreal and yet so real fight.
Is this the real face of Italy? Is this Calabria? Just two months ago, at the 10th Summit of the Nobel Peace Laureates in Berlin German director Wim Wenders told a different story about Calabria, where he recently shot his latest movie “The Flight”. Based on a true story, the movie is about two towns, Badolato and Riace, that opened some of the houses abandoned by Calabrian emigrants to foreign refugees, making a true miracle of social integration. Wenders described this experience as “the most beautiful thing of my life,” addying: “Utopia is not the fall of Berlin Wall, but what I witnessed there. People often talk of a global village and I believe that those two Calabrian towns are the perfect metaphor of this idea.”
Southern Italy’s shame
Violence is blamed on immigrants, though they are used as slaves – a welcome distraction for mob-owned industry
Tana de Zulueta
guardian.co.uk, Tuesday 12 January 2010 09.57 GMT
The manhunt in the citrus groves of the plain of Gioa Tauro, in Italy’s deep south, should be over at last. On Saturday a young African man was shot and wounded as he fled through the trees with two friends, hopefully the last victim of local villagers’ fury. More than a thousand men, mostly Africans, have been rounded up and bussed out of the area for their own safety after a sometimes two-day standoff between immigrant workers and local residents in the village of Rosarno. Improvised roadblocks put up by furious residents have been dismantled and police reinforcements ordered in. Law and order re-established, in appearance at least. So are we all going to roll over and forget about the whole thing?
We shouldn’t. Gioia Tauro and its neighbouring villages are part of Italy’s mafia badlands. Local government is so heavily infiltrated by the mob that both Gioia Tauro and Rosarno have had their mayors and local councils suspended. Police officers always patrol this area in well-armed groups of three or four, and only rarely at night. Certainly not for fear of the African fruit-pickers, many of them irregular migrants, who stream in during the winter months, when oranges and tangerines are in season, camping in empty warehouses and lining the roads at dawn to be hired for €20 a day.
What makes this area dangerous is the ‘Ndrangheta, the mafia’s Calabrian cousins, now rated more powerful than their Sicilian counterparts because of their world-wide drug-trafficking activities. This week a powerful bomb went off outside the region’s chief prosecutor’s office. The ‘Ndrangheta’s way, so the prosecutor suggested, of opening a conversation.
The wonder is, in this climate, how the fruit-pickers dared riot at all. Their march on the town had been preceded by a drive-by shooting against the miserable camp outside town where they live, which was not the first incidence of violence in the area, as Vittorio Longhi wrote here. But the timing, so local anti-mafia experts suggest, was not accidental. Recent convictions and property seizures by the courts have been hurting mafia business. Having a police appointee running the local authority in a port town like Gioia Tauro may also be viewed as an unwelcome intrusion. The riot, in any case, has concentrated the police force’s mind on other matters. A welcome distraction, from the mobsters’ point of view.
Italy’s interior minister, Roberto Maroni, has repeatedly blamed the troubles in Rosarno on previous governments’ “lax” immigration policies. The remark was out of place, and not just because the current rightwing majority headed by Silvio Berlusconi has been in government for most of the past decade, which means that the flow of immigrants into the country has largely taken place under their watch. It is a flow that will continue unchecked if the country’s informal economy is left to prosper. Nowhere is this plainer than in the citrus groves round Gioia Tauro.
Twenty years ago the leaders of a local fruit-pickers’ union were intimidated and some of their members killed by members of the ‘Ndrangheta families who were shifting their new-found fortunes into local real estate. That battle is long over. There is no longer any such thing as unionised farm labour in the valley. Court documents show that much local agriculture is now in the hands of criminal syndicates. The local gang masters who ply their brutal trade in the area are all working under the ‘Ndrangheta’s fief. They are the ones who seek out the meekest and cheapest workers: irregular migrants who can be blackmailed into accepting low pay and who are desperate for any work they can get. The result is something similar to slavery, but it is a problem the government chooses to ignore.
Workplace and health inspectors steer well clear of the squalid camps in which foreign workers huddle during the fruit-picking season here and elsewhere in southern Italyy. The more lawless the area, the more brazen the exploitation. Doctors without Borders, the international medical NGO whose Italian branch has conducted two surveys on the health of irregular agricultural migrant workers in Italy, has described the living conditions in some of these camps as worse than those of refugee camps in Africa. A volunteer on one of these surveys, conducted in Rosarno, recalls the shock of finding men and women living in cardboard and plastic hovels, with no running water, many of them with severe health and nutrition problems. “It was worse than anything I’ve seen in Africa. Those people were desperate.”
So desperate that they rebelled. Personally, I would describe as far worse than lax a government which lets such rotten trade-offs prosper undisturbed.
guardian.co.uk © Guardian News and Media Limited 2010
“I came here to find heaven; I found hell”
ROME – While Calabria burns, Rome fiddles (or rather, composes songs) and speaks of love.
The burning is literal. In the town of Rosarno, Carabinieri and police summoned from elsewhere in Italy to quell Friday’s revolt by an estimated 2,000 immigrants (of a total in Rosarno of 5,000) found a stunning arsenal of weaponry in the hands of the local population. In one punishment squad car were large cans of gasoline at the ready for burning down the immigrants’ shacks, plus iron bars and clubs. Elsewhere police uncovered a cache of heavy weapons, from Kalashnikovs to a missile-launcher with its long-range missile ready for firing.
The situation was grave enough that the clashes at Rosarno ignited a sympathy demonstration in Rome, with immigrants’ clashing there with police. On Sunday Pope Benedict XIV appealed for greater respect for immigrants, referring specifically to Rosarn.
The battle that began in Rosarno, which lies more or less on the toenail of the boot of Italy, began with a couple of bored young hoods amusing themselves by firing an air gun at black immigrants returning “home” (so to speak) after work. This was not the first such incident, but this one spread from the streets to a highway on the outskirts, where local thugs set up improvised roadblocks. The hunt for the black devil then led into the picturesque countryside, where the immigrants live in shanties without running water (read: without toilets), not to mention electricity. “I came here to find Heaven. I found Hell,” said one despairing Ghanaian, who, as it happened, is a university graduate with a degree in engineering.
Two black immigrant workers were kneecapped, others beaten. No one was safe: one local woman, seeing a black being beaten, intervened. To punish her, her fellow citizens destroyed her car. The flip side was that another local woman, a pretty young mother, was set upon by rampaging immigrant workers and had to abandon her car, which was then torched.
But Rosarno is also the town whose elected mayor and and councilmen were legally declared ‘Ndrangheta-“infiltrated” thirteen months ago and replaced by a commissioner from the Prefecture, which is to say a police official.
There is a connection between clandestine migrant workers and the town’s certification as a center for organized crime. Although it has existed only forty years, today Calabria’s ‘Ndrangheta is Italy’s, and for that matter Europe’s, wealthiest and most powerful criminal network. Its fairly recent formation, as compared with the Sicilian Mafia or even the Camorra, is part of its success. The ‘Ndrangheta is still a family affair, whose comparatively recent migration into countries like Germany and the U.S. has made it difficult to penetrate. The Calabrian bosses live without the ostentation that the drug-rich Sicilian Mafiosi exhibited in the Palermo of the Eighties, but they wallow in money from cocaine, the arms traffic (police believe that the arms cache discovered Saturday came to Italy from Russia via Africa), extortion and agriculture. “How else can the consumer buy canned tomatoes in supermarkets for such a low price?” one investigator said.
From a fairly low number of immigrant workers today Italy has something like 1.4 million. In the South these clandestine workers are seasonal: in summer they pick tomatoes, in the autumn olives, in winter oranges and lemons. By their own accounts, they work 12-hour days, for which they receive E. 25 ($37). Of this E. 5 goes to the caporale, or boss, who recruits them by the day, and another E. 2 or 3 goes to the driver of the bus who takes them to the farm offering work. Italian press reports say that these caporali are ‘Ndrangheta underlings or at least mob trustees. Needless to say, the pay is under the table, with no questions asked concerning labor laws, worker safety, working hours, job conditions, taxation, or welfare contributions by the employer.
Sunday’s editorial by La Repubblica editor-in-chief Eugenio Scalfari listed the government ministries and agencies which ought to have taken notice of and dealt with this specifically Southern Italian problem : the Ministries of Agriculture, Labor, Productive Activities and the Interior, and the Prefecture, the Carabinieri and the Regional Governor. (To this list I would add the Ministry of Finance, since the plantation owners are not declaring taxes and not making welfare contributions.) So where has everyone been, he asks: how is it that no one in charge noticed the mob-related exploitation?
Ironically, in the North, where the anti-immigrant sentiment is strong, immigrants are dealt with in a more coherent way, with a certain amount of community counseling and organization. The Northern League’s rhetoric continues to demand Italy for the Italians, and to attack those in the Church who urge better treatment of the immigrants, yet they know full well that their network of small- and medium-sized factories would shut down without the workers from abroad.
Medecins sans frontieres (MSF) has a program to help immigants at Rosarno; to read its hair-raising report about conditions there, see:
and one more report of one year ago, by MSF http://www.msf.org.uk/a_season_in_hell.show
A Season in Hell
MSF Report on the Conditions of Migrants employed in the Agricultural Sector in Southern Italy January 2008
Mιdecins Sans Frontiθres (MSF) chose the title “A Season in Hell” because it reflects the experience of thousands of migrants as they make their way between regions in the southern Italian countryside seeking employment as seasonal workers in the agricultural sector. To find gainful employment, migrants have no choice other than to accept miserable pay, poor living conditions and exclusion from the surrounding community. The plight of these migrants is a skeleton in the closet of mayors, state forces, labour departments, protection associations and ministries who are aware of the situation yet keep quiet on the subject. The use of low-cost labour, illegal recruitment, the denial of acceptable living conditions and the lack of access to medical care are all known and tolerated; national and local institutions turn a blind eye to the massive exploitation of foreigners in the agricultural sector in the south because their labour is required to sustain local economies. The aim of this report is two-fold: to express MSF’s dissatisfaction with the deplorable state of affairs that harms the dignity of migrants and to safeguard the fundamental right of access to healthcare.
From July to November 2007, a mobile Mιdecins Sans Frontiθres (MSF) team conducted a survey on health and the living and working conditions of migrants employed as seasonal workers in southern Italy. The survey sought to evaluate the living and working conditions of the seasonal foreign workers in agriculture, as well as assess potential improvements to their conditions with respect to a previous survey conducted in 20041. MSF examined 643 immigrants and distributed 600 questionnaires for the survey. The reference population was estimated at several thousands of migrants employed in the fields and in the greenhouses of various localities in southern Italy. The chart below shows the locations the MSF team visited, highlighting the regions, localities and types of crops grown in the area. Period 9-20/07 22/0701/08 6-22/08 22-25/08 30/0822/09 23-30/9 1-4/10 5-20/11 Region Locality Campania Piana del Sele Lazio Province of Latina Puglia Province of Foggia Basilicata Metaponto (MT) Sicilia Puglia Basilicata Calabria Valle del Belice Province of Foggia Palazzo San Gervasio (PZ) Piana di Gioia Tauro Crop Intensive agriculture: tomatoes, peaches, strawberries, courgettes, etc. Intensive agriculture: tomatoes, kiwi, courgettes, melons, etc. Tomatoes Melons Grapes Tomatoes, grapes Tomatoes Citrus fruits.
In 2004 MSF conducted an initial survey of seasonal migrants, the results of which were published in the report: The fruit of hypocrisy. Sinnos Ed., Rome 2005.
Gender and age Almost all the interviewees were young men (97%), aged between 20 and 40 (84%). Women accounted for only 3% of the sample and were mainly citizens of new EU member states such as Bulgaria and Romania. Countries of origin The migrants examined and interviewed were from: · Sub-Saharan African countries including Sudan, Eritrea, Ethiopia; · North African countries including Morocco, Algeria, Tunisia and Egypt; · South-east Asian countries, particularly from India; · New European Union member countries, particularly Bulgarian and Romanian citizens2 of the Romany ethnic group; Juridical status · 72% of those interviewed did not have a regular residential visa 3; · 28% had a residential visa for working or humanitarian reasons, had obtained refugee status or had filed for asylum. Asylum seekers and refugees 4 Once their application has been examined, asylum seekers leave the identification centres with either a refusal, a permit of stay for humanitarian reasons or refugee status. The lack of a proper reception system for refugees contributes to the exploitation of migrant workers in the southern Italian countryside and of those fleeing war and persecution. In Italy, the reception network for refugees, asylum seekers and holders of humanitarian protection, which is overseen by the Protection Service for Asylum Seekers and Refugees (SPRAR), are, as of 2006, allotted approximately 2,500 spaces5, to accommodate the approximately 10,000 requests for asylum presented each year. This is in addition to the thousands of refugees and humanitarian protection holders already recognised in the territory. These people, who lack housing and a stable income, are often forced to move from one part of the country to another, thus becoming easy prey on the circuit of illegal labour.
Period of stay on site
66.5% of those interviewed declared that they had been in the location where MSF visited them for less than 4 months; this data highlights the seasonal aspect of migrants who travel following the periods of harvest. In the Eboli and Battipaglia localities in Campania and in Latina in the Lazio region, a more permanent population, which claims to have been living and working in the area for more than 12 months, has been recorded. This data is explained by the year-round harvesting possibilities in the area.
“The typical day of a migrant employed as a seasonal worker starts at about 4.30 in the morning when they go to the recruitment spots. Squares, junctions and roads are the places in which the supply and demand of underground labour meet. Tens, sometimes hundreds of migrants wait in the hope of being recruited by a charge hand or by the landowner himself. Those who are not chosen go back “home”, to wait for another “opportunity”.
Citizens of new EU member states have been present in the area since January 2007, as a result of no longer being subject to expulsion measures, except for reasons of safety or public order, and can remain freely in Italy for short periods of time (less than 3 months) without formalities. 3 Legal migrants also include asylum seekers and refugees but those who were denied refugee status are counted amongst the illegal migrants. For a brief outline on Italian immigration laws, see the Enclosure Notes on national legislation on immigration pg. 28
The data in the “Annual Report on the Protection System for Asylum Seekers and Refugees year 2006″, by Census Anci Servizi edition, shows that SPRAR has witnessed the involvement of 95 Local Bodies with more than 100 projects, that have made available 2,428 reception spaces, making it possible to give protection to 5,347 people, 440 of whom in projects destined to vulnerable categories.
People fleeing from war and personal persecution who file an application for protection with the State of Italy.
Riccardo, MSF project coordinator · 90% of the sample interviewed declared that they did not have a work contract, nor did they enjoy any legal protection in terms of pay, accidents in the workplace or social security. This is a massive phenomenon of exploitation that also affects seasonal workers with a permit of stay; On average, seasonal workers are employed less than 4 days a week, as 67% of those interviewed declared. The length of the working day tends to be between 8 to 10 hours; Half of the workers earn a sum between 26 and 40 euros a day, whereas slightly more than a third earn 25 euros or less per day. The pay is agreed upon at the place of recruitment and may be calculated per day or per job, i.e. by the number of cases of fruit or vegetables collected. In the Foggia area, for example, MSF operators found that a foreign labourer earns between 4 and 6 euros for collecting a crate of tomatoes weighing 350 kilos; 37% of the migrants interviewed declared that between 3 and 5 euros were taken from their daily pay to be handed over to the charge hands.
“A., a young man of 22, fled from the dramatic Darfur situation three years ago. He was recently treated by the MSF team for a contused wound on his lip; the result of an assault by the charge hand. A few days earlier, he had complained to other members of the community about the poor pay for his work. The charge hand, for demonstrative purposes, beat him up in front of the entire community to set an example against speaking out”. The labour of seasonal workers contributes to the sustenance of the agricultural sector that is crucial to southern Italy’s economy. However, the working conditions discovered in the study areas relegate these people to conditions of extreme poverty. Although the common goal of migration is to financially support one’s family at home, 38% of the seasonal workers interviewed by MSF do not manage to transfer money to their country of origin because they are barely able to survive.
“Here, as you can see, we are in an awful state: we have no water or light, we go the bathroom in dirt, we often lack food to eat and during the winter months we risk dying of cold. We really need help. Living in these conditions, I cannot begin to imagine having a future.” A., 20 years old from Mali, lives in the Foggia countryside From the data collected by MSF, the shocking picture found in 2004 emerges once again: most of the migrants who are employed as seasonal workers live in deplorable sanitary conditions, in a state of extreme poverty and social exclusion. These conditions expose the seasonal workers to acts of violence and intolerance and, once again, confirm the almost total lack of measures aimed at ensuring minimum standards of reception. · · · · 65% of the immigrants interviewed live in abandoned structures; 20% live in rented spaces; 10% live in tents or in a reception camp set up by the local authorities; 5% of the sample has no other option than to sleep on the roadside or in town squares.
The data concerning conditions of over-crowding and the poor quality of housing structures is just as alarming. 21% have to share their mattress with one or more people and 53% sleep on the ground, on top of a mat or piece of cardboard. The following data reveals the lack of services for guaranteeing minimum conditions of health and hygiene:
62% of those interviewed do not have facilities for human waste where they live. In these cases, they are forced to use the fields; 64% do not have access to running water and must travel substantial distances to reach the closest water point. To get water for themselves, 44% use makeshift sources such as irrigation pipes and outdoor taps; 69% do not have electricity and use candles for light; In 92% of cases, the housing does not have heating. Due to the poor thermal insulation of the rooms, the immigrants suffer from cold and dampness during the autumn and winter months.
“And then at night I cannot go out because of the Italian guys who beat us up with glass bottles, who insult us. There are guys here who have been beaten up and we are scared to go to the hospital and to the police. I have also been beaten up twice, once with a stick and the second time they threw bottles at me from a car.” H, who comes from Morocco, was interviewed in Campania According to the testimony collected, in some cases migrants are subject to acts of intolerance and violence; 16% report having been victims of episodes of violence, falling prey to launches of stones and other foreign objects as well as verbal attacks.
ACCESS TO CARE AND CONDITIONS OF HEALTH
H. comes from Morocco, is 26 years of age, and lives in the ex-fruit and vegetable market in San Nicola Varco which is occupied by hundreds of migrants; MSF met him at 11 o’clock in the morning. He complained of having severe abdominal pain for the past three days. He had called 118 (Emergency Aid) and was waiting for an ambulance. He asked for a lift in the car up to the state road because the ambulance refused to drive into the area. At 5 p.m., MSF returned and found the patient was still in a state of severe pain- he reported having been treated with a blend of painkillers and discharged. The diagnosis of the Emergency Department was “painful abdominal syndrome”. The MSF doctor examined him and suspected acute appendicitis; the patient was accompanied to another Emergency Department where tests confirmed this diagnosis. H. was operated on urgently. Since 19986, Italian law guarantees access to care for all migrants present in the territory, whether legal or illegal. Legal migrants in possession of a regular permit of stay7 are obliged to register with the NHS, 8 which will then issue a health card . Illegal migrants are granted the right “to urgent and essential clinical and hospital care, even if continuative, for sickness or injury”9 and to preventative medicine. Irregular migrants may request an assigned TPM (Temporary Present Migrant) code, which is renewable and valid throughout the country for six months. In relation to this legislative framework, the data collected by MSF brings to light a number of problems that are related to access to care by foreign nationals employed in the agricultural sector: · · 71% of the migrants interviewed do not have a health card; 2 years after their arrival in Italy, 59% of irregular migrants still do not have a TPM card, while 47% of regular immigrants are not registered with the NHS.
According to data gathered by MSF, the migrant population employed in agriculture is young, with 75% of people examined under the age of 30. 76% of the patients claimed to have reached Italy in good health.10 Nevertheless, at the time of the MSF evaluation, at least one suspected diagnosis was formulated for 72% of the patients, 73% of those were found to be a chronic disease. For the remaining 24%, ailments were mostly minor.
· In 22% of cases, osteo-muscular conditions were diagnosed. Lumbago and/or lumbago-sciatica were the most frequent. Lumbago may be caused by a number of factors but there is a strong link between lumbago and strain from agricultural work such as heavy lifting, keeping a fixed position for long periods of time and repetitive movements11; In 15% of cases a dermatological ailment was diagnosed. The most frequent were mycosis (32% of the diagnostic suspects) and dermatitis. 79% of these diagnoses were chronic. Poor hygiene, 12 overcrowding and work out of doors are risk factors . Agricultural work involves contact with infectious, irritant or allergy-causing agents found on the ground or on the crops. The employers rarely purchase protective instruments (barely 7%) and, in most cases, these must be purchased by the migrants themselves. Moreover, working in a greenhouse environment exposes the skin to high temperatures and humid environments, encouraging the onset of mycosis; Respiratory disease was diagnosed in 13% of the patients examined. The most frequent pathologies are those classified in the ICD9-CM13 as infections of the upper respiratory tract, which include bronchitis (20%), colds (16%), pharyngitis (13%), tonsillitis (6%), sinusitis (2%) and tracheobronchitis (2%). Most infections were acute; Gastrointestinal illness was diagnosed in 12% of cases. The most frequent offenders were gastritis (35% of diagnostic suspects), 89% of which were chronic. The most frequent cause of chronic gastritis is infection by the bacteria Helicobacter pylori.14 The infection is aggravated by overcrowding, drinking contaminated water, eating badly preserved and poorly cooked food, a low intake of fruit and vegetables and by precarious living conditions (stress, poor hygiene, 15 low socio-economic level) . The living conditions of the patients examined not only favour infection by Helicobacter pilori, but also its progression to gastritis and respective complications; Oral cavity ailments were found in 11% of cases, mainly dental cavities (68%). The problem was chronic in 89% of the cases and the cavities were multiple and serious. Although these diagnoses are frequent even in the absence of precarious living conditions, it is clear that a lack of calcium and micro-nutrients, poor oral hygiene, the consumption of contaminated water and poverty increase the risk of developing and aggravating these conditions;
Infectious disease was discovered in 10% of cases. Of these, the most common was gastroenteritis (57%), which can be caused by bacteria, viruses and parasites. with infected faeces (oral-faecal route) and is therefore aided by poor personal hygiene in living spaces, by the lack of adequate sanitary services or by eating and drinking contaminated food and/or water. Of the migrants MSF encountered who were affected by gastroenteritis, 76% did not have running water, 79% did not have a bathroom, 66% kept water in jerry cans and 79% did not have a street cleaning and rubbish disposal service in the place where they live.
A. is 30 years of age, of Sudanese origin and has been legally living in Italy for 2 and a half years. He does not have a health card because he had no knowledge of them. MSF met him in Metaponto and then in Palazzo San Gervasio. During the first examination he had a cough and a temperature. He had had these symptoms for a number of months. He weighed 48 kilos: he had lost 17 kilos in 4 months. A week earlier he had gone to the Emergency Department where an X-ray had revealed a thickening in his lung. They had prescribed an antibiotic therapy and a pneumological examination the following month. The therapy had not resolved the symptoms and the patient had not dared to return to the Emergency Department. Suspecting TB, the patient was accompanied to hospital where he was admitted to the Infectious Disease ward where the diagnosis was confirmed.
The conclusions that follow are deemed useful in dealing with situations of an immediate nature which have elements related to humanitarian crises. They are not meant to provide solutions to the complex issue of seasonal workers. MSF has witnessed a dramatic situation that should weigh on everyone’s conscience, particularly politicians, local health centres, trade unions and civil society. Despite political changes and repeated promises by national and regional institutions since the last study, MSF was unable to find any substantial changes in the unacceptable conditions of seasonal migrants. Therefore, it appears that the mechanisms in force for regulating migratory flows, based on the long-distance management of the supply and demand of employment, contribute towards generating irregularities. In actual fact, the migrants entering Italy through this procedure only partially cover the requirements for seasonal labour. In the regions of southern Italy where the survey was conducted, employers mainly recruit migrants who are illegally present in the territory or migrants who have filed for asylum and have not found fitting reception in the territory. Each year, in some areas of southern Italy, a massive flow of seasonal migrants used in agriculture takes place. Either this phenomenon is not dealt with at all by the local authorities or, in some cases, is handled by measures catering exclusively to legal migrants. This approach results in situations that are unacceptable. · To overcome this situation, MSF requests that, within the areas affected by the presence of seasonal workers, local institutions, i.e. community, provincial and regional administrations, prefectures and territorial health centres, guarantee minimum conditions of reception to all migrants employed in agricultural farming.
Moreover, because of the conditions of marginality and social exclusion in which the seasonal workers live, and despite policies guaranteed by law, these people do not succeed in gaining access to health services. This is determined both by the lack of information services catering to the migrants, and to the lack of firstlevel clinics dedicated to irregular migrants. · Taking the above into consideration, it is MSF’s wish that the National Health Service comply with the law in force, thereby guaranteeing adequate information to foreigners regarding their right to health care and by providing suitable medical response in the areas affected by the presence of seasonal workers by setting up dedicated clinics and cultural mediation services.
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