Virus reveals economic and racial divide in healthcare in France

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BONDY, FRANCE – Under France’s pledge to ensure health care for all, lie deep disparities between economic and racial boundaries – differences painfully exposed by the COVID-19 crisis. Two recent studies have documented these shortcomings, but government officials have not issued new proposals in response. However, as France sees a further increase in cases of the virus, a health advocacy group called Banlieues Sante – Banlieues Sante – Suburbs Health – is trying to help, offering medical care and counseling in the suburbs and cities. poor neighborhoods populated by migrants.

After the outbreak of the pandemic, they set up daily distribution points for food and hygiene kits, and launched a phone app to coordinate NGOs distributing food – as well as translating public health information into the multiple languages ​​spoken in the various communities.

Jacqueline Mendy, a black mother of two, was one of the fifty or so people who came to a tent that Banlieues Sante set up last week in her neighborhood park in the Parisian suburb of Bondy, including the Seine-Saint-Denis region. saw the highest in France. death rate from the virus. She came with her son to ask health questions and learned of the existence of a free medical examination for young women whom she did not know.

“I hadn’t thought to ask the question” about preventive health to her family doctor, Mendy told The Associated Press. Usually, she says, “when I go to my doctor it’s because there’s an illness, or (the kids) have a fever or something like that. ”

Banlieues Sante drew people to their tents with a Moroccan percussion and trumpet orchestra that sang in front of the curious. Nurses and social workers spoke French but also five other languages ​​and distributed masks, gel and other basic items to families.

The COVID-19 crisis has refocused attention on the health challenges that have long plagued regions like Seine-Saint-Denis.

Last month, a national statistics agency study found that death rates rose disproportionately for people born in Africa and Asia in France compared to populations born in France in the first few months of the pandemic. Another study by French economists showed that France’s poorest cities in high infection regions suffered more deaths than wealthier cities. The study highlighted “a higher proportion of workers frequently in contact with the public and a higher proportion of overcrowded housing”.

These figures do not surprise Abdelaali el Badaoui, the founder of Banlieues Sante, an organization of doctors, social workers and health workers who has worked for 15 years in 300 French neighborhoods, mostly poor, immigrant and racialized. They deliver food and basic protective gear, translate public health advice on their social media accounts, and offer translators to help people navigate the French healthcare system.

El Badaoui hopes “to bring people back to the roads of health”.

“The sickest are those who are furthest away (from traditional society), due to the cultural or linguistic barrier,” as well as those who cannot afford additional insurance which facilitates access to a specialized treatment, El Badaoui told the AP.

France’s healthcare system is supposed to provide accessible medical treatment to everyone, but years of cost cutting left it stretched when the virus struck. The bureaucratic demands and co-payments of the system often frighten new immigrants or the very poor. And sometimes patients have to travel far to reach a specialist, which not everyone can afford.

As the virus spread across France, the overall death rate in Seine-Saint-Denis rose 129% in March and April from the previous year – the country’s biggest increase.

Marie Pastor, head of health for Seine-Saint-Denis, cited three main reasons: First, the department has a disproportionate rate of people with co-morbidities – for example, it has the highest rate of diabetes in mainland France. Second, the shortage of general practitioners contributes to a “sense of estrangement from institutions” and discourages people from seeking treatment, she said. Finally, the high concentration of essential workers among the region’s population has made it more difficult for people to protect themselves and their families.

A study commissioned by the Paris regional health agency found the same reasons – but did not recommend specific measures to address the situation.

Seine-Saint Denis has an unemployment rate twice as high as the national average, a third of its population is immigrants and many more are descendants of immigrants. And in five years, it has lost 8% of its general practitioners, despite a growing population.

All over France, minorities face other medical challenges. Last October, France’s top citizen advocate reported that it is 6.5 times more difficult for people with “African Muslim names” to get psychiatric appointments than for others. Despite calls from the human rights watchdog government to investigate discrimination in healthcare, there is little research on the topic as race-based research runs counter to French doctrine of color blindness.

Talking about racism in French healthcare can be difficult. Last week, a Twitter user posted a list of black healthcare professionals in France used by black communities to find doctors less likely to discriminate against them. The very idea of ​​such a list has come under heavy pressure. The Ministry of Health has expressed its “shock” and the National Council of Doctors has denied any discrimination between French doctors.

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Angela Charlton in Paris contributed.

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