Turkey’s health insurance denial ‘increases asylum seekers’ desperation’

Turkey’s health insurance denial ‘increases asylum seekers’ desperation’

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The Turkish government’s decision to stop providing free health insurance to asylum seekers has added to the “desperation” many feel, according to the regional manager of Article18’s partner charity Middle East Concern.

Rob Duncan told Article18 that since the decision was published by Turkish state media on Christmas Eve, the frequency with which he has been receiving messages from concerned asylum seekers has increased.

Among Turkey’s estimated four million asylum seekers are around 40,000 Iranians, many of whom are Christians converts.

Article18 has reported on the desperation of convert asylum seekers like Maryam Bateni Nia, Reza Mousavi and their eight-year-old son Daniel, who have been waiting to be resettled in a safe country for six years.

Another couple, Sohrab and Fereshteh, haven’t even had their initial interview with the UN’s refugee agency yet, and they’ve been in Turkey for five years.

Mr Duncan explained that it is the perpetual uncertainty that is most draining.

“It’s a chronic situation,” he said. “It’s a little bit like being in prison. If you know how long you’re going to be in prison for, then you can cope, psychologically, so much better. When you don’t know how long it’s going to continue for, it’s psychologically extremely damaging, it’s traumatising.”

Asylum seeker Reza Mousavi put it this way when speaking to Article18 last year: “For us the timing itself is not an issue. We’ve been here for too long, but at least if we knew the direction we were heading in, then we could manage the time.”

Maryam Bateni Nia, Reza Mousavi and their eight-year-old son Daniel

Mr Duncan cited the example of an Iraqi family he knows who have been waiting for resettlement for 13 years. He acknowledged that it is unusual for cases to take quite so long, but at the same time he said the family had a “very, very good case”.


Under the new directive, asylum seekers over 18 years of age are now eligible for only one year’s free health insurance, except in “special circumstances” where the asylum seeker can prove they are deserving of continued medical care.

For those asylum seekers who are over 18 and have already been in Turkey for at least one year, should a medical emergency arise they will now have to pay for their own treatment.

Mr Duncan said the directive has increased the vulnerability of an already vulnerable group of people, and that since many asylum seekers struggle financially, the cost of healthcare is only going to add to a heavy burden.

“It certainly puts people into a very vulnerable position,” he said. “And it’s also going to mean that… Let’s taken an extreme example: perhaps they’re showing symptoms where something could possibly be a cancer, but they’re not going to have it checked out, are they? They’re going to delay it. So anything that’s potentially extremely serious and where early diagnosis is going to be important, it’s going to delay that.”

Adding to the vulnerability is the “legally grey area” asylum seekers find themselves in.

The majority of asylum seekers are employed via unofficial channels, with the authorities generally willing to turn a blind eye, Mr Duncan said, but as a result he said that in every church across Turkey, there are “dozens” of examples of converts who have been dismissed without being paid – and were they to protest it would be them, and not the employer, who would be blamed.


Mr Duncan said the “very vague” directive can be “applied by different officials in different ways”, and is open to abuse.

He gave the example of the travel-permit system, whereby asylum seekers, who are designated a city of residence, must seek permission to travel, noting that in one city he had been told of an official who had begun charging a fixed price.

It is all part of a “more or less official policy” to “ratchet up the pressure on refugees” and to “pressure other countries to offer opportunities for resettlement”, he said.

This has coincided with a rise in Turkish nationalism, which has increased the feeling among asylum seekers that they are unwelcome.

Late last year, around the same time as the new directive was issued, “nationalists were going around, harassing and physically attacking some people they thought to be Syrians”, Mr Duncan said. (The vast majority of asylum seekers in Turkey are Syrian.)

He said he had heard many “horror stories” of the children of converts receiving “all sorts of threats from their own classmates”, while some converts have even faced violence from fellow asylum seekers – though not usually Iranians.

One couple spent months in prison after someone complained that they had been evangelising to them, even though evangelism is not a crime in Turkish law, Mr Duncan said.

He acknowledged that Turkey is hosting a “massive” number of asylum seekers – the largest such population in the world – but pointed out that Turkey has also been given billions of euros from the European Union to care for them, while at the same time taking advantage of them through the use of cheap labour and counting on the Syrian population, for example, for votes.

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‘Here for healthcare’

Mr Duncan said one of the drivers for the new directive may be the oft-cited claim that many asylum seekers only came to Turkey for the free healthcare.

He gave the example of one Christian woman, who fled Iran because her son was being beaten by her husband, and even more so since her conversion to Christianity. 

“The Turkish authorities have been saying time and time again, ‘No, you’re not here out of any religious persecution grounds, you’re here just to get free healthcare for your boy,’ when all she gets, actually, is a little bit of money for his diapers,” Mr Duncan said.

Although he acknowledged that some have claimed asylum on grounds of persecution “when it hasn’t been the case at all”, he said this has decreased and that “fewer people are coming for the sake of ‘finding a better life’, because the UNHCR process just isn’t working properly these days, so only the most desperate are actually going through that now”.

Call for sponsors

Mr Duncan called on countries like the United States to reconsider their policies on asylum seekers, saying it was “hypocritical” to speak so frequently and fervently about religious freedom while at the same time “denying people access to a safe situation – for genuine cases of religious persecution”. 

He said the situation was “hardest for families with children” and called on churches able to sponsor refugees to come forward. 

“These are people who have experienced persecution on account of their faith, and in good faith they went to Turkey thinking that it was just going to be a couple of years before they will be able to be moved to a third country and to start a new life, with a future for their children. But none of that has happened,” he said. 

“The years are passing, the children are getting older, and it’s only really countries like Canada and Australia offering a degree of hope to such people by making resettlement possible through their humanitarian programmes. 

“Sponsors are needed. If churches have that opportunity to be able to sponsor a refugee family, then they should get in touch with Article18.”

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