The impact of Turkey’s health insurance cuts on Iranian asylum seekers

The impact of Turkey’s health insurance cuts on Iranian asylum seekers

A migrant health centre and women’s refuge in Bursa, Turkey (Photo: UNFPA)

The coronavirus outbreak couldn’t have come at a worse time for many of Turkey’s asylum seekers.

Just a few months before, on Christmas Eve, the Turkish government withdrew its offering of free health insurance to the vast majority. Only those with proven long-standing health issues are exempt. 

For the rest, their health insurance provision runs out after the end of their first year in the country. And while once upon a time asylum seekers may have hoped to have found resettlement in another country by then, the reality today is that it usually take a lot longer.

Among the estimated four million asylum seekers in Turkey, the overwhelming majority (around 3.5m) are from Syria, but there are also around 40,000 Iranians, many of whose claims are based on having converted to Christianity.

Article18 spoke recently with two such asylum seekers to find out how the developments of the past few months have affected them. Their real names have been withheld due to the sensitivities of their situations.

The first, who we’ll call Marjan, was informed at the turn of the year that she needed an operation to remove her uterus, right around the time Turkey withdrew its health insurance provision.

Then, due to the coronavirus outbreak, Marjan was recently told that state hospitals would no longer be able to perform her operation and that she needed to go private.

“Since my condition is very acute, we were forced to go to a private hospital, and they said it had to be removed in the near future,” Marjan explained.

But when she asked how much it would cost, the answer astounded her.

“The first time, I was told 5,500 liras [approximately $800], but then I was told, ‘Because of the scans and so on, the price is actually 17,000 liras [$2,500].’ I said, ‘It can’t be! Is that even possible?’”

Marjan was eventually able to negotiate for the price to be reduced to 7,500 liras (around $1,100), but it is still much more than she can afford.

Another Iranian asylum seeker, who we’ll call Leyla, has a long-standing health issue requiring an ultrasound and blood tests every six months, at a cost of 6,000 liras [$850] a time.

Leyla explained that when her insurance was removed, she appealed to the Turkish migration authorities, explaining the regularity of her treatment.

“They told me, ‘Bring a report from your doctor,’” Leyla told Article18. “So, even in this situation of corona, I went to the hospital three or four times, and my doctor said, ‘You shouldn’t come here with your weakened immune system.’ But, even so, I went there and then took my report to the authorities, but they didn’t accept it and said, ‘It would have to be cancer for us to reactivate your insurance’.”

Meanwhile, the work situation for asylum seekers like Leyla, which was already precarious, has become harder still since the coronavirus outbreak.

“I was working before, but since corona came, there nowhere is open, so where we can go for work?” she said. “My job was at the hairdresser’s, and now nobody trusts anyone else to cut their hair, and I’m too scared to work anyway, in case I get sick.”

‘No-one listens’

In March, a 35-year-old Iranian asylum seeker named Massoud died after not being able to afford to pay his medical expenses, having had his insurance withdrawn.

An Iranian church leader who knew Massoud told Article18: “He couldn’t afford his medical expenses, so he applied to the migration authorities, but they refused to re-activate his insurance.” 

The church leader estimated that over 90 per cent of asylum seekers in Turkey would be unable to pay for their own treatment, due to the high costs and a lack of a reliable income.

“Refugees are in a very bad situation and they are very worried,” the church leader said. “Since the insurance was cut off, we have had many requests for help, but, unfortunately, due to limited funding, we cannot help everyone.”

And now with the coronavirus outbreak, the situation has become even more difficult, the church leader explained:

“The cost of a corona test for those who don’t have insurance is about $50. And if someone is sick, that is just the beginning. We have tried many times to get our voices heard by the migration authorities, to at least provide insurance at this critical time, but no-one listens.

“This could be dangerous even for Turkish citizens, because if one of the refugees is ill, he or she may not go to hospital due to a lack of funds, and that could mean the virus spreads further.”