Providing health care for those without legal status

At the age of 54, Sharon Barnett made a dramatic decision to leave the glittering corporate world in which she had risen high in the ranks of international conference organizers after first making aliyah from Birmingham, England in the early 1970s. While she considered the next step in her career, at an age when it is not easy to find a job at all in today's market, Sharon began volunteering for Physicians for Human Rights (PHR-Israel).

PHR-Israel is a nonprofit, human rights organization dedicated to advancing equal access to health care through advocacy and by filling gaps in services. Among other services, PHR provides medical diagnosis and treatment for individuals with no insurance and no means of receiving basic health care. These include, primarily, asylum seekers, but also foreign workers and their families, victims of human trafficking, and other dependents of Israeli residents whose legal status is unresolved.

A year ago, shortly after she had begun volunteering for the organization, a paid position as director of the Primary Care Clinic in Jaffa became available and Sharon applied. To her great surprise, she got the job despite the fact that, as she put it to me in our interview, she had no previous experience in the third sector or in health care. What she did have, as she would soon discover, was an arsenal of finely-honed skills from the private sector that are in short supply in the voluntary sector and which were infinitely more valuable than the experience she lacked.

Since its opening 15 years ago, the clinic has responded to 32,700 individuals in need of primary or emergency care. Today, roughly 60-70 percent of the 500 individuals who turn to the clinic each month are asylum seekers, mostly from Africa. They are generally young and basically healthy men and women with basic care issues that are not all that different from the general population. At the same time, they and their children have been through traumas associated with fleeing from their homes and the long and treacherous journey to a society which, on the whole, rejects and marginalizes them and, in some cases, verbally and physically abuses them.

The clinic operates three times a week on a walk-in basis, and once a week for specialized care by appointment. All of the medical care is provided by volunteers. In the month of January 2014, some 100 doctors, including general practitioners as well as psychiatrists, internists, gynecologists and surgeons, donated 570 medical hours; an equal number of administrative volunteers undertook 168 shifts of varying lengths. Among these volunteers are medical students, retirees and many others from various walks of life looking for a way to make a contribution to society.

Barnett does a lot of trouble-shooting on a daily basis, but also draws on the training she received, in what she refers to as her "previous life" to introduce more long-range planning and development. This includes training volunteers, improving channels of communication among professionals and volunteers and setting goals for the future.

"The population served by the clinic," she explains, "wants the same things as everyone else – to lead a normal life." This is poignantly demonstrated by the number of couples who come to the clinic to ask about fertility treatment.

"While we have to turn them down," she says, "I find it an extraordinary testimony to the strength of people. Despite their very distressing circumstances, they want normality and continuity."

Barnett herself never loses sight of the fact that her own grandparents in the last century were economic migrants from Eastern Europe to England whose sons went on to become doctors and make valuable contributions to society.

"Societies that are open and pluralistic are stronger," she says. "Economic migration is a global and not just a local phenomenon. Instead of putting our heads in the sand and riding on the backs of an already disadvantaged population, we need to advocate for policy decisions and formal review processes for every individual case. To ignore the problem is not moral and not human and it endangers people's lives."