Objectives

The decree 3 August 2007 from the Ministry of Health assigns to NIHMP the following tasks:

a. develop research activities aimed at promoting migrants’ healthcare and controlling poverty-related diseases, in accordance with the National and Regional Programmes;
b. design and implement, directly or through other organizations, training, educational and health information programmes within the statutory scope;
c. cooperate with WHO and other international organizations in supporting the control of poverty-related diseases in developing countries through clinical research and other means;
d. work out clinical research programmes and experimental models on the managing of health services specifically oriented to the problems emerging from poverty-related diseases. These activities can be carried out in cooperation with EU and WHO’s offices;
e. organize a network for the promotion of migrants’ healthcare and the control of poverty-related diseases involving Italian, European, international, public, private and voluntary organizations working in this field;
f. assure health assistance through the medical facilities of the involved regions.

In order to achieve these general tasks the following actions are needed:

- Provision of specialist medical advice to those responsible for the creation of regional medical centres. These will be centres for the control of poverty-related diseases and for the diagnosis, prevention and treatment of the pathologies related to migrants and other human mobile populations (tourists, international travellers, asylum seekers, refugees, victims of torture and nomads). These aims have to be pursued in cooperation with territorial services, regional ASL, voluntary and social work associations involved in the field of migration.
- Prevention of the most common tropical diseases through specialist medical examinations and updated information to tour operators, missionaries and travellers to and from tropical countries.
- Prevention and control of Female Genital Mutilations (FGM) in migrant women and children, following the advice of the relevant National Committee of the Minister of Health.
- Creation of multi-specialized centres with a multidisciplinary team and cultural mediators trained for receiving and facilitating the access to the Regional Health System’s services of Latium, Apulia and Sicily. This would allow to experiment, validate and diffuse a multidisciplinary and intercultural healthcare model aimed at facilitating the access to the services, enhancing their performances and respecting the social and cultural identity of migrants.
- Offer of outpatient and diagnostic services, also by drawing up agreement protocols with the existing regional health centres.
- Use of tele-consulting systems, including the Italian Hospital Worldwide network, in order to obtain fast and cheap support for diagnosis and treatment from Italian specialist centres of excellence. This kind of organization also makes it possible to avoid unnecessary displacements.

Training
Besides the above mentioned activities, it is necessary to train medical and social workers involved in migrant health care in order to guide them to a) an intercultural approach; b) protect the health of migrants, asylum seekers, victims of trafficking, homeless and nomads; c) control poverty-related diseases; d) facilitate and enhance the access to the Regional Sanitary System; e) respect cultural identity of people. These courses are CME accredited.
Particularly important is to train the workers of the local medical facilities and of the regional Temporary Stay and Assistance Centres for the migrants.
Training is also needed to improve the health care services aimed at controlling the most important tropical, emerging, re-emerging and imported diseases. The purpose is to offer education, prevention, diagnosis and treatment to disadvantaged groups through the intervention of local health workers in a multicultural context and cooperating with local medical centres. For this reason training courses in which experts in migration medicine and control of poverty related-diseases are involved would be of outstanding importance.

It is necessary to find a way to retrace the anamnesis of those population groups and their problems and design possible interventions in the short and medium period. This will be possible with the help of a multicultural staff including cultural mediators, suitably trained to cooperate with the health workers in local medical facilities.
Another important purpose is to inform local health and social workers about the pathologies and the conditions of the victims of torture, who can apply for refugee status and help them through accurate anamnesis and data collection.
Finally, it is necessary to start using e-learning technologies, as it happens in the Alliance of the Italian Hospitals Worldwide. It would allow to reach Italian and foreign specialized educational institutions.

Research
It is essential to carry out medical and scientific research and share it with national and international networks composed by structures specialized in migration medicine and control of poverty-related diseases. The networks should be web-oriented in order to allow to collect and exchange information.
Research activities should: a. test and validate effective means to find, monitor and assess the health care needs of migrants and groups at risk of poverty; b. test organizational and management models for the protection and assistance of the communities and the disadvantaged Italian population groups. The purpose is to facilitate timely access to health care services and to protect cultural identities of the above mentioned communities; c. carry out epidemiological observation in order to identify the typology and frequency of the pathologies (from the most common to the rare ones) and the most significant conditioning factors; d. set up a referral network among specialized centres in order to develop national and international scientific cooperation, clinical and experimental advice and training; e. produce scientific publications on the research outcomes and make them free for access to the national and international scientific community.