INTERREG V-A ITALY-SLOVENIA: INTEGRA PROJECT
The community identity and culture are written by women’s bodies and their free choice on sexual and reproductive health. As much as a woman is aware about her rights, so much more the community is an active actor on social, cultural and inclusion changes. These processes become intermingling and challenging when migration flows bring different cultures together, which are forced to face a world that is radically different than the Country of origin. Cultures with patriarcal and masculine orientation collide with the self-determination of women, particularly in regard to their choice on sexual practice and reproductive health. In fact, in the patriarchy, women don’t have the right and freedom to choose and decide on their body, but the father, husband or community have the power to impose such decisions.
The INTEGRA project aimed at protecting sexual and reproductive health of migrant women born and raised in cultures with a strong patriarchal imprint. The project, whose success thanks to the multidisciplinary collaboration among Italian and Slovenian universities, healthcare structures and local associations, gave a glimpse of the migrants’ situation in the trans-border region. Specifically, INTEGRA is a project funded by the Interreg V-A Italy-Slovenia Programme(1). Four partners(2) were involved for a total budget of € 611.072,85 of which € 519.411,92 from the European Regional Development Fund (ERDF). This project brilliantly ended last April with excellent outputs achieved. As testimony of that, the partners (PPs) wrote and published three documents: “State of Sexual and Reproductive Health of Migrant Women: Difficulties and Good Practices” (3) (both in Italian and Slovenian languages) edited by Giovanni Delli Zotti, Professor at the Department of Political and Social Sciences - University of Trieste; “Guidelines and Index of Reproductive Health”(4) (both in Italian and Slovenian) edited by Giuseppe Ricci and Federica Scrimin, resident doctors at the Obstetrics and Gynecology Clinic of the I.R.C.C.S. Materno Infantile Burlo Garofolo hospital in Trieste, and “Women, Migrations and Health. Ensuring Transcultural Healthcare” (English version) edited by Sabina Ličen, Igor Karnjuš, Mirko Prosen, on behalf of the Slovenian partners. These papers summarize experiences and translate the elaborated results collected in the project framework.
The main objective of INTEGRA was to increase cross-border cooperation, to protect the health of migrant women victim of patriarchal family systems, and train healthcare personnel to handle difficult situations in the context of sexual and reproductive health of migrant women, such as female genitalia mutilation (FGM) and/or forced marriage (FM), through establishing common guidelines and composing a sexual and reproductive health index. This allowed healthcare operators and professionals to tackle this serious and increasing problem in the cross-border area using a common intervention plan and protocol for serving the well-being and health of women.
The Programme area is experiencing an increase in number of migrants from Middle Eastern and African countries due to its proximity to the Balkan route. The project provided an interdisciplinary approach with an initial phase dedicated to assessment and examination of the phenomenon, followed by a phase of guidelines writing for social services and healthcare operators. The project also entailed specific trainings for social services and healthcare operators, with focus on overcoming the difficulties and barriers of intercultural communication, and specific medical trainings for migrant women to improve healthcare and wellbeing even in the most serious cases such as FGM. The cross-border approach of INTEGRA was decisively helpful in two main aspects. On the one hand, the migration phenomenon affects the cross-border area covered by the Programme since the border permeability favors the transit of migrant population between neighbouring countries, hence it becomes essential necessity to set common guidelines. On the other hand, the Italian healthcare facilities experienced more cases of migrant women from Asia and Africa, while thus far the Slovenian facilities have mainly encountered cases of women from former Yugoslavia (Bosnia and Kosovo), hence there is need to exchange good practices and common guidelines to cope sexual and reproductive health patients, and to give them the best sanitarian intervention and support.
Main results of INTEGRA pivot up common guidelines and specialized training. In fact, common guidelines were written for managing intercultural communication and relations, as well as on medical techniques for the treatment of women who are victims of FGM and FM. The guidelines are based on well-established good practices, on the exchange of experiences between operators, and on the new sexual and reproductive health index established by results collected during the research activities. To train healthcare professionals with regard to intercultural communications and relations, and the medical techniques to be adopted for patients who are victims of FGM and FM, a new profile of mediator was created. This specialized professional is capable of understanding inclusion requirements, and dealing with cultural and cohabitation issues between communities and the hospital institutions in order to establish a working healthcare relationship between the two entities.
The project started from hospital researching. When women went to the hospital for treatments they felt welcomed and protected by the health institution as it ridded them from the cultural violence experienced in their origin community as lack of freedom and decision-making power about their body and reproductive health. This approach helped to build their trust into the hospital institution, and female patients responded to surveys without conditionings and free from the social and cultural control exercised by their origin communities. Furthermore, at the hospital female patients receive information brochures such as flyers on family planning and resignation documents, that translated into 10 languages. This enables women receive the information in first hand, and to understand the value of sexual and reproductive health avoiding the risk of a misleading translation by husband, brother or another community member. Interaction between different professionals was very important, as it was possible to investigate and study this phenomenon from different points of view e.g. the doctor highlighting priorities of the health sector and the sociologist bringing into consideration the impact that such cultural violence exerted by the communities has on women and on their sexual and reproductive health.
During these studies, it emerged that cultural aspects were meaningful in the decision-making choices of women on their sexual and reproductive health. A woman who does not speak the local language is not a woman included in the social network, and she can be kept segregated in the origin community that dictates certain cultural laws. In this way, it was evident how the individual right of sexual and reproductive health is violated and sacrificed by community choices that often do not act to protect women's health. The hospital, as an institution, facilitates and supports the inclusion process of these women as it creates a new communication channel that contributes to the affirmation of their individual right on sexual and reproductive health. Thus, the hospital acts as a filter and provides valid tools that introduce rules and values aimed at protecting them.
In conclusion, the hope is that the INTEGRA project will find a concrete continuation within the post 2020 planning of the Interreg V-A Italy-Slovenia Programme. In fact, after long and careful research and writing of guidelines and good practices, it is fundamental that this project can further develop into a more complex phase focused on breaking down the cultural barriers that do not protect women regarding their sexual and reproductive health, and towards their inclusion and self-determination in the new social mesh to which they now belong.
For more and detailed information, visit the web-site https://www.ita-slo.eu/it/integra
LP Università degli Studi di Trieste Dipartimento di Scienze Politiche e Sociali – DiSPe; PP2 I.R.C.C.S. materno infantile Burlo Garofolo; PP3 Univerza na Primorskem Fakulteta Za Vede O Zdravju Facoltà di Scienze della Salute; PP4 Bolnišnica Postojna
Composed by two different reports respectively Report 3.1.1 “Analysis of migratory processes, characteristics of hospital access, status of sexual and reproductive health of migrant women” and Report 3.1.2 “Comparative analysis of health approach and best practices”. For more and detailed information, visit the web-site https://www.openstarts.units.it/handle/10077/23633
For more and detailed information, visit the web-site https://www.openstarts.units.it/handle/10077/27070
For more and detailed information, visit the web-site http://www.hippocampus.si/women-migrations-and-health/
(1) For more and detailed information, visit the web-site https://www.ita-slo.eu/it/integra
(2) LP Università degli Studi di Trieste Dipartimento di Scienze Politiche e Sociali – DiSPe; PP2 I.R.C.C.S. materno infantile Burlo Garofolo; PP3 Univerza na Primorskem Fakulteta Za Vede O Zdravju Facoltà di Scienze della Salute; PP4 Bolnišnica Postojna
(3) Composed by two different reports respectively Report 3.1.1 “Analysis of migratory processes, characteristics of hospital access, status of sexual and reproductive health of migrant women” and Report 3.1.2 “Comparative analysis of health approach and best practices”. For more and detailed information, visit the web-site https://www.openstarts.units.it/handle/10077/23633
(4) For more and detailed information, visit the web-site https://www.openstarts.units.it/handle/10077/27070
(5) For more and detailed information, visit the web-site http://www.hippocampus.si/women-migrations-and-health/