associations concerned about the health of the most vulnerable

Police checks, postponement of care, saturated system… Associations in Seine-Saint-Denis (93) fear that the health of the most vulnerable will take second place during the Olympic Games. To protect its public, the Médecins du Monde center in Plaine Saint-Denis is relocating from this Monday, July 1st.

The Médecins du Monde center in Plaine Saint-Denis (Seine-Saint-Denis) closes its doors this Monday 1^is July. In question, the location of the association in the middle of the “red zone”, between the Stade de France and the Olympic swimming pool. “It seemed irresponsible to us to remain open when we welcome many undocumented people here and we are already seeing the increase in police checks”underline the two coordinators of the center, Matthieu Dréhan and Clément Etienne.

This decision “difficult to take” follows more than a year and a half of discussions and meetings with the authorities. On the walls of the Médecins du Monde offices, a poster mocks the response regularly given by the prefecture: “all of this has nothing to do with the Olympics.” However, it is indeed on these dates – from 1^is July to September 15 – that the NGO will to relocate, still in the department but further away from the Olympic sites, in order to protect its undocumented patients. And Médecins du Monde is not the only structure in the department to fear the impact of the Games on the most vulnerable, on the monitoring of care and on the daily lives of health personnel.

“Filling the gaps”

“When we expressed our concerns to the ARS [Agence régionale de Santé] and at the town hall, we were told that the neighborhood would not be impacted”, annoys Salima Sidibe, coordinator of the La Place health center near the Saint-Denis canal. But the structure which usually welcomes patients followed by treating doctors will have to show itself “a little more flexible”. Especially in emergency slots. “We hear that it will be a great popular celebration, but we forget that we are also putting the health of a whole section of the population at risk,” she continues.

To resist the tourist influx, associations will indeed have to “fill the gaps”, denounces Matthieu Dréhan of Médecins du Monde. “ We were clearly asked to increase our sails this summer to compensate for the difficulties in the hospital system.” “We are going to do emergency, humanitarian work in France”deplores Clément Etienne. Their teams will notably return to old methods such as the distribution of medicines on site. A practice abandoned since the 1980s.

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For Laure Pitti, lecturer in sociology at Paris-8 University, specialist in health and precariousness issues, relying so explicitly on the associative fabric is a matter of “confession of weakness” » for the authorities. While the department of Seine-Saint-Denis is ranked 89^e out of 100 concerning the number of general practitioners per 100,000 inhabitants. “93 has been an urban medical desert for several years, even before the public authorities were concerned about the issue of medical deserts”she contextualizes. And to specify: “We are once again asking private actors to take on a public service mission, at the cost of additional work to obtain funding which, once again, is not sustainable”regrets the researcher.

“There will be over-control upon over-control”

The Regional Health Agency has indeed launched a call for projects, with funding at stake for the associations. On one condition: increase its activity during the Olympic Games. “Unthinkable” to apply for Salima Sidibe, the coordinator of the La Place health center. “We are a small team so it was impossible for us, we decided to focus on the most vulnerable people. »

The humanitarian association Bamesso et ses amis, located in Blanc-Mesnil, responded to this offer. The structure fights against sexually transmitted diseases, with prevention and screening actions. Crucial missions during the Games period, explains Maria Zientara, an intern in Aulnay-sous-Bois who is preparing a thesis on the impact of the Olympic Games on activity in the Paris region’s emergency departments. “As soon as there is a big festive event like the Olympic Games, there can be more drug circulation and large prostitution networks, and all the health risks that go with it, explains the doctoral student. This is a real fear for health authorities.”

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In addition to the strain on the healthcare system, the most vulnerable will also face increased police checks. Associations fear an additional obstacle to access to healthcare. “There will be over-control after over-control, it will limit the movement of vulnerable people, increase their stigmatization and keep them away from caregivers,” predicts researcher Laure Pitti. At Médecins du Monde, there is concern that the beneficiaries will not follow during the relocation period: “This is the big question, worries Matthieu Dréhan. Only the truth on the ground will tell us. »

But at Bamesso and his friends, we are convinced: “People won’t come to see us”. And the structure even matters “encourage patients not to take this risk. We will readapt, try to do small shopping for them so that they do not die of hunger.” Contacted about the Games, the ARS refers to its website, ensuring that the agency is organizing itself to guarantee care ” for everyone “ et “support for precarious populations (homeless, migrants, etc.)”.

” A time bomb ”

If there are fears about the health of the most vulnerable during the Games, it is above all the aftermath that is worrying. “The impact of the Olympics will not end on September 8warns Matthieu Dréhan of Doctors of the World, We are expecting a small time bomb.” People who did not dare to travel during the tests or who did not have access to sufficient medical monitoring will see their health worsen. Concretely, the associations expect treatment disruptions and diagnostic delays which will increase their activities in the long term. Médecins du Monde received a delegation from Vancouver who warned them. Fourteen years after the Winter Games, the effects on the health of the most vulnerable are still felt in this Canadian city and the system had to be rethought. “It will inevitably add work to us, plans the La Place health center, We will have to be careful with women who gave birth during the summer and with people who have avoided travelling.”

In hospitals, we can also expect an increase in activity after the Games. “There is not a huge stress of congestion at the time of the Olympics, explains intern Maria Zientara. On the other hand, there are fears about a delay in the diagnosis of STIs. This is something I can see later. » Activity in the emergency room could also increase since “in Seine-Saint-Denis, most of our patients are not followed by a general practitioner, observe l’interne. Their follow-up is in emergencies.”