Health vulnerabilities of undocumented central and eastern European migrants in Switzerland.

Destitute Central and Eastern European migrants, including homeless people, beggars, and sex workers, are in a highly vulnerable position in Switzerland. In the absence of residence permits, their access to health services and insurance is severely limited, and they suffer from institutional discrimination in Swiss medical facilities. The aim of this study is to examine the forms of health vulnerabilities of destitute mobile Eastern European citizens in Geneva and Zürich. To do this, we carried out narrative-biographical interviews with destitute migrants (n = 38) on their level of access to medical facilities and insurance. The results confirm that our respondents face severe vulnerabilities in accessing medical services and insurance mechanisms in Switzerland. This tendency is exemplified in the paper through the respondents' experiences of psychiatric disorders and substance abuse. Destitute migrants often transfer health vulnerabilities from their home countries. They mostly receive therapies and medicines in their countries of origin but remain untreated in Switzerland after arrival. Without Swiss health insurance, they turn to medical services only in cases of emergency, and even then, they are either rejected or discharged after very brief treatments. This dangerous combination of individual and systemic health vulnerabilities greatly exacerbates the disadvantages of destitute Eastern Europeans and hampers their integration into Swiss society.