Interiorization and Healthcare Access of Venezuelan Refugees in Brazil

• In Event: Navigating Healthcare Services and Resources

Abstract

The number of refugees in South America has grown exponentially in the last decade due to the economic and institutional crises that have affected Venezuela. Since 2014, over 7.1 Venezuelans have fled their country and most have migrated to neighbouring countries in Latin America. By January 2023, Brazil - the country with the highest GDP in South America - already had 400,000 Venezuelans living in its territory, of which 95,000 were seeking refuge. The multistakeholder humanitarian response organized by Brazil has been recognized by international organizations for its efficiency in the process of refugee reception and resettlement. The response is composed of two actions: 1) The "Welcome Operation," established in the border region, performs the reception of refugees, with the issue of documentation, health evaluation, and survival needs assessment; 2) The "Interiorização” [Interiorization] Strategy establishes ways to enable the resettlement of refugees to the various regions of Brazil, where there is greater economic development and greater chances of re-establishment of a new life. By January 2023, 91,000 Venezuelans were distributed to other Brazilian regions, with the largest contingents concentrated in the South and Southeast - regions with the highest human development indexes in the country. Although the two actions complement each other, they do not establish a continuous follow-up of the resettled refugees and their needs and challenges. An example is sexual and reproductive health needs. In the border region, 55 organizations support the humanitarian response by ensuring that refugees have information and access to necessary public services, such as conversation circles on family planning, access to contraceptive methods, sex education, and access to HIV and STI prevention and treatment methods. When refugees are resettled, they also lose the constant attention given by organizations and many of the bonds established at the border. This has a direct impact on access to primary health care services and on the continuity of various treatments, since the management of primary health care services (where most sexual and reproductive health programs are located) is the responsibility of the Municipalities, and in some cases the States, often distant from the management of the humanitarian response managed by the Federal Government in the Northern Region. Therefore, it is relevant to understand how displacement between regions impacts their access to healthcare and health information. Our research question is "how do sociocultural, institutional, and political factors shape barriers to knowledge and access to sexual and reproductive healthcare for Venezuelan refugee women in Brazil?" Our paper compares the access to sexual and reproductive healthcare provided to Venezuelan vulnerable asylum seekers (women, LGBTQIA+, people with disabilities) in refugee camps in the borderlands of Brazil to the resettlement sites in Southern Brazil. Based on fieldwork in refugee camps in Pacaraima, Boa Vista, São Paulo, Curitiba, Florianópolis, and Porto Alegre from October 2021 to February 2023, we found that the Interiorização strategy has provided greater chances for employability and livelihoods, however, few mechanisms exist for continued healthcare communication leaving refugees at the mercy of systems and services that are often unknown to them and at great vulnerability to healthcare mis- or disinformation. We also found there was a dramatic decrease in access to sexual and reproductive healthcare for women in the host communities in Southern Brazil as compared to services at the camps, and the exclusion of LGBTQ+ Venezuelan refugees due to lack of support networks and discrimination by employers in Southern cities.

Authors

• Gerson Scheidweiler, York University

• Yvonne Su, York University