The Building of Structures for Acute Care, Initial Medical Screening, and Vaccination Prevention for Refugees in the State of Berlin: Challenges and New Concepts
The German health system was exposed to a so far unexperienced challenge when many asylum seekers arrived in 2015 and 2016. Their need for medical treatment after a long and exhausting way to Central Europe met largely unprepared authorities not being able to establish a fast registration process, adequate housing, and immediate access to healthcare. Structures for a working healthcare system had to be established quickly at a professional level with a joint effort by authorities, public health institutions, hospitals and many volunteers. While the acute care of seriously ill and exhausted refugees was the primary concern, working structures had to be set up for the legally required initial screening of all asylum seekers at the same time. These preventive measures included also a vaccination program which was integrated into the initial medical screening procedure and supplemented with a mobile vaccination programme. All these activities were planned and gradually implemented by Charité – Universitätsmedizin Berlin, a university hospital, at a time when the massive need to provide healthcare for refugees was meeting a largely unprepared public health system. Altogether more than 75,000 refugees were examined by Charité between 2015 and 2018 in these newly implemented local healthcare structures. Therefore, the structures created for the medical care of refugees will be briefly presented and evaluated for their effectiveness and subsequent results.