WONCA Special Interest Group: Migrant Care, Int Health & Travel Medicine

Migrant Care, Int Health & Travel Medicine

At the WONCA Executive meeting in Cebu, the Philippines, in 2011 the expansion of the WONCA Special Interest Group (SIG) on Travel Medicine was endorsed. The group will now be known as the SIG on Migrant Care, International Health and Travel Medicine. Our vision is for good access and quality of primary care for all – temporally or permanently - displaced people and travellers at all places in the world.

We welcome new members, especially from outside Europe.

Convenor / Chair

Convenor: Dr Guss Busser (Netherlands)

email convenor

Guss Busser is a family doctor and medical educator who works at Radboudumc, Nijmegen, in the Netherlands. He combined working in clinical practice and teaching for 28 years, but these last seven years has focussed only on the teaching. Many of his patients were vulnerable, had a migrant background, less education, less income. They taught him a lot about their lives, and the world - but also about the imperfect nature of our medical care and of medical education. Improving and adapting our medical care for the most vulnerable groups gradually became my mission in medical education. The focus in his teaching is about the organization of care, culture and healthcare, health illiteracy, migration and vulnerable groups.

Co-Convenor or other office bearers

Past convenor: Dr Maria van den Muijsenbergh (Netherlands)


Dr Maria van den Muijsenbergh, is a general practitioner in a population with many vulnerable migrants such as refugees, undocumented and homeless people. She is a senior researcher and teacher in the Department of Primary and Community Care at Radboud University Nijmegen Medical Centre, in Nijmegen, the Netherlands. Her research and education focus is on immigrant health and healthcare for refugees and undocumented people (eg the EU-funded Restore-project). She is a senior researcher and adviser to Pharos, Dutch knowledge centre on migrants, refugees and healthcare, in Utrecht.

Executive Members

  • Dr Marius Besson (Switzerland)
  • Dr Guus Busser (The Netherlands)
  • Dr Garth Brink (South Africa)
  • DR Bill Cayley, Jr, (USA)
  • Prof Christopher Dowrick (UK)
  • Dr Sophie Durieux (Switzerland)
  • Dr Daniel Gelzer (Switzerland)
  • Prof Christos Lionis (Greece)
  • Dr Yves Jackson (Switzerland)
  • Dr Sylvia Mennink (The Netherlands)
  • Dr Eldine Oosterberg (The Netherlands)
  • Dr Wolfgang Spiegel (Austria)
  • Dr Evelyn van Weel-Baumgarten (The Netherlands)

Membership Open?

Vision and Mission of WONCA SIG on Migrant Care, Int Health & Travel Medicine

To improve the knowledge and skills of general practitioners as well as the organisational and financial conditions to deliver cultural competent, good quality of primary care to migrants of all kinds: travellers, economic migrants as well as refugees including the undocumented.

Objectives of the WONCA SIG on Migrant Care, Int Health & Travel Medicine


To enhance the exchange of knowledge, good practices, education and international research on migrant care en travel medicine in general practice by:

  • Concerning knowledge and good practices, aiming at GP’s in daily practice:
    • promoting access to and exchange of (web based) information to support GPs in daily practice on all aspects of migrant care, international health and travel medicine such as: infectious diseases, endemic conditions , mental problems related to displacement and migration, communication tools , ethnic and cultural differences in diseases, in health beliefs and expectations.
    • Exchange of good practices by international exchange practice visits.
  • Concerning education in migrant care, cultural competences and travel medicine:
    • Exchange of programs and materials for medical school, vocational training and post graduate education programs by establishing an internet forum for GP’s involved in teaching.
  • Concerning research on migrant care, cultural competences and travel medicine:
    • Exchange of existing and initiating new local and international research projects.
  • Networking:
    • Organising workshops and / or pre-conferences at WONCA Europe and other regional WONCA conferences as well as at the WONCA world conference.
    • Joint publishing of practice experiences and research results.

The strength of WONCA is the relation between daily practice of family medicine and academic research. Therefore the SIG will focus on the problems and experiences of GP’s regarding migrant patients – and bridge these to practice-based research. The most urgent problems concern the group of vulnerable migrants, especially undocumented migrants, refugees, low income migrants. So they will be the main focus of the activities of the SIG, but without excluding other groups, such as travellers and adoptees; or the ethnic differences in diseases.

There is a strong relation between migration, social problems and mental and physical health problems. Therefore the SIG seeks to include the public health perspective as well as connect with knowledge in the domain of sociology and anthropology. Related themes are the role of doctors in advocacy and testifying of the effects of social circumstances on health and the importance of compassionate care for vulnerable populations.

Publications & Documents


  1. Exchange of information
  2. Exchange of useful tools and initiatives.
  3. Personal exchange visits.
    In May 2011, a first exchange visit took place between Switzerland and the Netherlands, with the Swiss member visiting different Dutch family medicine practices and initiatives to improve healthcare for undocumented migrants. In 2012 some Dutch members visited practices in Japan. In July 2012, practice visits are planned during the WONCA Europe in Vienna.
  4. Joint research projects.
    As the European FP7 Restore (http://www.fp7restore.eu/) illustrates, there are possibilities for collaboration in research projects. It gives the opportunity to include larger study populations, and to look into the effects of different healthcare systems on health and access to health. This is also of interest for colleagues who are not connected to an university, but in this way will be able to participate in research projects. The strength of the SIG in this is practice-based research.
    A very interesting and promising field of research is brought up by colleague Yves Jackson, in Geneva: the role of migration related social problems and chronic stress to the rapid development of metabolic diseases as hypertension, obesity and diabetes, in migrants. There is some evidence for this from studies in the USA, but little research has been done until now in Europe.
  5. Publications.
    Publications in journals for GPs would offer the opportunity to leave a footprint of the SIG and attract attention of other GPs as well as of policymakers etc.
  6. WONCA conference presence.
    The SIG will continue submitting abstracts for workshops with topics relevant to a broader group of GPs, and start to organise symposia or pre-conferences. During WONCA Asia Pacific 2011 regional conference Evelyn van Weel-Baumgarten, Ryuki Kassai, Maria Fidelis Manalo held a workshop on cultural differences in communication on terminal diseases.
    During WONCA Europe 2011 regional conference Eldine Oosterberg, Christos Lionis and Maria van den Muijsenbergh organised a workshop on migrant care and good practices to overcome language and cultural barriers in which some 70 GP’s from 13 different countries participated. Oosterberg and van den Muijsenbergh also organised a workshop on low health literacy, a common problem amongst migrants.
    For WONCA Europe Vienna 2012 and WONCA Africa Zimbabwe 2012, oral presentations and workshop formats are planned


Relevant Resources


Anderson B, Blinder S. 2011 Who Counts as a Migrant? Definitions and their Consequences. The Migration Observatory, University of Oxford

Betancourt et al. Defining cultural competence: a practical framework for addressing racial / ethnic disparities in health and health care . Public Health Reports 2003;118:293-302. whitepaper. 2011 Language Line Services USA.

European Migration Network (2011) Key EU MigratoryStatistics, July 2011

European Union Fundamental Rights Agency (2011) Migrants in an irregular situation: access to healthcare in 10 European Union Member States, Luxembourg

Eurostat (2011a) online data code migr_asyctzandmigr_asyappctza

Eurostat (2011b) online data code - Asylum and new asylum applicants by citizenship, age and sex: annual aggregated data (migr_asyappctza)

Eurostat (2011b) online data code - Asylum applicants considered to be unaccompanied minors by citizenship, age and sex: Annual data (migr_asyunaa)

Gushulak, B Pace P and Weekers J (2010) Migration and health of migrants In Koller, T (ed) Poverty and Social Exclusion in the WHO European Region: Health Systems Respond, Copenhagen: WHO Regional Office for Europe


Papic O, Malak Z, Rosenberg E. Survey of family physicians’ perspectives on management of recent immigrant patients: attitudes, barriers, strategies, and training needs. Patient Educ Couns 2012; 86:205–9.

Vandenheede H, Deboosere P, Stirbu I, Agyemang C et al 2009): Migrant mortality from diabetes mellitus across Europe. European Journal of Epidemiology 2012; 27(2): 109-117

Priebe S, Sandhu S, Dias S, Gaddini A, et al. Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Public Health 2011, 11:187.

Nielsen SS, Krasnik A. Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review. Int J Public Health: 2010;55: 357 -371.

Pyykkönen AJ, Räikkönen K, Tuomi T, Eriksson JG, et al. Stressful Life Events and the Metabolic Syndrome. The Prevalence, Prediction and Prevention of Diabetes (PPP)- Botnia Study Diabetes Care February 2010; 33(2): 378-384

Bodenmann P, Vaucher P, Wolff H, Favrat B, et al. Screening for latent tuberculosis infection among undocumented immigrants in Swiss healthcare centres; a descriptive exploratory study. BMC Infect Dis 2009; 9:34.

Uiters E, Devillé W, Foets M, Spreeuwenberg P, Groenewegen PP. Differences between immigrant and non-immigrant groups in the use of primary medical care; a systematic review. BMC Health Serv Res. 2009; May 11, 9:76.

Schoevers MA, van den Muijsenbergh METC and Lagro-Janssen ALM: Self-reported health problems of female undocumented immigrants. Top of the iceberg. Self-rated health and health problems of undocumented immigrant women in the Netherlands, a descriptive study. Journal of Public Health Policy 2009:30,4: 409-22.

Lanting LC, Joung IM, Vogel I, Bootsma AH, et al. Ethnic differences in outcomes of diabetes care and the role of self-management behavior. Patient.Educ.Couns. 2008a, vol 72:1, 146-154

Schulz AJ, House JS,  Israel BA, Mentz G, et al. Relational pathways between socioeconomic position and cardiovascular risk in a multi-ethnic urban sample: complexities and their implications for improving health in economically disadvantaged populations. J Epidemiol Community Health 2008;62:638-646 doi:10.1136/jech.2007.063222

Harmsen JAC, Bernsen RMD.,Bruijnzeels MA, Meeuwesen L. Patients’ evaluation of quality of care in general practice: What are the cultural and linguistic barriers? Patient Education and Counseling 2008; 72:155–162

Andrulis DP, Brach C. Integrating literacy, culture and language to improve health care quality for diverse populations. Am J Health Behav 2007;31;Suppl.1: S122-S133

French CE, Antoine D, Gelb D, Jones JA, et al. Tuberculosis in non-UK-born persons, England and Wales, 2001-2003. Int J Tuberc Lung Dis 2007; 11(5):577-584.

Beach MC et al. Improving health care quality for racial / ethnic minorities: systemic review of the best evidence regarding provider and organization interventions. BMC Public Health 2006;6:104.

Scheppers E, van Dongen E, Dekker J, Geertzen J, Dekker J. Potential barriers to the use of health services among ethnic minorities: a review. Family Practice 2006; 23(3):325-348.

Campbell JL, Ramsay J, Green J. Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care. Qual Health Care 2001;10:90-95.

Links to relevant national initiatives

The Dutch website for GP’s with information on ethnic and cultural aspects of diseases and illness, and with patient education materials:


UK site with information on ethnic and cultural aspects of diseases and illness

Site of the European research project Restore, on bridging language and cultural barriers in primary care.