Until 2019, Victor Jeans Zavala's life in Italy went “without much change”. He moved to Milan from Peru, his native country, in 1998 and, before the Covid-19 pandemic, he worked for a cleaning company, securing through employment the necessary documents for his stay in Italy.
“Everything changed one morning when a scooter hit me and broke my leg,” he tells Avvenire.
“Since then, I have lost my job and therefore my residence permit and access to healthcare.” Today, Zavala is 68 years old, suffers from rheumatoid arthritis and has no money to buy the medicine he needs: “My hands and feet go numb,” he explains. “I'm trying to fill in the paperwork to get my license and health card back, but the employment agency keeps telling me they only hire people under 30.”
Without work, even health becomes a privilege that the 68-year-old man can no longer enjoy: “I have to take arthritis medicine every week, but I have no money. At home, only my wife works, who earns 700 euros a month. I can only manage thanks to the volunteers from Caritas and the polyclinic of the Fratelli di San Francesco foundation, who visit me and buy me medicine.
There are almost 600,000 foreigners over 60 in Italy who find it difficult to get healthcare
Like Zavala and other 590,000 foreigners over the age of 60 in Italy, it is difficult for them to benefit from medical visits, diagnostic tests and medicines. They are first-generation migrants who have mostly worked in Italy for decades and are now aging with the rest of the population. But with fewer protections, because among foreigners, there are “phenomena of under-diagnosis, unequal use of services and interruptions of treatment”, according to Immidem, the project of the Italian National Institute of Health that analyzes the health of people of foreign nationality now living in Italy, monitoring the occurrence of dementia cases.
The numbers are growing. Today, 7.6% of foreign citizens over the age of 60 have cognitive impairments and, even when they manage to be registered with the National Health Service, the resources for them continue to be insufficient: only 6.7% of the centers have multilingual information materials, 10.5% have access to personal interpreters, and 37.3% rely on the presence of a cultural mediator. “Migrants,” sums up Immedem, “have greater language vulnerability and more fragile family networks.”
“And we, in our clinic, consulted people with dementia,” explains Arianna Princiotta, coordinator of the Milan polyclinic of the Fratelli di San Francesco Foundation, which accepts foreigners without a residence permit. “But there is also a hidden dimension: often, families keep parents who show signs of dementia at home.”
The problems of the migrant population, according to the representative, are the same as those of elderly Italians: “Cardiovascular problems, diabetes, flu and vaccines that need to be injected.” But for the foreign population, the obstacles are more common: “Many tell me they can't even go to the pharmacy by themselves,” continues Princiotta, “because the drug leaflets are not translated into their language and they don't know what to buy.”
For foreigners with a valid residence permit obtained through family reunification, after the age of 65, medical assistance is no longer free
Things get more complicated in the case of chronic conditions, which require treatment by the National Health Service. “A Chinese man in his 70s,” says the representative, “had glaucoma. We examined him and then had to report the situation to the hospital, but they did not accept him for months. The man is now being treated at a public hospital in Milan, but other people in his condition bear the cost of these delayed treatments every year.
At Casa Donk in Trieste, where people without a residence permit are offered free medical and psychological assistance, Dr. Giovanna Cornelio knows all the chronic patients by name: “They are loyal customers,” she jokes.
In most cases, their problems are primarily financial: “A single bronchospastic bronchitis inhaler costs 50 euros,” she explains. Many of her elderly patients are unemployed and unretired, but even among those with regular residence permits, barriers to accessing care are growing.
For all foreigners with a valid residence permit obtained through family reunification, after the age of 65, healthcare is no longer free. It costs at least 2,000 euros per year. “It wasn't always like that,” comments Elisa Morellini from the legal department of the Milanese Naga association. “Before the 2024 budget law, the minimum price was 387.34 euros”. For those who cannot afford to pay, under these conditions even diabetes can be lethal: “The problem is the diagnoses,” concludes Dr. Anna Spada di Naga. “We diagnose many chronic diseases at the first admission: which means that, if we had not detected them, these elderly people would have arrived in the emergency room with hypertensive crises, or with decompensated diabetes.” (Material produced with the support of Rador Radio Romania)
