A way to enable refugees to help in the COVID-19 crisis

As the COVID-19 pandemic pushes health systems to the point of exhaustion around the world, innovation is called for. Letting refugee health workers help out can be one way to increase capacity, but currently recognition of refugees’ qualifications and professional licensing represents a major obstacle.

Most, if not all, health-related jobs are within regulated professions. To practice as a medical doctor or nurse, for example, you need a professional licence in addition to the required academic qualifications. The list of regulated professions varies between countries, but generally includes professions where the consequences of malpractice are often serious and immediate.

Requirements for professional licensing are strict and the procedures can be lengthy. There are good reasons for being strict and we all prefer to be treated by experienced and properly licensed health professionals.

Nevertheless, the present times are not normal. If we have the choice between being looked after by professionals who are qualified but not licensed, or receiving no healthcare at all, most of us would not find the choice difficult. In some countries, including Italy and Ireland, not only are retired health professionals being called back to service, but advanced medical students are being asked to help out.

While medical doctors and nurses immediately come to mind when we think about healthcare, many others are also essential, including ambulance staff, psychologists, laboratory technicians, nutritionists, pharmacists, midwives and occupational therapists. We should also not forget those who clean and maintain health facilities or who cook patients’ food.

An untapped resource

In many countries, there is an untapped reserve: refugees and migrants. As the Council of Europe and the UNHCR pointed out in a recent statement, many refugees have health-related qualifications. The statement got substantial coverage in international media, including the Guardian and Le Figaro. Few, at least among the more recent arrivals of refugees and migrants, are licensed to practice in their host country. They can, nevertheless, help in the current crisis, and many are eager to do so.

Again, the alternatives are not all or nothing – allowing qualified refugees to operate as licensed health professionals or not to work at all. What we must look for are ways to enable qualified but unlicensed refugee health professionals to work under the supervision of licensed staff. It will help their host communities and it will motivate refugees and help them keep their qualifications up to date. In addition, it will show in a very concrete way that most refugees are not a burden or a danger, but a potential resource and a help.

Some refugees were able to take their university diplomas with them, but many were not. Losing your diplomas, however, does not mean you have lost your qualifications. This is where the European Qualifications Passport for Refugees (EQPR) could be of help. Launched by the Council of Europe in 2017, this project brings together the national information centres on recognition from the ENIC and NARIC Networks in, so far, 10 countries, UNHCR, public authorities and some universities, to assess refugees’ qualifications even when these cannot be fully documented.

The methodology of the Qualifications Passport was developed by NOKUT (the Norwegian Agency for Quality Assurance in Education), and the Norwegian national information centre plays a key role as assessment coordinator. The EQPR provides a tested methodology for assessing such qualifications and a format for describing the qualification in an understandable and comparable format that can also be used if EQPR holders move to a new country.

To date, 543 refugees have had their qualifications assessed and 454 have received the EQPR. Forty-six of them have health-related qualifications. From an initial reliance on face-to-face interviews, assessment interviews are now increasingly conducted online and the methodology is therefore well adapted to the current circumstances.

The EQPR does not offer a professional licence, but it can identify refugees qualified to assist in the current crisis. Equally important, in the light of the COVID-19 crisis, it can contribute to the identification of individuals whose qualifications can then be taken into account in a professional licensing procedure.

The EQPR will not solve the COVID-19 crisis, but it can be part of the solution if the means and the will to make use of it are there. In cooperation with the UNHCR, the Council of Europe is now moving to organise new interviews of refugees with health-related qualifications, in the first instance in France, the United Kingdom and Italy, aiming to cover all relevant qualifications. The scheme could be expanded to include other countries as well.

The lessons learned from this initiative by the Council of Europe, UNHCR and key stakeholders in Europe will also be important to the further development of the UNESCO Qualifications Passport for Refugees and Vulnerable Migrants, which was tested last year in Zambia. This tool, established in the light of the newly adopted UNESCO global recognition convention, aims to expand the scope of qualifications passports globally in harmony with the EQPR, which is already in place in Europe.

The COVID-19 pandemic calls on all of us to do our best to help save lives and build futures. It would be unforgiveable if we did not include refugees in the call for action. Many refugees have relevant qualifications and they are willing to help. We cannot afford not to reach out to them. The European Qualifications Passport for Refugees provides us with means to do so.

Sjur Bergan is head of the Education Department at the Council of Europe. He has been central in both the development of the Bologna Process/European Higher Education Area and the Lisbon Recognition Convention. Stig Arne Skjerven is director of foreign education in NOKUT – the Norwegian ENIC-NARIC. He is the current president of the ENIC Network and was a member of the drafting committee of UNESCO’s global recognition convention. Both Bergan and Skjerven have been instrumental in developing the European Qualifications Passport for Refugees and schemes with similar methodology.