The COVID crisis was still in full force one morning in early April of 2021 when Adeline Grippon opened the doors of CASO, a Médecins du Monde-run social services and health clinic in the Seine Saint Denis suburb of Paris. (In French, CASO is an acronym for Centres d’Accueil de Soins et D’Orientation. In English, that’s Reception, Care and Orientation Center).
Outside, she found about 40 people waiting for her. Some had minor medical issues that needed attention. One pregnant woman, accompanied by her toddler, asked about prenatal care. Five or six of the people in line wanted help establishing a postal address to receive mail – a key step in establishing a formal asylum case.
Among the people in line that day was a government official, bearing a hospital bill for 4,500 Euros, addressed to Médecins du Monde’s CASO. A woman who had received some services at CASO gave birth in a local hospital, even though she wasn’t yet a recipient of France’s social service programs.
“This guy came to announce that there’s a legal case in process against this woman,” Grippon says. The next step in the process was for the woman’s wages to be garnished.
“But the people we work with don’t have a salary, or even a house,” Grippon says.
If the woman had brought her bill to CASO shortly after the childbirth, Grippon says, CASO’s social workers would likely have been able to get the hospital to classify the woman as someone in limbo: still in line to get the free medical care to which she’s entitled under French law. The bill would have disappeared, Grippon says.
Once that bill is in the hands of the state, though, it’s nearly impossible to get rid of it. And there are long-term, sometimes crushing consequences. If the woman applies for asylum, she might be rejected purely because she has a bill on record that she didn’t pay.
“Treating people is one thing,” Grippon says. “But the hardest thing is to explain their rights and help them get them.”
Fondation CHANEL’s funding means that Médecins du Monde can have experts on staff at CASO who work specifically with women, like the one with the hospital bill. There is a social worker, a health mediator and a field coordinator, as well as Grippon herself. Those staff members coordinate the 80-odd volunteers, most of whom are doctors and nurses, including mental health professionals, gynecologists, midwives and more.
CASO provides services for roughly 6,000 people every year, Grippon says. She estimates that number could easily balloon to 9,000 people every year, if there were more space in the center.
By the time many of the people who need help find it at CASO, they’ve experienced significant trauma, says Dr. Alain Benet, a retired general physician who has volunteered at the center for the past decade. A person from Mali, for example, likely has crossed the Sahara Desert before being imprisoned in Libya and then shunted onto an overcrowded boat for a dicey trip across the Mediterranean Sea. Humane treatment, for most people in that scenario, beyond expectation – and women often bear the worst of it.
“The number of women who experience sexual abuse is well over 50 percent,” he says through an interpreter.
Most people Benet sees at CASO hope to get a basic medical check. They’re highly motivated, he says, full of energy and eager to be strong and healthy so they can work hard and find success.
Some, though, have serious medical conditions – cancer, heart disease or chronic illnesses – that require ongoing care. For those people, Benet does what he can to help them secure a temporary immigration status in order to get the medical treatment they need.
That’s often a long shot, he says, but the effort sometimes pays off.
As a young doctor, Benet dreamed of working in clinics and hospitals in Africa. Now, especially as a volunteer for Médecins du Monde, he’s fulfilling that dream in an unexpected way.
“I wanted to work in Africa, but instead the Africans came to me,” he says.
Benet continues to treat patients at CASO even as the number of volunteers has dwindled due to the COVID-19 pandemic. At the same time the number of emergency requests from people newly-arrived in Europe for food and shelter has shot way up. These days, Grippon says, about half of the people who come to CASO, many with families in tow, are looking for a place to sleep. Médecins du Monde doesn’t operate any shelters.
“We can give them a place to rest for a while, we can help explain the process for seeking asylum,” she says. “We can’t help them fill out the documents, but we can explain how it works.”
From there, she says, the family must head out again, to continue its search for home.
Reporter for Fondation CHANEL