Delayed medical care leaves dozens of asylum-seeking children with serious health damage

Dozens of asylum-seeking children in the Netherlands suffered serious health deterioration last year because they did not receive medical care on time, according to the Dutch pediatric expertise center Ekann. Delays were often caused by frequent relocations or poor living conditions in shelters. In some cases, the lack of timely care resulted in lifelong health damage—or even death.

The alarm was raised by Ekann in a report to Dutch investigative platform Pointer. “We receive reports where care was initiated too late, and as a result a child suffered permanent health damage or even died,” Ekann co-founder and pediatrician Marijn Baauw told Pointer. “These forty reports are only the tip of the iceberg. We see refugee children in emergency shelters increasingly falling through the cracks.”

Currently, about 16,000 children under the age of 18 live in Dutch asylum centers, with many housed in temporary emergency shelters. These facilities are often unsuitable for children, according to repeated assessments by the Dutch Health and Youth Care Inspectorate. The buildings are unsafe, chaotic, and not equipped to meet children's basic needs.

Dr. Anne van Els, a pediatrician at Bravis Hospital in Bergen op Zoom, has encountered children in alarming condition. “I treated a boy who was severely malnourished. He had already been in a shelter for six months. Only when someone noticed his condition was he referred to me. But it took far too long before he received the help he needed,” she told Pointer.

Frequent relocations are one of the most disruptive factors in providing consistent medical care, Ekann warns. Each year, more than 7,000 children are moved one or more times to different asylum reception centers. These moves often interrupt treatment or force doctors to restart care from scratch.

Van Els described how one of her patients—a girl with a rare genetic syndrome—suddenly stopped showing up to appointments. “It turned out she had been relocated to another asylum center without my knowledge,” she told Pointer. “I had to track down which center she had been moved to and arrange care there. But that’s double work, because she was already under my care. Should pediatricians have to do that on their own? Not everyone will, simply because we don't always have the time or resources.”

According to the Central Agency for the Reception of Asylum Seekers (COA), it is the responsibility of parents to report when their child needs medical care. Parents are advised to notify COA staff, who serve in a “guide function” and can call the Health Care Asylum Seekers (GZA) helpline.

However, Ekann says many asylum seekers do not understand how the complex Dutch healthcare system works—especially in moments of crisis. “Many of these families carry trauma. When they have a seriously ill child, they need guidance. At some locations, access to care is simply not well arranged,” Baauw told Pointer.

COA also cited privacy regulations when asked about communication gaps. It said address changes must be reported by parents and cannot be shared with doctors directly. “We’re not allowed to do that at COA,” a spokesperson said. “We can support residents in doing so.”

The Association of Netherlands Municipalities (VNG), responsible for overseeing local emergency shelters, declined to comment in detail. A VNG spokesperson said they “lack clear visibility” into the issue at the municipal level.

Minister for Asylum and Migration Marjolein Faber acknowledged the problems but said the situation isn’t universally poor. “Not all emergency shelters are inadequate. Some are very good. Of course, some may not fully meet minimum standards, but we are doing our utmost,” she said in a response to Pointer.

On the issue of frequent relocations, Faber argued that the number of children who are moved fewer than three times is greater than the number moved more often. To reduce pressure on the shelter system, Faber wants to reverse the Spreidingswet—a law that mandates municipalities to accommodate asylum seekers. COA board member Gerard Kapteijns strongly opposes that plan.

“Those relocations are the source of all this misery,” Kapteijns told Pointer. “To get rid of that, we need stable locations. The Spreidingswet is crucial for that. We really want to keep it.”

Ekann is calling for the creation of multidisciplinary teams to support children with complex medical needs. “In hospitals we already use such teams, but what’s missing is the link to care providers at the shelter locations, such as general practitioners and youth doctors,” Sara Sahba, Ekann’s co-founder, told Pointer. “If a boy is placed at a municipal site in a bungalow park, the municipality must ensure that someone is prepared to anticipate complex medical problems.”

Meanwhile, the backlog in asylum procedures is reportedly adding further stress. According to data from the Immigration and Naturalization Service (IND), 13,500 children are currently waiting for decisions on their asylum applications. Of those, 5,500 have been in the process for over fifteen months.