Old and Undocumented: Concerns about a growing group of undocumented seniors

“Bring back the old Ajax logo,” says the poster in the room of Algerian Abdelhak (66). He should know, because in the years when Ajax were still playing with the old crest on their chest, they were already in the Netherlands. He has been living here without papers for 33 years. Sometimes on the street, sometimes in the garage, sometimes in a shelter, sometimes with friends, sometimes in prison.

He has now been living in the HVO-Querido emergency shelter in the west for several months. Before that, he lived on the street for nine months. Until he became too ill to live on the street. He woke up in hospital and later got a place in emergency care. “It's good here,” he says from his modest room. “It's good, much better than outside.”

Busy in the waiting room and reception

The director of the volunteer medical organization Kruispost, Stevie Janssen, is seeing more and more older and undocumented patients in her practice. “We see that the elderly group is growing. It is difficult to give a figure, but we made an estimate and arrived at about 4,500 unregistered people over 60 in Amsterdam. About 20% of the patients we see are over 60,” she says.

Frederik de Vlaming, from Regenboog Groep, is also concerned about the increase in the number of elderly Amsterdam residents who do not have papers. “We see more and more elderly people knocking on the door of the shelter,” she says. “This was expected. This is the generation that came here in the eighties and nineties.”

Richard Staring is a researcher at Erasmus University and describes the increase as a logical consequence of chain migration and the passage of time. “One problem is that people are getting physically worse. This causes all kinds of complaints and diseases. Formal access to work and housing is also closed. And making money is difficult, especially with those physical complaints. If you are young and fit, come on, it is easier to get a job.” “

To get free care if you are undocumented, in Amsterdam you can go not only to the Kruispost, but also to Doctors of the World on Osdorpplein in Nieuw-West. Director Jasper Kuipers sees the consequences of difficult life on the street in his practice: “A lot of people literally live on the street, and this has an impact on their health. This means that people age faster and develop age-related complaints more quickly,” he says.

This is also evident from figures released by CAK, the organization that manages the government fund where people unable to insure can go to claim their healthcare costs. Everyone in the Netherlands, including undocumented people, is entitled to care covered by basic insurance. In 2020, this scheme was claimed 37,461 times, and in 2022 this was 58,554. This number has increased by more than a third.

Despite this increase, in practice it seems that it is not always possible to apply this scheme. Due to the shortage of GPs, the high workload and because practices are not always aware of the scheme, almost half of GPs in Amsterdam sometimes refuse an undocumented patient. General practitioners are also sometimes ashamed of the labor-intensive administration involved in such advertising.

At the shelter, the Flemish regularly sees the result of people who continue to complain for too long because they are too old. This mainly concerns people with kidney failure, diabetes, back problems, stress complaints, cancer and dementia.

“A lot of people also fear deportation,” says Richard Staring of Erasmus University. “Then they start treating themselves. This is dangerous. Others start neglecting themselves. Sometimes medical problems become unsolvable.”

According to responsible consultant Rutger Groot Wassink, the 24-hour shelter for illegal immigrants currently takes the elderly group into account. Following GGD advice, people could be prioritized for shelter. For example, age and degree of self-reliance are indicators used.

He also recognizes the problems and says he is concerned about this group, especially when they do not receive the correct and timely care. However, there is also debate. According to the law, these people are illegal in Amsterdam. So the question is whether you can expect the same facilities for this group of people, who in many cases the courts have decided are not allowed to be here.

According to Staring, it's clear: “I don't think there's an argument to say they shouldn't have been here in the first place. Do you want these people to die unlawfully? Look away? They're simply there, their families.” “Asylum or deportation procedures have failed, or return is no longer possible. So, as a government, you have to do something about it. And also to combat abuses like people going crazy or doing something to others.”

Stevie Janssen: “It would be helpful if there were specific shelters for the elderly, although this should not be at the expense of other places. But we must realize that this group is no longer self-reliant,” says the director of Crosspost.

“I can’t go back,” Abdul Haq says. “This is not possible because of my health. Although I would like to. I think about my country every day. I will never forget it.”