Republic of Latvia Cabinet Regulation No. 686 Adopted 21 November 2017

Procedures for Performing Health Examination and Sanitary Treatment of an Asylum Seeker, and also for Registering the Results Thereof

Issued pursuant to
Section 12, Paragraph three of the Asylum Law

1. This Regulation prescribes the procedures for ensuring health examination and sanitary treatment of an asylum seeker, and also for registering the results thereof.

2. Health examination of an asylum seeker shall include the following:

2.1. the survey (anamnesis, complaints) and examination of medical documentation, where possible;

2.2. the general examination;

2.3. the anthropometrics (body weight, height);

2.4. the inspection for the determination of tuberculosis in accordance with the laws and regulations regarding the procedures for performing mandatory medical and laboratory examination, mandatory and forced isolation and treatment of persons in cases of infectious diseases;

2.5. the referral to perform other necessary investigations by taking into account health condition and symptoms of diseases of an asylum seeker, and also special epidemiological situation in the country of origin of the asylum seeker or the country where the asylum seeker resided prior to arrival in Latvia. If necessary, a medical practitioner shall consult the Centre for Disease Prevention and Control and the Limited Liability Company Riga East University Hospital;

2.6. the investigations for the determination of the presence of polioviruses if 30 days have not passed since an asylum seeker has left or transited through the countries affected by poliomyelitis. Investigations shall be conducted by the Limited Liability Company Riga East University Hospital;

2.7. informing an asylum seeker of actions in the case of disease, a possibility to receive health care services, and recommended preventive measures.

3. Sanitary treatment of an asylum seeker shall include the following:

3.1. washing in the shower;

3.2. the treatment for head lice if lice have been detected;

3.3. the disinfection or disinsection of personal clothing and personal belongings of an asylum seeker in accordance with the instructions of a medical practitioner and laws and regulations regarding disinfection, disinsection and rat extermination. If disinfection or disinsection of personal clothing, underwear and personal belongings of an asylum seeker is not required, the asylum seeker shall be provided with a possibility to wash his or her clothing, underwear and personal belongings in a washing machine.

4. Until the performance of sanitary treatment and health examination the asylum seeker who will be accommodated in an accommodation centre for asylum seekers (hereinafter - the accommodation centre) or on the State Border Guard accommodation premises (hereinafter - the accommodation premises) shall be accommodated in a separate room. Asylum seekers may be accommodated in one room if they have arrived as a group of asylum seekers. If the group of asylum seekers includes a person with obvious signs of infectious disease, this person shall be accommodated in a separate room.

5. In accommodating an asylum seeker in the accommodation centre or on the accommodation premises, a medical practitioner shall:

5.1. perform sanitary treatment and health examination of the asylum seeker, unless such examination has already been performed within the framework of the specific asylum procedure, and results thereof are documented in the form of sanitary treatment and health examination of the asylum seeker (Annex 1). The form shall be placed in an outpatient card of patient;

5.2. make an entry in an outpatient card of patient of the asylum seeker on a permit to accommodate the asylum seeker on living premises or on accommodation of the asylum seeker in a room especially equipped for this purpose for medical observation for the time period until receipt of the results of the necessary health examinations or expert opinions.

6. Sanitary treatment shall not be performed if an asylum seeker is not accommodated in the accommodation centre or on the accommodation premises.

7. If an asylum seeker is not accommodated in the accommodation centre or on the accommodation premises, an institution where the abovementioned asylum seeker submits an application for granting refugee or alternative status shall refer him or her to the health examination (hereinafter - the referral) (Annex 2), except for the case when the asylum seeker has a valid residence permit in the Republic of Latvia. The abovementioned asylum seeker shall undergo the health examination within the time period laid down in the referral and submit a certification of the performed health examination (Annex 2) to the Office of Citizenship and Migration Affairs.

8. An asylum seeker who has received the referral shall undergo health examination in a medical treatment institution where a family doctor provides State paid health care services. The family doctor shall perform health examination of the abovementioned asylum seeker in accordance with Paragraph 2 of this Regulation and register results of the health examination in an outpatient card of patient.

9. If an asylum seeker has documents at his or her disposal which certify the fact that he or she has undergone health examination in accordance with Paragraph 2 of this Regulation, he or she shall submit them to a family doctor or a medical practitioner of the accommodation centre or the accommodation premises respectively. The family doctor or the medical practitioner of the accommodation centre or the accommodation premises shall evaluate the abovementioned documents and take a decision regarding the need to perform the investigations referred to in Sub-paragraphs 2.3, 2.4, 2.5 and 2.6 of this Regulation.

10. Cabinet Regulation No. 620 of 20 September 2016, Procedures for Conducting Health Examination and Sanitary Treatment of the Detained Asylum Seeker, and also for Registering the Results Thereof (Latvijas Vēstnesis, 2016, No. 184), is repealed.

Prime Minister Māris Kučinskis

Minister for Health Anda Čakša

 

Annex 1
Cabinet Regulation No. 686
21 November 2017

Results of the Sanitary Treatment and Health Examination of the Asylum Seeker

Completed by:

the doctor

the assistant doctor

the nurse

Given name, surname
Signature

Health examination is performed by:

the doctor

the assistant doctor

Given name, surname
Signature
Date of the initial inspection (dd.mm.yyyy)
Language of communication

Participation of an interpreter: yes no

I. General data

1.	Surname
2.	Given name (names)
3.	Nationality and type thereof
4.	Date of birth	. . . (day) (month) (year)
5.	Gender	Male Female
6.	Country of birth
7.	Country from which he or she has arrived
8.	Date when he or she left the country of origin
9.	Countries which he or she has already transited through		1.
			2.
			3.
			4.
10.	Date when he or she arrived in the European Union
11.	Date when he or she arrived in the Republic of Latvia

II. Anamnesis

1.	Factors which could negatively affect health condition in the country of origin or during travel (for example, hunger, rape, torture)
2.	Chronic diseases	yes no not known/cannot answer If yes, specify ___________________
3.	Long-term pharmacotherapy with medicinal products	yes no not known/cannot answer If yes, specify ___________________
4.	Allergic reactions	yes no not known/cannot answer If yes, specify ___________________
5.	Pregnancy (this shall be asked to women of childbearing age)	yes no If yes, specify the pregnancy week ___________________ and the number of previous pregnancies _______
6.	Last menstruation (this shall be asked to women of childbearing age)
7.	Other important information (for example, bad habits, injuries, operations, family anamnesis)

Identification of risks of infectious diseases

Tuberculosis (TB)
Has he or she ever suffered from TB?	no not known/cannot answer yes (specify) ___________________
Parenteral virus infections
Has he or she ever been diagnosed with viral hepatitis?	yes no not known If yes, specify which A B C E Additional information (when, current treatment etc.) ___ ___________________
Has he or she ever been diagnosed with HIV?	yes no Additional information (when, current treatment etc.) ___ ___________________
Vaccine-preventable infectious diseases
Has he or she ever suffered from measles?	yes no not known/cannot answer
Has he or she ever suffered from mumps?	yes no not known/cannot answer
Has he or she ever suffered from rubella?	yes no not known/cannot answer
Has he or she ever suffered from chickenpox?	yes no not known/cannot answer
Other infectious diseases
Has he or she ever suffered from malaria?	yes no not known/cannot answer If yes, when ___________________ Has he or she been treated for malaria? yes no If yes, specify ___________________
STIs	Ask about risk factors and signs of diseases
Other risk factors of infection
Contact with other persons who suffer from infectious diseases (epidemiological anamnesis)	yes no not known/cannot answer If yes, specify the disease, when and where ____ ___________________
Additional information

Immunisation data

He or she has an immunisation card (certificate)

yes. If yes, specify the country which has issued it_______________

no. If no, complete the following table of vaccination

No.	Infectious diseases	Yes/No/Not known	If "yes", how many doses he or she has received	When the last vaccination has been carried out
1.	Tuberculosis	yes no not known
2.	Measles	yes no not known
3.	Mumps	yes no not known
4.	Poliomyelitis	yes no not known
5.	Rubella	yes no not known
6.	Diphtheria	yes no not known
7.	Tetanus	yes no not known
8.	Whooping cough	yes no not known
9.	Other (specify) ____________	yes no not known
10.		yes no not known

Complaints (confusion, different pain (headache, abdominal pain, joint pain), digestive disorders, breathing difficulties, cough, poor appetite, dark urine, childhood developmental disorders (if a child is examined), night sweats, rapid weight loss):

III. General examination

Height
Body weight	usually (according to the person) ___________________ when conducting measurements ___________________
Head circumference of a child under 1 year of age
Chest circumference of a child under 1 year of age
Body temperature (oC)

Presence of lice in hair, clothing: yes no
Skin (turgescence, jaundice, pallor), mucous membranes
Suspicions of scabies, microsporum or other contagious skin disease: yes no
	If yes, specify
Oral cavity
Lymphatic glands
Arterial blood pressure and heart rate
Cardiac and lung auscultation
Abdominal palpation
Psycho-emotional state (appetite, sleep, mood)
Sensibility, mobility impairments, neurological disorders
Consequences of injuries

IV. Administered investigations and results

Tuberculosis	Specify	Date of investigation	Result
Test for diagnosis of tuberculosis
Chest roentgenogram
Sputum investigation

Other necessary investigations and results
(conducted according to epidemiological or clinical indications)

Administered investigation	Date of investigation	Result

V. Opinion on health condition

VI. Recommendations

Necessary professional consultations (specify)
Administered treatment

Minister for Health Anda Čakša

 

Annex 2
Cabinet Regulation No. 686
21 November 2017

Referral for Health Examination of an Asylum Seeker

(name of the institution)

refers the asylum seeker to the health examination:

1.	Surname
2.	Given name (names)
3.	Nationality and type thereof
4.	Date of birth	. . . (day) (month) (year)
5.	Gender	Male Female
6.	Personal document of the asylum seeker, place and date of issue thereof
7.	Country of birth
8.	Country from which he or she has arrived
9.	Date when he or she left the country of origin
10.	Countries which he or she has already transited through		1.
			2.
			3.
			4.
11.	Date when he or she arrived in the European Union
12.	Date when he or she arrived in the Republic of Latvia

Official who issued the referral:

Position
Given name, surname, signature
Telephone
Date
I am informed that health examination of the asylum seeker shall be performed and a certification thereof shall be submitted to the
Office of Citizenship and Migration Affairs by
								(date)
Given name, surname, signature of the asylum seeker
Date

I hereby certify that the asylum seeker has undergone the health examination.

Given name, surname, signature of a doctor
Telephone
Date			Seal of a medical treatment institution

Minister for Health Anda Čakša

 

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Translation © 2018 Valsts valodas centrs (State Language Centre)