 So I think we can start. I see that many participants are joining. So good morning or good afternoon everyone and welcome from the EU IM Knowledge Management Hub, the App on Return Migration and Sustainable Reintegration. So for those of you joining our public events for the first time, Dick Change we will have today is part of a set of webinars aiming to present specific return and reintegration practices. And to encourage knowledge and experience sharing. So welcome again. So before we start, let me show you some technical indication about this webinar. The most important is that simultaneous interpretation is available in English and French. You can click the logo in the black bar at the bottom of your Zoom page to select the preferred language channel to follow the event. If you have any technical problem, please don't hesitate to contact us at the email address you find on the screen. Please feel free to ask your questions through the chat. They will be collected and addressed during the question and answer after the speakers presentation. As a last point, this webinar will be recorded and made available in the return and reintegration platform. So today we will present a series of lessons from the innovative practice of medical return and reintegration, and more specifically from the pilot scheme for assisted voluntary return from France to Georgia, funded by the French Office for Immigration and Integration. The project offers safe and dignified return and includes the provision of medical support before and during travel, as well as post-arrival medical reintegration assistance. As you see from this slide, 80 medical cases assisted, 100 accompanying family members, medical reintegration up to six months and evidence-based lessons learned. These are a few info and facts about this initiative, which has also been captured as a regional good practice in our latest Aviator key highlight 2021, which is available for consultation in the repository of the return and reintegration platform. So I quickly introduce myself. My name is Francesca Jassi and I'm very pleased to welcome you today. I work as knowledge management officer at the Knowledge Management Hub, funded by the European Union and implemented by UM through its Protection Division. So we are very pleased to share with you today different voices and experiences on this practice. We will have Dr. Le Luong, head of the medical department at the French Office for Immigration and Integration, who will help us to set the frame and share a few considerations on this pilot project. Following their interventions, colleagues from the IOM offices in Georgia and France will guide us through the experiences in the implementation of this practice. We will hear the voice of Returnee through a short video and the colleagues from Switzerland and Germany will tell us more about the complementarities with other existing projects. Last but definitely not the least, we will hear from Medical Escort, Dr. Yejvili, who will help us to better understand the lessons and the challenge encountered. And after these interventions, with the help of colleagues from IOM France, we will move to the interactive session where we will ask panelists to address the questions that you can share with us during the webinar. So let's start our conversation. It's a great honor to having with us today Dr. Le Luong. She's been managing the medical service of office since 2015, and she oversees all medical activities for migrants who benefit from office support. She has an extensive experience in development, implementation and evaluation of public health policy. And Dr. Le Luong today will tell us more about this pilot project, the collaborations built and the needs identified in Georgia. So please, Dr. Le Luong, the floor is yours. Thank you Francesco. Can you hear me correctly? I can hear you very well. Okay, so I will speak in French. Well, first of all, I would like to thank all the organizers that have managed to organize very well this webinar session and give me the honor to introduce the genesis of this experiment that we organized with the OFII. Since 2017, we have been given a visa for Georgian migrants towards the Shengen area. I have realized that there was an increase of asylum applications, especially for medical reasons within the European area. So in 2019, before the COVID pandemic, we estimated that 20,000 Georgians had made an application for asylum. Most of them were in France because they were looking for quality and free medical services. In France, the prefects as well as the OFII received from the hospitals that are under pressure that there are a lot of medical applications from Georgian people in several services. In December 2019, the French Embassy or the International Office for Migration and BSC organized an international conference with all the European area to extend the Georgian visa. There was a need to analyze the dynamics and the reasons of this sanitary migration as well as the asylum applications. But there was also a need to take into consideration the asylum seekers who were vulnerable from a medical point of view. In 2020, in agreement with the French Embassy in Georgia and the Georgian Embassy in France, a medical mission of the OFII led by the General Director, this is the slide number one that you can see, has indeed associated a medical director from 14 regions hospital and took place from the 11th up to the 14th of February 2020. The purpose of this mission was to meet the health minister in Georgia, most of the hospital services as well as the multilateral players, so that we could fine-tune our collaboration, in particular focusing on the Georgian mission that came to France in order to benefit from the French health services who had made application for resident permit for health care. Indeed, in France, there is a specific sector called Medical Resident Permits, or trainers that have been longer than a year in France and are seeking disease require exceptional services on a short-term basis. And if they cannot have these kind of health care in their country of origin. Here, you can see several figures between the 1st of January 2017 and the 3rd of September 2022. We can see that there was 37,273 Zilem applications from Georgians that are the fifth nationality among Zilem sickers and we've also registered more than 6,000 applications for resident permits for health reasons. So here we're talking about 48% of adults, more than a third are women. And the favorable opinion represents 43%. As an average, I would say. The main pathologies are the following. We see 17% are due to mental and behavioral disorders, which is more than the national average. Other applications, infectious disease, represent 15%. And cancers, 13% of the applications. On the next slide, you see the mapping of the applications intensity for health care. You have to understand that these applications are not exclusive. We don't only have Georgians here represented. The OFII has worked with the International Office for Migration in order to create an experimentation for medical assisted health care. And the financial support for health care when they're back in their country of origin. So this is the genesis of the project. And now I let the other panelists develop what happened within the project. Thank you very much. Thank you. Thank you so much. Just to confirm that your presentation is concluded. Can you hear me, Dr. LeLong? Yes. Yes, yes. Perfect. So thank you so much for setting the frame of this conversation and for describing the rationale behind this very interesting intervention. So now we move to the key lessons from the project. So colleagues from the IOM offices that have been at the forefront of design and implementation of this initiative will share with us the key lessons that have been captured from the different phases of the project from the pre-departure to the post-arrival support. So over to you, Chloe and Natia. Thank you, Francesca, for this introduction. I will also be speaking in French. So for participants to turn on the translation if need be. So we will be the two of us to make this presentation because we are really working in collaboration. There's a strong collaboration between the French team and the Georgian team. So I will talk about the upstream activity and Natia will share the downstream activities. So the proper medical reintegration. So here we're going to share with you the first lessons that we could draw from the experiment and the implementation of the project. As Francesca said at the beginning of the webinar, there was there's been an assessment at the beginning of the project. We are assisting the first departures back to Georgia and the medical recession will be happening till the end of December this year. So the reports that we will produce after the assessment will enable us to have a better analysis and to make some recommendation. So now I'll start with the pre-departure assistance. So summarizing, I would say that our work on this first phase was to inform the Georgian community about the existence of the program and how it worked. There was a French Georgian cultural mediator or counselor who was with us today and she was working with each applicant in Georgian so they can understand how the program was working and to prepare the projects from the first contact up to the departure. There's strong liaison work between the treating physician, the IOM coordinator and the colleagues that are in Georgia that are actually ensuring availability of treatment in Georgian that also prepare continuum of care with health professionals in Georgia. We also organized the logistic aspects of the project in lung transportation to airport that includes ambulance as well as escorts and all needed for colleagues to get organized, stretches and so on. And we have a collaboration with the Chardonnay Airport to make sure that everything works fine for all mobility applicants that have mobility issues. A few key statistics to share with you, unfortunately we cannot get further into details but I am at your disposal if you have any questions. The project was launched on the 1st of April 2021 up to the 3rd of September 2022. We've assisted 172 applicants that had medical requirements so it's the first lesson because 79 people went back to Georgia indeed by the end of September. So we have two and a half application per month basically with all implied which means translation etc. What I referred to. So here on the first graph you see that a few applicants died unfortunately before they could came back. Others didn't want to go back so they withdrawn and other applicants to whom we said that we needed a month to get organized for their return decided to come back alone on their own intention. If we look at the profiles we can make a comparison or with the figures that have been shared by Dr. LeLion. We didn't have a majority of people that were suffering from mental disorders. We see that most of the applicants were suffering from chronic stable chronic diseases such as heart failures or kidney failures. We also had a high number of applications who were in terminal phases of their cancers. So we could draw six lessons that we would like to share with you within this pre-departure phase. So the first lesson was that there's a need for close accompaniment and follow-up because this public has really specific needs. We had talking about mobility issues as well as psychological distress. And we see that we're talking about isolated and vulnerable persons. We've assisted persons who were severely ill and had difficulties to eat to get dressed so we're talking about basic needs. Second lessons for the serious cases. So the stretchers or the terminal cases. We see that we needed well-managed coordination between a broad range of stakeholders. So here I'm talking airlines that have their own medical services, medical escorts, medical teams in the country of return and in our case the local offices of the OFI with which we worked on each application. Third lesson, depending on the beneficiaries profile we saw that some needed more comprehensive integration assistance. So it meant medical assistance but also social or professional assistance. I think that one of the case that was really important was a man who was severely ill and came back from France with mobility issues and he sold everything he had in Georgia to come to France to get medical care. So when he came back to Georgia he needed some money to buy himself a bed. I mean basic commodities. So here it wasn't just about medical assistance but also about financial assistance. Another lesson within the French context with work with more than 100 different physicians and we realized that we needed constant support from the treating physicians who needed to do all the admin work that is required in parallel so it requires a lot of work. It wasn't always easy for some physician with whom we've been working. That had also to do with the other patients of course but for us it was vital to be able to organize the returns. We also needed an access to specialists for some applicants who were living in small villages or small cities in France and it was difficult for us to have this access to specialists that were required for stabilization before departure. I'm talking about here about heart failures or heart disorders. So these are the few lessons learned. I could probably speak for 20 minutes more but I will now give the floor to my colleague Natia who will now share with you the post-arrival lessons learned. Thanks Chloe. Good morning colleagues, good morning participants, thanks for attending the meeting and now I'll overview the post-arrival medical integration assistance. As you can see from the slide out of 79 assisted cases we had scheduled medical escorts for 44 cases and it's more than a half. These escorts were provided for medical cases which required special conditions during the travel. Out of these 44 escorts cases seven were stretcher cases. The first stretcher case was organized in 2021 and 2016-2022. Based on medical condition and requirements I am Georgia provided reception and secondary transportation to final destination by ambulance for 12 cases. Very often especially for the migrants who lived in different regions of Georgia families we are not able to meet them at the airport. So far relatively light medical cases, reception and secondary transportation were scheduled and provided by taxi. You can see that we have 40 ongoing cases. Many cases returned in 2022 and especially after June. A couple of cases are in old cases I'm talking about ongoing cases who exceptionally received extension for their eligibility period which is six months upon their arrival I have to mention that we are still processing new cases because these numbers are given for the end of September. Okay next slide please. Now about the challenges which are very important. State medical insurance coverage is very limited in Georgia. It covers only basic and general needs and emergency services. We have cases with chronic diseases and their medical costs are not covered by the state medical insurance. Maybe in future there will be a project oriented on advocacy with the state institutions for expanding coverage of state medical insurance. But this project has to be implemented by a medical staff with medical background and also project on advocacy wider coverage of the state insurance will need years I think. Logistical constraints of persons with disabilities to access services. This is very important because somehow Georgia is not well adapted country for the persons with disabilities. Even some medical institutions have not relevant infrastructure. The same goes to schools and educational institutions. For receiving disability status and some free services the person has to make to collect medical documents for example medical certificate and make relevant registration. The registration has to be done in big cities which is also very challenging for the person with disabilities. Even if the person is living in to be listed his transportation is a big challenge. Some medication are not available in Georgia. As part of our pre-departure assistance we are receiving information about the prescribed medications if they are to check if they are available in Georgia. So if they are not available in Georgia we can make special order, individual order based on provided medical certificate and it can be imported in Georgia. But and we had similar cases. But in 2022 situation has changed because now Georgia is officially importing medications from Turkey so person can't make individual order anymore but this does not refers to the medications for oncological patients. Direct payments to the medical institutions after provision of services. This is very challenging especially outside of Georgia. It's outside of Tbilisi. I am Georgia established cooperation with some multi-profile clinics mainly located in Tbilisi which agrees to assist our beneficiaries and invoice us instead of patients paying for the services. Such agreements were based on our long-term cooperation. In the regions however this process is going slowly as I UMP has to establish new contact in some instances however the beneficiaries refer to travel to Tbilisi for medical treatment in any case as sometimes this particular treatment is available only in Tbilisi. This was about the challenges and next slide please. Now about good practices and lessons learned post-arrival medical integration assistance. As I already mentioned it's very important when we have some partnership established with medical institutions where our colleagues can make schedules of different medical services for our beneficiaries and they don't have to pay their money and wait for reimbursement. It's about medical consultations of different medical procedures medical tests and even surgeries. Escort movements pool of Georgian escorts expanded to accommodate needs of beneficiaries. We have two emergency care doctors we have two psychiatric escorts we have two junior doctors and one pediatric doctor and it's very important for our project. Purchase of prescribed medications in pharmacies as I already mentioned we can make orders but not only about the oncological medications but we have relationship with different pharmacies network or pharmacies in Georgia where we can order this talk of medications which are available in Georgia and provide returnees with this prescribed medications which is also very comfortable for our beneficiaries and medical cases. Drafting contracts for paramedical is a paramedical personal for home care. The process is easy by special contract with paramedics and this issue is very important for the medical case in their family members. It especially goes to severe and terminal cases where they are able to hire some medical staff for day care or night care. Imediate inclusion of substitution treatment so this goes to methadone substitution treatment sub-substitution treatment and dialy substitution treatment and we have relationship with different official institutions where we can make inclusion of these beneficiaries upon the arrival based on provided pre-departure information and provision of relevant documentation. Liaison with families in Georgia which is very important because I'm the person who is in contact with family members prior to their departure and it's very important to provide some smooth inclusion in different substitution programs, different urgent medical follow-ups and safe return. Thanks. That was all. Thank you so much for this comprehensive information and reflections. I would like maybe to highlight something to your attention which is the importance of partnerships in all the phases of the project as we have heard from colleagues among different actors in the institution and indeed crucial to ensure successful and smooth medical return and reintegration process. We cannot have a proper understanding of this initiative without hearing from the returnees voice themselves so we can display now a short video for you. We can launch the video. Thank you. So thank you. Thank you for your attention. We can now move to other similar medical return project which have been implemented complementary to the pilot one and for this we have with us today two colleagues from IUM. We start from Nazli from IUM Bern. Nazli is covering different regions as Eviarar operation assistant and she has extensive experience in legal protection in federal asylum centers in Switzerland as well as in several international NGOs. Nazli, the floor is yours. Francesco, thank you very much. Thank you very much to all the people being present and thank you for the interesting presentation so far. I will quickly talk about IUM Switzerland. I will talk about pre-departure counseling about the reintegration assistance from Switzerland, the return information fund and about the movement program and then I will shortly explain the challenges that we face so far. So IUM Switzerland has IUM counselors in federal asylum centers. That means we have direct counseling which is provided by the counselors in five different federal asylum centers and IUM office. That means we are coordinating the cases with IUM Georgia and different partners and all the counselors in the federal asylum centers. In order to prepare the returns the counselors can ask us return-related questions which we call RIF. It's basically information gathering system which we call Swiss return information fund. Here they ask us return-related question. It could be related to a treatment in Georgia as Natia explained in a detailed way. It could be regarding a project and so on. This is important to show you that the RIF questions are for example in 2018 we have 33 questions out of 33 questions we have 25 medical-related questions. Same we can also see in 2019 here we had out of 50 questions we had 46 medical-related questions. So overall we see that the questions are medical. So the questions are mainly medical-related questions. The questions can be also regarding their integration assistance which they are provided in kind by IUM Georgia. Before I talk about their integration assistance it's maybe also important to know that Switzerland and Georgia have a visa-free policy which started already 28th of March 2017. So Switzerland is therefore actually not granting normal reintegration mandates anymore but only medical-related and hardship cases. Basically cash for care or housing are only granted if there is a hardship case or a medical component to it. Before the visa-free policy we had mainly more grants for business projects. And if we took here the numbers in 2018 for example we had 19 reintegration assistance out of them 18 were medical assistance. Also in 2019 we have out of 27 reintegration assistance grants we have 24 medical assistance. So here again we can see clearly the assistance which was provided was mainly medical. Maybe it's also important to mention that as Natia basically talked about the substance abuse program that the substance abuse cases are referred to IUM Georgia for inscription to the substance abuse program which is covered under the movement program. We will quickly talk about the movements program as well. The IUM movements program is basically we do the flight booking in-house for all medical returns worldwide. We follow the same process. The process looks as follows. First we get a standard assessment travel fitness form from the medical team and then we consult with the migrant health division who gives us the fit to travel and the travel requirements such as medical escorts for example and the third step is the flight booking and the airline medical clearance. The movement operations team in Bern books the flights and services needed for each case request of each case worker. The request could be for example a wheelchair, oxygen on board and so on. For escorting same as our French colleagues like Chloé told you previously, we contact IUM Georgia to provide medical personal. Lastly talking about the challenges when I compare with IUM France for example I observe that there has been an increase in terminal cases but still substance abuse cases remain the main pathology for returnees from Switzerland. When we talk about common shared challenges I would I have to mention that the lack of cooperation of medical stuff is an issue also the different treating physicians makes it difficult and on top of that in Switzerland we have different speaking canton. That means we have medical information in Italian, in French, in German in English which makes it quite difficult to standardize it. That's definitely a big challenge. An advantage of IUM Switzerland is definitely that we have only two airports and this is much easier because the country is small so we don't have too many airports. It's very standardized and also predictable. So this is definitely a logistical advantage if you have a clear routing and it's not too complicated. Another advantage is that the donor is very flexible adjusting to the migrants needs and the donor is basically ready to fund expensive medical returns. If I have to wrap up I have to mention we have up to 10, 15 years experience with IUM Georgia. We have been working on medical returns for at least for more than a decade together since 2006 and it has been a long time which also gives us a lot of experience and we benefited a lot from these exchanges and that's why we're grateful to have been working with IUM Georgia as well. Thank you very much. Thank you so much Nasli for showing us the key elements and lessons from the implementation of these programs. Very interesting to see indeed the common shared challenges. So over now to Baburian to hear more on similar practice of return and reintegration migrants with medical conditions. Baburian is working with donors, referral agencies and service providers in IUM Germany. Prior to IUM Germany again experience of reintegration and reintegration migrants with medical conditions. Thank you very much. Thank you. Thank you. I'm happy also to be here as a speaker and thank you to colleagues who invited me to join this webinar as a speaker. I want to inform you briefly about a VR program from Germany to Georgia and we have small IUM counseling centers in Germany. We mainly work with referral agencies of the states or referral agencies of non-governmental organizations and as soon as we receive the application we proceed this from medical point and it will be assessed evaluated from medical point and also we process the case then to the next stage. We always work with our colleagues from IUM Georgia to get the information about follow-up treatment or availability of treatment and medication in Georgia and also we can support the referral agencies or inform to referral agencies that the returners have possibility to attend virtual counseling with our colleagues in Georgia. It's also possible during the pre-departure process and they can also receive the information about the social impact of the return and reintegration components upon arrival. Our colleagues in Georgia are informed about our components. Upon arrival we can also provide within the program component grant transportation from airport to the final destination including ambulance transportation if it's needed and we request for our cases also always arrival assistance if the family or family member are not available to pick up the returner upon arrival. As you can see we have also reintegration component for persons for returners with medical health condition. We call it PAMA post-arrival medical assistance. This component can only granted to the returners with complex health conditions like persons with complex psychiatric health condition or terminal health condition. As you can see also the statistics we had in this year 28 cases that returned to Georgia and four of them were escorted within the program and 12 of these cases received also post-arrival medical assistance. It was granted within our program that we provide in U.M. Germany. We had a similar situation like our colleagues in France. We had 70 cases last year departed and 30 cases were also escorted and we had also three stretcher cases that were from Germany to Georgia within the program. It's briefly information about our program. If you have further questions I can answer your question then during our webinar. Thank you. Thank you, Baburium. This was very interesting. Before moving to the last intervention I'd like to remind you that you can share your questions or comments through the chat and there will be a question and answer session following the last intervention which will be the one by Dr. Yashvili who will share with us the key lessons and challenges encountered during the returner integration process. Dr. Yashvili is an emergency doctor and intensive care physician and the Medical Lab Georgia a medical service company based in Tbilisi and he has more than 30 years of professional experience so Dr. Yashvili the floor is yours. Hi everybody, I would like first of all I would like to share my cardio greetings to all the colleagues who are attending my speech. First of all, I would like to divide, I would like to inform that I was involved only in the question of severe and difficult medical cases so I was not involved in nurse cases and easy cases so what I can tell you, every procedure have its regulations and as any procedure this evacuation could be divided in the three steps, three major steps is pre-evaluation before flight evaluation in flight management and management after return to Georgia. Let's shortly look to all the steps. First of all, my main problems during the pre-evaluation was language problems because most of these returnees do not speak the language of the country they are living or receiving treatment and that's why it will be worth to use the possibilities of modern technologies to carry out pre-evaluation assessment with written doctor and with patient. I think everybody nowadays has mobile phones and it is not difficult to perform the short interview because I had some cases where for example it was ordered to stretch your case and patient in a flat position and in opposite. Second step is in flight evaluation which I would like to thank all the colleagues involved in this process starting with airport assessment in France and especially for Istanbul team who are doing very good job every time I needed hospitalization in airport clinic or assistance they were doing very promptly, very quickly and professionally and the last issue is treatment on upon the return as several of my colleagues mentioned here here in Georgia we have not very good medical coverage structures and you know in my opinion something should be decided how to deal with these patients because most of them have either terminal illness and terminal conditions or permanent invalid conditions so permanent disability so maybe something could be decided with donors or maybe it will be worse to designate one clinic for example who will take care of them at least ambulatory care this is my thoughts and concerns Thank you, thank you so much Dr. Yashvili for these If you have any questions I am ready to ask to answer, sorry Thank you, thank you so much Dr. Yashvili it is very interesting to hear your experience and these insights so we have reached the last session of this webinar we can move now to the question answer and I am very happy to leave the floor to colleagues in France Fanny Reunard, senior project coordinator who with the help of Ekabadokia return counsellor and Dr. Tamara Berberovic will moderate this session and address the questions that you shared with us so over to you Fanny Thank you Francesco I will moderate in French Thank you very much for all the questions that have been asked I think we can start with a first question for Dr. Tamara Can you explain to us how you work with the different patient files that have a quite vague medical history how do you deal with these cases and how do you assess the situation do you do it for each patient the need for medical experts escort, sorry for the trouble Thank you very much Dr. Tamara Thank you very much and thank all colleagues because I think that through the different situations and the programs we were working together all these years I would say as within my role of focal point, immediately focal point for Europe I was fully covering and supporting IOM France and IOM Georgia in this project what is specifically different is that this project was targeting France and Georgia directly meaning that all our efforts and the coordination were tailored to these two countries that was very relevant because I would say that all the problems that we revealed through this project we try to find the solutions as I think Katlina asked the question through the chapter did we identify the situation and the possible solutions for how to address the specific feedbacks within the country of departure in this case France what here was very specific is that as you could see that almost 40 to 50 percent of all returnees were terminally ill and I would say that this statistic is fitting very much at the other countries where the final destination is Georgia meaning that these persons are usually with the cancer in the terminal stage and what is also specific here is for returnees from Switzerland meaning that they are persons with substance abuse these specific cases or specific pathology I would say is also tailoring the way how we are organizing these returnees meaning that the detailed investigation of medical files we always go through each document of the person who applied for this process through these medical reports we understand or basically I in this case understand if there is a need for receiving more updated reports or we are asking for the new report or sometimes and I would say it is happening fairly frequently we are in direct contact with the treatment physicians and understanding the actual needs of the returnees especially for those that are in a critical condition then there is the point where we are monitoring this condition during the pre-departure phase and following any change in the status we are organizing and identifying the travel requirements and we are doing that in coordination with the medical expert in case that I understand that there is a need for the medical report and then we have the phase of post-arrival assistance which for these returns to Georgia was especially relevant because as I said this is the I would say very important part of this project that we were having a pool of medical experts that were Georgians doctors and the nurses there were actual speakers of the language which we also used in the counseling sessions or more detailed information that we needed to receive from the migrant in terms of medical questions. So I think that the statistic revealed that almost 50% were with the terminal stage of the cancer but also majority of them were having chronic medical conditions that were more or less I would say under the medical treatment we paid attention to each and all case depend on the condition that was reported and I think answering to Jaime's question I think that this project was very difficult from the beginning because of having this very requiring group of patients and I think that there are many portions of the project where we could consider if we continue how to develop deeply and that part also goes to statistic of more precise specific of the cases and the difficulties that we mentioned. Thank you very much. Thank you Dr. Tamara In the chat there is a comment by a doctor that is highlighting the fact that is essential to reassure the patients before the departure. I'm now giving the floor to my colleague Eka Bodokia who's a Georgian speaking cultural mediator and return consuler I would like her to explain to us why the pre-departure advice is very important. Thank you. Thank you for giving me the floor. Yes, it is very important to speak with the patients because these are not normal people they are ill they are tired and they want to ensure that everything is going well so they need to focus on the pre-departure information for some cases some people don't have any social assistance they are isolated they don't understand the language so it is important to talk with them and provide them with all the information they need to answer all their questions and to assure them to tell them that they will be able to have the cares and they will the cares will be funded so that is very important. Thank you very much Eka I am now going to give the floor to Natia from IOM Georgia I have two specific points Natia can you tell us how the IOM Georgia is checking the availability of the drugs in Georgia do you use the tools that the EUAA is providing you with and how do you take care of the medical follow-up in Georgia after the six months after the return how the transfer is done towards the healthcare facilities in Georgia. Thank you very much Natia Okay Thanks First of all I have to say that after receiving pretty pretty information about checking some medications or availability of medical treatment or for future follow-ups we are directly contacting different doctors pharmacies, medical institutions and checking everything in a practical way this is how we check this information to give our feedback to the migrant before the arrival to Georgia What about the state insurance company when state insurance is covering some part of treatment or part of the cost of the surgery of course our medical integration budget is not used for it because the person does not have to pay for it and after completing this six months period upon arrival from sending mission we are making we refer them to relevant programs if available of course Thank you Natia Thank you Natia One question maybe for Dr Le Luong regarding France action in order to support the medical system in Georgia Do you know if France has been involved in supporting actions in order to help Georgian to get treated in Georgia and then not envisage the option to emigrate outside Georgia to receive the corresponding medical care At my level I don't have the information I must say during the 2020 mission that we did in Georgia before the health ministry the idea was to put the specialist in collaboration that means the French or the Parisian teams with the Georgian teams in order to start discussing about specific cases and to make sure in particular for children that's what we've seen in the pediatric oncology to make sure I was saying that they are adequately taken care when they are returning however and that any formalization happened at that level This is the only information I have Nonetheless I know that an assessment project is happening regarding the sanitary reasons for migration within the European Union that's something that our Swiss colleagues have been reporting and I think this assessment study could be interesting for us in order to take the correct measures to make sure that Georgian can get treated in their country already Thank you Dr. Luong We also have a question for Chloe regarding the difficulty of access to specialists regarding the difficult access to specialists in the pre-departure system this is some difficulty that has been shared by several countries for instance the iron swiss Switzerland and the iron germany have referred that so have you been able to find some solution to tackle this challenge I'm sorry I cannot give you a perfect answer on that topic it is indeed a difficulty that we've been facing up to the end of the project so maybe I could give you some clues we couldn't share with you the detailed statistics but if we go back to the slide shared by Dr. Luong showing the density mapping for the applications of Georgian we do find the same mapping as well we've tried to be working on more ongoing basis with several regions in France and it's been easier when we worked with the physicians that have already been working with us on the first return so they could fulfill the medical report or take some patient visits so it was easier to have a list of physician partners that could then refer the applicants towards some specialists it was ideal let's say to have an ongoing collaboration we are not present all over the territory so those the person who have been assisted have all been assisted or supported by the office in Paris so we had to have local partners and independent on the territory you could have NGOs that were supporting the migrants or social assistance assistance that's dependent on municipalities and local authorities these social assistance could make a follow up and be with the beneficiaries and could help us to to make specialist appointments for the applicants it is indeed a challenge that was going way beyond our project because in France already the access to specialists is difficult in rural areas for everybody I mean not only for migrants so I hope I could give you some clues however thank you very much Chloe we are going to stop the Q&A session we understand that several questions didn't find any answer so we'll be able to even answer on the platform and I leave the floor to my colleague Francesco you participated and contributed to this very active conversation so the conversation as mentioned by Fanny now goes online please do not hesitate to register to the platform's community and join the Tomato Group return the link will appear shortly in the chat and under this Tomato Group you will find a dedicated forum where to share comments, experience and where to find the answers to the questions that we were not able to answer today so just before leaving the session it would be great if you could take a few seconds of your time to response to the poll that will appear shortly on your screen as last information let me remind you that the recording of the webinar will be shortly available on the returner integration platform so we have reached the end of the conversation today we really hope that the description please do not hesitate to contact us for more information I would like to thank again all the speakers Dr. Le Luon, Dr. Yashvili and all the colleagues in Tbilisi Paris, Berlin who helped on the organization and moderation has really been a collaborative effort so thank you so much again on behalf of the Knowledge Management Alp I wish you a good rest of your day, thank you so much again