This article consolidates extracts from the ATD Fourth World Luxembourg position statement in 2023. It was published in conjunction with national elections that took place in Luxembourg that year.

This statement was compiled from individual interviews with ATD Fourth World activists conducted between January and March 2023, along with insights from the experiences of ATD allies. This document also includes the collective work carried out in 2021 in the frame of the Participatory Talks held at LISER (Luxembourg Institute of Socio-Economic Research) and organised by Olivier De Schutter, UN Special Rapporteur on extreme poverty and human rights.

A vicious circle

People living in poverty are in a vicious cycle that is difficult to break.

“Living in poverty is a continuous battle. When you are poor, you can’t let yourself go; you must make sure that you continue to go on. As soon as you give up, you are lost and could fall very far. … Living in poverty is a vicious cycle that is difficult to break. We battle every day for ourselves and our children. But can we do it alone? Can we break this vicious cycle without being considered, listened to, or heard?”

In discussions with people living in extreme poverty, “social and institutional dependency” is a recurring theme. This real or perceived dependency prevents people from playing an active role in their future, which can have dire consequences.

“[Living in poverty means] constantly running around in circles never being at ease or at peace.”

Different levels of dependency

Access to healthcare

Despite the presence of a social security system, numerous people living in hardship do not have real access to healthcare in Luxembourg.

A significant portion of these individuals’ income is consumed by out-of-pocket healthcare expenses, exacerbated by the rising cost of living.

Some people do not go to the pharmacy to pick up the medicine they have been prescribed because the part to be paid by the patient is too high.

Moreover, some people lack a referral to a general practitioner and consequently refrain from seeking medical attention due to an inability to afford doctors’ fees. The situation is compounded for those who no longer visit dentists, as the reduced support for dental visits after a two-year gap adds financial strain. Over time, embarrassment and administrative hurdles further impede dental healthcare.

Additionally, the sometimes high costs associated with obtaining items such as braces, glasses, orthopaedic insoles, splints, etc., pose additional barriers to accessing essential healthcare services.

Faced with such difficulties, certain healthcare professionals support their patients. For example, general practitioners sometimes provide an arrangement by prescribing medication for which the patient contribution is lower, or dentists allow people to pay for dentures in several instalments, etc. But is it right for access to healthcare to be dependent on the goodwill and spirit of solidarity of healthcare professionals?

Social assistance provides specific measures that can reduce healthcare costs. But we have observed that people who could potentially benefit from this assistance do not ask for it: they could be embarrassed to do so or worry about having bad experiences. Some procedures are very complicated and sometimes hard to understand. The criteria for obtaining this assistance may also not apply to them.

Food

Due to inflation, people living in poverty have to review their eating habits, which are already very different from those of people with higher incomes. Some people say they are having more and more trouble getting access to healthy and/or good quality food.

To access inexpensive shops, people living in poverty often have to travel far from where they live. Although in some cities it is possible to travel by public transport, in small towns and in the country, this travel is more difficult for people who do not have a car.

Those who shared their thoughts on this subject described several difficulties concerning the food aid system. The procedures to get this aid can vary, involving receipts, wage or “replacement income” slips, forms to fill in, etc., but they are often perceived as humiliating and hard to understand.

What’s more, food aid cannot be considered a policy for fighting extreme poverty because it holds the beneficiary in a state of dependency concerning a fundamental need.

Is it normal for people, even those with income from a job, to depend on public aid to meet a basic need?

Aid and social support

Some so many laws and rules are supposed to cater to the needs of people living in poverty but it isn’t easy to know and understand them all. Even social workers are sometimes overwhelmed.

As a consequence, people living in poverty feel they are totally dependent on a large number of social workers. Some of them have shared their experience:

“We are also dependent on the institutions. Very often, we have to go and ask for help. We are under pressure. Running all around, telling our life story over and over. We have to repeatedly endure judgement based on our appearance, family history, and our journey… Each of us has gone through such experiences: “You are a welfare case.” … People stick labels on you, but they don’t know a thing.”

“We feel judged based on our appearance. I hate being stared at… So, when interacting with social services, we don’t feel understood. Communication is difficult. We no longer even dare to ask for help because we feel that no one can or wants to help us.”

This is why many people living in extreme poverty don’t dare to ask for help. They again describe embarrassment and fear stemming from previous experiences and apprehension of being. They also fear potential consequences, such as the possibility of their children being put into care if their living conditions are deemed unsuitable or if their refrigerator is empty.

Other people come up against bureaucratic barriers or don’t know who to turn to. They don’t understand what is expected of them, and some may have lost the energy to continue the procedures, which could then be held against them.

Protective measures for adults

Sometimes, people experience a significant setback and are therefore placed under legal protection. Subsequently, they regain their footing and can reassume control of their lives. Yet, the law in Luxembourg does not provide for periodic reassessment of legal protective measures for adults, as is the case in other countries. Of course, the adult under protection can ask for their file to be reviewed, but again, the lack of information and the complexity of procedures can be an obstacle. These people thus risk remaining under guardianship for a long time if they do not request to be freed from it.

Exploring new ways to break the cycle of poverty

During our collaborative discussions, we explored strategies to break the persistent cycle of poverty while respectfully and appropriately addressing the needs and circumstances of individuals living in poverty. Here are two more approaches, suggested by ATD Fourth World Activists, that were discussed during the 2021 Participatory Talks with Olivier de Schutter:

“Firstly, we believe that spaces should be created where professionals and families living in hardship could meet to find the best solutions for the wellbeing of all family members. Learning from one another and training together is important. Through such an exchange, people in difficult situations could better understand the roles of the different services (social offices, youth protection services, housing, etc.) and the type of assistance that social workers can offer us. We could also learn to express better what we are going through and our needs without getting angry. For their part, the professionals could learn from us what it means to “live in poverty” and understand that “asking for help” is very difficult and that often we are afraid of this. They could discover that we express ourselves differently, independent of the language used. They could understand that it is important to trust people and their capabilities. We could show them that we can and should be considered partners in changing our lives. Secondly, from a collaborative perspective, we observe the potential for adjustments that could enhance social workers’ ability to propose assistance better suited to individuals in difficult situations.”

Photo: ATD Quart Monde Luxembourg, 2023 © ATD Quart Monde