Institutional Precariousness And Cultural Mediation In Migration Medicine Services: The Case Of The U.O.S. Migration Medicine Center In Palermo

Abstract

Cultural mediators play a crucial role in facilitating migrants’ access to healthcare services, yet their work often unfolds within fragile and only partially recognized institutional settings. This article examines how institutional precariousness shapes the everyday practices of cultural mediators in migration medicine. Drawing on a qualitative case study of the U.O.S. Migration Medicine Center in Palermo, the analysis combines a review of the Italian and Sicilian regulatory framework with semi-structured interviews conducted with professionals working within the service.

The findings show that weak professional recognition affects not only contractual stability, but also role perception, professional boundaries, and the emotional burden associated with mediation work. At the same time, mediators emerge as key actors in building trust, facilitating communication, and supporting institutional access for vulnerable users. The article argues that the effectiveness of cultural mediation depends not only on individual competences, but also on stable recognition, organizational clarity, and adequate support structures.