5SS

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Migration and Health

Definition of Migration

Any process of movement of people,

either across an international border (i.e., international migration) or within a country (i.e., internal migration)

permanently or an a temporary basis, whatever its causes

Source: J. Weekers (IOM) (2004)

Definitions in Migration

Migration can include people who have been

displaced or people who have been forced to

migrate, or people who have voluntarily moved.

Displacement includes:

Forced migration includes:

Economic migration includes:

Lets look at each one of these migration terms

Displacement

Conflict induced displacement – happens

when people are forced to flee their homes

because of armed conflict including civil war,

generalized violence, and persecution on the

grounds of nationality, race, religion, political

opinion or social group.

 Source:

http://healthandrights.ccnmtl.columbia.edu/forced_migration/definiti

ons.html

Displacement Cont’d

Development induced displacement - occurs

when people are obligated to move as a result

of policies and projects implemented to

advance ‘development’ efforts. Examples of this

include large-scale infrastructure projects such

as dams, roads, ports, airports; urban

clearance initiatives; mining and deforestation;

and the introduction of conservation

parks/reserves and biosphere projects.

Displacement Cont’d

Disaster induced displacement - occurs

when people are displaced as a result of

natural disasters (floods, volcanoes,

landslides, earthquakes), environmental

change (deforestation, desertification, land

degradation, global warming) and human-

made disasters (industrial accidents,

radioactivity).

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Forced Migration

Refugees - The legal definition enshrined in 1951

United Nations Convention, is a person residing

outside his/her country of nationality, and is unable

or unwilling to return because of a ‘well-founded

fear of persecution on account of race, religion,

nationality, membership in a political social group, or

political opinion’.

Those recognized as refugees have a clear

international legal status and are afforded the

protection of the United Nations High

Commissioner for Refugees ( UNHCR)

Forced Migration Cont’d

Asylum seekers - Asylum seekers are

people who have moved across

international borders in search of

protection under the 1951 Refugee

Convention, but whose claim for refugee

status has not yet been determined.

Forced Migration Cont’d

Internally displaced persons (IDPs) - The

United Nations definition: are groups of persons

who have been forced or obliged to flee or to

leave their homes or places of habitual

residence, due to or in order to avoid armed

conflict, situations of violence, violations of

human rights or natural or human-made

disasters, and who have not crossed an

internationally recognized State border.

Forced migration cont’d

Development induced displacement - includes people

who are compelled to move as a result of policies and

projects implemented to ‘enhance’ development. also

referred to as ‘oustees’, ‘involuntarily displaced’ or

‘involuntarily resettled’.

Environmental or disaster induced displacement –

also known as ‘environmental refugees’ or ‘disaster

refugees’, people displaced by environmental factors or

disasters and do not leave the borders of their homeland.

(floods, volcanoes, landslides, earthquakes),

environmental change (deforestation, desertification, land

degradation, global warming) and human-made disasters

(industrial accidents, radioactivity).  Source: http://healthandrights.ccnmtl.columbia.edu/forced_migration/definitions.html

Forced Migration Cont’d

 Smuggled people - Smuggled migrants are moved

illegally for profit. Smuggled migrants may include

those who have been forcibly displaced as well as

those who have left their homeland in search of better

economic and social opportunities.

 Trafficked people - Trafficked people are those who

are moved by deception or coercion for the purposes of

exploitation. The profit in trafficking people comes not

from their movement, but from the sale of their sexual

services or labor in the country of destination.  Source:

http://healthandrights.ccnmtl.columbia.edu/forced_migration/definitions.

html

Economic migration  This type of migration is defined as a choice to move in order

to improve one’s standard of living or in order to obtain a

better paid employment, residence, education.

 Employment seekers

 Temporary workers

 Education seekers

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Global Trend on forced migration

 In 2014 the Number of forcibly displaced worldwide: 59.5 million

 There were 19.5 million refugees worldwide at the end of 2014, 14.4 million under the mandate of UNHCR, around 2.9 million more than in 2013.

 The other 5.1 million Palestinian refugees are registered with the United Nations Relief and Works Agency (UNRWA).

 During the year, conflict and persecution forced an average of 42,500 persons per day to leave their homes and seek protection elsewhere, either within the borders of their countries or in other countries.

 Developing countries host over 86% of the world’s refugees, compared to 70% ten years ago.

 Read more in: Global Trend Report http://www.unhcr.org.uk/about-us/key-facts-and-figures.html

Migration Health

Health issues, conditions and risks

related to migrant populations, and

the way in which it also affects:

Population of origin,

Communities in the places of transit and

destination, and

Second and later migrant generations

(Roux, 2004)

Migration and health  We all understand the importance and need for good health

for all. This also includes people or populations that have

moved or are displaced. But migration and health does not

only affect those that are migrating but also:

 Populations of origin (where they came from)

 Populations they transit through

 Populations of their final destination

 Second generations or people born to migrant populations

Question?

Can Migration be considered as a

determinant of health ?

Answer

 Yes, it is a determinant of health.

 Migration is not a health risk but the conditions

surrounding the migration process can lead to increased

vulnerability

 Migration places increased pressure not only on the

individuals but also on local communities and local

government to respond to the needs of the its population

 It also posses a challenge on providing adequate prevention,

testing, treatment and support , due to lack of migrant friendly

health services

Migration as a determinant of

health

Victims of trafficking also increases risks especially for

women

Smuggled people and other migrants may be forced

into labor, leading to physical and sexual abuse, lack

of respect their human rights and subsequently their

rights to health

Migrants may also come into communities without

adequate health screenings which may exacerbate

existing health care resources

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Migration as a determinant of

health

 reduces access to hygiene facilities and increases

diseases such as STI and AIDS

Government health surveillance may not take

migration related data which means policies and

programs will not include migrants

Migrant populations often depend heavily on their

partners and other co migrants which creates further

dependency and lowers access to social security

Migration as a determinant of

health

Women can get reluctant to report abuse such as domestic, rape etc for fear of deportation

Migrants experience increased exposure to psychological, physical and sexual abuse

Migrants will lack sufficient education which hinders health seeking and access

Lack of family planning services increases unwanted pregnancies

What can be done?

Organizations like the IOM (International Organization for

Migration) works in various programs to promote migrant

health including:

Research and Policy guidance on migrant health

Health promotion for migrants especially in areas of:

HIV/AIDS

Reproductive health

Prevention of Gender based violence (GBV)

What can be done? Cont’d

provides evidence-based tools for health providers

provides practical, non-clinical advice

 recognize some of the associated health problems

 identify safe and appropriate approaches to providing healthcare for trafficked persons.

 Information campaigns to prevent trafficking

Training health providers

Direct assistance to migrants victims of exploitation

 informed and attentive health care provider can play an important role in assisting and treating individuals who may have suffered unspeakable and repeated abuse.

Remove barriers to health services regardless one’s migration status

Reference UNHCR- Global Trends Forced displacement in 2014.

(2014). Retrieved from

http://www.unhcr.org/556725e69.html#_ga=1.43793253.151

5990145.1454905977

 IOM, WHO, UN Human Rights. (2013). International

Migratoin, health and human rights retrieved from

http://www.ohchr.org/Documents/Issues/Migration/WHO_IO

M_UNOHCHRPublication.pdf

Source: J. Weekers (IOM) Global Consultation on Migrant

and Health, Madrid, Spain (3–5 March 2010); adapted from

IOM Glossary on Migration (2004)

 International Organization for Migration. Managing

Migration, 2004.

www.iom.int//DOCUMENTS/PUBLICATION/EN/Migration_d

ec_2004.pdf