‘Leaving no one behind’: how states can help migrants access health services

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The health of migrants is not only determined by individual biological aspects, but also by broader socio-economic factors such as social and community networks, living conditions, education, employment, income and community safety.

When people migrate in a safe, orderly and regular fashion, migration can help migrants and their families by improving their socioeconomic status, offering better education opportunities, and improving their access to health services.

According to IOM’s 2018 World Migration Report, out of 250 million international migrants, 50 million of them are irregular; so, while the majority of migration flows are safe, a significant amount of people find themselves in unfavorable economic, political, social and/or environmental conditions in their country, making them vulnerable to health risks since their pre-departure.

For migrants in transit, health risks increase due to limitations to access safe means of transport and accommodation, sufficient and safe food, and access to medicines or health services when needed.  Upon their arrival, they may face inadequate housing conditions such as overcrowding, lack of ventilation and insecurity, along with limited access to drinking water and basic sanitation systems.

Once in the destination country, many migrants face difficulties integrating into the host community and might not be granted equitable access to affordable health care. Alternatively, local health systems may have limited capacities to meet migrant health needs.

The World Health Organization’s report details other barriers that migrants face to access health services including discrimination and stigmatization, language barriers, administrative hurdles, and restrictive norms generating fear of deportation or the loss of employment. Health services available to migrants may not be sensitive to their needs, leading to delayed or undiagnosed conditions or ineffective treatment.

Some of the main factors that hinder migrants’ access to healthcare are:

  • The lack of sufficient mechanisms to ensure migrants’ access to health insurance schemes
  • Lack of formal language interpretation services at health centers caring for international migrants
  • Administrative requirements to access health services, such as identification documents
  • Expensive out-of-pocket mandatory payments for health services
  • Stigmatization and fear of negative consequences of seeking healthcare, due to migrants’ irregular status
  • Limited availability of healthcare services at some locations, such as border communities

The United Nations 2030 Agenda for Sustainable Development is geared towards the commitment to “leave no one behind”, including migrant populations. However, achieving their inclusion is quite a challenge for most countries.

IOM outlines some considerations to promote the inclusion of migrants to public health systems, including a greater inclusion of migrant issues in health plans and strategies at national and regional levels. Instead of developing separate plans of actions for migrant populations, public health must be approached comprehensively to migrants and other vulnerable populations. Another important consideration is the continual collection of data on migration trends and migrants’ access to health services to develop informed health policies and actions. Access to robust data, such as knowing the actual costs and resources at hand, along with better coordination among stakeholders is key for planning effective responses.

IOM’s report on migration governance in the Caribbean also recommends the following actions to offer migrant-sensitive health services, such as:

  • Strengthening public health systems funding schemes
  • Making interpretation services available at health facilities (an example of this is the employment of multilingual staff, professional interpreters or cultural mediators)
  • Establishing mechanisms that allow for systematic data collection on migrants’ access and use of health services
  • Consistent adherence to international standards regarding migrant access to health care
  • Outreach initiatives for vulnerable populations such as elderly populations or unaccompanied minors
  • Sensitization campaigns for the general public and healthcare providers on migrant-sensitive approaches

A safe migration process means people’s physical and emotional integrity are not jeopardized, and that migrants are able to exercise their rights fully, including the right to health. migration is a driver for economic and human development in communities of origin and destination. IOM promotes regular, safe and orderly migration to boost migrant’s integration into host communities.


Responding to hate speech against migrants in social media: What can you do?

Responding to hate speech against migrants in social media: What can you do?
Categoria: Migrant Protection and Assistance
Autor: Guest Contributor

"We all have to remember that hate crimes are preceded by hate speech." This is how Adama Dieng, UN's Special Adviser on the Prevention of Genocide, starts the Stopping Hate Speech video. "We have to bear in mind that words kill. Words kill as bullets", he continued.

To speak about hate speech it is necessary to refer to Article 19 of the International Covenant on Civil and Political Rights (ICCPR). The article stresses the importance of freedom of expression, but it also calls attention to the responsibilities that come with it. 

The United Nations has recently launched the "UN Strategy and Plan of Action on Hate Speech", to strengthen UN actions that address the causes of hate speech, and the impact this discourse has within societies. Among other measures, the strategy includes monitoring and analyzing data, using technology, and engaging with new and traditional media. It also encourages more research on the relationship between the misuse of the Internet and social media for spreading hate speech, and the factors that drive individuals towards violence.

Just like the UN must assume responsibility, traditional media oulets also face challenges in guaranteeing that the information they offer on migrants is conscientious and data-based (here are some recommendations on how to do this).

But beyond these institutional responsibilities, the reality is that thousands of people publish hate filled content on their social media every day, sometime explicitly calling for violent actions against migrant populations and other vulnerable groups. What can each of us do to fight back against this content?

  • Speak up against hate: Silence and apathy can be taken as acceptance. Comments on social networks are more than just words, and should not be seen as harmless, especially when social networks are a source of information for migrants and contribute to their experiences. According to the Department of Justice of the United States, "insults can escalate to harassment, harassment can escalate to threats, and threats to physical violence." Intervening assertively is important both in the digital world and in face-to-face situations. However, it is necessary to assess the risk in each context to avoid dangerous situations.
  • Create positive content: To counteract the weight of hate speech, it is necessary to create and share empathetic information. According to Cristina Gallach, High Commissioner for the 2030 Agenda, to combat this problem, we must present images that appeal to the best of us, and focus on powerful and universal messages that unite us through our shared values.
  • Avoid sharing sensational videos and photos: Even when it is to criticize this type of content, sharing it will increase traffic to the channels and users that broadcast negative media.
  • Report on the platform: Each social network has its own guidelines on which content is acceptable or not not. While there are teams dedicated to verify this information, in many cases it is necessary to report it for it to be seen. Facebook continually checks if there are new vulnerable populations that should be included in their protected categories, and on previous occasions, migrants have fit within this group. According to the Facebook hard questions blog:

"When the influx of migrants arriving in Germany increased in recent years, we received feedback that some posts on Facebook were directly threatening refugees or migrants. We investigated how this material appeared globally and decided to develop new guidelines to remove calls for violence against migrants or dehumanizing references to them — such as comparisons to animals, to filth or to trash. But we have left in place the ability for people to express their views on immigration itself."

There is a whole discussion about whether social media companies are the ones who should define, in their own platforms, what constitutes freedom of expression and what constitutes hate speech, but that is material for another blog. Here you can see what kind of content to report in Facebook, Twitter, Instagram and YouTube.

  • Report to the authorities: When there are personal threats to the physical integrity or the lives of others, it is time to report the situation to the competent authorities to intervene. Since the digital world moves faster than changes in laws, there may be "holes" in the regulations that will hinder intervention. Documenting hazardous materials through screenshots and collecting as much information as possible about the aggressor before they close their account will be useful for the reporting process. Platforms and companies can also be reported if they spread violent content. For example, a few months after the massacres in two mosques in Christchurch (New Zealand), the Australian government approved new legislation against spaces that do not quickly eliminate "violent and abominable material".

“We need to use the verb to become a tool for peace, a tool for love, a tool for increase social cohesion”, said Adama, later in the video. Let’s speak up against hate speech.