Universal health: three proposals for the inclusion of migrants

 

World Health Day forces us to reflect on the habits that could cause a negative effect on our health and on the measures, we must take to minimize the risks to a disease. It forces us to eat better, to perform more physical activity, to avoid stress and fundamentally to perform medical examinations that allow us to detect and treat all kinds of illness in time.

But what happens when people migrate? Many of those factors, habits and conditions that are already known and that determine your health are modified. You can now find multiple administrative barriers to access services, language limitations, stigma and discrimination and many other conditions that will limit access to basic services, thus affecting your health in an important way. There are still inequities very present in the region preventing the adequate access of large population groups to health services, with barriers based on their migratory status, nationality or other conditions.

Therefore, today we must also reflect on the close link between human mobility and health, and how we are responding as a society to everyone's needs. The campaign, promoted this year by the World Health Organization, "Universal Health Coverage: Everyone, Everywhere" means looking back at those populations that, because of their migratory status, are falling behind. Because of this, I consider it necessary to take action in the following aspects:

  1. Strengthen joint work in a multi-sectoral manner that guarantees access to quality health services, with cultural appropriation and sensibility to the migrant.
  2. Formulate policies that guarantee the inclusion of vulnerable populations and eliminate structural barriers that hinder access to universal health.
  3. Seeking partners, generate alliances, strengthen networks and promote joint and multi-sectoral work that allows us to address issues that merit a regional response, multinational and fundamentally multidimensional.

In Mesoamerica we have a regional and multi-sectoral coordination mechanism that aims to advance these proposals. It is the Joint Initiative of the Health of Migrants and their Families (INCOSAMI) that brings together governments, civil society organizations, regional associations, academia, United Nations agencies and development partners, in order to promote the health and migration agenda in the region.

“Without migrants, including internally displaced people, universal health coverage (UHC) would not be truly universal.”  -Jacqueline Weekers, IOM Director of the Migration Health Division.

On the other hand, it is important to emphasize that the access of migrant populations to universal health must also go beyond services. It is about carrying out actions in places where they are located, either in transit or destination communities. This leads us to the need to design prevention and health promotion campaigns with inclusive communication strategies. It invites us to sensitize and train all health personnel and migration authorities about the rights, contexts and conditions of the migration process.

 

 

   Sobre el autor:

Carlos Van der Laat is the IOM Regional Migration Health Officer for the Americas. Specialist in Family and Community Medicine, he has a Master's Degree in Human Rights and Education for Peace. He has worked for the Costa Rican Social Security Fund and the University of Costa Rica, as well as a consultant forespecia the Pan American Health Organization and UNICEF. He specializes in intercultural health, from where he has formulated and coordinated community projects.

 


Internal displacement, extractive transnational corporations and the protection of rights of affected communities

Internal displacement, extractive transnational corporations and the protection of rights of affected communities
Categoria: Environmental Migration
Autor: Guest Contributor

 

The export of raw materials, hydrocarbons, and minerals occupy a prominent place in Latin America’s economic model. However, due to the extraction characteristics of some of these resources, environmental conflicts appear in several places around the continent (see details here). According to the UNDP, migration and displacement appear as a result of conflicts due to the activity of extractive industries. In the words of said organization:

"For many developing countries, mineral extraction continues to be an important economic engine with the potential to improve the results of human development, in line with the Sustainable Development Goals (SDGs). When properly managed, mining can create jobs, foster innovation and bring investment and infrastructure to a scale that changes the game in the long term. However, if handled badly, mining can also lead to environmental degradation, displaced populations and an increase in inequality. " (Read more here)

In 1998, the United Nations established the guiding principles of internal displacement to address the protection needs of internally displaced persons. These principles include, among others, the prohibition of arbitrary displacement "in cases of large-scale development projects, which are not justified by a superior or primordial public interest". Although the IACHR has gathered information on the relationship between extractive interests and the displacement of persons, by 2016, in Latin America, only Mexico, Colombia and Peru had adopted laws on internal displacement, and only Guatemala had adopted policies on internal displacement. (see map).

In October 2018, however, a new tool relevant to the discussion appeared, with the release of the first draft of the legally binding international instrument on transnational corporations and other companies with respect to human rights, developed by a working group of the High Commissioner for Human Rights (OHCHR), and described in resolution 26/9.

This tool is important because it refers specifically to internally displaced persons and migrants - without excluding their involvement in other parts of the text - as groups that must be given special attention in consultations (Article 9, point g.) and on the impact of the projects (article 15, point 5 of the implementation). This is significant given that one of the great consequences of the extractive transnationals is the displacement of people due to the repercussions on their economic, social and cultural rights (ESCR), established in the Universal Declaration of Human Rights.

Due to their political, social and environmental characteristics, Mexico and Central America have historically represented geostrategic value for the extraction of multiple natural resources. Mining for obtaining different materials, hydroelectric production and extensive agricultural crops (pineapple and palm, for example, the latter representing an important agrofuel) are some of the main industries related to environmental conflicts, causing potential displacement phenomena in the region. 

In this context, it’s important to ask what the displaced people of these territories can do to defend their rights. From the OHCHR draft, four relevant elements can be emphasized for the protection of people’s rights in displacement situations due to the involvement of transnational corporations in their environment:

· Address the legal process without economic cost, since there is a consensus on the need to address the lack of resources of affected communities that request the protection of their rights. Civil society campaigns recommend that once there are sufficient indications that a person is a victim of a human rights violation, the costs of the process to that person are exempted and he or she is not obliged to indemnify the corporate counterpart in case of acquittal. The economic support by the States towards the victims when carrying out legal proceedings of this nature is contemplated in the draft of the OHCHR (Article 8, point 6).

· Creating group processes is necessary, since the legal processes of protection of rights benefit from a collective approach when dealing with the issue of displacement, due to the characteristics of the impact of extractive industries in the communities. This way, it is possible to avoid opening several cases that can become discordant, reduce costs for the State and pool the victims’ resources. The draft accepts and includes the rights of victims both individually and in groups (article 6, point 1, article 8, points 1 and 2, article 12).

· Procure due diligence in the processes, allowing the displaced victims access to the necessary documentation with the cooperation of all parties. At the end of a process, if a displaced person victim of transnationals wins the case, it’s important that the reparation (economic, moral or otherwise) is given within a reasonable time. The impact of both the dispossession of land and the legal process affects several aspects of the victim’s daily life (food, family and community relations, economic activity, physical and mental health) so restoring their original conditions must be a priority for effective justice. OHCHR’s draft refers to cooperation as a function of the national implementation mechanisms of the binding instrument; for example, when responding to inquiries from victims, companies and the general public, or when sending recommendations to improve the implementation of the binding instrument itself (article 3, point 2, detail a. and b.)

· Find an integral solution to the problem, because even when processes are carried out collaboratively (previous point), these are usually long, which may cause the victim to consider agreements that are not integral solutions to their problem in order to resolve it in less time. This type of outcome can also be seen by the company as a simpler way to access land while improving their public reputation, which constitutes a serious antecedent when evaluating the impact of extractive companies, which is minimized. According to OHCHR’s draft, the victims have the right to "a) Restitution, compensation, rehabilitation, satisfaction and guarantees of non-repetition for victims; b) Environmental remediation and ecological restoration when appropriate, including coverage of expenses for relocation of victims, and replacement of community facilities."