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Beyond Borders
16th Annual GHEC Conference : : Beyond Borders: Global Health and Migrating Populations
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February 15 - 17, 2007
Santo Domingo, Dominican Republic
: : White Paper
“Migration is the “movement of a person or group of persons from one geographical unit to another, across an administrative or political border, to settle definitively or temporarily in a place.” >1
PREAMBLE
The history of humankind is one of migration. From the earliest records of existence, humans have migrated in search of food, water, shelter and security. The root causes of migration are manifold, ranging from gross economic disparities to conflict and civil wars. Societies have grown in the footsteps of migrants; culture and civilization has evolved.
Over the past two decades, the landscape of the world has been dramatically altered by the concept of globalization. While new technologies have made even the most remote regions of the world accessible via the information highway, more efficient means of communication and transportation have resulted in the increased movement of goods and services. With the growth of this global economy, tremendous job opportunities have arisen. However, this economic growth has not been equally shared throughout the world. Gross economic disparities within and between countries exist, creating a gradient, which in turn favors the migration of people in search of the means to improve their daily existence. These individuals are known as economic migrants, and they represent a rapidly expanding global phenomenon.
The World Health Organization (WHO) defines health as “a state of physical, mental and social well-being, not merely the absence of disease or infirmity”.>2 In this context, economic migrants represent some of society’s most “at risk”, vulnerable and disenfranchised individuals. Economic migrants frequently exist in isolation from social networks, living in poverty as 3 rd class citizens in the communities where they work. Accessto health care is a major challenge for economic migrants. Due to the absence of basic health care in many of their countries of origin, long-term effects of chronic illness such as diabetes and hypertension have often gone unchecked. The most vulnerable members of this group, the children, the elderly, pregnant women with no prenatal care, people with chronic diseases (diabetes, hypertension, renal failure, cancer etc…) are left on their own, thus creating the setting for catastrophic illnesses that increases significantly the national health cost paid by tax payers.
Migration now occupies an important role in the economic and social life of nearly every region and country in the world. According to UN international migration statistics from 2005, it is estimated that there are nearly 191 million international migrants; a number that has more than doubled since 1980.>3 Of these individuals, 33.6 percent (64 million) live in Europe; 23.3 percent (44.5 million) in Northern America; and 28.0 percent (53.5 million) in Asia.>4 From the perspective of a health care provider, a link between migration and health can be traced back to the transmission of the Plague during the Middle Ages. More recently, SARS, HIV, and multi-drug resistant TB serve to highlight this important relationship. Preventing the introduction of disease into communities through traditional exclusionary immigration policies has led at times to ineffective and discriminatory migration health policies. To improve health for all, policy-makers must take into account the physical, mental, and social well-being of individual migrants, their families and their communities, and strive to bridge the health concerns and needs of communities of origin, transit and destination. >5
CALL FOR ACTION
Given the complex social, political, and economic factors impacting on migrants and their health, any solution to the healthcare challenges they face must look beyond the scope of traditional healthcare providers. It must include sociologists, economists, politicians, educators, business leaders and community organizers. GHEC is in a unique position to bring these various players together. The 16 th annual GHEC Global Health Conference “Beyond Borders: Global Health and Migrating Populations” offers the opportunity to establish a framework of collaboration among all individuals and groups interested in the health of economic migrants. It is the hope of the conference organizers that it will serve as a steppingstone for the development of an action agenda that includes advocacy, better and well targeted service provision, and strategies for research and long-term influence on health policy.
1. Adapted from IOM. World Migration Report, IOM, Geneva (2003).
2. http://www.who.int/about/definition/en/
3. United Nations’ Trends in Total Migrant Stock: The 2005 Revision, http://esa.un.org/migration
4. United Nations’ Trends in Total Migrant Stock: The 2005 Revision, http://esa.un.org/migration
5. Migrant Health For The Benefit Of All. Geneva: International Organization for Migration; 2004. MC/INF/275.
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