Migration Health

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Addressing health issues and concerns surrounding the migration process has been a keystone of IOM’s work since 1951. From health assessments to building and strengthening capacities of national health systems, IOM’s migration health response underscores its unique and holistic approach to migration management. While protection of the human rights of migrants and their right to health has been increasingly recognized, security concerns and the unprecedented increase in unregulated and precarious migration have resulted to rising anti-migrant sentiments, threatening the realization of the 2030 Agenda for Sustainable Development of leaving no one behind.

Embedded within the Department of Migration Management (DMM) but closely inter-linked with the Department of Operations and Emergencies (DOE) and the Department of International Cooperation and Partnerships, the Migration Health Division (MHD) meets the aspirations of migrants and Member States towards the fulfilment of the physical, mental and social well-being of migrants and their family, enabling them and their host communities to achieve social and economic development.

IOM and our partners work to ensure migrants’ health needs are addressed across the whole migration cycle – at pre-departure, during transit and travel, at the destination and upon return home. IOM’s approach to migration health responds to the key priorities and action points of the Global Operational Framework on the Health of Migrants that is guided by the 2008 World Health Assembly Resolution (WHA 61.17) on the Health of Migrants.

People, particularly the most marginalized and disempowered living in and contributing to equitable and inclusive societies are the main essence of the UN 2030 Agenda for Sustainable Development. It acknowledges the development potential of migration, owing to the intellectual, cultural, human and financial capital that migrants contribute to the social and economic development of their host societies and communities, as well as countries of origin. For migrants to be productive and achieve these purposes, being and staying healthy is a necessary pre-condition.  

An overview of our activities is available here.

Migration health assessments and travel health assistance for migrants and refugees are among the most well-established migration management services provided by IOM. At the request of receiving country governments, IOM provides an evaluation of the physical and mental health status of migrants to assist them with resettlement, the obtainment of temporary or permanent visas, international employment or enrolment in specific migrant assistance programmes. Reflecting differences in immigration and public policies and practices, there is a diverse range of health assessment requirements among receiving countries. Services within IOM health assessment programmes include tuberculosis diagnostics and treatment or referrals for treatment, laboratory diagnostics and treatment for other conditions of public health concern, counseling and health education and health informatics, among others.

Travel health assistance is a related service that addresses individual health and safety and manages conditions of public health concern as individuals move across geographical, health system and epidemiological boundaries. Within health assessment programmes, pre-embarkation checks and pre-departure medical services are provided to assess migrants’ fitness to travel and provide medical clearance. These measures also ensure that migrants are referred to appropriate medical services once they arrive in their destination countries. Migrants who need medical assistance and care during travel are escorted by health professionals to avoid complications during transit. Pre-departure treatment, vaccinations and other public health interventions are also tailored to meet the needs of migrants and immigration authorities.

Other services, such as assistance within the context of Assisted Voluntary Return and Reintegration programmes for persons with medical needs, and DNA sample collection services for family reunification are cross-cutting with other thematic areas of the migration management portfolio of IOM.

In South-Eastern Europe, Eastern Europe and Central Asia, IOM provides migration health assessment and travel health assistance services to immigrants and refugees through its missions in Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Israel, Kazakhstan, Kosovo 1244, Kyrgyzstan, former Yugoslav Republic of Macedonia, Republic of Moldova, Russian Federation, Serbia, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan. The majority of the refugees assisted in the region were bound for the United States, followed by Canada and Western European countries, such as the United Kingdom, Germany and Italy. Turkey and Ukraine assisted the largest refugee caseloads, which originated primarily from Syria and Ukraine, respectively. Prospective immigrants to Australia, Canada, New Zealand, South Korea, United Kingdom and the United States made up the majority of all migrants assisted by IOM’s health assessment programmes in the region with Russia and Ukraine providing most of the pre-departure health assessments.

Combatting TB

Central Asian labour migrants travel long distances to find work, and often in close quarters. Tuberculosis thrives in such an environment, putting many migrants at risk for contracting it. IOM provides health checks in countries of departure and destination, helping to reduce spread of the curable disease.

© Elyor Nematov

Inadequate access to health services and the unfavourable conditions in which many migrants live and work make them subject to a variety of health risks. These are of particular concern to vulnerable groups, such as irregular migrant workers, victims of trafficking and exploitation, displaced persons, refugees and representatives of ethnic minorities, such as the Roma population of Europe. In South-Eastern Europe, Eastern Europe and Central Asia (SEEECA), health systems are facing shortages and imbalances in the geographical distribution of the health workforce brought about by emigration of health professionals to Western Europe and other OECD countries.

Despite decreasing trends globally, Tuberculosis (TB), including drug-resistant TB, HIV/AIDS and other sexually transmitted infections in Eastern Europe and Central Asia are increasing, putting migrants at risk, and, considering the high mobility in the region, make the issue of migrants’ health a priority. Also, the rising trend of non-communicable diseases, from substance abuse and metabolic diseases to cardiovascular conditions among the general population reflects a potential trend among well-integrated migrants as well as their family members. Policy and programmatic gaps, particularly in compliance with the international standards on human rights and in mainstreaming migration health in the public health approaches of governments are impeding migrants’ right to health.

IOM’s Health Promotion and Assistance for Migrants programmes are specifically designed to facilitate the access of migrants to high-quality health services regardless of their migration status and promote evidence-based programming and development of migration health policies through operational research. IOM works with partners in advocating, designing and delivering interventions on mental health, psychosocial response, inter-cultural communication, TB, HIV/AIDS, non-communicable diseases, emerging and re-emerging diseases, sexual and reproductive health and rights, maternal and child health, social determinants of health and health development, labour migration, border management, health and social protection of trafficked persons, assisted voluntary return and reintegration of migrants, environment and climate change.

Emergency Health Response

IOM provides health assessments and assistance in coordination with other humanitarian organizations on the Western Balkan route in Mitrovica, Kosovo* in 2017. As a formal partner of WHO and member of the Inter-Agency Standing Committee’s Global Health Cluster and the Global Outbreak Alert and Response Network, IOM responds to humanitarian and public health emergencies, and supports health system recovery and resilience by alleviating suffering, saving lives and protecting human dignity throughout the migration cycle and mobility continuum. Health support is an essential part of IOM’s humanitarian mandate, and it is recognized as one of the 15 sectors of the IOM Migration Crisis Operation Framework.

Humanitarian crises produce increasingly complex and often large-scale migration flows and mobility patterns, which typically expose affected populations to significant vulnerabilities and generate serious and longer-term migration management challenges. In disasters or crisis situations, health systems, depending on their health infrastructure and services, may suffer from acute to chronic setbacks in their capacities, and often lack adequate resources to provide the much-needed services to displaced persons or migrants. Logistical support, procurement, rapid deployment and transport of medical supplies and equipment, as well as support to service providers in disasters or emergencies is critical.

Countries in South-Eastern Europe, Eastern Europe and Central Asia face a variety of natural hazards, among which floods and earthquakes have the most impact, and which may have significant health consequences. The World Bank has reported that close to 500 significant floods and earthquakes have hit Europe and the Central Asian region in the past three decades with 50,000 fatalities, affecting nearly 25 million people and resulting in over billion USD in damages[1].

In 2015, the unprecedented rise in the number of migrants crossing borders on land and at sea towards Europe placed Turkey and the Western Balkan region along the path of this movement. Driven by conflicts and insecurity in the Middle East and East Africa, as well as deep-rooted socio-economic problems, poverty and human rights violations in their countries of origin, this mass mixed-migration flow of people carried with it an enormous economic, political and social impact for host and transit countries. The health implications of these mass movements rest mainly on the burden to health, security and immigration services who manage the situation – particularly those who were caught unprepared.

As the migration flow to Europe has stabilized, Turkey is left with approximately 3.5 million foreign nationals seeking international protection, mainly from Syria, Iraq, Afghanistan, Iran and Somalia. In the SEEECA region, the Republic of Serbia and former Yugoslav Republic of Macedonia are also left with close to 4,000 refugees and asylum seekers in reception or detention facilities. Ensuring access to health and psychosocial services in accordance with international humanitarian and human rights standards and principles can be daunting tasks for governments in the region. Since 2015, the crisis has taken more than 8,000 lives and displaced more than 800,000 people across Europe.

 

[1] World Bank. 2017. Europe and Central Asia - Country risk profiles for floods and earthquakes. Washington D.C.: World Bank Group. http://documents.worldbank.org/curated/en/958801481798204368/Europe-and-Central-Asia-Country-risk-profiles-for-floods-and-earthquakes

Dr. Jaime Calderon, IOM Regional Migration Health Adviser for South-Eastern Europe, Eastern Europe and Central Asia outlines the risks of tuberculosis and ways to protect oneself at a meeting in Astana, Kazakhstan.

1-2 November 2017

South Caucasus Regional Workshop in the Framework of the Project “Enhancing Mechanisms for Prevention, Detection and Treatment of HIV/AIDS and Tuberculosis among Migrant and Mobile Populations in the South Caucasus Countries.”

27 September 2017

Meeting to discuss an essential HIV care package for migrants: Central Asia 
Copenhagen, Denmark

25-26 September 2017

Meeting of National HIV Programme Managers in Eastern Europe and Central Asia (EECA) and non-EU/EEA Countries 
Copenhagen, Denmark

19 June 2017

Mainstreaming the Global Compact for Safe Orderly and Regular Migration 
Baku, Azerbaijan

15 May 2017

Re-HEALTH Concluding Workshop 
Brussels, Belgium

3-4 April 2017

Fourth South-Eastern Europe Health Ministerial Forum on “Health, Well-being and Prosperity in South-eastern Europe by 2030 in the Context of the 2030 Agenda for Sustainable Development”
Chisinau, Republic of Moldova.

Report of the Fourth South-Eastern Europe Health Ministerial Forum on “Health, Well-Being And Prosperity In South-Eastern Europe By 2030 In The Context Of The 2030 Agenda For Sustainable Development”

5-6 December 2016

Regional Workshop on Migrant’s Right to Health, Comprehensive Approach to Protection of the Migrants’ Health including Prevention of Substance Abuse among Migrants 
Ashgabat, Turkmenistan.

 

Further reading:

Chandonnet, A. et al.
     2017     Migrants’ Right to Health in Central Asia: Challenges and Opportunities. International Organization for Migration, Bishkek. Available at http://www.iom.kz/images/books/IOM_2017_migrants_health_eng.pdf.

World Health Organization (WHO) 
     2017     Women on the move: Migration, care work and health. WHO, Geneva. Available at http://www.who.int/gender-equity-rights/knowledge/women-on-the-move/en/.

 

In the implementation of the SDGs, migrants’ health are reflected in the following goals: