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“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family...”
Article 25, UN Universal Declaration of Human Rights 1948
Key points
Situations of forced migration has increased health risk initially, during migration and after displacement
Access to healthcare is a significant barrier in a new region, in part due to social factors
New policy may be a way to address improving physical and mental health of migrants
Image credit: un.org.ir
The UN estimate that 65.6 million people have been forcibly displaced from their homes by conflict and persecution alone; a figure which is increasing year on year. Not only do forced migrants experience increased health risks, but also face persistent barriers to accessing appropriate healthcare. For those displaced, there are therefore significant challenges to realising the right to health, requiring the concerted action of governments, NGOs and communities.
In situations of conflict or environmental disaster, systems of food production, sanitation, healthcare and shelter are often dramatically disrupted, leading to an increased risk of malnutrition and the spread of disease. In addition, those affected may also sustain physical injuries and experience acute trauma and stress.
Moreover, the conditions experienced by forced migrants during and after the migration process also contribute to an increased risk of poor health. In many refugee camps, conditions are cramped and sanitation is poor, leading to an increased risk of communicable diseases such as Cholera and Hepatitis E. In addition to the risk of disease, women in refugee camps also face an increased risk of gender-based violence as established methods of accountability break down. Stark and colleagues (2010), for example, found that in one refugee camp in northern Uganda, 52% of women reported experiencing physical abuse.
Restrictive immigration policies, border policing and detention regimes also contribute to greater risk of mental and physical ill-health during the migration process. In Europe, tight border controls have contributed to an increase in dangerous border crossings across the Mediterranean sea, creating severe risks to the health and even lives of forced migrants. In 2015 alone, the UN estimate that over 1,200 people were killed while attempting to cross the Mediterranean Sea and enter Europe.
The experience of life as a displaced person in a new region or country can also have a negative effect on health. Forced migrants are likely to experience downwards social mobility and racial discrimination as they travel away from their former homes. These processes not only affect the material resources of displaced persons but also their mental and physical well-being. Asylum seekers who have not yet been formally recognised as refugees are frequently prohibited from paid work and provided with only limited financial support from national governments. Consequently, many asylum seekers resort to employment in the informal sector, experiencing low pay and poor working conditions.
Despite their increased health risks, forced migrants often face barriers to accessing healthcare provision. Where healthcare is provided on an insurance-based model, it can take a significant length of time for migrants to establish coverage and forced migrants may face out of pocket expenses and charges beyond their financial means. Forced migrants also face difficulties in countries with universal healthcare systems. In the UK, Doctors of the World have reported that many undocumented migrants and asylum seekers are wrongly turned away from NHS services because they could not provide requested documentation and, in many countries, the interpretation and information services required by migrants to effectively access care are not widely available.
Governments, NGOs and communities must work to respond to the particular risks faced by forced migrants, including the more intangible risks of isolation and downwards social mobility. Accordingly policy responses should be holistic, improving the material conditions of forced migrants and supporting diaspora communities as well as ensuring formal access to healthcare. Such an approach is vital in ensuring the right to health is truly realised for all, including forced migrants.
Further reading
Ager, A. (2014). 'Health and Forced Migration'. Fiddian-Qasmiyeh, E., Loescher, G., Long, K., & Sigona, N. (eds). The Oxford Handbook of Refugee and Forced Migration Studies. Oxford, Oxford University Press. http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199652433.001.0001/oxfordhb-9780199652433-e-041
About the author
Megan is currently a postgraduate student of Social Policy at the London School of Economics with a special interest in migration and social security. Before beginning her Masters, Megan studied law at Oxford University where she also conducted research on the law and policy relating to Female Genital Mutilation for the NGO, 28TooMany. Megan has also worked as a paralegal in the legal aid sector, assisting low-income clients with housing and social security problems.
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