Dr Renuka Jayatissa is Head of the Department of Nutrition at the Medical Research Institute of Sri Lanka. While Renuka has always conducted nutrition and public health-related research, her interest in migrant health stems from her involvement in studies of internally displaced populations in the wake of the 2004 tsunami disaster. While Renuka’s work is primarily focused on the health of internal migrants – including those forced to move to due to the civil conflict in Sri Lanka- in recent years she has increasingly engaged with the area of cross-border migration. Renuka collaborates with various agencies and organisations working on migration and health issues in Sri Lanka and South Asia more broadly, particularly with MHADRI Secretariat Dr Kolitha Wrickramage at the International Organisation for Migration (IOM) who, last year, recruited her to join the MHADRI network.
During her time working for UNICEF, Renuka developed a broader understanding of the migration and health challenges experienced in different global south regions – particularly South Asia and parts of East and Southern Africa. Whenever she conducts national studies, Renuka includes migration as a variable in order to collect and compare data on the health outcomes of migrant populations. Renuka looks at nutrition status across different population groups but is concerned about the lack of studies of the overall health of people affected by migration in Sri Lanka. She stresses the importance of not only considering the health and wellbeing of those who migrate, but monitoring the health of the children left behind and the relatives who care for them. So far, Renuka’s studies of the nutrition status of migrants have revealed that nutrition levels are not too dissimilar to that of native populations, however, without targeted research that considers all aspects of health it is difficult to further understandings of health behaviours, challenges and risks for migrant populations in Sri Lanka.
While the government appears, on the surface, to be proactive about migration and health issues – as evidenced by numerous regulations and policies – Renuka questions to what extent these regulations and policies are actually implemented. Concerned about the effectiveness of these efforts, Renuka posits that monitoring and evaluation of existing programmes should be carried out in order to measure how these policies and initiatives are performing. A monitoring and evaluation framework could be the missing piece in the puzzle of migration and health governance in Sri Lanka.
Renuka observes that Sri Lankan government ministries often follow the lead of international agencies such as World Health Organisation (WHO), meaning that documents such as the Global Compacts – on Refugees, and on Safe, Orderly & Regular Migration – have potential to refresh the government’s focus on migration issues and can, hopefully, improve migration governance.
“Sometimes in government we are very monotonous and go in the uniform direction, so it is good when [external actors] bring new ideas to reimagine and restructure our programmes.”
However, Renuka remains apprehensive about the relevance of the Compacts across different contexts. For her, the Compacts illustrate an intention to influence countries when it isn’t always necessary given that migration challenges vary considerably from region to region.
Regional Nutrition conference in Korea with Nutrition teams
Renuka and her colleagues are pushing for a greater focus on migration in health policy and research and the consideration of health and wellbeing in migration management. In order to achieve this, Renuka takes part in various forums relating to internal migration issues, and shares research and ideas relating to public health and the health of those affected by migration.
“Because I am working for the Ministry of Health, I have access to all the committees … so I can always raise my voice, even up to the President level. We write to newspapers, run workshops, start awareness programmes and appear on television in order to leverage policy makers and raise awareness with the general public.”
At present, migrants are largely ignored in research and policy, but Renuka is optimistic about the potential for “strong evidence”, gathered from scientific research, to affect positive change. In the 20 years Renuka has been working as a researcher, she has found that people do not argue with evidence and if migration and health challenges are to be taken seriously and acted upon, then compelling data needs be collected and shared. She believes that improving access to data and research is essential to shaping domestic and international policy.
“It’s much easier to inform policy action and convince people when you have strong evidence, otherwise it can be dismissed as a ‘perceived’ issue.”
Though demographic and health (DHS) surveys in Sri Lanka collect useful data, for those studying migration and health this resource is relatively limited as the DHS doesn’t factor in migration or mobility. Renuka feels that if the DHS surveys were to consider migration then it could be a valuable resource for scholars in this field. However, when it comes to improving access to peer-reviewed literature and published research Renuka is confident that a central database could address some of these barriers.
“Sometimes when you are searching it is very hard to find [what you’re looking for]. I know I have half a paper sitting on my computer which I have not been able to complete … but it is very difficult to find the literature. Sometimes you do the work but you get stuck with the discussion because you can’t really find much literature for that. So, it’s a very good idea to have a kind of central database, at least some abstracts or something, so it is easier for people doing migration-related research so they have more access, that would be a great idea actually.”
In terms of staying up-to-date with migration and health research in Sri Lanka, Renuka explains that people in the field tend to know each other and try to meet at least once a year to exchange ideas and research. For Renuka, networks are a key tool for accessing and disseminating research and data. She is a member of formal networks in the health field, such as the Sri Lanka Medical Nutrition Association, though networks relating to migration and health specifically are less formal.
“We have a network within Sri Lanka. The National Science Foundation tried to do the official kind of network, but in addition to that people have unofficial networks because we meet each other in our professional forums. Even within the Ministry of Health we have a very good networks, and if anyone is doing research within the Ministry we will know.”
Through Renuka’s connection to the IOM she has been able to connect with others working on migration and health issues, something she believes gives her the necessary exposure to different methods and knowledges.
“It is good to see the research others are doing and see how you can do the same kind of research in your country. It’s very useful to learn from each other, then we can compare and improve together.”
Renuka identifies networks as one of the most helpful tools for early-career researchers, and believes that getting involved by coordinating events to link new and established researchers together is an important role early-career researchers can fulfil. Given that established researchers are often very busy and don’t have time to organise such events, Renuka is optimistic that early-career researchers can benefit in the long-term from investing their time in strengthening existing networks.
A network like MHADRI is full of experts and Renuka believes that there is potential not only for established researchers to share their experiences and ideas with one another, but for early-career researchers to receive much-needed mentoring. Renuka hopes that the MHADRI network can be catalyst for joint research ventures which measure and compare migration and health issues in different regions, enabling countries to learn from each other, shaping migration and health governance to ultimately improve health for all.
Dr Renuka Jayatissa can be contacted here .
Dr Jayatissa and Dr Kraus Karmer at the 2017 Scaling Up Nutrition Movement Global Gathering, Ivory Coast
Renuka was interviewed in October 2018 by MHADRI Research Assistant and intern Holly McCarthy as part of a scoping exercise with leading migration and health researchers based in the global south.
This scoping exercise aims to
We envisage publishing a summary of this initial scoping in some form, and will be posting more profiles like this on the work and reflections of leading migration and health researchers.
If you are interested in taking part in this exercise please contact us.