South Africa, Migration, Gender and Health — Closing Notes of a Pakistani Researcher

MHADRI member Dr Roomi Aziz reflects on her participation in a week’s worth of migration and health events, co-hosted by MHADRI, that took place at the University of the Witwatersrand, Johannesburg at the end of July 2019. This post was originally published here.

Just got some time to review and recap the last week of July 2019, which was everything Gender and Migration and South Africa, beginning with a research workshop, having the privilege of being on an all-female panel on decolonizing global migration and health research, weaving a high level policy dialogue, closing with the UCL-Lancet Commission Launch of report on Migration and Health, and a symposium on gender, migration, health and public policy at the dynamic University of the Witwatersrand and the African Centre for Migration & Society.

We also went through some existential questions, of what does it even mean to be a migrant? What does health access imply? Especially since health often gets short-handed for the biomedical healthcare system, and this understanding is one of the many structural determinants leading to health inequities. For example, health insurance is not universal health coverage, but one of the many factors contributing to it. At the end of it, what stayed with me was the birth-right of a human, to live a meaningful life, and create a home.

Just want to record my five key Points-to-Ponder from the week, one for each day:

P1 | CHANGE THE PERSPECTIVE: It is important to step outside the box we live and operate in, to understand and grasp a broader, ‘helicopter’ vantage point of the situation and the context. Unlearn. Couldn’t be more truer for migration and health, and their bidirectional journey. There was a lot of discussion on the need to look at both systems response and global governance, and be conscious of the rhetoric of migrants’ health. Current public health policies do not engage with migration or mobility of populations, which raised some pertinent questions, on whether the local conversations are reflective of global realities? And about the drivers of policy-making? Is it fear or rights-based approach? Then again, as long as health is discussed in humanitarian paradigm where migration is discussed in securitization paradigm, challenges will continue to grow. We must remember Ellis Island. Exceptionalism in policy frameworks can further hurt a cause. #Mobility is the new normal. It is time that we accept it. We also need to know what we do not know, to truly understand and learn. It is important that we acknowledge the lack of evidence, rather than pretending that we have all the answers/ solutions. We need more data, better data to feed into politics and decisions, and understand the issue enough to take action.

P2 | WHO HOLDS THE POWER: Are we aware of what the rights-based arguments may drive away, and what are the most effective ways to make our case on policy tables? We have limited orientation as to who holds the power in the global discourse. Who has the loudest voice and who is determining the global or the national agenda? While we are continuously dealing with complexities, we must find levers of change within the system that are on our side, and learn to influence them. We must also not forget the key role of national treasury, which can make or break our comprehensive action plans. We religiously talk of evidence-informed decision making, when we also need to remember that sometimes this evidence is not politically correct, and sometimes lack of evidence is desirable for scape-goat-ing. More importantly, how do we make sure that the research generated is responding to the evidence need and who needs it. In either case, we need to be cognizant of our complicity and role in this system of control, and our responsibility towards challenging the global narrative.

P3 | AFFILIATIONS AND IMPLICATIONS: We are very trigger-happy when it comes to the use of adjectives like ‘vulnerable’ and ‘marginalized’, but are we aware of the implications that assignment of such adjectives has? We speak of biometrics and blockchain, without realizing the cost to personal security and implications for non-nationals as well as nationals. These discussions are critical today, when we are still grappling with the idea of profiling people on the basis of their looks, professions, languages, socio-economic status, beliefs and nationalities.

P4 | STAYING AWARE: By virtue of things beyond our control, like the country we were born in, the family we were born into, the skin color we inherited, we hold unequal power and privilege. It is critical that we do not centralize our agenda or usurp the central stage and remember the ‘invisible’. That is the crux of the bone of contention we have with Eurocentric understanding of migration and health and inequalities vis-à-vis Global South being reinstated. This goes back to the ‘changing the perspective’ point, where we must endeavor to visibilize the invisible, profile them to understand what can be done for them, since they cannot be passive actors in the society, lest they are left behind. We must remain acutely aware of the danger of propagating a single narrative, recognize the associated complexities and contestations associated with it.

P5 | CREATE OPPORTUNITIES: Not always there is a demand and supply match. Sometimes one must push and manipulate situations and strategize for interest. There are important advocacy windows all around us. There is a need to identify these strategic windows, the sticking points, and realize the power of our personal networks, to push forward our agendas. There is no time to wait for tailor-made opportunities.

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