Migration and Disability in South Africa

Prepared by Edward Govere and Jo Vearey on behalf of MiCoSA (Migration and Coronavirus in Southern Africa Group) in collaboration with the IOM team: Lily Sanya, Sibuko Dinake, Wambui Gititu, Teenage Rapatsa and Anisa Ibrahim

This project and resulting brief consisted of 39 semi-structured key informant interviews with those who have direct experience in working with migrants with disabilities. COVID-19 restrictions meant that migrants with disabilities themselves were not interviewed, although the project included a photojournalism insight into their lives and experiences.

Conclusions included that migrants with disabilities are not a homogenous group but that across the board, disabilities do heighten challenges that all migrants face. There is a shortage of reliable data regarding migrants with disabilities in South Africa, and specifically about their experiences during COVID-19. Policies for supporting such migrants are lacking as well.

Next steps involve working directly alongside migrants with disabilities and across sectors to generate and use accurate data to inform policymaking. Disability policies and programming must be migration-aware and inclusive of migrant voices.

About MiCoSA
The Migration and Coronavirus in Southern Africa Coordination Group (MiCoSA) is hosted by the Migration and Health Project Southern Africa (maHp) at the African Centre for Migration & Society (ACMS), Wits University,
Johannesburg. MiCoSA is an informal network of migrant-led organisations, non-governmental organisations, international organisations, civil society, activists, lawyers, researchers, government officials and policy advisors.
Through an online platform and virtual meetings, MiCoSA brings together national and SADC regional partners who are concerned with the health and well-being of asylum-seekers, refugees and migrants during the current
Coronavirus pandemic. To date, MiCoSA has over 150 members; to join this network, please email coronavirusmigration+join@googlegroups.com

COVID-19 VACCINE IN AFRICA

By: Rebecca Walker, Nicholas Maple & Jo Vearey

Researching Migration & Coronavirus in Southern Africa (MiCoSA)
June 2021

This occasional paper is the start of a series that explores the impacts of COVID-19 and ensuing responses on migration and the wellbeing of migrant and mobile communities in Africa. This paper provides insight into how vaccine nationalism is impacting the rollout of vaccination programs, including the inclusion or exclusion of migrant groups. The paper demonstrates that

“the vast majority of international migrants, refugees, asylum seekers and IDPs are being excluded from state-based vaccine roll-out programmes either via formal policy directives or through various forms of de facto exclusion, such as barriers to access healthcare at the local and national level. These forms of exclusion are likely to have far-reaching public health implications across the continent, affecting both citizens and migrants alike.”

Page 3, “Migrants & the COVID-19 Vaccine Roll-out in Africa: Hesitancy and Exclusion”

To view the other papers in the series, see http://www.mahpsa.org/micosa

About MiCoSa

The Migration and Coronavirus in Southern Africa Coordination Group (MiCoSA) is hosted by the Migration and Health Project Southern Africa (maHp) at the African Centre for Migration & Society (ACMS), Wits University, Johannesburg. MiCoSA is an informal network of migrant-led organisations, non-governmental organisations, international organisations, civil society, activists, lawyers, researchers, government officials and policy advisors. Through an online platform and virtual meetings, MiCoSA brings together national and SADC regional partners who are concerned with the health and well-being of asylum-seekers, refugees and migrants during the current Coronavirus pandemic. To date, MiCoSA has over 150 members; to join this network, please email coronavirusmigration+join@googlegroups.com

European Borders, COVID-19, and the Economy of Home Care

Ursula Trummer, PhD (August 25, 2020)

This article examines the impact that COVID-19 has had on the movement of migrant healthcare workers throughout Europe. Dr. Trummer specifically focuses on how the shutting of borders (with a specific case study on the border between Romania and Austria) has restricted low-income 24-hour care providers who depend on free movement in order to complete their shifts:

“For the European Union, free movement of EU citizens within EU is an important element of the very idea of a united Europe. The right to freedom of movement is guaranteed by Article 21 of the Treaty on the Functioning of the EU (TFEU). It states that “Every citizen of the Union has the right to move and reside freely within the territory of the Member States.”This should especially serve the further development of a European economy, where a European work force can fulfil labor market demands where needed across national borders.
 
The COVID-19 pandemic changed that. All of a sudden, the European Union got fragmented again into 28 national states each with their respective responses to the pandemic. National public health policies demanded the closure of national borders and overruled the freedom of movement. As health issues of EU member states are subject to national regulations, countries established different policies of border control and regulations on who is allowed to travel under which circumstances, and how matters of quarantine are handled. National borders were seen as the most important checkpoints for controlling the spread of COVID-19.
 
Ironically, this has a tremendous negative consequence especially for the health care sector in rich EU countries which depend on migrant health care workers. The closure of EU-internal borders furthermore revealed the relevance of a borderless EU for another important health issue: care for the elderly. Countries like Austria are characterized by an ageing population and consequently elder care, either in nursing homes or at home, has become a major challenge.”

Austria depends heavily on care providers from Romania, and COVID-19 has impacted their ability to travel immensely. Read the rest of the article for more detail.

Sequential screening for depression in humanitarian emergencies: a validation study of the Patient Health Questionnaire among Syrian refugees

This study utilized data from a cross-sectional survey done with Syrian refugees in a camp in Greece. The goal was to determine if a sequential screening process would be able to accurately assess the number of patients with major depressive disorder (MDD) in the population. While the initial data was collected through the eight-item Patient Health Questionnaire (PHQ-8), this validation study simulated the use of the two-item Patient Health Questionnaire (PHQ-2) as well. The PHQ-2 was used to first screen the data of patients who scored less than 2 on the PHQ-2, who were then ruled out for MDD symptoms. The other patients’ answers were then used in the PHQ-8. The findings were analyzed to see if the two-part process would be able to accurately and efficiently determine who would be most at risk for symptoms of MDD. 

The conclusion of this study was that “The benefits of the sequential screening approach for the classification of MDD presented here are twofold: preserving classification accuracy relative to the PHQ-2 alone while reducing the response burden of the PHQ-8. This sequential screening approach is a pragmatic strategy for streamlining MDD surveillance in humanitarian emergencies.” 

World Migration Report 2020

The International Organization for Migration has just published its 2020 World Migration Report. Read and download it here!

Chapter 7 of the report (“Migration and Health: Key issues, governance and current knowledge gaps”) was written by MHADRI steering committee members Jo Vearey (Vice Chair), Charles Hui (Chair) and Kolitha Wickramage (Secretariat).

“The World Migration Report 2020 presents key data and information on migration as well as analysis of complex and emerging migration issues. Some of the topics covered in the report include human mobility and environmental change, migrants’ contributions in an era of disinformation, children and unsafe migration, migration and health, among others.”

The Director General of the IOM addresses the goals of the report (and indeed of the IOM as an agency) in his foreword:

“As the United Nations’ migration agency, IOM has an obligation to demystify the complexity and diversity of human mobility. The report also acknowledges IOM’s continuing emphasis on fundamental rights and its mission to support those migrants who are most in need. This is particularly relevant in the areas in which IOM works to provide humanitarian assistance to people who have been displaced, including by weather events, conflict and persecution, or to those who have become stranded during crises.”

“Likewise, IOM remains committed to supporting Member States as they draw upon various forms of data, research and analysis during policy formulation and review processes. Indeed, this is reflected in IOM’s Constitution where the need for migration research is highlighted as an integral part of the Organization’s functions. The World Migration Report is a central component of this important function.

In this era of heightened interest and activity towards migration and migrants, we hope this 2020 edition of the World Migration Report becomes a key reference point for you. We hope it helps you to navigate this high-profile and dynamic topic during periods of uncertainty, and that it prompts reflection during quieter moments. But most importantly, we hope that you learn something new from the report that can inform your own work, be it in studies, research and analysis, policymaking, communication, or migration practice.”

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Seasonal migration and health in India: Constraints for research and practice

Divya Ravindranath and Divya Varma

Ideas for India for more evidence-based policy (Published March 2019)

Seasonal migrants in India engage in temporary informal work in work environments that actively flout labour laws on wages, work hours, and living conditions. The most significant impact of this is on the health outcomes of workers and their children. In this note, Varma and Ravindranath describe the roadblocks in conducting in-depth enquiries into migrants’ health status and healthcare-seeking behaviour, and designing and implementing health programmes conducive to their needs.

Read full article here

How Labour Conditions at Construction Sites are Leading to Higher Rates of Child Malnutrition

Divya Ravindranath, Sep 27 2019

This commentary focuses on female workers in construction sites in India, and the impact of mothers’ work on the health and nutrition of their children. The sector provides good opportunities for work, but it also affects children’s health outcomes.

“A study of 131 migrant children living at various construction sites in Ahmedabad showed that half of the children surveyed were underweight (low weight for age), 41% were stunted (low height for age) and 22% were wasted (low weight for height). According to the National Family Health Survey (2015-’16), 35.5% of children under the age of five in the country are underweight, 38.4% are stunted, 21% are wasted.”

The article highlights various reasons why children are in this condition. Mothers do not have time or comfortable environments to breastfeed exclusively, and can also have difficulty finding the time to wean at the proper age. Mothers don’t have access to affordable, healthy food, so older children eat a lot of packaged food. The water in construction sites is often contaminated and not potable. Utilizing health services means taking time off work, which results in a loss of wages.

The author argues that NGO’s can be one way to help alleviate the situation, but they can be difficult to access as well. Dr Ravindranath’s main recommendation is that “it is also critical to view the role of parental work environment and migration as factors contributing to undernutrition. Policies and interventions designed to address undernutrition must consider these as key factors without which such children would continue to be denied a chance of improved nutrition and better health.”

Read full commentary here

Community-Based Global Mental Health for Refugees and other Migrants

Deadline: May 1 2020

This call for papers seeks insights into questions such as:

  • What are the best approaches to deliver community-based services for migrants?
  • How can primary care collaborate with mental health specialists and community-based support systems?
  • What form of training programs and supervision are warranted?
  • How can trans-national influences on mental health, such as migration, conflict, and disasters, be integrated into community-based care? 

Keywords are global mental health, refugee and migrant health, community mental health, implementation science, trauma, primary health care, and health equity.

The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks

(Featured image shows first two themes out of a total five from this research)

Authors: Pramod R. Regmi, Edwin van Teijlingen, Preeti Mahato, MSc; Nirmal Aryal, Navnita Jadhav, Padam Simkhada, Quazi Syed Zahiruddin, and Abhay Gaidhane

International Journal of Environmental Research and Public Health, https://doi.org/10.3390/ijerph16193655, (Published Sep 2019).

Current research on Nepali migrant workers in India neglects work, lifestyle, and health care access in favor of focusing on sexual health. This article aims to gain a broader sense of migrant workers’ health by conducting focus groups and interviews. The researchers analyzed their data and determined five different themes:

  1. Accommodation
  2. Lifestyle, networking, and risk-taking behaviours
  3. Work environment
  4. Support from local organisations
  5. Health service utilisation

This qualitative study demonstrates that health risks for Nepali migrant workers’ emerge because of a wide range of factors. The authors recommend a larger quantitative study to gain more insight.

Read the full article here.