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.

[Open Access] BIBLIOMETRIC ANALYSIS ON COVID-19 IN THE CONTEXT OF MIGRATION HEALTH

BIBLIOMETRIC ANALYSIS ON COVID-19 IN THE CONTEXT OF MIGRATION HEALTH

International Organization for Migration
20th April 2020
Under review

“To strengthen the current knowledge base on COVID-19 and migration health, the scientific and research community should consider examining specific health-related outcomes in specific migrant groups as well as other relevant variables that can impact on migrants (i.e. structure and process measures). Investigations on COVID-19 and migration health should not be limited to the role of movement/mobility in the dynamic importation of cases in a pandemic; a more inclusive research strategy integrating the relevant interests of migrant populations is suggested.”

Read the full paper here

[Open Access] Neglect of low-income migrants in covid-19 response

Neglect of low-income migrants in covid-19 response

A South Asian perspective on the failures of global and national public health policies

THE BMJ OPINION | 29 MAY 2020

“Given the regional implications, countries in South Asia must “act in unison” to conceive public health for the entire region. [6] The Covid-19 Emergency Fund created by South Asian Association for Regional Cooperation (SAARC) is a promising step. However, an effective response requires greater regional cooperation, facilitating safe passage, and strong political commitment to universalise health and social protection, continue primary care and guarantee socio-economic rights. Ignoring poor migrants and those in informal economies nationally will not only erode lives but also impede national economic and social recovery from covid-19.”

Read the full article here

Anuj Kapilashrami is senior lecturer in gender and global health policy at the Centre for Global Public Health, Queen Mary University of London, London, UK

Anns Issac is technical officer at the Asia Pacific Observatory on Health Systems and Policies, New Delhi, India

Jeevan Sharma is senior lecturer in South Asia and International development at the School of Social and Political Science, University of Edinburgh, Edinburgh, UK

Kolitha Wickramage is the Migration Health Research and Epidemiology coordinator at the Migration Health Division, the UN Migration Agency, Manila, Philippines

Ekatha Ann John is researcher at Centre for Global Public Health, Queen Mary University of London, London, UK

Divya Ravindranath is postdoctoral fellow at the Indian Institute of Human Settlements, Bengaluru, India 

Roomi Aziz is technical lead in health data and communication at Pathway to Impact, Punjab, Pakistan 

Patrick Duigan is the regional migration health advisor, Regional Office for Asia and the Pacific, International Organization for Migration, Bangkok, Thailand

on behalf of the Migration Health South Asia network

[Open Access] National preparedness and response plans for COVID-19 and other diseases: Why migrants should be included

National preparedness and response plans for COVID-19 and other diseases: Why migrants should be included

Dominik Zenner and Kolitha Wickramage

Migration Data Portal | 14 May 2020

“An inclusive approach to epidemic control requires detailed knowledge and information about all relevant population groups, including their demography, their cultural-linguistic and socio-economic needs and of course, their health and illness, including COVID-19. The benefits of ensuring that public health messages can be understood and help appropriately should be obvious for any public health campaign and are vital if COVID-19 is to be successfully controlled. It is also critical to understand potential benefits and costs of public health measures to all population groups, and to avoid inadvertently aggravating vulnerabilities, such as deterrence of health service access through police-enforced social distancing measures or separation of migrants from family and social support networks when being stranded due to border closures.

In many countries, rapidly applied and crude public health measures for COVID-19 are increasingly being fine-tuned in renewed efforts of deconfinement of populations. This phase will require detailed knowledge and information about the epidemic and active inclusion of all migrant population groups in healthcare and in epidemic control plans will not only be the right thing to do from a human rights perspective, but also vital to successful COVID-19 control going forward.”

Read the full article here

[Open Access] The neglected health of international migrant workers in the COVID-19 epidemic

CORRESPONDENCE | LANCET PSYCHIATRY | VOLUME 7, ISSUE 4, E20, APRIL 01, 2020

The neglected health of international migrant workers in the COVID-19 epidemic

“Of the 150 million international migrant workers (IMWs) worldwide, 95% reside in the five WHO regions in which cases of coronavirus disease 2019 (COVID-19) have been confirmed. The absence of a coordinated response for IMWs highlights a key deficiency in public health planning.”

Read the full article here

[Open ACcess] ethnicity and COVID-19: an urgent public health research priority

CORRESPONDENCE | THE LANCET | VOLUME 395, ISSUE 10234, P1421-1422, MAY 02, 2020

Ethnicity and COVID-19: an urgent public health research priority

“As the coronavirus disease 2019 (COVID-19) pandemic continues advancing globally, reporting of clinical outcomes and risk factors for intensive care unit admission and mortality are emerging. Early Chinese and Italian reports associated increasing age, male sex, smoking, and cardiometabolic comorbidity with adverse outcomes.1 Striking differences between Chinese and Italian mortality indicate ethnicity might affect disease outcome, but there is little to no data to support or refute this.”

Read the full article here

[Open Access] Is ethnicity linked to incidence or outcomes of covid-19?

Is ethnicity linked to incidence or outcomes of Covid-19?

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1548 (Published 20 April 2020)

“Clear evidence to confirm or rule out an association between ethnicity and outcome in covid-19 is important not only for the UK but also for other regions such as South Asia and Africa, where the pandemic is at an earlier stage. Efforts must be coordinated to collect an international data set that includes ethnicity. If an association is confirmed, further research will be needed to determine the causes.”

Read the full paper here

[Open Access] Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data

Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data

Aldridge RW, Lewer D, Katikireddi SV et al. Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data [version 1; peer review: 3 approved with reservations]. Wellcome Open Res 2020, 5:88 (https://doi.org/10.12688/wellcomeopenres.15922.1)

ABSTRACT

Background: International and UK data suggest that Black, Asian and Minority Ethnic (BAME) groups are at increased risk of infection and death from COVID-19. We aimed to explore the risk of death in minority ethnic groups in England using data reported by NHS England.
Methods: We used NHS data on patients with a positive COVID-19 test who died in hospitals in England published on 28th April, with deaths by ethnicity available from 1st March 2020 up to 5pm on 21 April 2020. We undertook indirect standardisation of these data (using the whole population of England as the reference) to produce ethnic specific standardised mortality ratios (SMRs) adjusted for age and geographical region.
Results: The largest total number of deaths in minority ethnic groups were Indian (492 deaths) and Black Caribbean (460 deaths) groups. Adjusting for region we found a lower risk of death for White Irish (SMR 0.52; 95%CIs 0.45-0.60) and White British ethnic groups (0.88; 95%CIs 0.86-0.0.89), but increased risk of death for Black African (3.24; 95%CIs 2.90-3.62), Black Caribbean (2.21; 95%CIs 2.02-2.41), Pakistani (3.29; 95%CIs 2.96-3.64), Bangladeshi (2.41; 95%CIs 1.98-2.91) and Indian (1.70; 95%CIs 1.56-1.85) minority ethnic groups.
Conclusion: Our analysis adds to the evidence that BAME people are at increased risk of death from COVID-19 even after adjusting for geographical region. We believe there is an urgent need to take action to reduce the risk of death for BAME groups and better understand why some ethnic groups experience greater risk. Actions that are likely to reduce these inequities include ensuring adequate income protection (so that low paid and zero-hours contract workers can afford to follow social distancing recommendations), reducing occupational risks (such as ensuring adequate personal protective equipment), reducing barriers in accessing healthcare and providing culturally and linguistically appropriate public health communications.

Read the full paper here

Abstract