IAMAT |International Association of Medical Assistance to Travellers| IAMAT |International Association of Medical Assistance to Travellers|

Travel Health Journal

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No one left behind: Supporting migrant health

When IAMAT was established in 1960, it was with a strong spirit of global community and a desire to live in a world where healthcare is accessible to all, no matter where or who you are.

In honour of World Health Day, we take a look at migrant health, the barriers migrants face when accessing healthcare, and how universal coverage can make a difference.

Migrant populations often arrive at their destination healthier than the native-born population, but they can face a range of health concerns that go unmet.  Universal healthcare – having access to quality healthcare regardless of your ability to pay – is an opportunity to ensure that everyone, including travellers and migrants, get the medical care they need.

Context of migration

Human migration has been occurring for thousands of years. Estimates suggest that today, roughly 258 million people are migrants living outside of their country of birth. Migrant populations are diverse: Nearly 150 million people migrate for work, but others migrate for varying and complex reasons including to escape poverty, conflict, gender identity and sexual violence, environmental degradation, natural disasters, and to seek new opportunities. In addition to cross-border travel, migration can also take place within a region or a person’s home country.

For some, factors that drive them to relocate may be associated with limited availability or access to quality healthcare services in their home country. Currently, half of the world’s population does not have access to basic health services and 800 million people spend at least 10% of their household budgets on the healthcare needs of themselves as well as for their family members. For about 100 million of those people, these unaffordable expenses push them into extreme poverty.

In transit

Regardless of who we are or where we travel, some of us may face health challenges during our journey. Similar to the average traveller, migrants may be travelling with a pre-existing condition, have an undiagnosed condition, acquire an infection, or become injured. However, during their journey, migrants rarely have access to adequate healthcare. For migrants travelling with a pre-existing health condition, for example, losing access to necessary medications, treatments, and continuity of care can lead to a life-threatening situation.

Even without a pre-existing condition, migrants can be exposed to health risks during their journey such as malaria, dengue, and respiratory and gastrointestinal infections. In fact, the risk of infectious diseases increases for migrants without access to pre-travel health services or quality healthcare in their origin country and who are exposed to poor sanitary conditions before or during their journey. Women also face risks related to maternal, sexual and reproductive health, as well as violence.

The stress of travel also has negative effects on mental health. Migration may lead to extended detention and separation from family members. In addition, culture shock, homesickness, uncertainty regarding immigration proceedings, and negative public perception of migrants can cause or exacerbate a mental health condition, including post-traumatic stress.

Upon arrival

Following their journey, migrants are often left out of national healthcare coverage where it exists. Language barriers and a lack of awareness of healthcare services can further inhibit access to essential services. Undocumented migrants may avoid accessing healthcare services altogether for reasons such as physical distance from medical care, language barriers, legal restrictions, and fear of deportation associated with using government services.

Certain migrant groups, such as refugees, undocumented or irregular migrants, and low-income immigrants with limited ability to speak the local language can be vulnerable to poor mental and physical health. Migrant workers, who make up more than half the world’s migrants, can also be at risk of poor health living in their host country. They can be exposed to infectious diseases such as sexually transmitted infections, malaria, and tuberculosis as well as health challenges related to unsafe working conditions and mistreatment, unsanitary or overcrowded living conditions, low wages, deceptive recruitment practices, and limited legal protections.

Without access to medical care, health concerns may go undiagnosed and untreated, leading to the potential spread of the illness or more severe forms of disease.

Promoting migrant health

Healthcare is a human right and should be available and accessible regardless of one’s status or insurance coverage. To create migrant-friendly healthcare, services should be culturally appropriate and available in the patient’s language. Healthcare providers also need to be equipped to meet the needs of their patients; training in tropical and travel medicine should be widely available to providers so they are able to better identify and address illnesses in the populations they serve.

Supporting and developing migrant-inclusive policies that address the specific needs and vulnerabilities of migrants can ensure they are able to lead healthy and productive lives. Many countries – even those who have universal healthcare policies – do not have any provisions for migrants; inclusions of migrants in healthcare policies has been largely overlooked and neglected.

Migrants are valuable contributors to their host societies. With the number of international migrants expected to double by 2050, there is no better time than now to ensure that all people, including migrating travellers and new immigrants, have timely access to affordable quality health services.

Additional sources:

The Lancet. Harmful, unfounded myths about migration and health have become accepted, used to justify policies of exclusion. ScienceDaily.

World Health Organization. Migration and Health: Key Issues. WHO Regional Office for Europe.

Image by: Jason Leung from Upsplash

Article by: Jacqueline Tucci