“Poorly managed migration could contribute to the global impact of AIDS, but migration itself is not a cause for the disease,” said IOM Director General William Lacy Swing on World AIDS Day, December 1.
“It is very important to highlight that the act of migration alone does not in itself cause disease – any disease. However, socioeconomic, political, cultural and environmental conditions are deeply connected with population movement, and they can impact health and vulnerability to disease. We are already doing a lot to mitigate that, but more needs to be done,” he noted.
When migrants leave their homes, be it fleeing war, disaster or economic hardship, they lose connection with everything that is familiar, and have to cope with unfamiliar customs, legislation and culture. In their new host communities, migrants can also often face social exclusion and discriminatory practices, and may have to endure poor living conditions, financial insecurity and fear of arrest or deportation.
If and when migrants need health care, existing stigmatization and insensitivity can discourage them from approaching health facilities. Migrants can also be excluded from existing health systems due to discrimination, language barriers, legal status and financial barriers. This can lead to ill-health, and emphasize the negative narrative on migrants as carriers of diseases.
As the United Nations migration agency, IOM works with governments and international partners to conduct disease mapping and risk assessments; runs education, sensitivity and awareness campaigns; and facilitates migrants’ access to voluntary HIV testing and counselling, prevention, treatment and psychosocial support.
The following are some examples of IOM programmes currently being implemented around the world.
In Georgia today, IOM missions from across the southern Caucasus are launching a regional project to counter HIV and tuberculosis (TB) in the region. Working alongside the governments of Georgia, Armenia and Azerbaijan, the project includes health awareness, voluntary testing and counselling, treatment, training for health professionals, and a regional survey of migrant health to ensure better care for migrants and mobile populations.
IOM has been providing health services in under-served and remote parts of Myanmar for almost a decade. Part of IOM’s support comes in the form of comprehensive HIV awareness, detection and prevention services to migrants and high-risk populations in Mon and Kayin states. Working with Myanmar’s National AIDS Programme, IOM provides HIV testing and counselling, condom distribution, and anti-retroviral therapy for adults and child migrants and host communities, including cases of HIV-TB co-infection.
Meanwhile, in East Africa, IOM, the Kenyan Ministry of Health and local partners offer free, non-discriminatory and comprehensive health care to urban migrants – the majority of whom are from Somalia – and the host community through the Eastleigh Community Wellness Centre (ECWC) in Nairobi.
The health facility was established in 2002 and serves both Kenyans and migrants, offering friendly services in several languages, including Somali, Oromo and Amharic to over 2,000 patients per month, 56 percent of whom are migrants. It currently offers free comprehensive TB and HIV services; sexual and reproductive health services; maternal, new-born and child health; nutrition services; and community health services, including mobilization teams composed of a migrant workforce.
This year alone, 2,411 HIV tests have been carried out so far at the ECWC and an average of 157 patients have been enrolled each month to receive counselling and treatment at the HIV clinic. From January to September 2016, 13,230 household visits were also conducted to provide health information and Information, Education and Communications (IEC) materials.
“I discovered that I was HIV positive when I was attending the pre- natal clinic at the Eastleigh,” says Halimo, a client at the centre. “I was devastated and thought that was the end of my life, I cried and cried. There was no consolation for me. The nurse calmed me down and told me that if I take care of myself I will live, I could not understand how, all I knew was if you get HIV you die.”
Through continuous counselling and antiretroviral (ARV) treatment offered for free at the ECWC, Halimo has been able to live a normal life. The clinic has established a support group where people living with HIV/AIDS meet once a month to interact and encourage each other to live a healthy life.
“While migrants may indeed be at greater risk due to societal factors, the lack of access to health care facilities and prevention measures pose risks to us all,” said Director General Swing. “Health inequities, inadequate social protection, human rights violations, stigmatization and discrimination increase the vulnerability to HIV infection for everyone, irrespective of colour, creed, income – or journey.”