Why the global response to COVID-19 must address the needs of migrants

A health worker performs a nose swab test on a migrant worker amid the coronavirus outbreak in Singapore. PHOTO: REUTERS via BBC

COVID-19 is presenting the world with a number of serious and far-reaching challenges. By 2 May 2020, 3,267,184 cases with 229,971 COVID-19-related deaths had been reported to WHO. As COVID-19 continues to spread, it will pose a major threat to millions of migrants as well as to countries everywhere. Migrants are an essential part of the global economy and in many countries, they have become an integral part of key industries such as health care. In the era of Universal Health Coverage and “leaving no one behind”, migrants must also be an integral part of the public health response to the COVID-19 pandemic.

1. Migrants often have limited access to COVID-19 information

The global response to COVID-19 can only succeed if everyone in society has the information needed to stay healthy, and is also able to act on that information. Public information campaigns designed to shape people’s behavior and prevent the spread of the virus must keep in mind that some migrants may have a poor proficiency in the language of the host community, limited access to everyday information channels, and little COVID-19 information materials in their languages. Where this is the case, migrants may not be sufficiently aware of the virus, its implications, what they must do to avoid it, and how they should respond if they or those around them show signs of infection. In the absence of effective outreach campaigns tailored to meet the needs of migrants, they will also be less likely to follow public health guidance and avoid misinformation or fake news about COVID-19.

2. Migrants often lack access to health services

Legal and administrative regulations as well as language and cultural barriers often limit the access migrants, especially irregular ones, have to healthcare services. In the case of irregular migrants, fear that personal information will not be used confidentially and will be shared with legal authorities leading to deportation, family separation or detention is a frequent problem. Late presentation and other delays in seeking healthcare are often due to this. The economic and labor crisis created by the COVID-19 pandemic may push many regular and irregular migrants into unemployment, underemployment and working poverty. Where they are not covered by national medical insurance schemes and no longer covered by employer insurance contributions, this may mean even more limited access to healthcare, including COVID-19 testing, diagnosis, and treatment. This will be especially the case of fee-for-service medical systems where migrants as well as others may be turned away because they do not have up-front funds. Failure to receive COVID-19 testing and treatment will place everyone in harm’s way.

3. Migrants may face barriers in following recommendations

Social distancing and good hand washing practices are critical elements of COVID-19 prevention. Migrants, especially irregular ones, however, often need to share housing with many other people, and live in housing situations where social distancing is difficult and where basic hygiene measures and opportunities for self-isolation is limited. This is also likely to be the case in the many formal and informal migrant labour camps that are set up around seasonal agricultural and other industries. Countries that depend on very large numbers of long-term migrant workers, but do not intend/want to integrate them also tend to establish special housing facilities for them. These too, are at times overcrowded and not convivial to good public health principles and practices. Failure to improve conditions in these facilities and/or the houses that migrants agree to live together in, will lead to increased vulnerability to COVID-19 by both migrants and host communities.

4. Migrant workers may face limited protection

In many countries, migrant workers represent a significantly large share of the workforce serving on the front lines and carrying out essential jobs in health care, transportation, construction, and agriculture and agro-food processing. They may nevertheless be overlooked in national COVID-19 policy responses, including wage subsidies, unemployment benefits, or social protection measures. In many instances, migrants may simply be unaware of the steps that are being taken to protect workers from economic hardship, and also be ill-informed about COVID-19 protection measures they are eligible for. Ensuring equal working and remuneration conditions, together with equal access to workplace safety and health protection, in line with what nationals enjoy, is fundamental if the health and wellbeing of the larger society is to be upheld and informed participation in COVID-19 initiatives is to be sustained.

5. Migrants face discrimination and violence

Fears about the COVID-19 pandemic in some settings have resulted in xenophobic reactions, hate speech and discrimination against migrants. This at times has been exacerbated by misinformation and fake news in the media, and the instrumentalization of the issue for political interests. Such attitudes and expressions can adversely affect public health and the willingness of migrants to internalize COVID-19 prevention messages and/or report symptoms in themselves, family and friends.

ICMHD is committed to ensuring that migrants are not “left behind” and are included in any and all public health responses to COVID-19. ICMHD has prepared a series of guidance Notes designed to remind national and local authorities that the war against COVID-19 cannot be won if migrants and other vulnerable populations are forgotten. These guidance Notes can be found here.

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