LILLIAN BANDA, Lusaka
DERRICK Mukumba, aged 23 years, is a Rwandese national who has been living in Zambia for about four years now. He was brought to Zambia by a fellow Rwandan national to help him manage a grocery store.
Derrick, who has been managing the store in Lusaka’s Kamwala South area, narrates that sometime last month, he suddenly developed a fever and terrible abdominal pains.
Despite being in great pain and anguish, his boss advised him to take some antibiotics and take a break from work for a few days.
“I begged him to let me go and seek professional help, but he refused, stating that what I was suffering from was a mere case of constipation and it would go away, but it has not; at least not completely. Once in a while I experience some abdominal pains,” he narrates.
His continued demand to seek professional medical services has seen him lose his liberty and being totally confined to the store from which he operates.
“My boss has even stopped me from going to get merchandise for the grocery store and given that responsibility to someone else. I think the idea is to ensure that I have no time to make any movements that are against his wishes,” he says
With the increasing numbers of people crossing borders for work and to seek asylum, migration and health has become a worldwide public health matter that can no longer be ignored.
Migration is simply the movement of persons from one country to another or from one state to another. And any person who makes such a movement, regardless of the person’s legal status, whether the movement is voluntary or involuntary, irrespective of the causes of the movement or the length of the stay, is a migrant.
In our contemporary times, migration has been necessitated largely by economic hardships, wars and natural disasters
International and regional human rights instruments compel nations to ensure that migrants enjoy their rights, including access to health care, information and other services and as members of the human family. This is based on the understanding that human beings are all born free and equal in dignity and status.
However, reports on migration and health rights of migrants indicate that migrants, particularly those in an irregular status, endure dangerous working conditions for fear of drawing attention to themselves and losing their jobs or being deported.
Those that are in employment may not be allowed to form or join trade unions, which may be an additional obstacle to raising concerns about their health and safety in the workplace. Even when laws and policies guarantee access to health services, lack of awareness among migrants and health professionals of migrants’ rights and entitlements may hinder the use of healthcare services and, consequently, the realisation of the right to health.
However, conversations with a number of foreign nationals point to the fact that for many of those that have been in Zambia for at least more than five years, access to health services is not exactly a challenge as the majority of them know their way around and do freely access health care services.
A man who only identified himself as Felix, a Tanzanian national currently living in Zambia, says inadequate health care information and a lack of information about available services are the main reasons why most irregular migrants and those in transit may fail to fully utilise health care services.
He says one sure way to counter this is to invest in education and sensitisation programmes targeted at new migrants so that more can be encouraged to access health services.
In an effort to respond to the health rights of migrants, Paralegal Alliance Network (PAN) has been conducting trainings for paralegals and other key community actors in boarder areas of Zambia and strategic mainland areas. The trainings which are being conducted with support from International Migration Organisation (OIM), an agency of the United Nations (UN) concerned with migration issues, seeks to empower participants with knowledge and skills needed to manage and advance health rights of migrants and help migrant populations to be aware of health services available and how to access them.
“Migrants have the right to information about health and health care services irrespective of their legal status. The right to health is equally tied to the key principle of non-discrimination, which recognises the ‘inherent dignity’ of every human being.
“However, many migrants, especially those in an irregular situation, are unable to access healthcare and social services despite being exposed to hazardous and exploitative working environments and substandard living conditions.
“Notwithstanding migrants’ vulnerability and existing concrete grounds for their social rights in international law, in practice many states limit the effective and full realisation of the right to health of migrants, particularly those in an irregular situation,” says PAN national coordinator Phillip Sabuni.
Public health specialists say that denying migrants the right to health leads to their marginalisation, increases their susceptibility to ill health and fuels health inequalities.
“Moreover, the lack of financial and legal protection in accessing health services means that many migrants are likely to postpone seeking treatment until they are seriously ill and have to seek costly emergency treatment. Such delays would undoubtedly lead to long-term effects on the health of migrants,” Mr Sabuni says.
He further adds that the exclusion of migrants from health services will ultimately create a financial burden on the host nation and may pose a public health risk to host communities.
“It is, therefore, only prudent that migrant populations are provided with health care services and information,” he contends.
Mr Sabuni also says the training on migration and health rights of migrants is bearing fruit as evidenced by the increase in the number of cases that paralegals have attended to as well as encouraging reports of key community members involved in sensitising the public about migration and health rights of migrants.
It is true that providing health care services for migrants can place additional burdens on a country, more so on one that has a vast number of migrants’ populations. On the contrary, not taking measures to address migration health can lead to public health crises.
Taking small measures such as putting in place proper water and sanitation facilities in border areas and encouraging inter-governmental corporation in responding to migration and health as has been the practice in the recent past, can be said to be some of the ways of promoting health rights of migrants.
“Migration, if managed properly, has considerable potential for economic growth and development for countries where migrants come from and host nations. All that needs to be done is to ensure that we take steps that ensure that migrants’ rights to health along with other rights are realised,” explains access to justice analyst from the Ministry of Justice Greenwell Lyempe.