COVID-19: Marking the Gaps in Migrant and Refugee Health in Some Massive Migration Areas

Abstract

The health of migrants and refugees, which has long been a cause for concern, has come under greatly increased pressure in the last decade. Against a background where the world has witnessed the largest numbers of migrants in history, the advent of the COVID-19 pandemic has stretched the capacities of countries and of aid, health and relief organizations, from global to local levels, to meet the human rights and pressing needs of migrants and refugees for access to health care and to public health measures needed to protect them from the pandemic. The overview in this article of the situation in examples of middle-income countries that have hosted mass migration in recent years has drawn on information from summaries presented in an M8 Alliance Expert Meeting, from peer-reviewed literature and from reports from international agencies concerned with the status and health of migrants and refugees. The multi-factor approach developed here draws on perspectives from structural factors (including rights, governance, policies and practices), health determinants (including economic, environmental, social and political, as well as migration itself as a determinant) and the human security framework (defined as “freedom from want and fear and freedom to live in dignity” and incorporating the interactive dimensions of health, food, environmental, economic, personal, community and political security). These integrate as a multi-component ‘ecological perspective’ to examine the legal status, health rights and access to health care and other services of migrants and refugees, to mark gap areas and to consider the implications for improving health security both for them and for the communities in countries in which they reside or through which they transit.

Working With Refugees' Health During COVID-19—The Experience of Health- and Social Care Workers in Sweden

“…It is, therefore, important to prevent further suffering socially, physically, and mentally for refugees residing in Sweden. Recently published findings highlight the vulnerability of refugees during the COVID-19 period in relation to healthcare access and information as well as their living conditions ( 28 ). To help understand why refugees are particularly impacted by the pandemic, it is necessary to observe how health- and social workers have viewed refugees and their needs in relation to COVID-19.…”

Ambivalence towards the Protection of Refugee Children: A Developmental Relational Approach

“…For example, length of time in assessment centers, insecure residence and family separation have flow-on effects on refugee individuals' mental health whether they be parents or children [49]. Patterns of exclusion of refugees from health services also have flow-on effects to other systems of service for them and for the total population [50].…”

“…The environments of children's interactive participation are never neutral spaces. The physical and sociopolitical terrain constrain the opportunities and resources that refugee children may access and use, for instance, as when public service resources of resettlement countries are limited and cause governments to be less generous to migrants and refugees [1,3,50].…”

“…Despite the legitimacy of their rights, the ambivalence that Bhabha [12] exposed leaves the protection of refugee children unresolved. Oppositional priorities give rise to inequities in the public organization and delivery of health, education and welfare [3,50]. Children's protection is especially neglected where it is, or seems to be, opposed to the protection of national borders, local interests, and entrenched attitudes.…”

Refugee Crisis: Why Scientists and Scholars Need to Step Up

“…With limited resources, managing the COVID-19 pandemic also has to be balanced with the cost of other essential health services. 10 This includes mental health, for which problems have been exacerbated in displaced populations due to the COVID-19 pandemic. 11 There is often a limit to the global attention span, as we see headlines discussed one week and overlooked a few weeks later.…”