Amrita Journal of Medicine

REVIEW ARTICLE
Year
: 2021  |  Volume : 17  |  Issue : 3  |  Page : 86--88

Migration and health during COVID-19: Indian perspective need to focus on the migrant health


Ambarish Das, Manish Taywade, Bimal Kumar Sahoo, Kajal Das 
 Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India

Correspondence Address:
Dr. Manish Taywade
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, Odisha.
India

Abstract

Migrants and forcibly displaced people are one of the worst affected sections in the COVID-19 pandemic. More or less every country has felt it to be a challenging task to look after the health of migrants in a similar way as they are supposed to do so for their own citizens. Migrants need to be given special attention when it comes to testing and treatment because they could be both victims and potential sources of this SARS COV-2 virus. In this article, some important issues related to migrants’ health in this pandemic have been briefly addressed.



How to cite this article:
Das A, Taywade M, Sahoo BK, Das K. Migration and health during COVID-19: Indian perspective need to focus on the migrant health.Amrita J Med 2021;17:86-88


How to cite this URL:
Das A, Taywade M, Sahoo BK, Das K. Migration and health during COVID-19: Indian perspective need to focus on the migrant health. Amrita J Med [serial online] 2021 [cited 2022 Jan 23 ];17:86-88
Available from: https://www.ajmonline.org.in/text.asp?2021/17/3/86/331118


Full Text



 Introduction



COVID-19 has badly affected each and every section of society. It has forced us to think about the efficiency of the public health system we have. Governments across the globe are facing great difficulty in managing the crisis, especially when it comes to bending the curve of morbidity and mortality. Migrants are people who move away from their native place whether to a different country or even within their own country. The period of migration can be temporary or permanent depending upon the reason for migration. It has been reported that the majority of the bulk of migration occurs from developing countries and they are at high risk of being affected by this pandemic. As per the report of the International Organization of Migration, there are 272 million international migrants across the globe and they are one of the most vulnerable groups in this current pandemic.[1] There are multiple documented evidences on the outbreak of COVID-19 in asylum seekers and migrant population especially those staying in refugee camps.[2] People living in these crowded places hardly practice any prevention measure viz. social distancing, hand hygiene, or self-isolation if symptomatic.

Global migration was at its highest level before the beginning of this pandemic with approximately 1 billion people moving across different countries. A huge number of these people were moving toward high-income countries as their destination. People were going to these developed countries either for work opportunities or for political asylum.[3] As per the systemic review, it is well evident that migrants in high-income and industrialized countries are at high risk of getting infected with the COVID-19 virus.[4] Migrants staying in camps need to be documented and made aware of the health systems of those countries. But in lower and middle-income countries, internal migration is seen, generally from one province to other, where the bulk of the migrant population is composed mainly of migrant laborers.[5]

 Migrant’s Health



Migrants as a whole comprise a heterogenous population with their respective health needs which they may have before the start of a journey or during the journey. Migrants can be healthier than the citizens of the country they moved to or can have health vulnerabilities, the reasons being socioeconomic status, over-crowded or suboptimal environment, restriction in being eligible to avail health services of that country or communication barrier in the form of language or health information.[1],[4]

 Predisposing Factors Behind Increased Risk and Severity of COVID-19 among Migrants



Multiple factors lead not only to increased risk but also the severity in migrant populations. Crowded living environment, common workplace, difficulty in accessing health care, previous comorbidity and potential genetic susceptibility are some of the important determinants of increased morbidity and mortality among migrants due to SARS COVID-19.[4],[6],[7]

Conditions in refugee camps are more worrisome. Inadequate and overcrowded living environment predisposes to a different health crisis for the inhabitants. Basic amenities viz. clean running water and soap are not available in those places. Poor access to adequate health information adds to their vulnerability toward adverse health consequences. Public health measures like proper hand hygiene, social distancing, or self-isolation are tedious jobs to implement in those settings.[8]

 Health Insurance



Once the morbidity advances in severity and people get admitted to hospitals, health insurance play a big role in managing the medical expenses. Migrants who moved to some other country find difficulty in availing and claiming this service, which ultimately put their health at stake. Migrant workers in a country like Singapore have faced great difficulty in seeking proper health services because they did not have health insurance.[9]

 Underreporting



This is well evidenced that this pandemic brought social stigma along with it and this is seen even in the educated section of the society. To get rid of any social stigma migrant class people refrain from testing even if they get influenza-like symptoms. This leads to underreporting and the COVID positive keep on hanging out with other healthy people. So they remain as a potential source of infection to others and this chain of transmission continues.

 The Mental Health of Migrants



In countries like India, where there is a vast population of internal migrants in most of the states, mental health issues of migrants need special attention as it is one of the cultural taboos and studies say that mental health issues are mostly seen in single, unskilled, illiterate daily wage laborers with higher years of migration and lack of housing and proper sanitation facilities.[10] Restrictions imposed owing to the pandemic will have a significant impact on the mental health of migrants who are stuck in a particular place and cannot go out for earning daily livelihood. Such internal migrant workers have higher vulnerability towards manifesting severe, acute and chronic mental conditions. Apart from all containment policies and restrictive measures, the revised legislation and laws of occupational safety and health in India have the potential to aggravate adverse mental health conditions of internal migrants.[11]

 Challenges



In developing countries like India, it is quite challenging to look after the health of such a vast number of people. Panic is the first and most obvious consequence when any kind of restriction is imposed on the public. The contemporary migrant crisis was seen when the lockdown was imposed and a large number of people fled from their workplace to their native places. For bringing out a proper solution for it, accurate data on internal migrants are required. The majority of the migrant population stay excluded from important government health schemes due to their “neither here, nor there” status.[5]

Food and basic amenities supply to migrants living at shelter houses or camps, providing them with the preventive sanitation kits, maintaining social distancing among them, screening of potentially infected person and doing their quarantine, providing them psychological support and doing their counselling are some of the major concerns. In addition, this development of an authentic database for migrants at camps, destinations, highways, and return migrants is of urgent need. The livelihood of migrants will be at stake unless they are provided basic income support.[12]

 India’s Strategy and Recommendations



The strategy to manage the health and socioeconomic crisis of migrants has to be holistic and futuristic for developing countries like India. Coordination between food security and migration policy agendas should be established. The price of domestic food price should be stabilized because food insecurity can further lead to the migrant crisis.[13] By proper use of infrastructure like Public Distribution System (PDS), food grain and pulses should be supplied to migrant workers and their families. Migrants should be considered as an important stakeholder in long-term development. Recommendations by UNESCO-UNICEF and working group on migration need to be looked into. Public health systems need to be strengthened as far as primary and secondary care are concerned. Panchayati Raj Institution (PRI), self-help groups (SHGs) and non-government organizations (NGOs) should be incorporated in the fight against this pandemic at their fullest capacity. Collaborative efforts from governments, health care stakeholders and non-governmental organizations should be made to address mental health and holistic care of migrant workers, as it was tried and practiced in countries like Singapore.[14] A strong database on migrants and migrant households should be made through migration survey, National Family Health Survey, National sample survey or census. Migrants should be provided health insurance schemes and they should be made aware of its benefits in such a crisis and in long term.[12] This pandemic has exposed the disparities in the health care delivery system and at the same time has opened up different opportunities to fill up the lacunae.[6],[15]

 Conclusion



COVID-19 pandemic has compelled the medical fraternity and the government authorities across countries to introspect about the strength of the health care system and crisis management. Especially, when it comes to public health, need to look after each section of society. In the context of the immigrant community, the level of inequalities they are facing in terms of economy and health care service should be addressed and sorted out.

Specific author’s contribution

All authors have substantial contribution to the manuscript conception and design of study, drafting of article, critically evaluated by intellectual content. Final approval version is submitted.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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