Millions of people migrate providing essential contributions to national workforces and economies. There is extensive evidence showing that the vast majority of labour migrants are young, fit and healthy when they embark on their migrant journey. Migration can benefit the health status of migrants and their families through increased socioeconomic status, better education and purchasing power for their families ’left behind’, thanks to remittances.
However, migrants’ health vulnerabilities can occur throughout the migration cycle. The conditions in which they travel, restricted access to health services upon arriving to destination country, exploitation, poor living and working conditions, discrimination, the geographical distance from their families and support system, are some of the aspects of the migration process that can impact the health of labour migrants and lead to the deterioration of their health status.
Many migrant workers are employed in high risk and hazardous sectors such as mining, agriculture and construction. These kinds of jobs usually involve long hours and hard physical labor, which can result in increased occupational accidents. Particularly those in an irregular migration status endure dangerous working conditions and fear drawing attention to themselves and losing their jobs, or being deported. Furthermore, migrant workers are often not allowed to form and join trade unions, which may be an additional obstacle to raising concerns about their health and safety in the workplace. In addition, sexual exploitation has been widely reported in particular in the context of female labor migrants working in informal sector, such as domestic work.
Many labour migrants undergo some form of health screening or health assessments pre departure and/or upon arrival as a recruitment pre-requisite. Costs of the testing procedures can be high, and often paid by the migrants. Existing evidence indicates that health assessment providers often operate in isolation, with little to no formal association or information sharing with a country’s public health system, and do not ensure referral for needed treatments and follow up. Mandatory testing for some conditions, such as HIV or pregnancy, or lack of proper diagnostic practices, is of limited public health value and leads to unnecessary deportations of many. If health assessments are to meaningfully contribute to the greater public health good, and moreover, benefit the health of labor migrants, national health systems linkages and migrants’ ability to take health improvement measures, must be strengthened.
Providing easily accessible and quality health services that include prevention, health information, and access to primary health care, to labour migrants and their families not only benefits migrant populations but also serves as an important public health measure that simultaneously protects the people of the communities of origin, transit, and destination. If labour migrants are unable to access public health systems (for example, due to their documentation status, fear of arrest, financial costs, or lack of time) they may be forced to remain untreated, potentially undermining public health responses. Mechanisms for extending social protection in health and increasing social security coverage for migrants and their families can enhance access to needed health services and avoid excessive out of pocket payments by migrant workers in need of health services.
Health vulnerabilities of labour migrants within the ASEAN region, for example, also extend to health security threats such as influenza pandemics and other public health emergencies of international concern. An example is the health vulnerabilities faced by migrant workers in poultry and animal husbandry sectors in the context of an avian influenza viral outbreak. Due to a combination of legal, socio-cultural, behavioural, language and economic barriers some migrant workers have limited awareness or access to health and social services, which extends to pandemic preparedness, mitigation and response at national level.