HIV-Positive Migrants Face Deadly Barriers | Human Rights WatchHIV-Positive Migrants Face Deadly Barriers
June 18, 2009
International groups, nations and donors should give increased attention to the protection of human rights and the HIV-prevention and treatment needs of migrants, Human Rights Watch said in a report released today. The report was issued in advance of the UNAIDS Programme Coordinating Board meeting in Geneva on June 22, 2009.
The 22-page report, "Discrimination, Denial, and Deportation: Human Rights Abuses Affecting Migrants Living with HIV," describes how discrimination and human rights abuses faced by migrant populations result in increased vulnerability to HIV infection and barriers to care and treatment.
"Discriminatory laws and policies that deny migrants' access to prevention and treatment threaten progress on the global fight against AIDS," said Joseph Amon, director of the Health and Human Rights Division at Human Rights Watch. "HIV treatment interruptions can lead to more infections, the development of drug resistance, and death."
Hundreds of millions of people cross borders annually, travelling and migrating for work or school, for family reasons, or to flee persecution or natural disasters. Millions of others move within countries. Yet, even while pledging to achieve ‘universal' access to HIV prevention, treatment, care, and support by 2010, nations have largely failed to remove barriers and ensure that internal and international migrants have access to HIV services. Instead, many countries have discriminatory laws and policies that restrict the entry, stay, or residence of persons living with HIV and limit the access of internal and international migrants to treatment. Many countries deport migrants without considering whether HIV treatment will be available in their country of origin.
In its report, Human Rights Watch called on nations, international agencies and donors, and nongovernmental organizations to work jointly on law reform and provision of services to ensure freedom from discrimination and continuity of treatment for HIV-positive migrant populations worldwide.
Such discriminatory laws and policies can have devastating results. The report documents:
* The deportation of migrants who test positive for HIV in Saudi Arabia.
* How the vestiges of an internal registration system hinder access to free health care for internal migrants in China and Russia.
* The striking gap between South Africa's guarantees to refugees, asylum seekers, and especially undocumented migrants of access to health care and the harsh reality.
* How HIV-positive individuals deported from the United States often face harsh conditions and a lack of access to health care back in their country of origin.
Nations, international agencies, donors and nongovernmental organizations should continue to demand that countries that have HIV-related restrictions on entry, stay, and residence repeal them immediately and entirely, Human Rights Watch said. Restrictions on access to HIV/AIDS treatment based on origin and citizenship should be immediately eliminated, and deportation laws sending people living with HIV to countries where adequate treatment is unavailable should be reconsidered.
"Since the onset of the epidemic, the vulnerability to HIV infection faced by migrants has been well known," said Amon. "But donors and governments continue to fail to ensure that migrants can access HIV-prevention programs and neglect their urgent need for treatment. Instead of ‘universal access,' migrants face denial and deportation."
Medical News Today News Article
05 Jun 2009
According to a report released Tuesday by Medicins Sans Frontiers (MSF), "Zimbabweans continue to cross the border [into South Africa] every day, legally and illegally, in massive numbers as a matter of survival," AFP/Google.com reports (AFP/Google.com, 6/2). An estimated "three million Zimbabweans - about a quarter of the entire population" have fled "the economic collapse and human rights abuses at home, as well as a cholera outbreak that has infected about 100,000 people," according to the BBC, and the "inauguration in February of a fractious power-sharing government in Zimbabwe has not stemmed the flight" (BBC, 6/2).
The AP/Washington Post says the report indicates, "South Africa's health system has been overwhelmed by an influx of Zimbabweans, and that South Africa was struggling to provide shelter and other services for Zimbabweans." The report also documented that some refugees had been "raped by criminals at the border, harassed by South African police once they cross and denied medical care at South African hospitals," the AP/Washington Post writes.
"It's a major humanitarian crisis ... here on this side of the border," said Eric Goemaere, medical coordinator for MSF in South Africa (Bryson, AP/Washington Post, 6/2). MSF performs thousands of consultations monthly for Zimbabwean refugees in its centers, many of whom have HIV or TB, according to Goemaere (Ncube, Zimbabwe Times, 6/2).
The MSF report calls for the government of South Africa and U.N. agencies "to do more to ensure desperate migrants were safe and had shelter and health care" (AP/Washington Post, 6/2). "This should be paid for by the international community," Goemaere said (SAPA/News24.com, 6/2).
The AP/Washington Post reports that South Africa has lifted visa restrictions for Zimbabwean refugees - which Nomvanela Kota, a spokeswoman for South Africa's international relations department - said has made it easier for Zimbabweans to come and stay in South Africa and shows that the government has "long been seized of this matter." Kota welcomed foreign help, "but as part of a 'coordinated effort' led by South Africa" (AP/Washington Post, 6/2).
This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.
allAfrica.com: South Africa: Health Care System Not Equipped to Deal With Migrants
2 June 2009
Johannesburg — South Africa's adoption of a "liberal immigration policy" for Zimbabweans is placing greater burdens on the already stretched health care system, the international relief NGO, Médecins Sans Frontières (MSF), said on 2 June in Johannesburg.
At the launch of its report, No Refuge, Access Denied: Medical and Humanitarian Needs of Zimbabweans in South Africa, MSF's medical coordinator in South Africa, Eric Goemaere, told a press briefing there was a misconception that the crisis in neighbouring Zimbabwe had been resolved by the formation of the unity government on 11 February.
"The political and economic situation in Zimbabwe today is far from stable, and the health system continues to exist in a state of near collapse," the report said. "As a result, Zimbabweans will continue to flee to South Africa in desperation, and will require both guaranteed protection and proper assistance to address their medical and humanitarian needs."
In April, South Africa announced the introduction of a special permit for Zimbabweans that would also make a range of social services available to migrants.
"The permit confers on them the right to stay in South Africa for a period of six months, it confers on them the right to schooling or education, it confers on them the right to work and access to basic health care," Jackie MacKay, director-general of immigration services at the department of Home Affairs, told local media at the time of the announcement.
In May, Home Affairs announced a new 90-day visa, but it would only apply to people with travel documents; a Zimbabwean passport costs about US$820, a price few can afford.
Goemaere conceded that few, if any, countries would have adopted such a liberal entry policy, especially as the volume of Zimbabwean migration to South Africa has been estimated at three million to four million people, most of whom were poor and desperate. Giving migrants legal status was better than not, as it would prevent alleged abuse by the police, he added.
"We will wait for the policies to see what it [the special permit] means ... [in terms of] rights. Everyone in South Africa has access to health care, but will they [Zimbabwean migrants] have access to free health care? That is important. Will they have access to shelter if they have no where else to go? And who will pay for a roof over their heads?"
Although issuing the special permits and stopping deportations were welcome developments, two months after the announcement the special permits had not been enacted. "We're scared it might just be a promise and not come into reality, and is just a delaying tactic," Goemaere told IRIN.
Poor migrant health
The MSF report said their mobile clinics in the South African border town of Musina and central Johannesburg were treating between 4,000 and 5,000 Zimbabweans monthly, "mainly for respiratory-tract infections, including a substantial proportion of tuberculosis, sexually transmitted infections, gastro-intestinal and diarrhoeal conditions." About 30 percent to 40 percent of those treated tested HIV positive.
But xenophobia remains a problem and the report highlighted incidents of severely injured Zimbabweans being turned away by hospital staff, a six-year-old Zimbabwean rape victim being denied follow-up medical treatment, and nurses leaving a pregnant woman on the gurney after realizing she was "a foreigner".
Bianca Tolboom, an MSF nurse and Johannesburg project coordinator, told IRIN: "It is absolutely true the South African health system is overburdened and understaffed, and is triggering this problem [of healthcare] for Zimbabweans."
South African health care workers, including doctors, have been protesting poor pay, working conditions and interruptions in essential medical supplies.
Goemaere said that should the South African government call for assistance in providing health care, the international community should respond.
[ This report does not necessarily reflect the views of the United Nations ]
BBC NEWS | Health | Immigration change will hurt NHS
Patient safety could be put at risk because changes to immigration rules could force hundreds of junior doctors out of the NHS, a union warns.
The British Medical Association said reform of the tier one skilled migrant category was unfair on foreign medics.
The union said it meant doctors in the first two years of training would not be able to apply for the next stage.
But the Department of Health and the Home Office said the rules would ensure "only those we need come here to work".
However, the BMA warned that this could lead to a shortage of doctors eventually, compromising safety in the process.
“ The BMA is requesting that the Department of Health intervenes ”
Dr Hamish Meldrum, of the British Medical Association
BMA chairman Dr Hamish Meldrum has now written to Health Secretary Alan Johnson urging him to intervene to protect the NHS workforce.
He wants the Department of Health to take up the issue with the Home Office immediately as the NHS is also facing difficulties over the forthcoming introduction of the European working directive for junior doctors.
From August, the scope of the directive will be extended to junior doctors, limiting their working week to 48 hours.
Dr Meldrum said: "The full implementation of the directive coupled with a situation in which a proportion of prospective trainees can no longer continue with their training due to ever-tightening immigration rules is likely to exacerbate rota gaps, putting patient safety at risk.
"The BMA is requesting that the Department of Health intervenes."
Excluded
The change to immigration rules in March means that those applying for the tier one category, which in the heath service covers junior doctors who have completed the foundation stage of their training and want to move on to specialist training, need to have a master's degree.
But a medical degree - despite being a five-year course - is only classed as a bachelor's, meaning all foreign junior doctors from outside the EU will be excluded.
In his letter, Dr Meldrum pointed out that as well as affecting those doctors who have already started junior doctor training, the thousands of foreign medical students at university in the UK could also end up leaving.
He said workforce planning in the health service was counting on these students becoming NHS doctors over the next few years.
In a joint statement, the Department of Health and the Home Office said the system had the flexibility to meet the needs of the NHS, the labour market and the country as a whole.
"There is no evidence that medical training is any less effective than it was a decade ago," the statement added.
"The new competency-based system, which was pioneered by the Royal College of Surgeons, ensures that junior doctors are able to continue to train as they demonstrate the competences required. "
It added that the status quo remained in place for current trainees.
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