A Guest Post by Sandro Galea, Catherine K. Ettman, and Muhammad H. Zaman, the Editors of Migration and Health
In the Egyptian resort town of Sharm El Sheikh, leaders from countries large and small, bureaucrats and philanthropists, academics, and activists, gathered last week to talk about the future of the planet at the COP27 meeting. The discussion this year was not simply about greenhouse gases and carbon footprint, fossil fuels, and electric cars, but also about the impact of the changing climate on the migration of millions of people all around the world. A few years ago, conversations like these were rooted in hypotheticals. This year, however, these conversations were grounded in the very real increase in migration worldwide, some of it directly linked to climate change. The events of the summer of 2022 in Pakistan have shown that the displacement of millions due to climate change is no longer the domain of a distant future or the active imagination of alarmists. The impact of rains and floods on crop failures and lost revenue, and on destroyed lives and livelihoods is happening in real-time. Mass migration is the clearest manifestation of an unpredictable force of a changing climate.
This adds to the millions of migrants worldwide, driven to migrate by a range of social and economic reasons. A year ago, few would have predicted the forced displacement of several million Ukrainians, displaced both internally within their own country and often forced to seek shelter in neighboring states. The events in Ukraine are however just the latest episode in the long list of conflict-related forced displacement of innocent civilians in Asia, South and Central America, the Middle East, Africa, and Southeast Asia.
The drivers of migration are not just conflict or climate, and migration is not simply a phenomenon in countries far from our own shores. Closer to our homes on the East Coast of the United States, we find vulnerable Venezuelan communities brought to Martha’s Vineyard from Florida, under the guise of false promises and xenophobic political rhetoric that is increasingly becoming the norm of politics in the US and elsewhere. At the same time, despite strong opposition from human rights groups, reports in the last week suggest that the Biden administration is considering sending migrants from Haiti to Guantanamo Bay.
At the time of this writing, over a hundred million persons are displaced and have been forced to migrate due to conflict, persecution, and climate change globally. There are more than 200 million international migrants globally. Economic anxiety and inequality, created due to unjust global policies and exacerbated by COVID-19, have forced millions more to migrate in search of a better, safer, and more dignified future. Migrants are at high risk of disease and death, not just because of poverty, malnutrition, and routine exposure to pathogens, but also because of the prolonged and often perilous journey, the detachment from a supporting community, the lack of support along the way, and a hostile and xenophobic environment in the new location. All these factors contribute to adverse health outcomes even when migrants are no longer on the move. While health remains a fundamental human right, to paraphrase Paul Farmer, many migrants are not considered human enough to have this right.
As migration increases worldwide, so does the need for a better scholarship on migration that may inform policies that can protect the health of migrants. While the impact of migration on health has long been the subject of various research initiatives, scholarly articles, conferences, and symposia, it has historically been evaluated from siloed disciplinary approaches. Boundaries have been created between communicable and non-communicable diseases, between those who are in the early phase of their migration, and those who have arrived at their said destination, between the health of the elderly and the health of newborns, and between those who leave because of conflict and those who leave because of economic collapse. Research efforts have also stayed within specific academic disciplines—artists and humanists have not worked with scientists and engineers, and area study experts of one region have had limited interactions with experts and scholars specializing in other regions. Quantitative approaches have not appreciated the insights from qualitative methods and vice versa. While important and meaningful insights have been gained from these diverse scholarly methods, our understanding of the health of migrants remains limited and falls substantially short of the scope of migration and our need to understand its consequences.
Robust policy rooted in ethical leadership and equity requires all of these disparate areas to come together to give us better insight into how we can protect the health of migrants. We need to take a stock of not only stubborn challenges that have affected migrants’ health for decades but also be ready to tackle new and emergent threats, whether they are rooted in a new pathogen, or a new wave of misinformation. Equitable access to quality healthcare, and a holistic approach to ensuring this access, is the right of all persons in all places—including those who are unable to live in one place. It is now well-accepted that health is the product of the world around us, and we can create healthier contexts for people who come to our shores. Thinking about the health of those who migrate is not only the right thing to do, but it is the smart thing to do: only when all people are healthy can a nation thrive and live up to its full potential.
Sandro Galea is dean and Robert A. Knox Professor at the Boston University School of Public Health. He is the author of several books, including The Contagion Next Time. Catherine K. Ettman is chief of staff and director of strategic initiatives at the Boston University School of Public Health. Muhammad H. Zaman is the Howard Hughes Medical Institute Professor of Biomedical Engineering at Boston University. His most recent book is Biography of Resistance: The Epic Battle Between People and Pathogens.