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FOCUS September 2002 Volume 29

Human Rights, HIV and the Migrant Workers

CARAM-Asia

According to the World Report 2000 of the International Organization for Migration (IOM), over 150 million people are residing outside their countries of origin. Other estimates state that more than 25 million are Asian migrants working in other countries.

In recent times, Asian migration patterns have been marked by intra-regional migration, temporary labor migration and a rise in irregular migration.

There is also an increasing trend towards the feminization of migration. The IOM report puts the gender distribution of migrants internationally at 52.5% for men and 47.5% for women migrants. However, the increase in the participation of women in the regional labor migration from 15% in 1976 to 27% by 1987 with the upward trend showing no let up in the 1990s is evidence of the feminization of migration in Asia.

In the Philippines, newly hired women Overseas Filipino Workers (OFWs) increased from 61% in 1998 to 68% in 1999, as against a percentage share of 12% of total OFWs in 1975. The situation is the same for Sri Lanka. (see table)

TABLE -1
Migration of Sri Lanka Workers to All Countries Distribution by Gender

1981

1996

Male

Female

Male

Female

27,265

30, 385

41,315

121, 257

Source: BATU-SAARC Migrant Year Book 2000 (based on Sri Lankan Foreign Employment Bureau)


While the vulnerability of migrants to HIV and other infections is recognized because of various working and living conditions which impact on their human rights, the feminization of migration exacerbates the problem. Recent UNAIDS (2001) estimates indicate that out of five million people who were newly infected, two million were women. Similarly, by 2001, 19 million out of the 40 million people living with HIV/AIDS were women.

Human rights issues

Some of the human rights issues affecting the health and HIV vulnerability of migrant workers concern the following:

Access to information

In the context of active promotion of export of labor to finance economic growth and meet foreign debt obligations by many sending countries, the availability and accessibility of information for migrant workers at pre-departure, post arrival and reintegration stages are either limited or non-existent. In a survey of Bangladeshi workers in Malaysia, 91% say that they did not receive orientation or training relating to HIV or AIDS before leaving their home country.1 Existing information available to migrant workers focuses on developing job skills and greater subservience2 ignoring rights-based orientation programs which facilitate development of survival skills and empowerment against health and HIV vulnerabilities. Such a situation could adversely impact on the security and health status of the migrant workers in the other stages of migration.

Mandatory testing, notification and deportation

Most receiving countries in Southeast and Northeast Asia and in the Middle East require people applying for overseas jobs to undergo mandatory testing for HIV and other infectious diseases. In addition to the discriminatory nature of the mandatory testing, it is often undertaken in an insensitive and irresponsible manner.

Though the Bangladesh government condemned in 19973 the mandatory HIV testing requirement, emigrating workers are still required to undergo tests in Bangladesh prior to departure. The 2000 survey done by CARAM of Bangladeshi migrant workers in Malaysia reveals that:

  • Pre-departure medical tests were completed by 83% of the workers
  • 48 workers (65.8%) were aware that they were undertaking HIV testing
  • Of the 48, only 3 who knew that they had been tested for HIV received pre- and post-test counseling.

Similarly, in a study conducted in the Philippines, many migrant workers were unaware that they were tested for HIV.4

HIV testing can also be a discrimination tool when imposed on people in difficult situation. The mandatory HIV testing by the Burmese government in April to June 2002 of the three thousand Burmese migrant workers, who were deported from Thailand, constituted a discriminatory act against people whose migration was caused by the forced relocation and forced labor policies of (along with economic mismanagement by) the government.5

Access to health care

Access to health care is not considered a right of migrant workers in receiving countries. For undocumented migrant workers, their fear of arrest effectively restricts the use of medical facilities especially of state-run hospitals. Lack of or poor access to health care by migrant workers precipitates their HIV vulnerability.

Working conditions

Labor rights violations such as long working hours with little or no rest, exposure to unsafe working conditions, poor sanitation and nutrition, and wage withholding, underpayment or illegal deduction have the potential of compromising the health of migrant workers and predispose them to infections.

Single entry policy and denial of right to marry

Most receiving countries require migrant workers to enter the country without spouses and partners. Further, marriage in the receiving country often becomes reason for deportation. Such policies deny the human, social and sexual identities and needs of migrant workers, and increase their health and HIV vulnerabilities when they opt for unsafe means of pursuing relationships.

Detention centers and health

Reports indicate that in most detention centers, migrant detainees face poor nutrition and sanitation, minimal or no medical attention.6 Rape and sexual abuse of women migrant detainees are also common. Such violations may cause direct infection with HIV and severely compromise the health of detainees and increase vulnerability to infection.

HIV-positive migrant workers

Returning migrant workers who are HIV positive face discrimination at home. The case of two returning migrant workers in Bangladesh illustrates this point. They were isolated in a jail-like situation in a hospital and the media hounded them by publishing their photographs in newspapers using information supplied by the hospital.7

Until returning migrant workers are protected and are able to enjoy their rights to privacy, information and access to appropriate health care, it is not possible to protect the societies they belong to from the AIDS pandemic.

Health and HIV vulnerability of female migrants

The increasing number of women migrant workers engaged in the informal labor sector (as domestic help and sex workers) raises health issues. Their isolation and poor working conditions cause their vulnerability to health problems, and decrease their protection against abuse. Their lack of capacity to negotiate for safe sex and denial of right to make a free choice regarding their body as women exacerbate the risk of contracting HIV.

Government policy and employers' practice in receiving countries of prohibiting women migrant workers from getting pregnant during their employment institutionalize the suppression of the women migrant workers' right to control their bodies.

Likewise, the ban on migration of women workers (such as in Nepal, India and Bangladesh) leads to the use of irregular migration channels that expose them to health risks. This policy obviously restricts their freedom of movement.

Given the regional scenario of increasing number of women infected with HIV, lack of protection for migrant women workers will lead to increased vulnerability of women to HIV/AIDS.

Awareness of health rights

Minimal recognition of the health rights of migrant workers causes many of the problems they face. Failure to appreciate the link between the rights violations in HIV-infection prevention measures and the consequent increase in HIV infection of migrant workers, the focus on "welfare approach" to infection prevention (supply of condoms and information materials for example) without developing an enabling environment for health rights protection, and the inadequate recognition of the link between health rights and the economic rights of migrant workers, among others, will not lead to a holistic approach to fighting HIV/AIDS infection.

Mandatory testing and discrimination

The significance of HIV testing as an epidemiological tool or as a necessary medical intervention for treatment is not challenged. However, the focus on migrant workers and the notification and deportation process related to HIV testing is discriminatory. The infringement of the human rights of migrant workers in relation to mandatory testing-deportation process is shown as follows:

  • Since HIV infection does not diminish the capability of a person to function at various levels, medical tests for HIV infection and other diseases restrict the right to travel, and deny the right to work when used in conjunction with deportation. Also, in cases of easily treatable sexually transmitted diseases (STDs) and other infections, should they be ground for deporting migrant workers who paid so much just to get their jobs abroad?
  • Selection of migrant workers as a category for mandatory testing appears to arise from their marginalized status. Professional expatriate workers are excluded from such testing. It appears that only migrant workers are required for mandatory HIV testing because they are perceived to be transmitters of the HIV virus. But everyone regardless of status is at risk of becoming virus transmitter. With the exception of Singapore, most receiving countries require only migrant workers to undergo mandatory HIV testing.
  • Conduct of mandatory HIV testing without their knowledge (and consequently without pre- and post-test counseling) violates the right to information, privacy and confidentiality.
  • Deportation of migrant workers due to false positive test result makes the discrimination even more severe.8
  • Testing is also unfair as it places the responsibility of handling the HIV epidemic on the migrant workers. Granting that their support is also necessary, how can they help when their situation places them at risk of acquiring HIV?
  • The social responsibility of governments, companies and other institutions that test and deport migrants is also questioned. How are they responding to the fact that many migrant workers enter the country with a clean bill of health but subsequently become HIV positive?

A false sense of security occurs among the local population of receiving countries by thinking that they are free from HIV infection because mandatory testing and deportation of migrant workers are undertaken. Granting that employers of receiving countries have the right to hire healthy workers, what is their responsibility in keeping the workers healthy and giving them access to health care during the course of their employment?

Conclusion

The protection and promotion of the rights of migrant workers effectively reduce not only their vulnerability to HIV but also that of the societies they live in. The crucial elements of this approach are:

  • enabling national and regional environments that provide protective mechanisms covering migrant workers;
  • regional co-operation and intervention with the responsibility being more on receiving countries because of their role in the development of transborder migration system based on their development strategies, as well as their greater capacity to contribute to the building of an enabling environment. This in no way means lesser support from sending countries in managing the HIV pandemic;
  • co-operative and collective interventions at the local level that increase community action and involve migrant workers themselves, to enable them to protect themselves against health/HIV infection risks;
  • empowerment of migrant workers as a pre-requisite as well as an end result of the strategy to reduce their HIV vulnerability.

CARAM-Asia is a regional network of organizations committed to action-research on Mobility and HIV/AIDS in Asia. It has 11 partner-organizations in South, Southeast and the Middle East.

For further information, please contact: Coordination of Action Research on Aids and Mobility in Asia (CARAM-Asia), 8th floor, Wisma MLS, 31 Jln Tuanku,Abdul Rahman 50100 Kuala Lumpur, Malaysia, ph (603) 2697-0708, fax (603) 2697-0282, e-mail: caramasia@hotmail.com; website: caramasia.gn.apc.org

Endnotes

  1. Kanlungan Center Foundation Inc, Fast Facts on Filipino Labor Migration, Philippines, 2000.
  2. Migrant Services Center, BATU-SAARC Migrant Year Book, 2000, Sri Lanka.
  3. Vulnerable - A Case Study of HIV/AIDS and Bangladeshi Migrant Workers in Malaysia, Tenaganita - CARAM Malaysia, April 2000.
  4. Krisnawaty et al, Report of the Preparatory Meeting of the Regional Summit on Pre-Departure, Post Arrival and Reintegration Programs for Migrant Workers, CARAM Asia, 2000.
  5. Riza Faith C. Ybanez, Labor Migration and HIV/AIDS: Vulnerability of Filipino Migrant Workers in Hongkong, CARAM Philippines, 2000.
  6. NGO Statement - "Deportation of Burmese Migrants and HIV Testing," during the 24 June 2002 meeting of groups working with Burmese migrants.
  7. A Memorandum on Abuse, Torture and Dehumanized Treatment of Migrant Workers at Detention Centres, Tenaganita, Malaysia, 1995.
  8. Joachim Victor Gomez, "Overview of the Policy on Health and Migration in Bangladesh and Reproductive Health Status in South Asia," CARAM NEWS, Issue # 7, October, 1999.
  9. Tenaganita case files, 2000.

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