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Promising practices for the right to health for migrants

Human Rights Council side event on the Right to Health for Migrants

Friday, 20 September 2019, from 13:00 to 14:30

Palais des Nations in Geneva, Switzerland - Room XXV

Opening Statement by Ms Peggy Hicks, Director Thematic Engagement, Special Procedures and Right to Development Division at the UN Human Rights Office (OHCHR)

 

Distinguished panellists,

Excellencies,

Colleagues and friends,

I’m delighted to be here today to launch our publication on promising local practices that show how the right to health can be delivered to some of the most vulnerable groups in society.  Having worked as a doctor in paediatrics and public health, I am particularly passionate about delivering the right to health. It has the power to transform and heal our societies as well as transforming and healing individual people.

I would like to commend the panellists for the contribution they are making to the realisation of human rights. I am also pleased to share the podium with Ms Michèle Boccoz, the Director General of the World Health Organization. Today’s panel is one illustration of the strengthened partnership between our organizations.

Migrants – and especially irregular migrants – are among the most likely to be left behind when it comes to enjoying their right to health. Many find themselves at the very edge of society, not just excluded from public health care and services, but with their physical and mental health endangered by the precarious and unsafe conditions in which they live and work. They may face not just legal restrictions, but practical barriers such as high costs, cultural and linguistic barriers, often onerous administrative requirements, and fear of being reported to immigration authorities.

So how can we ensure that migrants enjoy their right to access the highest attainable standard of physical and mental health, without discrimination and regardless of their migration status?

Today’s publication provides us with some significant answers to that question. The positive practices that have been identified in a number of European cities are very encouraging.  And while this particular research was carried out by our regional office in Europe, I believe the same five key policy options can be applied by other cities and in other contexts.

In terms of the first  intervention – ensuring the continuity, quality and affordability of health care and services for migrants – the report offers ample evidence of what this looks like in practice. For example, it can mean local authorities adopting regulations that allow irregular migrants to register with general practitioners; or if necessary establishing medical centres or health teams for irregular migrants who cannot be registered in the national system; or supporting access to shelters for irregular migrants with particular medical needs.

The second intervention, overcoming administrative barriers, means finding ways to ensure no one is denied medical care because they have no proof of residence or of migration status. Solutions here include local authorities issuing special medical cards, or making existing cards available to people with irregular migration status, limited documentation, or no fixed residence.

The third policy, ensuring the affordability of health care and services for migrants, can be tackled with innovative solutions. Local authorities can set up special funds to cover costs, which private donors can support, or support NGOs providing care, or allow doctors to claim reimbursements directly from the municipal authorities.

The fourth action deals not with costs but with patient confidentiality. It’s hard for us to imagine not being able to seek the medical care we need for fear of being reported to the immigration authorities, or of being deported. But this is the reality for many migrants, especially those with irregular status. Again, creative solutions are available. Local authorities can create administrative “firewalls” between migrants and any officials who are duty-bound to report on their status. Or they can establish dedicated centres that can be accessed anonymously.

Finally, people need to know their human rights and the care they’re entitled to, and so do health centres. Local authorities can play a proactive role in a variety of ways, whether by carrying out meaningful and accessible public information campaigns, or funding groups working with migrants and health providers.

These five actions have the potential to transform migrants’ access to healthcare. They are inclusive and firmly founded in a human rights approach. Crucially, they draw in contributions from municipal and regional governments, civil society organisations, and health care providers.

Friends and colleagues,

Positive partnerships are essential if we are to ensure that migrants, and their children, can receive the full healthcare that is their right. It’s one of the reasons my Office has stepped up its engagement with local authorities. Cities and towns have an increasing role in promoting respect for human rights.

Today’s publication, and our event here today, are important signs of all these partnerships. As we share our expertise and experiences, we can drive forward our goal to ensure that all people, including all migrants, can enjoy their right to health.  And of course it’s not just our goal – it’s a key part of the 2030 Agenda for Sustainable Development. Meeting SDG 3 on health will deliver benefits elsewhere, including SDG 10 on reducing inequalities. The right to health is also explicitly recognised in the Global Compact for Safe, Orderly and Regular Migration.

Globally, several States are taking concrete action. Thailand, for example, is one of the few countries in the world that extends health coverage to undocumented migrant workers.  In Argentina, the 2004 Migration Law states that no foreigners who need medical attention should be barred from receiving it, irrespective of their migratory situation.

In some cases, the good practices begin in migrants’ home countries. In Bangladesh, a government bureau runs training programmes and briefings to prepare migrants for employment abroad, including specifically raising awareness of the risks of disease and how to reduce them.

Alongside the direct role of governments, many positive contributions are made by NGOs. In Nepal, the NGO Pourakhi – which means “self-reliant”– runs a hotline providing psychosocial, legal and medical counselling to returning migrant women.  In Japan, the Centre for the Health and Rights of Migrants, or CHARM, enables women with neither visas nor money to receive medical treatment.

Other major differences are made by positive partnerships. In 2012, the National Red Cross in the Republic of Korea began providing affordable or free medical services for vulnerable migrants on the basis of a memorandum of understanding with the Seoul National University Hospital and Hyundai Chung Mong-Koo Foundation. By 2017, five similar Healthy Neighbourhood Centres were up and running.

In India, the NMS trade union has worked with the ILO to enhance healthcare for construction workers, and with the Aids Control Society in Maharashtra State to improve access to care and support services.

Friends and colleagues,

Positive practices, and positive partnerships. These examples show just a small amount of what is already being achieved, and I’m sure many more will be shared here this afternoon. Research shows that accessible and quality health care and services for all avoids over-burdening emergency services. Addressing health problems early on, through preventive and primary care, as opposed to eventual emergency interventions, can lower costs for the health care system overall. So the benefits of success flow not just to the individual people, but to our societies as a whole.

Thank you.