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RIGHTS: Scant Compassion for Migrants with HIV

Am Johal

UNITED NATIONS, Jun 17 2008 (IPS) - Even as people who migrate from their homelands run a higher risk of contracting the HIV virus, they also are far less likely to receive adequate healthcare, and often face deportation or other harsh treatment in destination countries, activists say.

The International Organisation for Migration (IOM) estimates that there are 191 million migrants worldwide. Global figures on how many are living with HIV/AIDS are hard to come by, in part because the fear of deportation, job loss or other punitive reactions means that many cases go unreported, and civil society organisations have difficulty reaching out to marginalised, mobile populations.

“In HIV/AIDS work, we know about sexual minorities, gay men, transgendered issues, sex work issues, but the migration piece is unheard of,” Vince Crisostomo, coordinator of a group called The 7 Sisters based in Bangkok, Thailand, told IPS. “Since they are not citizens, they are particularly vulnerable. Most activists are not aware of these issues.”

Special risk factors for migrants include poverty, exploitation, separation from families and partners, and loss of the sociocultural norms that guide behaviours in stable communities.

The consequences of revealing one’s HIV status can be severe. More than 70 countries have long-term travel restrictions on migrants living with the disease. But some take it a step further, forcing migrant workers to undergo testing as a condition of employment.

In Malaysia, only migrants who fill unskilled jobs and who make up the lower socio-economic classes face such mandatory health testing – for which they are forced to pay a fee. If classified as “unfit”, they are deported despite the availability of treatment for AIDS and tuberculosis, notes the group CARAM Asia. Rather than protecting public health, it says, these discriminatory practices will simply lead more migrant workers to enter countries illegally.

“Criminalisation and deporting people with HIV/AIDS is not a fair or rational response,” Laxmi Narayan Tripathi, a transgendered HIV/AIDS activist from India with the organisation Astitva, told IPS. “We need to abolish those laws and ensure the right of people to access treatment and make sure that their basic human rights should be respected.”

“There is often no treatment, medicine, there is so much harassment,” she added. “There is discrimination against people who employ them – it is very hard for them to survive due to the social structure around them collapsing due to their health status. There is such an inhuman, uncivilised response. We have the most uncivilised laws in place currently around the world.”

Beyond travel and work restrictions, migrants also have difficulty accessing health services due to their disputed status and existence at the periphery of dominant societies.

In South Africa, for example, many Zimbabwean migrant workers who were rounded up in a February police raid were denied their HIV medications, activists said. In the United States, Human Rights Watch charged in a report last December that the country’s immigration agency has failed to respect the rights of thousands of detainees with HIV, monitor and provide appropriate life-saving treatment, or even keep track of exactly how many have the virus.

“The main thing we hear is about the violation of their human rights,” Crisostomo said. “These are people trying to retain their livelihood…With women, it’s connected to violence – they are not allowed to get pregnant as well.”

“The implications of these policies is that they are growing the stigmatisation of the disease and driving these issues underground, which is exacerbating the problem,” Bolivian activist Gracia Violeta Ross Quirogo told IPS at an international conference on HIV/AIDS at the United Nations last week. “Migrant workers travel to another country, and then, after being there for a while at the destination country, they get evicted from there. They are then deported. Who is responsible here? There is a kind of denial of their status and refusal to take responsibility.”

“They are choosing to pass these policies and assume that we are crossing borders with the specific aim of spreading HIV/AIDS,” she added. “People are not migrating to transmit HIV/AIDS – they are trying to work.”

Indeed, the IOM notes that while many people believe that migrants and mobile populations bring HIV with them, in fact the opposite is more likely to be the case: rather than bringing diseases, migrants often become vulnerable to contracting HIV during transit and after they arrive at their destinations.

Some countries are taking steps to address this problem. In Sri Lanka, where 40 percent of women infected with HIV had contracted the disease overseas, the two national HIV/AIDS prevention programmes are working closely with the Foreign Employment Bureau to developed extensive programmes for pre-departure migrants, families of migrant workers, re-migrants and employment agencies.

At the U.N. conference, Ratri Suksma of the Malaysia-based CARAM (Coordination of Action Research on AIDS and Mobility) said, “I would like to remind member states that they committed to universal [treatment] access goals by 2010 and we haven’t seen significant progress. We have little more than a year to go…they have to keep their promises to civil society.”