Migrants want equality and dignity

Migrant workers keep many economies in Asia and the Middle East functioning, yet migrants are often vulnerable to violence, discrimination and lack of social and healthcare services.

Migrant workers keep many economies in Asia and the Middle East functioning, yet migrants are often vulnerable to violence, discrimination and lack of social and healthcare services.

In some countries the policy and practice of mandatory HIV testing for migrant workers is discriminatory and violates their human rights.

According to Mara Quesada-Bondad, executive director of Action for Health Initiatives, who spoke on behalf of migrant workers at the recent International Congress on AIDS in Asia and the Pacific (ICAAP 11) in Bangkok: “One of the biggest issues we are facing is the slow movement of legal reforms related to mandatory HIV testing and deportation among migrant workers. In many contexts, migrant workers are excluded from laws and policies that allow them to access health services in general and HIV treatment in particular.”

Migrant with HIV deported

Elena Felix, originally from the Philippines, was deported from the Middle East where she was working when she was diagnosed as living with HIV. She said: “We were once considered as the ‘new heroes’ as we were bringing back money to our country but now we face stigma and discrimination, all I want is to live with equality and dignity.”

In Thailand, there is a new health insurance policy for migrants but the insurance premium is costly which makes service providers reluctant to provide services. For the Malaysian government the health issues of migrants are considered a threat. Migrants are registered and tested but deported if found to be HIV positive or when women migrants are pregnant.

Male workers from other countries are stopped and questioned at immigration in Hong Kong if they carry condoms, which makes them reluctant to carry them in the future. Women working as domestic workers are particularly vulnerable in Singapore as pregnancy and HIV are causes for deportation.

Healthcare discrimination for migrants

There is an intersection of groups most at risk of HIV who struggle to access healthcare with migrants who are also: men who have sex with men; migrants already living with HIV; sex workers; young people; transgenders; and people who inject drugs.

Some 2.5 million Burmese migrant workers live in Thailand, about half of whom are estimated to be undocumented. In hospitals they often face discrimination and the healthcare providers tend to treat the Thai patients first. Even with health insurance, some only get given paracetamol regardless of their health condition. For migrant workers who trying to access antiretroviral therapy, the system is usually too bureaucratic and difficult to navigate.

The migrant community at ICAAP 11 discussed key issues and recommendations needed to promote HIV prevention and treatment services for migrants. They concluded that there should be no termination from work and deportation, as this violates the right to work and the right to move and stay. Instead, access to HIV prevention, treatment and care must be provided and any health testing should be accompanied by the three C’s – counselling, consent and confidentiality – and be connected to treatment.

At the policy level, activists at ICAAP advocated for more progressive and inclusive policies that mandate non-discrimination in accessing health services for migrant workers. They called on national governments, both in countries of origin and in destination countries, to provide funding for HIV prevention and treatment and to support community-based organisations that assist migrants to sustain their work.