3 March 2016, 13:00 – 15:00 Room XXIV,
Palais des Nations, Geneva
Excellencies, distinguished participants, ladies and gentleman,
It is my great pleasure to contribute this afternoon to this important discussion on migrants and the right to health. It is an issue of grave concern to the High Commissioner and his Office is committed to shedding light on the barriers encountered and practical guidance needed to uphold health rights for all migrants.
With this in mind, aware of the pressing challenges many regions in the world including Europe, we will present a study on the situation of migrants in transit to this session of the Human Rights Council.
I therefore want to illustrate in my remarks today some of the study’s findings by focusing specifically on the health rights of migrants en route.
While millions of international migrants cross dozens of inter-national borders safely each year, for many others their journey could not be more different - long, circuitous and perilous. Compelled to voyages in unseaworthy vessels, confined in overcrowded trucks, crossing deserts on foot, migrants on the move can find themselves in urgent need of shelter, food, water, and medical aid.
Those who are poor, without well placed social networks or diaspora connections, women at risk of violence and exploitation, those who are in an irregular situation, or are vulnerable children are most at risk. They are often also the most invisible in our policy responses.
And in the drive to improve or even to save their lives, thousands are losing their lives instead. Over the course of 2015 until now, along the world’s migratory routes almost 6,000 women, men and children have lost their lives, - more than 4,000 in the Mediterranean alone.
Tens of thousands more have been exploited, abused, or have become the targets of xenophobic attacks.
Whilst migrants may begin their journey in relative health, the demands of their migratory journey, the conditions of their travel and the absence of access to physical and mental health care means many migrants – thanks to their migration - also experience poor physical and mental health outcomes.
Migrants may face hazardous conditions as they move, causing such as communicable diseases, respiratory and gastrointestinal infections. They may suffer from dehydration, hypothermia and they are at heightened risks of experiencing violence and trauma, which may have a profound impact on their health.
In transit, the specific health needs of migrant women and girls, particularly in relation to their sexual and reproductive health and rights, frequently remain unmet. Where medical services are provided to migrants in transit, they may not include consultations with gynaecologists or other specialised services for survivors of sexual violence. Imagine going into labour as you cross the desert or nursing a tiny new-born while trudging down the rail track. Fear of deportation drives many women away from health care at the very moment when care is needed most.
In transit, children lack access to timely and essential childhood vaccinations.
In transit, chronic conditions often go untreated. It has been reported that migrants in transit will often wait until their health deteriorates significantly or rely on self-medication, reluctant to seek basic medical services for fear of detection, detention and deportation.
In transit, mental health care is often disregarded as a ‘luxury’.
Migrants in detention are particularly vulnerable to poor health outcomes - depression, anxiety, post-traumatic stress syndrome and self-harm can result. We know that detention of children, even for short periods, is extremely detrimental to their physical and mental health.
And yet, all migrants, regardless of their legal status or other circumstances, are entitled to the full protection of their right to the highest attainable standard of physical and mental health, as provided by the International Covenant on Economic, Social and Cultural Rights (art. 12). States have an obligation to ensure that all migrants, regardless of their status, have equal access to preventive, curative and palliative health services.
In our Principles and Guidelines on Human Rights at International Borders, OHCHR has recommended that States ensure that competent medical staff are present at the point of rescue or interception to carry out screenings and refer persons for further medical attention, including mental health referrals where appropriate. We also call on States to ensure timely access to mental health services for all migrants, particularly survivors of torture, trauma and violence, and to establish firewalls between public health service providers and immigration authorities.
Women, men and child migrants are being left behind, excluded from national health systems and inadequately served by humanitarian and development programmes. This is directly at odds with the commitment of the 2030 Sustainable Development Agenda to “leave no one behind”.
Better, more cooperative and solidly rights-based systems of migration governance must be put in place around the world, to ensure that we deliver on our commitment to those migrants who are at grave risk of being left out – left behind – as the most marginalised, excluded.
The mobility of people across international borders - the very foundation of modern globalization – dates back to the very creation of borders themselves. Indeed, movement of people – both forced and free - has been the rich and fertile ground on which so many of our countries were formed and flourished. And demography makes clear how needed their contributions are for the future of so many countries. Many of us were born of migrants or are indeed migrants ourselves. And our children too will want to cross borders. To whom among them would we wish health and dignity denied? For whom among today’s migrants can we say – they have no rights.