Migration and Women's Health: A Neglected Issue in Need of Action

There is a current tendency to think of migrants as young men. Although in some cases this stereotype still holds true, patterns of migration are rapidly changing and more must be done to ensure that vulnerable female migrants are protected, particularly in terms of their health. Although earlier in the European “migrant crisis” the vast majority of those arriving were men (over 70% of irregular migrants into Greece and Italy in June 2015 were adult men), this gender gap has gradually decreased over the past year and UNHCR estimates that men now make up only around 40% of migrants arriving in the Mediterranean. Forced movements in particular seem to affect higher numbers of women and children. Indeed, over three quarters of Syrian refugees registered by UNHCR are either women or children under the age of 18. Women are also participating to a greater extent in economic migration; for example in some in South Asian countries, such as the Philippines, a significant portion of national GDP now comes from remittances sent home by female migrants working abroad.  With levels of migration increasing across the globe it is essential that migrant women’s health and access to care is high on the political agenda. Although in some cases - especially within cultures where women are marginalized - migration can help to improve women’s professional opportunities and access to education/care; the health of female migrants, however, is often negatively affected. Migrant health is a complex issue involving many different determinants. Several models have shown the dynamics between health statuses and systems in countries of origins and host countries, as well as the stresses involved in the process of migration itself. In the context of migration, the rights of women can be especially precarious and opportunities for their protection are often limited by the social, political and economic environments which they have migrated from and to. With female migrants from cultures where women are traditionally given little autonomy over their healthcare decisions, these traditions/ideologies can persist even after migrants are settled in their host countries. This in turn affects their ability to seek and access quality healthcare. Limited knowledge about the available health services that are accessible in their host country is also a major barrier. Health care needs and expectations of female migrants obviously differ from those of men and must be taken into account. However it has been repeatedly reported that women’s reproductive health needs are often overlooked even within well structured refugee camps. For example, due to the poor levels of hygiene in migrant reception facilities migrant women are at heightened risk of severe gynecological problems. Such problems could easily be prevented by assessing health requirements of women on arrival and providing clean sanitary pads and other such products. Pregnant women are also among those arriving at migration hubs such as Lampedusa in Greece. Pregnancy is always a sensitive and vulnerable time for women, the dangers of which can be further augmented by the process of migration. Asylum-seeking women can have high-risk pregnancies due to the severe physical and emotional strain of their journeys and due to previous treatment in their countries of origin; many having suffered sexual violence or genital mutilation (which can cause major birthing complications). Evidence shows that migrant mothers are more likely to suffer from pregnancy complications, including preterm delivery and postpartum depression compared to national women.  A review also showed that migrant women settling in Western Europe had poorer maternal health indicators, including perinatal mortality compared to native women. It is therefore important for sufficient provision to be made for the reception of pregnant women at known immigration landing points. The vulnerability of women to exploitation and violence has also been consistently raised, especially within asylum seeker settings. All too often women are placed in cells alongside hundreds of men and are not provided with safe, well lit bathrooms. MSF as well as UNHCR and UNFPA have repeatedly urged for improvements to refugee holding centers to help protect women from sexual harassment and abuse, yet in many areas the risks of sexual abuse remain very real. Furthermore, the vast majority of victims of human trafficking are women and girls (79%). The most common form of human trafficking (79%) is into the sex trade, where rape and sexual violence are common. Sexual violence can not only affect the psychological health of female migrants but can also be a major cause of infectious diseases such as HIV and other STIs. This vulnerability to sexual abuse is exacerbated by a lack of appropriate policies and programs designed to protect female migrants’ health. As we move into an era of increasing female mobility both internationally and domestically, attention must be focused on making migration safer and healthier. In the area of women’s health, much remains to be done if the wellbeing of women and girls is to be protected.   About the Author: Elizabeth Maclean is a Research Officer at the International Center for Migration, Health and Development in Geneva, Switzerland.