11.8 Forced migrants and other displaced populations

Abstract

This chapter provides an overview of the global health dimensions of forced migration and the associated public health challenges. The chapter begins by identifying different categories of forced migrants including refugees, internally displaced persons, asylum seekers, trafficked or smuggled persons, as well as environment and development displacees. The causes must be viewed in global context in which globalization is simultaneously a force for greater integration while at the same time contributing to forced migration. Global influences include economic inequalities, armed conflicts, human rights abuses, environmental degradation, and natural disasters among others. The problem of forced migration is difficult to quantify, and statistics are contested. In 2006, the United Nations High Commissioner for Refugees (UNHCR) recognized 32.9 million ‘persons of concern’ including 9.9 million refugees and 12.8 million internally displaced persons. Legal frameworks, including the 1951 UN Convention on Refugees and its successors, identify formal protections to which refugees and other groups of forced migrants are entitled. Nevertheless, the public health situation of forced migrants are varied and often poor. They may form distinct populations or be dispersed amongst host populations; they may be displaced within their own country, to a nearby country, or to a more distant country of asylum; and they may dwell in a developing country experiencing conflict, a more peaceful but poverty-stricken developing country, or a wealthy developed nation. The health of each forced migrant population will be shaped by these contextual factors, but also by prior health and social conditions, the journeys they have had to take, the social structures within which they now live, including access to services, and the stability of these new structures. The role of public health professionals in developing a comprehensive understanding of these dynamics, advocating for forced migrant health, and enabling forced migrants to speak and be heard, aiding them in transforming their own health outcome is discussed.