Migration, gender, and cultural issues in healthcare: psychosomatic implications

Abstract

Human migration involves moving to a new permanent or semi-permanent location. Whether on an individual basis, in small groups or in large numbers, whether due to economic necessity (emigrants), sociocultural strife or the effects of war (refugees), it can contribute to stress in the mobile along with the settled population. Uncertainty then, increases the risk of psychosomatic disease in those relocating because of the changes in their personal/social support networks. The available healthcare for the displaced may not address their health needs adequately. Chapter 12 deliberates on this. Gender-related issues, with a female preponderance as victims come to the fore in displaced populations. These include the health effects of domestic and sexual violence or gender-based violence. International organisations, including the UN, the WHO, and FIGO, along with organisations from various countries that promote women's and children's health, have developed guidelines, and attempted to engender political will to endeavour to stop this preventable morbidity. Nevertheless, it persists with a biopsychosociocultural impact, and can be fatal. Unwanted pregnancies can result from gender-based violence or failed contraception with the pregnant woman seeking termination (abortion). Annually, about 42 million women resort to illegal methods of abortion, and risk grievous harm due to a lack of legalized services. Female genital mutilation, a form of gender-based violence with genitourinary sequelae that is carried out on girls, has global implications. It prevails due to cultural acceptance, despite major health consequences. It is illegal in the UK, and the RCOG has developed guidelines. Vignettes in this chapter illustrate these gender-related health issues.