Vulnerable Migrants Research Articles

Association between migration paths and mental health of new-generation migrants in China: The mediating effect of social integration.

BackgroundThe new-generation migrants born in 1980 and later are large and vulnerable internal migrants in China. Migration paths and social integration are important factors to explain for their mental health. However, they faced difficulties in social integration varying from migration paths. We aimed to explore the mediating role of social integration between migration paths and the mental health of new-generation migrants.MethodsThe migration paths included urban-to-urban, urban-to-rural, rural-to-urban and rural-to-rural. Mental health was assessed by the Kessler Screening Scale for Psychological Distress (K6) and the Perceived Stress Scales (PSS-4). Social integration was measured by economic integration, life integration, maintenance of the local culture, acceptance of the host culture and psychological integration. Multiple linear regressions with bootstrapping were used to examine the mediating effect.ResultsA total of 9,830 new-generation migrants were included in this study. The mean age was 26.92 (SD = 4.47) years and the proportion of rural-to-urban migrants was 63.7%. Compared with the new generation of rural-to-rural migrants, rural-to-urban migrants had higher psychological distress (β = 0.305, 95% CI: 0.152–0.458) and perceived stress (β = 0.328, 95% CI: 0.199–0.456). The bootstrapping test found that two dimensions (“life integration” and “acceptance of the host culture”) of social integration as a mediator weakened the negative effect of the rural-to-urban migration path on the mental health of new-generation migrants.ConclusionRural-to-urban migrants had poorer mental health, and the association was mediated by their poorer social integration. The migration policies developed to enhance social integration could effectively improve the mental health of new-generation migrants.

Irregular migration and governance: implications for Nigeria

The global irregular migration crisis has gained momentum in the 21st century due to the high fatality rates and risks among vulnerable migrants in their quest to cross the scorching desert and violent sea. Irregular migration is the movement of people illegally and without the required or proper documentation across international borders. Migration is as old as humanity. Today, Africa faces the enormous challenges of high migratory flows across the Sahara Desert via North Africa and the Mediterranean Sea into Europe. The challenges of this trend include human trafficking, xenophobia, organ harvesting, and insecurity. Nigeria is not exempt from this crisis irrespective of its endowed natural/human resources, the advent of democracy, and its prominent role as the biggest economy in Africa. Nigeria is rated low in infrastructural and human capital development among nations. Many vulnerable youths are leaving the country in droves for a better living standard. This study examines the trends, triggers, and problems of governance on irregular migration and the implications for Nigeria. The study employs data from secondary sources such as journals, reports, books, and the internet for analysis. Also, the security theory of migration was employed to explain the irregular migration trends. The findings reveal that significant Nigerian youths are irregularly migrating in droves to Asia, the Middle East, and some African countries, But not only to Europe. It shows a thriving and growing industry of irregular migrants’ handlers in the country because of ineffective migration policies, unemployment, poverty, and porous borders. The study concludes that a more comprehensive public policy approach towards addressing unemployment, crushing poverty, humanitarian crises, insecurity, poor governance with attendant consequences of mismanagement of resources, and corruption would perhaps reduce the rise in irregular migration.

Trajectories, Food Choices and Dietary Acculturation of Vulnerable Migrants in Brazil

ABSTRACT Migrants in situations of socioeconomic vulnerability face many hardships regarding their eating practices. The aim of this study was to identify how migratory trajectories affect their food choices and the processes of dietary acculturation they experience. This is a qualitative study, conducted through the episodic narrative method, based on interviews of eight migrants. The Food Choice Process Model was adopted as the theoretical framework for the Content Analysis. Integration, assimilation, and separation were identified as acculturation processes and it was concluded that the financial situation was what most affected migrants’ food choices in the early stages of life in Brazil.

Gender, race, and crisis-driven institutional growth: discourses of ‘migration crisis’ and the expansion of Frontex

ABSTRACT Migration movements at the EU external borders are increasingly understood and governed through a logic of crisis that draws on gendered and racialised stereotypes of migrants and colonial Self-‘Other’ representations. These narratives of ‘migration crisis’ not only shape public discourse, but also inform institutional processes within the EU border security architecture, particularly the growth of the European Border and Coast Guard Agency (Frontex). Bringing critical border and migration studies in conversation with feminist postcolonial scholarship on crisis, we argue that gendering and racialisation underpin Frontex’s ‘crisis labelling’ that gives way to institutional claims for extended resources and competences. In an analysis of Frontex’s Annual Risk Analysis Reports (2010–2020), we identify four themes through which Frontex engages in crisis labelling on the basis of gendered and racialised stereotypes, dualisms, and postcolonial (self-)representations: migration as threat; the unknownness of migrants; the hierarchical creation of (non-)European spaces; and humanitarian concerns over vulnerable migrants. Through these themes, gender and race not only made migration intelligible as crisis but importantly justified demands for Frontex’s extension. These findings reveal how gender and race inform the institutional politics of defining and governing migration in ways that reproduce intersectional power relations and (post-)colonial legacies.

The semiotics of Heiren (黑人): race, everyday language, and discursive complicities in a Chinese migrant community

ABSTRACT Among Chinese migrants in Tanzania, “Heiren (黑人)” (black person/people) is a ubiquitous term with many referents, encapsulating everyone from labourers to state officials, and ranging from an ethno-racial category to an individual pronoun. In English translation, the term bears on a contentious debate regarding racialisation in Africa-China relations. In this paper, based on seventeen months of fieldwork among Chinese migrants in Tanzania, I examine racialisation in everyday discourse, and also the politics of (white) ethnographic reportage on (non-white) racism. I focus on the social lives of the word heiren among Chinese, examining how it is deployed in heterogenous social situations and discursive contexts. I argue that the use of ‘Heiren’ flattens otherwise heterogeneous experiences with and attitudes towards Tanzanians, contributing to the construction of an African other. Specifically, talking about Heiren becomes a way that economically privileged but politically vulnerable Chinese migrants talk about the tense relations they have with Tanzanians. However, I argue the significance of Heiren talk is not that it defines ‘the Chinese’ in isolation as ‘racist’, but rather how it becomes discursively complicit with global anti-blackness.

Development of a multiagency protocol to support people with No Recourse to Public Funds in Wolverhampton (UK).

No Recourse to Public Funds (NRPF) status is applied to individuals and families that are subject to immigration control, resulting in them having restricted access to state-funded benefits within England. NRPF is a public health risk as it increases the risk of destitution among vulnerable migrants. The aim of this study was to engage with public and voluntary sector staff within Wolverhampton working with people with a NRPF status to develop and create an easily accessible guide ('protocol') to help facilitate identification of appropriate cross-sector interventions and support. Data were collected via an online survey as well as face-to-face semi-structured interviews with local NRPF stakeholders. Four themes emerged from the thematic analysis of participant responses: understanding NRPF statuses, varying support requirements, poor communication and awareness of vulnerabilities. Currently, in England, there does not appear to be a standardised localised protocol which can be used to reduce the complexities and confusion encountered by public and voluntary sectors who support people with NRPF status. The findings from this study have allowed the Wolverhampton NRPF to create an online information resource that includes training events to raise the awareness of NRPF, as well as the development of a localised multiagency protocol that has better equipped it to support and safeguard people with NRPF.

‘Protection’ on my own terms: human smuggling and unaccompanied Syrian minors

ABSTRACT Child migration has generated shock, the global public appalled by photos of corpses of children washed ashore or abandoned in deserts. However, despite the growing visibility of child migration there has been scant research into the practices and interactions often associated with the smuggling of minors. We still lack a clear understanding of the interactions between minors and smugglers that go beyond a stereotypical predator/victim frame. This paper is grounded in the conviction that any understanding of the complex interactions between minors and migrant smugglers requires an epistemic reversal in conventional learning and debate. Instead of investigating the systematic exploitation of vulnerable migrants at the hands of criminal rings, we need to focus on the capacity of minors to exert agency and craft new spheres of possibility in situations characterised (also) by exploitation and extreme dependence. The article does so by investigating the day-to-day interactions between facilitators and Syrian minors who left their country following the outbreak of the civil war in 2011. What will be shown is that minors’ interactions with human smuggling provide them with new forms of action, while contending with exploitation, constraints or dependency.

COVID-19-Related Health Literacy of Socioeconomically Vulnerable Migrant Groups.

Objective: Understand the COVID-19-related health literacy of socioeconomically vulnerable migrant groups. Methods: We conducted a survey available in 8 languages among 2,354 members of the target population in Switzerland in 2020. We measured health literacy in four dimensions (finding, understanding, evaluating and applying health information) and assessed adherence to official recommendations during the COVID-19 pandemic. Results: Most migrants felt well informed about the pandemic. Using an extended index of health literacy, we found a moderate correlation (r = −0.28 [−0.24, −0.32]) between COVID-19-related health literacy and socioeconomic vulnerability. The most socioeconomically vulnerable migrants tended to have more difficulty finding and understanding health information about COVID-19 and adhered more to unscientific theses that were not part of the official communication. Conclusion: Special communication efforts by public health authorities have reached most migrants, but socioeconomic vulnerability can be a barrier to taking precautions.

A comparison of resource use of insured and uninsured venezuelan migrants: evidence from the hospital setting.

BackgroundThere is no characterization of resource use in the hospital setting for immigrants in Colombia, we aimed to describe the resource use by Venezuelan immigrants, comparing those enrolled in the national health insurance system with those with and without the ability to pay.MethodsRetrospective review in the billing data system of our Hospital from 2011 to 2020. We collected information for 6,837 hospital episodes associated with 1,022 Venezuelan patients, hospital’s billing information for all services rendered was extracted.ResultsThe mean cost per patient event were 4,595 USD for those without the ability to pay, costing 2.37 times more than a legal resident insured. Care in the ICU, inpatient days, surgery, and OB-GYN department consume most resources provided to vulnerable migrants.DiscussionEnrolment in the national health insurance may allow better access to health services by vulnerable Venezuelan migrants and thus reduce resource use for the health system.

Scarred survivors: gate keepers and gate openers to healthcare for migrants in vulnerable circumstances.

BackgroundThe main barriers to ‘vulnerable migrants’ receiving good quality primary care are language and administration barriers. Little is known about the experiences of healthcare discrimination faced by migrants from different cultural groups. The aim was to explore vulnerable migrants’ perspectives on primary healthcare in a UK city.MethodsThree focus groups and two semi-structured interviews were aided by interpreters. These were analysed against a pre-developed framework based on national standards of care for vulnerable migrants. Recruitment was facilitated via a community organisation.ResultsIn total, 13 participants took part, six women and seven men. There were five Arabic speakers, four Farsi speakers and four English speakers. Themes included access to primary care, mental health, use of interpreters, post-migration stressors and cultural competency.ConclusionVulnerable migrants perceived high levels of discrimination and reported the value of a respectful attitude from health professionals. Appointment booking systems and re-ordering medication are key areas where language barriers cause the most disruption to patient care. Medication-only treatment plans have limitations for mental distress for this population. Community-based therapies which manage post-migration stressors are likely to enhance recovery.

Health promotion strategies toward improved healthcare access for migrants and refugees in Europe: MyHealth recommendations.

MyHealth European project (2017-2020) was committed to elaborate on models to engage vulnerable migrants and refugees (VMR) in their health through community involvement. Low healthcare access and poor quality of healthcare services for VMR is a common reality in many European countries. The purpose of the present study, as part of MyHealth project, was the development of an agenda for actions and consequent recommendations to tackle the issue. A qualitative research design was applied at four study sites in Barcelona, Spain; Berlin, Germany; Brno, Czech Republic and Athens, Greece. The Metaplan® group discussions allowed the collection, organization and process of ideas and opinions elaborated in the collaborative groups. In total, 14 sessions took place: 4 with health and social professionals (n = 41) and 10 with VMR (n = 77). A participatory thematic analysis was performed at every session and overall for all sessions a thematic analysis synthesized the findings. The suggested actions were divided into two levels of recommendations: (i) local authorities at destination country-related, such as the investment in health professionals' cultural competences, and (ii) VMR-related, such as adaptation of help-seeking behavior patterns. Special attention was proposed to women survivors of violence and homeless minors. The study concluded to an agenda for action in Europe. We advocate for a public health paradigm shift where, while holding a bottom-up approach, VMR as well as professionals working with them are actively and meaningfully engaged in the decision-making process of access-enhancing and health promotion strategies in a given socio-cultural context.

Human-affective Dimensions, Entrepreneurial Intentions, and Entrepreneurial Behaviors in Entrepreneurship Training Programs for Vulnerable Populations

This research investigated the entrepreneurial behaviors of vulnerable migrants who participated in an entrepreneurial education program and its management. By applying a structured questionnaire to the program participants, the variables that stood out most were: entrepreneurial intention, attitude towards the entrepreneur, social integration, and the usefulness of the entrepreneurial education program.

Conceptualizing “Vulnerability” in the European Legal Space: Mixed Migration Flows and Human Trafficking as a Test

The article discusses the role of “vulnerability” in the legal and political discourse of today's Europe as a dual-mode dispositive. On the one hand, “vulnerability” allows the legal formalism to incorporate the precarious subjects that the traditional language of “rights” risks to exclude. Compared with the human rights language, “vulnerability” better articulates the relationship between legal categories and rapidly changing social and ecological landscapes. The “vulnerability language” captures intersectionality. On the other hand, however, through examples taken from the EU normative production on irregular and mixed migrations, with a focus on refugee “screening” and reception and on managing identification and referral procedures of persons victims of human trafficking, this article shows that the assignment of an individual to a “vulnerable group” has the effect not only of expanding and intensifying their protection under normative human rights regimes, but also of accentuating some risks already inherent in human rights discourse, namely paternalism and essentialism. Paradoxically, a possible outcome can be fragmentation of rights protection frameworks, and exclusion. Vulnerable migrants may have to face additional challenges stemming from their inability (coupled with objective difficulty) to decodify communications and instructions concerning their status. Divergent ways of conceiving vulnerability, depending on subjective assessments, public policy standards, the legal framework, and the political agenda on welfare, contribute to neutralizing the potentially emancipatory impact of the vulnerability language.

Family Matters: Older Refugee Minors in Vienna and Factors for Resiliency

Abstract European migration discourses emphasize that unaccompanied refugee minors (URMs) are one of Europe’s most vulnerable migrant groups. The absence of an adult caregiver often serves as the sole explanation for the heightened vulnerability of URMs vis-à-vis their accompanied counterparts. This article challenges the assumption that the absence of adult caregivers always breeds greater vulnerability among young refugees who have received international protection. Based on 72 surveys and 31 in-depth interviews with refugees who received international protection and who arrived in Vienna, Austria between the ages of 14 and 18, this article contributes to empirical analysis on the complex impact adult relative caregivers specifically have on the integration and resiliency of refugee youth. It explores the influence that family status has on employment, education, social connections and personal outlook and sense of belonging. We hypothesize that refugees who arrived as older URMs experience a financial and social autonomy, as well as benefit from a more advantageous legal and social treatment, speeding up their adaptation process and engendering greater resiliency. While the findings highlight that family matters, they also show that family may not play a ubiquitously positive role in young refugees’ adaptation process as previously assumed.

Diagnosis and treatment of vulnerable migrants: a retrospective study at a Doctors of the World clinic in Stockholm

BackgroundAt Doctors of the World Medical Clinic in Stockholm (DWMCS), medical care is offered to migrants who live under particularly vulnerable conditions and who lack access to subsidized care. The demographic, diagnostic and therapeutic panorama of vulnerable migrants is unknown.MethodsA quantitative, retrospective study mapping gender, age, diagnostic group, primary diagnosis, therapeutics, referrals, and session timing (whether the care session took place in summer -April to September, or winter - October to March) by reading all patients’ electronic journals at DWMCS between 2014-04-01 and 2017-12-31. Diagnostic groups were classified according to the classification system ICPC-2 which contains six diagnostic groups: symptoms/complaints, infections, neoplasms, injuries, congenital anomalies and other diagnoses. Primary diagnosis was defined as the diagnosis that was first in the diagnosis list for the visit. Difference in median age was calculated with the Mann-Whitney test (MW), and two-group analysis of nominal data was performed with Monte Carlo simulations (MC) and chi square test´s (X2).ResultsThe study included 1323 patients: 838 women and 485 men. The median age for women 37 years (29-47) was slightly lower than for men, 40 years (31-47) MW (p = 0.002). The largest diagnostic group was symptoms / complaints. The five most common primary diagnoses were cough (4%), back symptom / complaint (4%), cystitis (3%), upper respiratory infection acute (3%) and abdominal pain epigastric (2%). The most common therapeutic (55%) was pharmaceutical. Referrals accounted for 12% of the therapeutics and 25% of the referrals were to an emergency room. Tests of significance indicated an uneven distribution of diagnostic groups MC (p = 0.003), infectious primary diagnoses MC (p = 0.0001) and referrals MC (p = 0.006) between men and women and an uneven seasonal distribution among the Other diagnoses MC (0.04) and ten most common drug treatments MC (p=0.002).ConclusionsThe demographic, diagnostic and therapeutic panorama of vulnerable migrants at DWMCS was elucidated. Vulnerable migrants have differences in morbidity depending on gender and season, differences in therapeutics depending on gender and differences among their most common drug treatments depending on season. This knowledge is important when addressing the health problems of vulnerable migrants.

Critical Perspectives on Social Work and Social Policy Practice with Vulnerable Migrants in an Era of Emergencies

Critical Perspectives on Social Work and Social Policy Practice with Vulnerable Migrants in an Era of Emergencies

CEDAW and Transformative Judicial Obligations: The Vulnerable Migrant Domestic Worker and Root Causes of Abuse

The first part of this article sets out CEDAW’s transformative approach to rights and its implications for MDWs and state actors such as courts. It then juxtaposes this approach to the tendency of state officials in destination countries to condemn the abuse of vulnerable MDWs by errant employers without recognizing the impact of official laws and policies on MDWs’ vulnerabilities. The second part of this article examines judicial discussions of MDWs’ vulnerabilities in Hong Kong, Singapore, and Malaysia. Judges in these countries have primarily drawn attention to the isolation of MDWs in their employers’ homes, the dependence of MDWs on their employers for their basic needs, and their lack of financial resources. While such judicial developments are important, the third part of this article argues that these courts need to go beyond discussing specific MDW’s vulnerabilities and their individual criminal cases by identifying and critiquing the root causes of MDWs’ vulnerabilities. It analyzes cases where courts have advanced or overlooked CEDAW’s transformative objectives to argue that criminal law courts can and should advance CEDAW’s goals by naming and contesting the laws, policies, and prejudices enabling MDW rights violations. Such a systemic or transformative approach to adjudication that pinpoints the root causes of MDW abuse can catalyze change at both the legal and policy levels, leading to a more rights-centered approach to MDWs that is consistent with CEDAW requirements.

COVID-19 financing strategies for refugees and migrants in the Eastern Mediterranean Region.

The COVID-19 pandemic has had devastating consequences on health care systems worldwide. While the world was slowly moving towards achieving health for all, the pandemic destroyed progress made over the past 25 years and exposed the vulnerability of health care systems and health insurance schemes as well as their lack of resilience. Heath care systems failed to respond in a timely and efficient manner, lives have been, and continue to be, lost and vulnerable populations, especially refugees and migrants, are more at risk than ever as many are left out of country vaccination programmes. The Eastern Mediterranean region hosts 13 million internally displaced persons and 12 million refugees as of 2018. Thus, adopting inclusive health financing mechanisms is crucial to addressing the crisis and protecting indigenous and displaced populations. By looking at regional best practices and the response of the United Nations, we outline possible financing tools for including refugees and migrants in health insurance schemes for COVID 19 and introduce novel solutions for addressing gaps in funding. Among the suggested solutions are the inclusion of refugees and migrants in national health care systems, setting up community-based health insurance for migrant and refugee populations, as well as introducing a catastrophe bond financing scheme. While COVID-19 is far from over, many countries in the EMR have included migrants in their COVID-19 vaccine rollout plans. While this is not the first instance of inclusion in some countries, many others are unable or do not prioritize migrants in their health systems, to the detriment of the entire country. This paper, therefore, tackles the possible health financing measures which curb or prevent migrants from accessing such systems and presents possible solutions to change the status quo.

Vulnerable migrants’ access to healthcare in the early stages of the COVID-19 pandemic in the UK

ObjectivesTo understand the living conditions, changes in the service user profile, and needs of vulnerable migrants trying to access healthcare in the early stages of the COVID-19 pandemic. Study designMixed methods study; using quantitative questionnaire data collected from migrant service users of Doctors of the World UK (DOTW UK) with qualitative data from free-text notes. MethodsDOTW UK provides drop-in clinics to vulnerable migrants. Consultations switched to remote during the UK's first lockdown. We compared patient profile, well-being, healthcare access and reason for consultations of individuals attending the virtual clinic between March and September 2020 to those of the prepandemic periods between 2011 and 2018. ResultsDuring the pandemic, consultations dropped to under half of the prepandemic numbers, with the shift to remote consultations attracting more users outside of London. DOTW UK's user base changed to include a greater proportion of asylum seekers, younger adults (18–34) and individuals reporting good health. Socio-economic conditions and housing stability deteriorated for the majority of users. Those in the greatest need of healthcare appeared to be less able to access remote services. General practitioner (GP) registration remained the most common reason for contacting the virtual clinic with a lack of knowledge of the healthcare system being the main barrier to access. ConclusionThe shift to virtual consultations may have exacerbated existing inequalities in healthcare access for vulnerable migrants. Given that many clinical services continue to operate remotely, it is important to consider the impact such actions have on vulnerable migrants and find ways to support access.

Climate change as the last trigger in a long-lasting conflict: the production of vulnerability in northern Guinea-Bissau, West Africa

ABSTRACT Climate-related conflicts, although expected to also cause cross-border tensions/fights and intra-state civil strife among Southern countries, have been mostly framed as a problem for the rich Global North citizens produced by the poor, more environmentally vulnerable Global South potential migrants. However, violence under a climate change scenario might be more frequently expressed as small-scale and local level ‘invisible’ uprisings and armed conflicts, namely around land. This article focuses on a conflict over land involving a few villages of northern Guinea-Bissau, which is transforming the inhabitants of a maritime island into climate migrants/landless people. We conclude that climate change was not a direct driver but the last trigger of a long-lasting conflict with multiple and complex causes.