Overlooked Migrants Of The COVID-19 Pandemic: Migrant Workers
African Platform for Migration and Inclusion in Health (APMIH) is one of the emerging authorities for information and resources about the health of vulnerable migrant communities on the African continent. In response to the ongoing pandemic of COVID-19 worldwide, APMIH is publishing a 4-part blog series: ‘Overlooked Migrants of the COVID-19 Pandemic’.
Published: 7th May 2020
To date, there are over 50,000 documented cases of COVID-19 on the African continent. Countries urgently need to mobilize resources across the continent to ensure the most vulnerable communities are protected. Among these communities are migrant workers, many of whom face existing precarity in the form of low pay, exploitative contracts, insecure immigration status, and poor access to healthcare. The transient nature of these workers puts them at high risk of becoming vectors - and forgotten victims - of the COVID-19 pandemic. This community is at risk of being overlooked due in part to the lack of recognition of these workers as people for whom the country- and by extension its health system - has responsibility. Therefore, to fully suppress COVID-19, countries must recognize their responsibility to ensure migrant workers are not overlooked in their public health response. Countries need to make sure that migrant workers in their country are included in resource allocation and in their public health messaging.
A migrant worker is formally defined as being "a person who is to be engaged, is engaged, or has been engaged in a remunerated activity in a state of which he or she is not a national". A large portion of this population engages in the informal economy, which contributes an average of 41% of gross domestic product (GDP) across Sub-Saharan Africa. Their occupations include market vendors, farm laborers, domestic workers, miners, and taxi drivers/conductors, all of which can involve working in unsanitary and close-contact environments. Forming part of the complex picture of human mobility across Africa, these individuals travel frequently between their home communities and their locations of occupation. Most workers move intra-regionally, while others engage in internal mobility within country borders.
The COVID-19 pandemic has resulted in many countries restricting border movements to limit the flow of persons, in an attempt to contain the spread of disease, while they implement social distancing and public health interventions. These actions leave migrant workers either locked away from their home communities in their country of employment or away from their jobs while in their home villages. In both cases, these workers are placed in precarious positions that encourage continued disease transmission.
In their country of employment, migrant workers risk being overlooked by health efforts due to language barriers and job insecurity; both factors also impact on occupational safety and on workers’ ability to access necessary health services. Worldwide, public health officials are instructing communities to curb the spread of COVID-19 by keeping 6 feet or 2 meters between persons and limiting public movement through lockdowns and curfews. These guidelines are often communicated orally or in writing to target communities using the dominant language spoken, a language that may not be spoken or well understood by a worker should they be from another region or country.
For migrants working in crowded or unsanitary spaces, the nature of their occupation prevents them from adhering to the distancing rule. Furthermore, the insecure nature of their job can prevent them from adhering to stay-at-home orders if a failure to show for work would result in job loss. Migrant workers who lose their usual income may seek other, more precarious positions, such as sex work or prostitution - a route taken disproportionately by women and girls. When an individual is engaging in sex work or prostitution - and they may be doing so for a variety of reasons - this increases the risk of COVID-19 transmission, because the porous sex work/prostitution network extends into local communities. Any loss of income can also lead to homelessness, which drives migrants to seek housing in overcrowded dwellings that have limited basic hygiene amenities. All these factors place migrant workers and the wider community at greater risk for sustained COVID-19 transmission.
Returning migrant workers risk transmitting COVID-19 to their home communities, in cases where lockdowns have led to mass exoduses. These returned workers, having crammed onto public transport to do so, could likely have been exposed to asymptomatic or symptomatic carriers of COVID-19. If illness occurs, they face difficult decisions in seeking health services. Rural communities, in particular, are located 2 hours away on average from their nearest health outpost, often accessible only by non-paved roads. Furthermore, the financial insecurity of the worker will impact their health seeking decisions: Can I afford transport to a health outpost? Can I afford the care? If I am found sick, can my family afford for me to be quarantined?
African states must recognize their responsibility to ensure migrant workers - irrespective of worker origin - are not overlooked in their public health responses to COVID-19. It is imperative that migrant workers have access to preventative and curative health services, when available. Widespread testing - wherever possible - must include migrant workers, with their employers given the appropriate guidance on COVID-19 prevention and management, while being held to account when necessary. APMIH stands with grassroots advocates across the continent who are appealing for migrant workers’ right to health to be upheld and protected in line with UNHCR conventions and International Health Regulations.
We acknowledge that migrant workers commonly experience discrimination and marginalisation - at the hands of employers, the general public, health providers, and governmental bodies - that is intimately associated with detrimental health outcomes. Therefore, public health decision makers at all levels of government must involve employers and migrant rights organisations to ensure their COVID-19 response is migrant worker-inclusive. Lastly, any public health response must deter xenophobia towards migrant workers in their countries of occupation and allow for gender-mainstreaming - supporting migrant workers who are women or are of a gender minority who may be experiencing added vulnerability during the pandemic as a result of sexism or transphobia.
Laëtitia KM Diatezua - Knowledge Repository and Policy Researcher; and Christy Adeola Braham - Founder
**APMIH would like to support individuals from migrant communities in Africa who have been impacted by the COVID-19 pandemic. We invite you to anonymously share your experiences with us in English or in French**