Identities in Motion;                        Migration and Health In India                                Chandrima B. Cha...
First Published in October 2006           By           Centre for Enquiry into Health and Allied Themes           Survey N...
FROM THE RESEARCH DESK           Health and Human rights has explicit                     The Background Series is a colle...
ABOUT THE AUTHOR                     Identities in Motion; Migration and Health In India                        Chandrima ...
CONTENTS                Introduction ........................................................................................
LIST OF TABLES           1.    IDPs in Neighbouring Countries ...............................................................
LIST OF ANNEXURES           1.   Latest Census Questions on Migrants/Non-Migrants ...........................................
BLANK PAGE                                                  viiiPDF created with pdfFactory Pro trial version www.pdffacto...
Identities in Motion;                             Migration and Health In India           INTRODUCTION                    ...
collective complexities of societies has           Restrictive migration policies in many           introduced instability...
destinations.                                             case of migrants, the common factor that                        ...
instance, a bias against the migrants may                 prevents irregular international migrants           translate in...
conditions and thus allowing for more          vulnerability point of view, the conditions                 bias to continu...
Figure 1                             Increased Internal Migration by Place of Birth in India                              ...
poverty, landlessness, debt, unemployment           ethnic conflicts. Here, there is a need to           act as the push f...
Box 2                                  Categories of Internal Displacement in India                           l   Politica...
Table 1 : IDPs in Neighbouring Countries of India             Country          No of IDPs    Estimated Date             So...
The re ha s bee n no syste ma tic                     Karbis in Assam; 262000 Kashmiri Pandits           documentation of ...
Table 2 : Overview of available Estimates of Internally Displaced                                               due to Con...
In India, internal displacement has also           alternative schemes offered to the project-           re sulted from na...
1.B. ii) International Migrants in India                 children from the neighbouring countries                         ...
Refugees are international migrants to                   entered the country after 25 March 1971           India, who are ...
“associated” migrants with the main                       lead to the reversal of the income dynamics           decision t...
There are a large proportion of women and                 popula tions      when      dise a se s   are           children...
The morbidity patterns among migrants                     headache, pain in the neck, swelling of           vary with the ...
Box 4                                        Migration, Mobility and HIV/AIDS                           Migrants and mobil...
Box 5                                    Health Problems in the Context of Trafficking                                    ...
Various reports have underlined the                      have been recognized as groups with           importance of meeti...
But the increased movement of people                       Most of the rights set out in Part III, which           across ...
There are only two international treaties            about the protection of the rights of all           that recognize he...
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
Chehat migration paper
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  1. 1. Identities in Motion; Migration and Health In India Chandrima B. Chatterjee, Ph.D The Centre for Enquiry into Health and Allied Themes (CEHAT), MumbaiPDF created with pdfFactory Pro trial version www.pdffactory.com
  2. 2. First Published in October 2006 By Centre for Enquiry into Health and Allied Themes Survey No. 2804 & 2805 Aaram Society Road Vakola, Santacruz (East) Mumbai - 400 055 Tel. : 91-22-26673571 / 26673154 Fax : 22-26673156 E-mail : cehat@vsnl.com Website : www.cehat.org © CEHAT ISBN : 81-89042-46-7 Printed at : Satam Udyog Parel, Mumbai-400 012.PDF created with pdfFactory Pro trial version www.pdffactory.com
  3. 3. FROM THE RESEARCH DESK Health and Human rights has explicit The Background Series is a collection of intrinsic connections and has emerged as papers on various issues related to right to powerful concepts within the rights based health, i.e., the vulnerable groups,health approach especially so in the backdrop of sy stems, h ealth po licies, affecti ng weakening public health system, unregulated accessibility and provisions of healthcare in growth of the private sector and restricted India. In this series, there are papers on access to healthcare systems leading to a wo men, elderly , mi grants, disable d, near-to tal ecli pse of avail abil ity and adolescents and homosexuals. The papers are accessibility of universal and comprehensive well researched and provide evidence based healthcare. A rights-based approach to health recommendations for improving access and uses International Human Rights treaties and reducing barriers to health and healthcare norms to hold governments accountable for alongside addressing discrmination. their obligations under the treaties. It We would like to use this space to express recognises the fact that the right to health is our gratitude towards the authors who have a fundamental right of every human being and contributed to the project by sharing their it implies the enjoyment of the highest ideas and knowledge through their respective attainable standard of health and that it is papers in the Background Series. We would one of the fundamental rights of every human like to thank the Programme Development bei ng and that gove rnme nts have a Committee (PDC) of CEHAT, for playing such responsibility for the health of their people a significant role in providing valuable inputs which can be fulfilled only through the to each paper. We appreciate and recognise provision of adequate health and social the efforts of the project team members who measures. It gets integrated into research, have worked tirelessly towards the success advocacy strategies and tools, including of the project ; the Coordinator, Ms. Padma monitoring; community education and Deosthali for her support and the Ford mobilisation; litigation and policy formulation. Foundation, Oxfam- Novib and Rangoonwala Right to the highest attainable standard is Trust for supporting such an initiative. We encapsulated in Article 12 of the International are also grateful to several others who have Covenant on Economic, Social and Cultural offered us technical support, Ms Sudha Rights. It covers the underlying preconditions Raghavendran for editing and Satam Udyog necessary for health and also the provisions for printing the publication. The cover page of medical care. The critical component design and the photograph has been provided within the right to health philosophy is its by Jhanvi Graphics. We hope that through realisation. CEHAT’s main objective of the this series we are able to present the health project, Establishing Health as a Human Right issues and concerns of the vulnerable groups is to propel within the civil society and the in India and that the series would be useful public domain, the movement towards for those directly working on the rights issues realisation of the right to healthcare as a related to health and other areas. fundamental right through research and documen tati on, advo cacy , lo bbyi ng, Chandrima B.Chatterjee, Ph.D campaig ns, awareness an d education Project In-Charge (Research) activities. Establishing Health As A Human Right iiiPDF created with pdfFactory Pro trial version www.pdffactory.com
  4. 4. ABOUT THE AUTHOR Identities in Motion; Migration and Health In India Chandrima B.Chatterjee is presently working with the Centre for the Enquiry into Health and Allied Themes. She is the Project-In-Charge of research on Establishing Health as a Human Right. She holds a doctorate in Sociology and has been involved in several research projects on various issues. She has published and presented papers both nationally and internationally. Her research interest includes labour migration, migration and health, urban health, human trafficking and health and human rights. ivPDF created with pdfFactory Pro trial version www.pdffactory.com
  5. 5. CONTENTS Introduction ............................................................................................................... 1 1. Migration and Health ................................................................................................ 1 1. A. Degrees of Vulnerability along Types of Migrants affecting Health - An Exploration of their health impact ............................................................. 3 1. B. i) Internal Migration in India ........................................................................ 5 1. B. ii) International Migrants in India ................................................................ 13 1. C. Migrant Women and Children ......................................................................... 14 2. Health Implication for those on the move ............................................................. 16 3. The Human Rights of Migrants ............................................................................... 20 3. A. Migrants Rights in India .................................................................................. 23 3. B. Existing Gaps Interfering with the Realisation of the Right to Health ........ 25 4. Conclusion: Including the Excluded ...................................................................... 26 4. A. Inclusive Healthcare for Migrants .................................................................. 27 References ............................................................................................................. 31 Definitions And Concepts ................................................................................... 39 Annexures .............................................................................................................. i vPDF created with pdfFactory Pro trial version www.pdffactory.com
  6. 6. LIST OF TABLES 1. IDPs in Neighbouring Countries ............................................................................. 9 2. Overview of available estimates of internally displaced due to conflict in India ....................................................................................................... 11 LIST OF BOXES 1. Vulnerability Among Migrants ............................................................................... 3 2. Categories of internal displacement in India ........................................................ 8 3. Causal Factors Affecting Migrant’s Health ............................................................ 16 4. Migration, Mobility and HIV/AIDS ......................................................................... 18 5. Health Problems in the context of Trafficking ....................................................... 19 6. International Convention on the Protection of the Rights of All Migrant Workers and Members of their Families .................................................. 22 7. Existing Labour Laws in India Relevant for Migrant Workers ............................. 24 8. Inter State Migrant Workmen Act, 1979 ................................................................ 25 9. Integration Health and Migration- Achieving a Balance (Benefits) ................... 29 10. Priority Areas ............................................................................................................ 29 LIST OF FIGURES 1. Increased Internal Migration by Place of Birth in India ...................................... 6 viPDF created with pdfFactory Pro trial version www.pdffactory.com
  7. 7. LIST OF ANNEXURES 1. Latest Census Questions on Migrants/Non-Migrants .......................................... i 2. Status of Ratification on the CPRMW ...................................................................... ii 3. Key Provisions of the Unorganised Sector Bill ...................................................... iii viiPDF created with pdfFactory Pro trial version www.pdffactory.com
  8. 8. BLANK PAGE viiiPDF created with pdfFactory Pro trial version www.pdffactory.com
  9. 9. Identities in Motion; Migration and Health In India INTRODUCTION This paper addresses the issue of migration and its public health implications within Human spatial mobility started about two the huma n rights fra mework. decades ago for various systemic, economic Disaggregated information on the types of and individual reasons, but there is a lack migrants in India, their magnitude and of systematic information and health-risk their vulnerabilities impacting their health assessment among the mobile population. a nd access to he a lthca re ha s bee n The specific socio-demographic structure, presented. The migrants are vulnerable at that is, age, sex, education, attainment, the source, throughout the migratory occupation and income, determines the process and at the destination areas. The context in which migration takes place and degree of vulnerability of migrants in India their health-risks are predetermined by is different in different situations and so certain factors at the destination areas. are the challenges that migration poses for They are health policy-makers. Understanding l Government-related factors such as migration through a human rights national policies, public service framework helps explain the health needs system, community development, of migrants in the context of the current development and housing; migration patterns. l Employer-related factors such as work site safety, living conditions, 1. Migration and Health insurance coverage, women worker’s maternal and reproductive health At the start of the new millennium, spatial benefit, etc; movement of the human population has l Health-sector related factors such become more pronounced. Migratory a s hea lth/pre ve ntive ne twork, movements characterized by increased service coverage and approaches, q ua ntitative growth and q ualita tive service items and prices; and differentiation along the lines of migratory l Individual-related factors like social patterns, nature of migrants, their quality support at the destination, health and final destination have facilitated a awareness, health beliefs, health differe ntia te d de velopme nt pattern beha viour and he lp see king creating spaces of vulnerability. The behaviour, impacts the individual unfolding of the socio-political dynamics a nd colle ctive he alth risk of of different countries and the persistent migrants. economic growth along the individual and 1 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  10. 10. collective complexities of societies has Restrictive migration policies in many introduced instability at all levels. This countries have resulted in different kinds has increased the migration of populations of human right violations on migrants and within a nd across the ge ogra phica l refugees. The marginalization and health contours of the na tion-sta te. In the of migrant populations are a growing public globalization debate, movement of people health concern as they represent one of the received scant attention. Yet the sheer most ‘at need’ groups in the world. magnitude of migration- force d and voluntary, regular and irregular, clearly Migrants have always been conceptualized suggests that migration has the potential as problematic in the context of policies to pose a potential public health challenge. both nationally and internationally. This Migration can expose individuals and mindset has led to complex public health groups in many settings at health risks. issues posed by migration. Migrants and Many individuals and groups, in certain their human rights have to be understood kinds of settings, remain excluded from the from the existing contradictions within benefits of health and healthcare. and across countries between skilled and voluntary migrants at one end of the General Comment 14 of the International spectrum to the other end comprising of the Covenant on Economic Social and Cultural poor and unskilled migrant population Rights comments on the right to the highest destined to be excluded and obscured from attainable standard of health (Committee the fabric of the host societies. For the on Economic Social and Cultural Rights, latter, the intersection of human rights and 2000). This has been largely translated as migration is a negative one, with bad a right to health care and has enabled focus experiences throughout the migratory ‘life on ensuring that the rights of individuals cycle’, in areas of origin, journey or transit are not violated through the creation of in case of international migrants and structural and other barriers to the access destination. The intersection of migrants to healthcare facilities. The application of and human rights becomes even more principles in international law reminds comple x whe n irre gular or ille ga l governments and relevant authorities of migration clashes with the interest of the their obligations to their populations. But area of destination. Cases of exploitation the rights of migrants have always been a of migrants by employers, smugglers or problematic area with many challenges. traffickers in such cases never meet While globalization, conflict and disasters justice. All these directly impact the rights have contribute d to the ne ed for of individual migrants. populations to be mobile and governments, particula rly those of the de velope d The focus of this section is on the health countries, have promoted globalization for implications for poor unskilled/semi- economic and development reasons, they skille d migra nts, both internal and have become increasingly reluctant to international, in the context of public a cce pt migration as one of the health as well as in relation to the health consequences of opening up markets for of the individual and the existing barriers the exchange of goods and services. of access to health services at the host Identities in Motion ... 2 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  11. 11. destinations. case of migrants, the common factor that justifies their vulnerability is perhaps the 1. A. Degrees of Vulnerability along Types fact that their origin differs from their of Mig rants a ffe c ting He a lth-An present residence. The difference is not Exploration of their health impact merely limited to the experience of change of space but extends to other experiences Vulnerability can be understood as a state of differences of culture, language and of being exposed to or susceptibility to people . The vulne rability which is danger or abuse. It comprises of weakness primarily premised on the alien status 1 of of physica l a nd mental strength, the migrant gets complicated by the defe nse lessne ss, unprote cte d ne ss, combination of factors at the area of fragility and exposure to undesirable destination. Limited choice and reduced conditions/ factors. In addition to the capacity to negotiate results in increased health environment in the place of origin, discrimina tion in life cha nce s. The transit and destination (including disease migrant is considered an ‘outsider’. prevalence), they include patterns of mobility (regular, circular, seasonal, etc) Various survey and studies have shown that define the conditions of journey and that migrants are disadvantaged relative to their impact on health; the status of the na tive population re garding migrants in de stination are a s tha t employment, education and health. These determines their access to health and circumstances are not formally separable social services; and familiarity with the into causes such as deficient education culture a nd language of the host and health, initial prejudice, and effects community. Vulnerability is a relative such as poor wages, inferior healthcare term. Simila rly, fa ctors lea ding to provision and sustained discrimination. vulnerability are varied and relative. In the But they mutually reinforce each other. For Box 1 Vulnerability among Migrants l Migrants are disadvantaged relative to the native population l They often have a low socio-economic status with no access to either healthcare or social services l They suffer from mental and emotional vulnerability and low self-esteem l Lack of provision of social goods, education and health, impedes the integration of migrants into the local population. 1 This is more evident in the case of international migrants Identities in Motion ... 3 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  12. 12. instance, a bias against the migrants may prevents irregular international migrants translate into health provider neglect from seeking healthcare and treatment is which in turn perpetuates poor migrant the fear of their illegal status being health. discovered (WHO 2003). In the case of internal labour migrants, their fluidity in The degrees of vulnerability in which terms of movement and their working migrants find themselves depend on a conditions in the informa l work variety of factors, ranging from their legal arrangements2 in the city debars them status to their overall environment. In the access to adequate curative care. case of international migrants, one of the most important determining factors that The vulnerability of the migrants and their pose barriers to accessing health services health and human rights has to be assessed is the question of their legal status in the from the framework of host area.1 The discussion on health and l accessibility of health and health human rights issues of migrants is most service s in re la tion to the pertinent in the case of the mass exodus of availability of services; stigma and poor population from the areas of origin to discrimination, discrimination on the areas of destination for economic and the basis of sex and gender roles socio-political reasons internally and and economic affordability, undocumented or irregular migration from l quality of available services and the outside the country. Laws and policies are prior conditions of health like right either redundant or prevent migrants from to safe and he althy working a cce ssing social se rvices, including conditions, right to adequate food, healthcare. The hiring of migrants in an physical accessibility of health irregular situation (both internal and services, culturally sensitive and international) allows employers to be good quality health services, and exempt from providing health coverage to the right to seek and receive health them as the labour force then becomes related information. cheaper than recruiting locals/natives. Local bias stigmatizes migrants and N ationa l hea lth- care plans ofte n may be used as an excuse by host discriminate against temporary migrants communities to supply inferior care, and especially undocumented ones by impe de integration, re strict the making only emergency care available for migrant’s care er a nd e duca tional non-citizens. This forces migrants to delay mobility and ultimately act as a socially hea lth-se e king till the condition is and culturally indenturing force. Bias sufficiently hazardous to justify going to also acts as a self-perpetuating force, emergency clinics. Another factor which sustaining the migrant’s negative 2 Refugees and illegal migrants often get caught up in the internal geopolitics of the host countries and have no legitimate right that can protect them. They are denied basic rights. 3 Delay in health-seeking is also due to associated costs, inability to miss work, problems of transportation. Many are unfamiliar with the local health-car e syst ems and hav e linguistic or cultural diff iculties communicating their problems. Source: Census India, 2001 Identities in Motion ... 4 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  13. 13. conditions and thus allowing for more vulnerability point of view, the conditions bias to continue. prior to migration are important. Broadly speaking, migration is of two 1. B. i) Internal Migration in India different types—internal and international. Both the types can be either voluntary or Internal migration by place of birth has forced. Migration is voluntary or forced on increased in India, from 1991 (838.5 in the basis of the factors that propel migration millions) to 2001 (1,028 in millions). In at the point of origin. In the case of voluntary migra tion, the de cision to a lmost eve ry ca tegory 4 ba rring the migrate is taken as a part of an informed intrastate migration, there has been an choice made by the prospective migrant, increase in migration in the 2001 census while in the case of forced migration, as compared to the 1991 census data. The conflict, political violence, armed conflict, Figure 1 clearly shows that there has been development-induced displacement, are an increase in the internal migration major reasons for migration. From the between the two census periods. 4 Migrants 1999 2001 Intra-district 136.2 181.7 Inter-district 59.1 76.8 Inter-state 27.2 42.3 Source: Census India, 2001 Identities in Motion ... 5 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  14. 14. Figure 1 Increased Internal Migration by Place of Birth in India 1999 2001 Total Migrants Intra-district Inter-district Inter-state Intra-state Source: Census, Government of India, 2001 5 During the 2001 census period, 14.4 work in the urban informal manufacturing million people migrated within the country construction, services or transport sectors for work purposes either to cities or areas and are employed as casual labourers, with higher expected economic gains. The hea d loa de rs, ricksha w pulle rs and National Commission on Rural Labour hawkers (Dev, 2002). (NCRL) estimates the number of internal labour migrants in rural areas in India Migrant workers predominate in the lower alone at around 10 million (including income labour market with higher risks of roughly 4.5 million inter-state migrants exposure to unsafe working conditions.6 and 6 million intra-state migrants). The Migration for labour among the poor has a 2001 Census has recorded about 53.3 peculiar characteristic. It can be voluntary million rural to rural migration within the in the sense that the prospective migrants country. According to the NCRL, a large in most cases take the decision to migrate number of migrants are employed in based on their expectations of estimated cultivation and plantations, brick-kilns, gains from the movement and in some quarries, construction sites and fish cases, the same movement could be processing. A large number of migrants also considered as forced migration where often 5 Jammu & Kashmir has been excluded in both the Census 6 Allotey Pascale (2003), Is Health a Fundamental Right for Migrants, Guest Editorial Column in the journal Development, Vol 46, No 3, September. Identities in Motion ... 6 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  15. 15. poverty, landlessness, debt, unemployment ethnic conflicts. Here, there is a need to act as the push factors for mass exodus. differentiate migration from displacement. Migration may include both voluntary and Globalisa tion a nd the a ssocia te d forced movement of people. Displacement casualisation of work have favoured the implies the use of force or generation of migrants who are absorbed in all forms of conditions that displaces people from their low paying, low or unskilled jobs with source of origin. Because of political crisis higher prospects of potential hea lth a nd ethnic cla she s, re a sons of hazards. Employers prefer to employ development or natural or man-made migrant labour with lower wages and they disasters, people are forced to flee their are steadily replacing local labourers homes to new destinations. So while (Breman, 1994). The mobile existence of the migration implies both voluntary and migra nt labour furthe r affe cts their forced migrants, and includes the element sustainability in the urban industrial of ‘choice’ or pull factors alongside the system in India (Breman, 1985; Singh, possibility of ‘force’ or push factors, 1995; Grewal and Sidhu, 1979; Sidhu et displacement is solely dependent on the a l., 1997,Roga ly, 1996). Thus, the push factors. It takes away the voluntarism economic vulnerability of the migrant is from the individual and the collective. kept a live by the informa l work Internally Displaced People (IDPs) are a arrangement from the employers’ end. product of displacement and are different Seasonal and annual migrant labourers from refugees in the sense that their areas from the rural areas working in the urban of destinations are not across the borders. areas are denied voting power and are They resettle in a different place but within therefore not allowed to develop any stakes their country of origin. Again, while in the destination areas. They are not refuge e s a re eligible to rece ive allowed to participate in the planning and international protection and help under the governance processes thereby perpetuating 1951 Refugee Convention and the 1967 political vulnerability. Social vulnerability Protocol, the international community is is perpetrate d by the e xpe rie nce of not under the same legal obligation to discrimination, social distance and feeling protect and assist internally displaced of alienation in the host area/destination. people. National governments have the primary responsibility for the security and The other type of internal migration which well-being of all displaced people on their is purely forceful is due to political and territory. Identities in Motion ... 7 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  16. 16. Box 2 Categories of Internal Displacement in India l Political causes, including secessionist movements l Identity-based autonomy movements l Localized violence l Environmental and development-induced displacement l Religion-based violence and displacement Globally Asia is the second largest region around 6 lakhs (IDMC, 2006). Even among having IDPs close to 2.8 million after Africa the neighbouring countries, the available (12.1 million).In India, the internally estimates of IDPs in India are quite high. displaced people are estimated to be See Table 1 below for details. Identities in Motion ... 8 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  17. 17. Table 1 : IDPs in Neighbouring Countries of India Country No of IDPs Estimated Date Source Comments Global 25,300,000 Dec,2004 Internal Estimates based on Displacement analysis of available Monitoring country figures and Centre (IDMC) additional information on displacement and return trends India 600,000 May-05 Internal Compiled from Displacement various figures Monitoring Centre (IDMC) Bangladesh 5000,000 2000 State Committee on Statistics, Chittagong Hill Tracts Pakistan 30,000-50,000 Sep-04 IRIN; Local Media Estimates relates to South Waziristan. Most IDPs in Pakistan controlled Kashmir reported to have returned Nepal 200,000 Jun-05 UN/NGO IDP Survey, IDMC Myanmar 540,000 Oct-05 Thailand Burma Estimates relates to Border Consortium eastern border areas only and does not include significant number of IDPs in the rest of the country Srilanka 341,175 July,2005 UNHCR/MRRR Source: http://www.internal-displacement.org, accessed 20 Feb, 2006 Identities in Motion ... 9 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  18. 18. The re ha s bee n no syste ma tic Karbis in Assam; 262000 Kashmiri Pandits documentation of IDPs both globally and from Jammu and Kashmir; 35,000 Brus/ nationally. The estimates are largely based Reangs from Mizoram and about 50000 on official estimates published and on displaced persons in Tripura (Norwegian analysis of additional information on new Refugee Council, 2005). Insurgency and deve lopme nts with re ga rd to ne we r retaliatory operations by security forces are displacements returns and reintegration. a major factor of displacement. Civilians Availa bility of IDP data ha s a lways have fled fighting and have sometimes rema ine d a proble m a nd the re are been directly targeted by militant groups enormous information gaps. In most in Kashmir, the Northeast and in several countries, the scope of the displacement states of Central India. Many people are crisis is known with lowe r le ve ls of known to be internally displaced due to accuracy. In such cases, detailed and conflicts in the Indian states of Jammu and specific information on the IDPs’ total Kashmir, Gujarat and in the North-east.7 estimate, their living conditions and needs The la rge st situa tion of inte rna l is always a problem. The figures used by displacement however, stems from the the governments a nd interna tiona l conflict in the north-western state of organisations are often rough estimates, Jammu and Kashmir.8 There are no surveys and at times contradict each other. All these increase the vulnerability of the IDPs to date that specify the extent of the to human right violations. Large numbers problem and the actual number of people of IDPs are caught in desperate situations internally displaced by conflict could be a midst fighting or in remote and much higher than the official statistics ina cce ssible are as cut-off from made available. A majority of the internally international assistance. Others have been displaced people (IDPs) have not been able forced to live away from their homes for to return for several years either due to many years, or even decades, because the protracted conflict or unresolved issues conflicts that caused their displacement related to land and property. One example remained unresolved. is India’s largest group of internally displaced, the Kashmiri Pandits who have India at present has over half a million been fleeing the Kashmir Valley since conflict-induced Internally Displaced 1989 due to conflict in the Kashmir Valley. Persons — 200000 consisting of the Table 2. provides an overview of IDPs in Adivasis, Bodos, Muslims, Dimasas and India and their nature of displacement. 7 Assistance to IDPs remains inadequate, http://www.internal- displacement.org/8025708F004CE90B/ (ht t p Count r ies)/5 762D122F45E14B0802570A7 004BBA1F?ope ndocument &c ount =10000&e xpand= 2&link=20.2&count=10000#20.2, Posted on 13 May 2005, accessed on 13.02.’06 8 The status of Kashmir has been in dispute since the creation of an independent India and Pakistan in 1947, and the two countries have twice gone to war over the issue. Protection of the remaining Pandit population has been far from adequate, leading to further displacement during 2004 when 160 of the estimated 700 Pandit families remaining in the Kashmir Valley fled an upsurge of violence and killings (Central Chronicle, 4 January 2005 Identities in Motion ... 10 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  19. 19. Table 2 : Overview of available Estimates of Internally Displaced due to Conflict in India State Who are IDPs? Nature of Reasons for Displacement Displacement NORTHERN INDIA Jammu and 1) Kashmiri Pandits Political Conflict Conclusion of the ceasefire Kashmir 2) Residents LoC with Pakistan; due to shelling and border areas between India and Pakistan. NORTH-EASTERN INDIA Assam Santhals, Nepalis, Ethnic Conflict Santhal-Bodo9 conflict Bengalis (2003), conflict between Karbis and Kukis (Oct-Nov 2003); violence towards Hindi- speaking people ( Nov 2003); fighting between Dimasa and Hmar tribes; eviction of Muslims of Bengali origin; violence between Karbis and Dimasa tribes (2005) in Assam Manipur Kukis, Paites10 and Ethnic Conflict Conflicts between the tribes11 Nagas, Hmars Tripura Tribals, i.e., Reangs12 Ethnic Conflict13 Clashes between tribes; and non-tribals, i.e., security reasons 14 Bengalis. WESTERN INDIA Gujarat Religious groups Communalism Communal conflict Central Chattisgarh Villagers Political Conflict Clashes between naxalites and police15 Source: Internal Displacement Monitoring Centre, February, 2006 9 The Bodos refer to themselves as Boros 10 Paites refer to themselves as Zomis 11 Around 1,000 were displaced in Mizoram and 5,000 in the Tipaimukh sub-division of Manipur. 12 Reangs refer to themselves as Bru 13 The official reports confirm about 47,742 people displaced between Jan 1999 and Nov 2003. More than 100,000 Bengali settlers have been internally displaced (BBC News, 6 th May 2004). A large amount of Reangs have been displaced. 14 Many people has also been displaced due to building of fence along Bangladesh border (Telegraph, 13, March,2005) 15 Many villagers from nearly 420 villages in Chhattisgarh have fled for safety Identities in Motion ... 11 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  20. 20. In India, internal displacement has also alternative schemes offered to the project- re sulted from na tural disasters a nd affe cted pe rsons. This re duces their development projects. Floods and other chances of resettlement and exacerbates natural disasters displace many people their vulnerability impacting access to every year. Recently, the tsunami in the health and healthcare (Himadri et al., Indian Ocean which hit southern India in 1999). There are reports of lack of basic December 2004, devastated the Andaman facilities like food, medical supplies and and Nicobar Islands and a 2,260 km stretch sanita tion in the Sta te gove rnment of the mainland coastline in Andhra organized relief camps for the internally Pra desh, Kera la , Ta mil N a du and displaced people (HRW, April 2002). Pondicherry affecting several households. An estimated 2.7 million people were Reports suggest that more than half of the affected by the disaster and some 650000 IDPs are at risk of falling victim to physical were displaced (World Bank, 3 May 2005). violence threatening their lives (Norwegian Kashmir, in the north of India, was badly Refugee Council, 2005). Many IDPs affected by the South Asian earthquake in remain exposed to violence and other October 2005, which made thousands of human rights violations during and after people homeless. According to official their displacement. Often they have no or records, 150000 people were homeless only ve ry limite d a cce ss to food, following the earthquake disaster.16 employment, education and health care. Large numbers of IDPs are caught in Available reports indicate that more than desperate situations amidst fighting or in 21 million people are internally displaced remote and inaccessible areas cut-off from due to development projects in India. India international assistance. Others have been is the third largest dam builder country in forced to live away from their homes for the world. It now has over 3600 large dams many years, or even decades, because the and over 700 more under construction.17 conflicts that caused their displacement Large dams are the single largest cause of have remained unresolved. Women and displacement in India. Of those who were children often are particularly vulnerable displaced in India due to construction of to sexual and other forms of violence. As dams, more than 50 per cent are tribal lack of security also affects humanitarian (HRW, January 2006). The estimates of access, many of those stuck in dangerous IDPs due to deve lopme nt induce d situations also have limited possibilities of displacement lack authenticity of data. getting humanitarian assistance, which, Lack of proper surveys on development- in addition to immediate physical threats, induced displacement excludes a large make s the m more vulnera ble to proportion of affected families out of the malnutrition and diseases. 16 USAID, 2005, Earthquake Estimates, December 17 Taneja, Bansuri and Thakkar, Himanshu, On Dams, World Commission on Dams, accessed:5th April, 2006 Identities in Motion ... 12 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  21. 21. 1.B. ii) International Migrants in India children from the neighbouring countries to India. Bangladesh, SriLanka and Nepal In India there are a large number of are common neighbouring countries from inte rna tional migra nts from othe r which women migrate to India as part of countries. In 2001 Census about 5.1 an organized trafficking network. The million persons were reported as migrants movement of trafficked persons is based on by last r esidence from a cross the deception and coercion and its main Inte rna tional border. N e ighbouring purpose is exploitation. In the case of countries are the main source of origin of illegal international migrant, the issue of the international migrants to India. 4.9 legality is the main cause of vulnerability. million persons who migrated from the The vulne ra bility of undocume nte d neighbouring countries constitute 96.9 migrants is multiplied by their illegal and per cent of the total migrants from abroad. clandestine condition. When migrants The bulk of these migrants were from e nte r a nothe r country ille ga lly and Bangladesh, followed by Pakistan and subsequently lose any legal immigration Nepal. But for the purpose of this paper, the status, his or her vulnerability to abuse and main focus would be on low-skilled and exploitation increases sharply. In many unskilled internal migration to India and situations, migrants do not know what refugees. rights they are entitled to, and still less how to claim them, hence the cases of abuse Restrictions on legal entry at in most goes unrecorded. countries of destination, enforced through strict visa regimes and carrier sanctions, Another area where exploitation is rampant mean that a large proportion of migrants is forced labour which takes place in the travel with illegal documents, often using long, torturous and dangerous routes to illicit underground economy and so tends countries of de stina tion. Since the to escape national statistics. Irregular movement of population is illegal, the migrant workers are easy victims of abuse estimates of entry of migrants to the and exploitation by employers, migration countries of their destination remain agents, corrupt bureaucrats and criminal largely undocume nte d. Restrictive gangs. They often live on the margins of approaches based on efforts to obstruct or society, trying to avoid contact with deter people moving from one country and authorities and have little or no legal region to another, have had a negative access to prevention and healthcare impact on prospective migra nts and services. Migrant workers predominate in asylum seekers violating their human the lower income labour market with higher rights principles and force them into the risks of exposure to unsafe working hands of human traffickers. Trafficking conditions. 18 Many often they do not occurs in a wide range of situations and approach the health system of the host take s many forms. There a re we ll- countries in the fear of their status being established trafficking routes of women and discovered. 18 Allotey Pascale (2003), Is Health a Fundamental Right for Migrants, Guest Editorial Column in the journal Development, Vol 46, No 3, September. Identities in Motion ... 13 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  22. 22. Refugees are international migrants to entered the country after 25 March 1971 India, who are understood as a fleeing would need to return to Bangladesh by the stranger in need of sanctuary or someone end of February 1972. Remarkably, by the who was received and treated as guests. end of February 1972, over nine million Some refugees were integrated into the refugees had returned back to Bangladesh. receiving society, while others may have chosen to return to their homes after a A recent estimate of refugees in India period of time (Samaddar, 2003). There amounts to 162687 (UNHCR, 2005). The have been several political developments number of refugees in India is declining and ethnic considerations which have from 1994 to 2004 (See Appendix 2). The resulted in a refugee problem in India. total number of refugee population living Because of ethnic violence in Sri Lanka, a in camps is 165292 of which 11493 stay large number of Sri Lankan refugees have in urban areas and the rest 153799 are crossed over to India since July, 1983 and dispersed across various regions. Refugees their influx, though substantially reduced, have an added complexity of nationalism, still continues19. Displaced persons from ethnicity and social norms20. Refugees may East Pakistan who had come into India also face racism and xenophobia in the upto March 31, 1958 are known as ‘Old countries of destination. At times of Migrants’. They number about 41.17 lakh political crisis, they may be the first to be and the bulk of them, over 31 lakh stayed targeted. In recent years, the linkages on in West Bengal. Following the partition, dra wn betwee n a ntiterrorism and India received 2.55 million Hindu refugees immigration control in the context of the from East Bengal. Again following the war ‘wa r on te rror’, ha s le d to many of liberation in 1971, an estimated ten governments having uninte ntiona lly million refugees fled from Bangladesh to e ncoura ge d discrimination a ga inst neighbouring India to escape from the international migrants and refugees. atrocities of the Pakistan Army and their local collaborators. Within a month after 1. C. Migrant Women and Children the crackdown of the Pakistan Army on 25 March 1971, nearly a million refugees Migration among women and children entered India. By the end of May, the (both internal and international) warrants average daily influx into India was over spe cia l a tte ntion in the context of 100000 and had reached a total of almost migration from the perspective of human four million. By the end of 1971, figures rights. Migration a mong women and provided by the Indian government to the children and its associated vulnerability United Nations indicated that this total had poses complex public health challenge. In rea che d 10 million. India q uickly the migratory pattern within India, women announced that all refugees who had and children have always featured as 19 Sri Lankan Refugees in India Year January February March Apr il May June July August Sept. October November December 1999 370 408 579 546 769 612 448 387 287 379 72 120 2000 92 181 257 198 288 200 138 45 29 41 46 105 Source: Ministry of Home Affairs, mha.nic.in/AR01CHP14.htm 20 Bangladesh Documents, Vol. I, New Delhi, Government of India, Ministry of External Affairs, p.464 Identities in Motion ... 14 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  23. 23. “associated” migrants with the main lead to the reversal of the income dynamics decision to migrate being taken by the male of individual households. Post 1990s, of the household. Internally migration globally the identity of women as laborers within and outside the States of India, has became pervasive. Women migrant labour always thrown out higher figures of female now accounts for 46 per cent of the overall migrants citing, ‘Marriage’ and ‘Moved with international migration from developing household’ as the two most important countries.22 In India, there are a large reasons to move among women. This is number of international women migrants. primarily in consonance with the belief Female migration to India constitutes 48 that man is the prime breadwinner of the per cent of the total in-migration from other household and is responsible to take countries. Migration among women has important decisions. Women are largely been high from Bangladesh and Nepal as care givers. This belief holds ground as is compared to other neighbouring countries. evident from the trend displayed in the Low/skilled or semi-skilled migration has subsequent censuses on migration. 21 an impact on their choice of occupation According to the 2001 Census, 42.4 and the conditions of work. Many of the million migrants out of the total 65.4 low/semi skilled female migrants work in million fe male migra nts in India , the unorganized sector.23 They work in mentioned marriage as the main reason to hazardous conditions, live in shanty migrate within the country. As associated arrangements and are denied access to migrants, wome n suffer gre a te r health and health care. vulnerability due to reduced economic choices and lack of social support in the Trafficking also contributes to the cross- new area of destination. In the case of border movement of a large proportion of semi/ low-skilled or unskilled women migrants, this can translate into their entry women into other countries. As mentioned into the low paying, unorganized sector earlier, there are established routes of with high exposure to exploitation and trafficking in India used to facilitate the abuse. movement of women and children from across the borders in order to sustain the But this scenario has changed globally. unde rground e conomy. Women and International migration of women for children in an irregular situation are employment has increased over a period doubly vulnerable owing to their lack of of time ma inly with the changing proper legal status and high risk of sexual vicissitudes of the global economy that has exploitation. 21 In India, out of the total 82.1 million migrants by last residence during 1981-1991 about 36.1 million and 10.1 million were female migrants who migrated due to marriage and moved with family. In 2001 Census, about 42.2 million and 12.2 million were female migrants who migrated for marriage and moved with household respectively out of the total 97.8 million migrants. This estimate includes both skilled and unskilled female migrants. 22 Citation available in Meenakshi Thapan’s Series Introduction for Sandhya Arya and Anupama Roy edited, Poverty, Gender and Migration, New Delhi: Sage Publication, pg.9. The original citation is Susie Jolly, Emma Bell and Lata Narayanswamy,(2003), Gender and Migrat ion in Asia: Overview and Annotated Bibliography, No 13. Bridge, Institute of Development, UK. 23 Many of the migrant women work as domestic help, in beauty parlours as helpers, sweepers, prostitutes etc. Identities in Motion ... 15 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  24. 24. There are a large proportion of women and popula tions when dise a se s are children refugees in the camps in India. communicable and infected persons move There are 1, 22,078 Tibetan refugees in or migrate. Cataloguing the morbidity India, of which 43,708 are women and reported among migrants makes the 23,122 childre n (0- 14 a ge group) 24 . relation between migration and morbidity According to the UNHCR estimates, there clear. Understanding the relationship is are 12,760 Afghan refugees in India, of particularly important from the public whom 9,417 are women, and children, health perspective. Different types of which amounts to 74 per cent being women migration lead to diversified vulnerability and children. Of these 4 percent are among both internal and international children below the age of five years.25 Those migrants. The common possible in the refugee camps face large-scale de terminants of he alth risks among atrocities. Very often, women in the camps, migrants are the motivational factors suffer se xua l abuse during conflict. (reasons for migration, occupational at the Women migrants have higher risks of being victimized at the work place and suffer source of origin 27 ), occupation related sexual exploitation with its associated factors 27 and environment-re la te d reproductive and mental health problems. factors28 . The factors that increase the health risks and health outcomes either 2. Health implications for those on directly or indirectly are not exclusive. Box the move 3. below gives several factors that affect migrant’s health. The factors are inter- Public health threats arise in migrant correlated. Box 3 Causal Factors Affecting Migrant’s Health l Overcrowded living conditions which facilitate increased transmission of infectious diseases l Poor nutritional status( and consequent lowered immunity) due to lack of food before, during and after displacement l Inadequate quantities and quality of water to sustain health and allow personal hygiene l Poor environmental sanitation l Inadequate Shelter 24 Tibetan Planning Commission, 1984, Tibetan Demographic Survey, Dharamshala 25 UNHRC, 2001, ht tp: //www. UNHRC.CH, Women, Childr en and Older Refugee: The Sex and Age Distribution of Refugee Population with a Special Emphasis on UNHRC Policy Priorities, Geneva: Population Data, Unit Population And Geographic Data Section, United Nations High Commissioner For Refugees, p.10. 26 These factors change and impact priorities at the destination areas. For example, perception and awareness of poor health; however, health expenditure depends on the socio-economic profile of the migrants at the areas of origin. 27 Occupation related health hazards. 28 Poor living conditions impact health. Identities in Motion ... 16 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  25. 25. The morbidity patterns among migrants headache, pain in the neck, swelling of vary with the type of migration and its legs, swelling of hands, hair loss, skin scope for generation of health risk. For diseases, injuries, chest pain, eye problems instance, in the case of internal migration among others (Jeyaranjan, 2000). Migrant among poor labourers, their susceptibility labourers avail themselves of curative care to health problems stems from their but they fall outside the coverage of peripheral socio-economic existence in the preventive care largely due to their fluidity host areas. Since they are absorbed in the of movement caused by uncertainty of informa l e conomy, the y e xist a s employment. The low health status of undocumented labour in most cases and women can be seen from indicators such fall outside the coverage of the labour- as antenatal care coverage, prevalence of welfare sche mes 29 a nd he nce , the anemia, prevalence of reproductive tract employer does not provide them their due. infections and violence against women Poor living conditions such as lack of (Kundu, 2002). Children suffer from proper water supply, poor drainage system malnutrition and low immunization when and unhealthy practices and deplorable their parents are in perpetual low-income sanitary conditions expose the migrants to uncertain jobs that necessitate frequent various kinds of health risks predetermined shifts based on concentration of work by their standard of living and their choice (Sundar et al, 2000). Measles is found to of occupation (Sundar et al, 2000; VHAI, be common a mong migrants ma inly 2000, Ray 1993). These harm the migrants a mong childre n who do not have and increase the chance of their being immunization (Harpham, 1994). prone to infectious diseases30. Migrant labour is more susceptible to HIV/ Living arrangement, living conditions, and AIDS infection. A study on the hea lth be haviour a re re la ted to the vulnerability of the workers in an industrial incidence of infectious diseases. Malaria, are in New Delhi that in the absence of hepatitis, typhoid fever, and respiratory proper observance of existing labour rights, infection are found with a higher incidence the migrant labourers continue to live in among migrants The occupation-related squalid surroundings and have hazardous commonly reported problems among working atmosphere. They are not provided migrant workers working in the informal the basic needs. Most of the workers have sector are cold- cough fever, diarrhea, multiple partners and indulge in high risk tiredness, lack of appetite, giddiness, behaviour with a very low pattern of condom weight loss, stomach pain, hip pain, usage. They also reported high alcohol 29 In cases of rural to urban migration where the push factors are essentially economic i.e., landlessness, debts, joblessness, etc., the need of the migrant is more than the employers need for labour. This gap in the level of need between the labourer and the employer reduces the time of bargaining for the right price of labour benefiting the employer who buys labour at his price irrespective of the market price. The need element of the migrant reduces his/her labour price. 30 The World Bank and WHO has estimated that in India, 21 per cent of all communicable diseases (11.5 per cent of all diseases) are water related. The specific diseases are diarrhea, trachoma, intestinal worms, hepatitis and tropical cluster (schistosomiasis, leishmaniasis, lymphatic filariasis in India) of diseases (Parikh, 2000). Identities in Motion ... 17 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  26. 26. Box 4 Migration, Mobility and HIV/AIDS Migrants and mobile people become more vulnerable to HIV/ AIDS. By itself being mobile is not a risk factor for HIV/AIDS. It is the situations encountered and behaviours possibly engaged in during the mobility or migration that increases vulnerability and risk. Migrant and mobile people may have little or no access to HIV information, prevention (condoms, STI management), health services. – International Organization of Migration, 2005. consumption and drug use. All these place crowding, and extremes of climate, lack of them at high risk for HIV/AIDS (Singh R., hea lthca re , joble ssne ss, idlene ss, N Atteq, J.John, 1999 ; Lingam,1998). The depression, disease and death. A health most vulnerable sub-population is sex survey among displaced Kashmiri Pandits workers is found to be those who are reveals that the affected population shows trafficked from neighbouring countries or multiple signs of deteriorating health like those from rural areas who lack education high incidence of serious and potentially and migrate to cities a s a surviving fatal diseases (Norwegian Refugee Council, strategy. 2005). There are health risks for people displaced The emotional stress of displacement and due to development activities such as dam the toll that this takes can have a great construction 31 and conflicts. Internally impact on physical as well as mental displaced people are usually housed in health. Large numbers mental health tents or one-room tenements or just problems are reported among IDPs. Stress spaces, bereft of basic amenities of life. disorder leads to cardio-vascular stress, Others are on the move in search of shelter psycho-tra uma , e ndocrine stre ss, a nd livelihood a nd lea d a noma dic musculo-skeletal stress, stress-belly existence. The health, both mental and (ulcers etc) and cranial stress (tension physical, of IDPs has been the greatest headaches and migraines). Hypertension casualty. The trauma of forced exodus and is common even among the youth. Stress the exposure to an alien and hostile dia bete s is a ne w syndrome (Da ily environment are further compounded by Exce lsior, 3 Se ptember 2003). the problems of acclimatisation, lack of Psychological and mental disorders are basic amenities such as drinking water, e pidemic in proportion. Re active drainage and sewerage, absence of proper depression and nervous breakdown are lavatory facilities, poor housing, over- very common in the youth. Males have overt 31 Sometimes water impoundments increase favourable vector sites at times of the year offering to be a breeding site for mosquitoes. They transit a number of tropical diseases. Identities in Motion ... 18 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  27. 27. Box 5 Health Problems in the Context of Trafficking Mental trauma Physical trauma Communicable disease Violence, including sexual abuse Source: International Organisation of Migration, 2005. depression. Female complaints are more and this is most pronounced among somatic in nature. Older people have childre n unde r five ye a rs of a ge . retarded depression. Even schizophrenia is Malnutrition is both a prima ry and reporte d a mong IDPs. C o nstant secondary cause of death among children unce rta inty has cre a te d chronic, (Norwegian Refugee Council, 2005). The impending and ongoing phobias. Refugees refugee camps lack basic medical facilities. like IDPs suffer from poor mental health. The results are devastating in terms of Cases of neurological disorders are also morbidity a nd morta lity a mong the commonly reported in the refugee sites children (Norwegian Refugee Council, (Norwegian Refugee Council, 2005). 2005). Children also suffer as they grow in some time s violent a nd inse cure Refugees are placed at a high degree of environment. The NHRC reported that vulnerability as far as their exposure to children were one of the major sufferers in diseases is concerned and this exacerbates the refugee camps due to the neglect of by their status in the host country and their their education and health32. uncertain future of relationship with the country of origin. They have restricted Women like children have specific needs access to social goods in the host country. than others in the refugee camps. The Many refugee camps lack sanitation, water, gender dimensions of ethnic nationalism electricity and have little or no access to and the related struggle for identity medical facilities (Norwegian Refugee formation, manifests itself in the form of Council, 2005). A report by the South Asia violence on women in the case of refugee Human Rights Documentation Centre in women. As women they are targeted for 1994 described the conditions in the sexual violence because of the nation or camps as abysmal (SAHRDC, 1994). The the community they represent. Several major causes of morbidity and mortality cases of chronic vaginal discharge due to among refugees are measles, diarrhoeal vaginal infection and ovarian failure diseases, acute respiratory infections, related to sexual abuse are commonly malaria and malnutrition. A direct causal reported by women in the refugee camps relationship between malnutrition and (Internationa l Initia tive of Justice , mortality in the refugee sites is evident, December 2003, pp.64, 67). 32 National Human Rights Commission, India, July 1996, ‘Human Rights Newsletter’. Identities in Motion ... 19 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  28. 28. Various reports have underlined the have been recognized as groups with importance of meeting the reproductive special protection needs. Each government health needs of women and adolescents in is a llowe d to e xercise its na tiona l the camps. 33 Cases of polymenorrhea sovereignty to decide who to admit into its (shorte ne d me nstrua l cycle s), territory, but once the individual has dysmenorrhoea (painful menses) and e nte re d the country, the na tiona l menstrual irregularity are common among gove rnment is re sponsible for the women and adolescent girls in the refugee protection of his or her rights. But between camps. The most common cause for such refugees and migrants, the former received health problems is violence on women and more attention than the latter on the the associated psychological and physical grounds that they lack protection by their stress. (International Initiative of Justice, own governments. A special protection 2003). There are also many cases of mental ‘regime’ was created for the refugees to problems reported among women in the protect the m from re foule me nt, to refugee camps. Skin diseases, nutrition recognize their civil, social, economic and syndromes, incidence of tuberculosis, cultural rights, and place them under the renal stones, renal failure and asthma are protection of individual states and of the among other commonly reported morbidity UNHCR.35 The UNHCR was formed with in the camps (Samaddar, 2003). enormous protection mandate for refugees. 3. The Human Rights of Migrants Refugees and children’s rights have been defined in separate treaties quite early but The Vie nna De cla ration a nd the there was no legal text for migrants which Programme of Action (1993) attached great included all the different elements and importa nce to the promotion and aspects of migration, and which was protection of the human rights of persons a cce pte d a s lega lly binding and belonging to vulnerable groups, including authoritative by a majority of states. It was migrant workers.34 States were urged to perhaps the move to prioritize the rights of create conditions to foster greater harmony refugees which has led the international and tolerance between migrant workers community to give less attention to the and the rest of the society of the State in rights of migrants a nd a much le ss which they reside. Refugees and migrants developed human rights protection. 33 A study was conducted to compare 400 females with menopausal symptoms after migration and an equal number who developed menopause before exile. It showed that 25 women in the age group 35-40 years developed menopause after exile compared to nine before migration. In the age group 41 to 45 years, 34 developed menopause after exile as against 26 before exile. More than 36 per cent women become infertile by the time they reach 40 years of age after Migration (Norwegian Refugee Council, 2005). 34 In the last half century, human rights have been transformed from the abstract principles embodied in the Universal Declaration of Human Rights (UDHR), to become legal entitlements for individuals, and legal duties for states. The body of international law seeks to regulate the relationship between the state and individuals within its territory and jurisdiction. The central principal is nondiscrimination and equal treatment. In the context of vulnerable groups, governments have recognized that some individuals and groups are particularly vulnerable; although they enjoy the same universal protection as everyone, they also have special protection needs. 35 Convention on the Status of Refugees (1951) and Protocol. Identities in Motion ... 20 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  29. 29. But the increased movement of people Most of the rights set out in Part III, which across the globe for labour and the serious applies to all migrant workers are related concerns raised about the existing labour to the fundamental civil and political standards of individual states necessitated rights. 36 The Convention establishes a the need to protect the rights of the migrants Committee to oversee implementation by by governments. The value of a rights based the States.37 The CMW treaty came into approach to migration lies in its ability to effect only in 2003. It has been accepted identify at an early stage laws, policies and a s lega lly binding by rela tive ly fe w practices which could lead to abuse of governments but no major employment migrant’s rights. The Hague Declaration country has thus far ratified it (See focused on adopting a more humane Appendix 3 for Status of Ratification of the approach to migrants and migration. CMP by countries). At present, the number Migrants now have rights under two sets of ratifications of the Convention is 25 of international instruments: first, the core (Steering Committee Report, 2003). The huma n rights tre a tie s such as the CMW lacks the legal authority of other International Covenant on Civil and Political human rights treaties as it has not been Rights (ICCPR), whose provisions apply ratified by majority of states. But, the UN universally, and thus protect migrants; and Convention on the Protection of the Rights second the new Convention on Migrant of All Migrant Workers and Members of Workers (CMW) and the ILO Conventions their Families (UN Convention on Migrant which specifically apply to migrants, and Workers) clearly spells the global focus on in particular to migrant workers. Despite the human rights of migrants several attempts, migrants continued to be protected under an amalgam of general Migrant’s rights in the most extreme internal law, human rights law, labour law, situations, that is, war, genocide or crimes and international criminal law. But with against humanity are protected under the Convention of Migrant Workers (CMV), inte rna tiona l crimina l la w, and the provisions for the protection of the international humanitarian law. Two migrants received formal sanction. The protocols to the UN Convention against CMW was adopted by the General Assembly Transnational Organised Crime protect at its 45th session on 18 December 1990. migrant’s rights in situations of trafficking and to a lesser degree where they are The Convention on Migrant Workers brings smuggled. The mandate for the Special together in a single text the rights of the Rapportuer for Human Rights of Migrants migrants including the irregular migrants. was established in 1999. 36 Part III contains that there has to be equal treatment between all migrant workers and nationals to their families, giving them equal treatment in respect of their basic economic and social rights, including remuneration, work and employment conditions, social security, emergency medical care, and access to education for the children of migrant workers. Part IV, is only for regular migrants and relates to access to educational institutions and service, vocational guidance and training, housing, social and health services, and participation in cultural life. They are given the right to form trade union and rights to political participation. They also have a right to family reunification. 37 The Committee examines reports from States, and considers communications from individual and other states alleging violations. An ILO representative is to participate in a consultative capacity at the Committee’s meetings. Identities in Motion ... 21 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com
  30. 30. There are only two international treaties about the protection of the rights of all that recognize health rights of irregular migrant workers and the members of their migrants: the Convention on Migrant families. It makes a reference to the access Workers (1990) and the Rural Worker’s to social and health services by migrants Organizations Convention (1975). The right in the host countries. (See Box 6 below for to health among migrant workers is details.) encapsulated in Article 43 of the CMW Box 6 International Convention on the Protection of the Rights of all Migrant Workers and Members of their Families Article 43 1. Migrant workers shall enjoy equality of treatment with nationals of the State of employment in relation to: a. Access to educational institutions and services subject to the admission requirements and other regulations of the institutions and services concerned; b. Access to vocational guidance and placement services; c. Access to vocational training and retraining facilities and institutions; d. Access to housing, including social housing schemes, and protection against exploitation in respect of rents; e. Access to social and health services, provided that the requirements for participation in the respective schemes are met; f. Access to co-operatives and self-managed enterprises, which shall not imply a change of their migration status and shall be subject to the rules and regulations of the bodies concerned; g. Access to and participation in cultural life. 2. States Parties shall promote conditions to ensure effective equality of treatment to enable migrant workers to enjoy the rights mentioned in paragraph 1 of the present article whenever the terms of their stay, as authorized by the State of employment, meet the appropriate requirements. 3. States of employment shall not prevent an employer of migrant workers from establishing housing or social or cultural facilities for them. Subject to article 70 of the present Convention, a State of employment may make the establishment of such facilities subject to the requirements generally applied in that State concerning their installation. Identities in Motion ... 22 Chandrima B. ChatterjeePDF created with pdfFactory Pro trial version www.pdffactory.com

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