1. Minnesota State University Moorhead
How do communicable diseases affect International Migration?
Anna Sylva
Political Science 364
Dr Conteh
December 1 2014
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Abstract
The mass movement of people has led to an increase in the spread of communicable diseases.
Globalization and population movements have contributed immensely to the rapid spread of
these microorganisms. Mass movements of people creates new opportunities for communicable
diseases to be introduced to places they have never existed before. These issues have led to
increase in legislature as nation states try to limit the number of immigrants they allow into their
territories. Intensive research and studies to find ways to manage the movement of people while
respecting their right to move and also managing the spread of communicable diseases are
examined in this paper. Migration patterns and certain groups of individuals are targeted as the
leading bearers of communicable diseases and through their presence, pathogens that were once
foreign to an area are now introduced into a new environment where its people have not
developed resistance to this new pathogen.
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International migration according to the International Organization of Migration is
defined as the movement of a person or a group of persons across an international border and this
can include migration of refugees, internally displaced persons, economic migrants and other
people moving for different reasons (International Organization for Migration). International
Migration is mostly associated with the transmission of communicable diseases which has led to
the establishment of limitations and restrictions when it comes to the movement of people.
Human beings have always moved since the beginning of human existence to search for other
opportunities thus the issue of migration or the movement of people is nothing new. In today’s
world most people that migrate are “forced migrants” who have been forced to flee their homes
and seek refuge someplace safer (Castles and Miller, 7).According to the United Nation’s
declaration of human rights in article 13 it states in summary that individuals have the right to
move freely within territories. This right however is heavily managed as many immigrants are
denied entry in so many nation states. Freedom of movement, limitations, stipulated legislations,
biases, problems arising from the arrival of new immigrants and globalization have served as a
major concern for nation states in issues pertaining to communicable diseases and international
migration. These above mentioned issues have become the pillars to which it can be determined
how communicable diseases affect international migration.
As this paper deals with International migration and communicable it is very important
that we define what communicable diseases are and also the emerging communicable diseases
that pose as possible threats to the future of international migration. A communicable disease is
an illness caused by an infectious agent or its toxins that occurs through direct or indirect
transmission of the toxins from an infected individual or animal to a susceptible host (Center for
Disease Control). There are numerous communicable diseases that are potentially very
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dangerous to the humans and our movements. Emerging communicable diseases today are the
Human Immunodeficiency Virus (HIV), Tuberculosis, Hepatitis, Influenza, Ebola, etc. These
communicable diseases have become a constant source of research to reduce the spread.
Unfortunately some of these communicable diseases are very widespread in migrant
communities and thus migratory processes are automatically linked to the spread of
communicable diseases.
Human Immunodeficiency virus also known as HIV is a virus that can lead to acquired
immunodeficiency syndrome (AIDS). The human body has not developed ways yet to flush out
the virus from our systems hence once an individual acquires the HIV virus it remains in his
body for the rest of his life. It is spread mainly through sex or by sharing injections with an
infected person or other equipment that can come in contact with your bodily fluid (Center for
Disease Control). HIV still continues to be a major issue in the world, in 2013 it was estimated
that about 35 million people were living with HIV. Sub-Saharan Africa is home to 70 percent of
people living with HIV (Center for Disease Control). As so many immigrants migrate from Sub
Saharan to the west it has become an issue of paramount importance to receiving states.
Tuberculosis or TB is an infectious bacterial disease caused by mycobacterium
tuberculosis and it mostly affects the lungs. It is transmitted from individuals to individuals via
droplets from the throat and lungs of infected persons (World Health Organization). TB is
treatable and can be treated within a span of six months however it still counts as a
communicable disease because it can be spread from one person to another. In 2013
approximately 480,000 people were diagnosed with Tuberculosis and ranging from 2000 through
2013, about 37 million lives have been saved through effective treatment and diagnosis (World
Health Organization).
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Hepatitis is another communicable disease that has received much attention due to its
severity. It is an inflammation of the liver and it is most commonly caused by a viral infection.
There are five different hepatitis viruses and they are referred to as types A, B, C, D and E.
These five types have the potential for outbreaks and epidemics and their common modes of
transmission are through the receipt of contaminated blood or blood products and medical
procedures using contaminated equipment (World Health Organization). Areas of high risk
infections are in developing countries with struggling economies and below standard sanitary
levels (World Health Organization). In these developing countries most of the children before the
age of 10 have contacted the Hepatitis virus. The World Health Organization is working on
methods and strategies to educate people especially individuals that live in high risk areas.
Our last communicable disease for this paper will the Ebola virus, a virus that has caused
thousands of deaths on the West African coast in Guinea,Liberia and Sierra Leone. Ebola is a
deadly disease caused by infection with one of the Ebola virus strains. It can cause diseases in
both humans and nonhumans especially monkeys and gorillas (Center for Disease Control). Even
though Ebola was first discovered in 1976 in the Congo River which is located in the republic of
Congo it is still considered an emerging diseases and its frequency for spread has increased
rapidly in 2014. There has not been a proven available treatment yet but with supportive care and
oral fluids one can increase their chances of survival. The Ebola virus has become a major
conversation starter in 2014. As people that live in the infected areas are bracing themselves for
the worst, the international community is working on ways to keep citizens or people from
infected nation states at arm’s length.
Culture can be defined as the beliefs and customs of a particular society hence the
behavior of migrants usually can be linked back to their various cultural backgrounds. Migrants
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have different identities and different ways of doing things but one thing that is common in most
cultures is the stigma attached to people that have communicable diseases even after they have
received treatment. The stigma and discrimination against migrants starts at the grassroots level
which is typically their home countries or countries of origin (World Health Organization). For
example in Guinea, Ebola survivors are stigmatized in their societies as people fear
contamination or even association (World Health Organization). Survivors are forced to take up
new identities in order to fight the stigma attached to them but this does not do much for these
survivors. According to a Guinean lady interviewed by the World Health Organization, she lost
her job because she once suffered from the Ebola Virus. Despite the fact that she was treated
back to perfect health, people around her still lived in fear and thus was forced to give up her job.
The stigma faced by people that suffer from communicable diseases start from within their
communities and often continues as they migrate and resettle in new places.
As we talk about individual cultures, the issue of globalization can also be tied into it as
globalization has succeeded in integrating people of different nations with the aid of technology.
With modern technology, news spreads so much faster and events unfolding in a state can reach
the other part of the world with just a click on the computer. We live in a globalized world where
almost everyone talks about “rights and freedoms” but do they really exist or are they just
theoretical aspects of our globalized world? With the dawn of new technology, it has become
relatively easier to move from one place to another with little or no hassle at all yet despite all
these developments the freedom to move is still very questionable. In article 13 of the Universal
Declaration of Human rights, it states that “everyone has the right to freedom of movement and
residence within borders of each state” (The Universal Declaration of Human Rights) yet nation
states have put up restrictions that limit the entry of people. Through globalization there is now a
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high tendency for more nation states to be affected by migration. There has also been a surge in
the number of migrants and thus nation states are unable to keep up with the numbers especially
with policies that limit entry (Castles and Miller, 11). Even though almost everyone will agree
that globalization has resulted to a massive increase in the movement of people, the free
movement still continues to be an issue within the international community.
Culture is a fundamental part of any individual and thus when people migrate they take
their cultures with them and if people migrate from an area with a high prevalence of
communicable diseases they can carry with them a higher risk of infection, in cases like
Tuberculosis(Grondin,561). In 2014, the restriction of people’s rights to move is very evident as
we have witnessed the outbreak of the Ebola virus in three West African countries namely,
Guinea, Liberia and Sierra Leone. Due to the highly contagious nature of the Ebola virus
movements from infected states have been severely limited. Whether or not they are being
denied their right to move is still very debatable as states have sovereignty and they have every
right to protect its citizens if there is eminent risk. The welfare of an entire citizenry cannot be
jeopardized for a basic right, this however has become an issue and there has been an uproar
about the strict limitations that have been imposed on these three countries. The cultural outlook
on how communicable diseases has contributed to the inability to curb or reduce the spread of
communicable diseases. Every culture has health perceptions and health issues are perceived
differently around the world and thus this complicates culture and how they deal with the
emergence of communicable diseases.
With the limitation on the right to move freely comes the issue of legislations that have
been put in place to restrict the entry of people with communicable diseases especially in the
developed world. In order to control the spread of communicable diseases like the Human
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Immunodeficiency Virus, up to 50 countries have introduced border restrictions or required
testing for the Human Immunodeficiency Virus (Gellert, 1494). In the United States, admission
of refugees is refused if they test positive for the Human Immunodeficiency Virus unless in
circumstances whereby the refugees demonstrates that his entry will not endanger the lives of
United States Citizens which in that case they are allowed entry(Gellert,1495). However due to
the massive number of immigrants that come into the United States on a yearly basis not all
immigrants are screened for communicable diseases prior to entry. In Egypt, Iraq, Qatar,
Singapore and Turks and Caicos Islands, individuals are required to prove that they are HIV
negative in order to be allowed entry (plwha.org). In countries like Bahrain, Russia, Sudan,
Saudi Arabia, Yemen, and The United Arab Emirates, individuals are deported once their HIV
positive status is discovered (plwha.org). It is relatively hard for people with known
communicable diseases to migrate to other places as the stigma follows them wherever they go
and the restrictions placed on them by nation states does not make the process an easier. It is
already hard enough that one has to resettle in another country for economic, environment or
other reasons but being denied entry because of one’s health condition is a bit discriminatory and
very prejudice.
These restrictions lead to bigger problems especially in managing the spread through
international migration. Immigrants who migrate into the United States with the Human
Immunodeficiency virus usually flee their countries of origin due to fear and prosecution and
sending them back will only further endanger their lives. If individuals are denied legal status
they usually tend to live unnoticed in the United States community and this further prevents them
from seeking medical attention (Gellert, 1495). Also the fear of deportation will lead infected
individuals to live an isolated life and this will hamper any efforts to further educate the
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American populace about the Human Immunodeficiency Virus. In many parts of the world the
intolerance towards people from other countries rapidly increasing and thus governments do not
see immigrants and communicable diseases as their responsibility. This mindset however has
contributed to creating a universal healthcare problem especially with the issue of migrants and
the healthcare of migrants (Carballo and Mboup, 13). The cost of universal healthcare has also
become a paramount concern as most people infected with communicable diseases do not have
the means to pay for a proper medical treatment (Carballo and Mboup, 13) and therefore they are
forced to live with it as they migrate into new places for better living opportunities. As migrants
move around they carry with them the health “footprints” of their countries of origin (Carballo
and Mboup, 6) and therefore communicable diseases with regards to migration deserves much
more attention than what it is getting right now. Migration cannot be limited no matter how
many restrictions and laws are put in place, the human race has always moved around and that is
not coming to an end anytime soon. The sooner world governments and institutions realize that
international migration is a contributing factor to the spread of communicable diseases the easier
it will be to tackle these diseases at the grassroots level before they escalate into bigger issues.
In as much as there are issues that need to be dealt with in regards to international
migration and the spread of communicable diseases it is also very evident that statistics regarding
the movement of people and communicable diseases are very biased. From my research I have
not stumbled upon any compiled work on communicable diseases in the developed world but
rather all fingers seem to be pointed at countries in the developing world. Most communicable
diseases are traced to Sub-Saharan Africa. There is very limited information on communicable
diseases in the developed world, the focus only seems to be on developing countries. Migrants
are mostly perceived as health threats when they move into new nation states and thus this
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increases the likelihood of discrimination and inequality in their neighborhoods (Grondin, 561).
Malaria has been mentioned severally as a communicable disease but in actual sense it is not a
communicable disease because it cannot be contacted from one person to another. Malaria is
considered a great threat to people in Sub-Saharan Africa but it does not qualify as a
communicable disease which goes further to prove my point that most of these diseases are
pinned on developing nations. It is believed that travel from developing countries to developed
countries may expose new susceptibles and elevate risks for the spread of communicable
diseases (Gellery, 1494). Statistics on International migration and communicable diseases tends
to ignore the fact that migration does not only take place in developing countries but rather
people in developed countries also migrate to other places and usually as tourists tend to be
carriers of communicable diseases. However this is not mentioned but rather it is said that
tourists risk their lives when they find themselves in new environments because they are exposed
to illnesses for which they have no resistance (Soto, 27). It is very evident that most developing
nations lack proper sanitation and up to standard medical facilities that can treat people with
communicable diseases or even minor diseases but that does not justify the fact that all fingers
are being pointed at developing countries as the leading cause of the spread of communicable
diseases. There are communicable diseases all around the world and to pinpoint a certain group
of people as the leading cause is somewhat biased. The bias affects the way policies can educate
people from all walks of life about the dangers of communicable diseases. If developing
countries are associated with the spread of communicable diseases then people who live in
developed countries but within communities that are hard to reach it will become a major issue
because they might not have much knowledge about these diseases.
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According to research, approximately 66 percent of all heterosexually transmitted Human
Immunodeficiency virus in the European Union were diagnosed in people from countries with
high HIV prevalence (Carballo and Mboup, 7). Most governments believe that migration can be
turned on and off (Castles and Miller,33) as they please but this is not the case because migration
is a continuous process and no matter how much limitations and legislations that are put in place
it will still be a continuous process. In light of the Ebola outbreak, some of the busiest airports in
the United States like Kennedy International Airport in New York, Washington Dulles in
Washington DC and Newark Liberty International in New Jersey have put in place laws that
require people coming in from Guinea, Liberia and Sierra Leone to be screened thoroughly
before they are allowed entry (New York Times; Tavernise, 2). It has also been speculated that
banning airline travel from infected West African nations might be a possibility (New York
Times; Tavernise, 4).In Denmark, refugees arriving from countries with high prevalence of
Tuberculosis are extensively screened and if need be receive follow up six months follow up
treatments and this is also the case in Norway,Germany,the Netherlands and Belgium(Carballo
and Mboup,3).Legislations are important in limiting the spread of communicable diseases with
regards to international migration however in cases where flights are banned then more harm
than good is caused because the ability to respond to the outbreak would be undermined. Also
the movement of health professionals will be limited with legislations such as banning and this
increases the risk for further spread.
Despite the numerous legislations that has been put in place, states still experience
numerous problems with regards to the movement of people. According to research, public
health is underfunded and unless an outbreak happens little attention is given to most
communicable diseases (McFee, 430). The persistent problem with sanitation, poverty,
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overcrowding in housing and health care facilities and also cutbacks in in research and health
care resources also contribute to problems within people who migrate frequently (McFee, 430).
In Spain, a study revealed that approximately 85 percent of migrant workers lived in make shift
accommodations with little running water and poor sanitation which according to Spanish health
officials contributes to chronic and possibly drug-resistant Tuberculosis(Carballo and
Mboup,7).Most immigrants that move around due to famine or other environmental factors are
mostly uneducated or have received minimum education and thus they do not have a better
understanding of what communicable diseases are and how they are spread and therefore they
move across borders without having prior knowledge that can possibly carriers of communicable
diseases(McFee,430). Also these legislations have made migration more complicated and
difficult compared to previous years and this can be detrimental to the health of migrants and
some migrants migrate internationally to seek medical attention elsewhere because it is
unavailable in their home countries (Carballo and Mboup, 3).
Even though these legislations and social situations pose serious problems in
international migration there are however possible solutions that can aid in controlling the spread
of communicable diseases as people migrate across borders. Greater attention must be focused
on monitoring risk factors and reemerging communicable diseases like the Ebola virus (Gelbert,
1496). International organizations that that tackle issues of migration should establish
collaborative local, national and international databases for communicable diseases (Gelbert,
1496). Training future health care professionals especially with regards to travel-related illnesses
and global communicable diseases that might show up as people migrate (McFee, 431).Another
useful thing is to provide useful references for communicable diseases when it comes to
international travel(McFee,431). As migration increases health care providers should strengthen
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competencies in diagnosis and treatment of communicable diseases (Gelbert, 1494). In essence
more systematic studies should be conducted to understand the relationship between
international migration and the spread of communicable diseases. By doing so, travelers or
migrants from all around the world will have sufficient knowledge about communicable diseases
wherever they find themselves and they will be better prepared in handling any outbreaks.
Migration has now become a priority and thus migratory processes and the dynamics of
international migration needs to be understood. International migration today encompasses
serious complications and governments are faced with huge responsibilities of limiting the
inflow of migrants. Policies that governments choose to establish shapes the future of their
societies as well as their relationships with other nation-states. We live in a globalized world and
that should serve as enough caution to nation states because as people move they move along
with various diseases ranging from communicable to non-communicable diseases. In order to be
able to defend the emergence of communicable diseases a surveillance system must be in place
to detect emerging communicable diseases at their early stages (Soto, 28). As at now it is safe to
say that communicable diseases cannot be completely eradicated but with time sustainable
solutions can be developed and there might be a decrease in the number of people infected
worldwide.
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