Cehat chandrima

Identities in Motion;
Migration and Health In India

Chandrima B. Chatterjee, Ph.D

The Centre for Enquiry into Health and Allied Themes (CEHAT), Mumbai

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First Published in October 2006

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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

iii


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.

iv


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

v


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

vi


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

vii


BLANK PAGE

viii


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. Chatterjee


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. Chatterjee


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



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



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



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.



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.



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.



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



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



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



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



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.



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



“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.



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.



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).



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.



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’.



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.



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.



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.



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