This document discusses different types of migration including forced and voluntary migration. It notes that humanitarian organizations have traditionally prioritized assisting refugees fleeing conflict, violence or persecution. However, given the increasing complexity of migration flows, some argue humanitarian organizations should take a more inclusive approach and address the needs of all migrants, regardless of their legal status. The document discusses some of the key needs of migrant populations including basic necessities, healthcare, special protections for women and children, food security and water sanitation, and ensuring their human rights are upheld.

1. “Mixed flows of forced and voluntary migration are taking place widely across the world.
Which migration issues should humanitarian organisations prioritize and why?”
Forced displacement is one of the most acute and visible consequences of disasters and
conflict. Its scale and complexity have increased dramatically in recent years – António
Guterres, United Nations High Commissioner for Refugees.
Introduction
Millions of people in the world migrate. Some out of choice, others forced to leave their
homes due to armed conflicts, fleeing war, abuse, violence, political upheaval, seeking
freedom, security, some seeking for a better life for themselves and their families. There
are also other factors that influence migration such as climate change, environmental
degradation and even developmental projects. The vast majority of migrants are either
displaced within their own countries or are seeking refuge in neighboring countries.
The International Organisation of Migration defines a migrant as any person who is moving
or has moved across an international border or within a State away from his/her habitual
place of residence, regardless of (1) the person’s legal status; (2) whether the movement
is voluntary or involuntary; (3) what the causes for the movement are; or (4) what the length
of the stay is. States and refugee advocates often insist that ‘refugee’ and ‘migrant’ are
separate distinct categories, despite ample evidence that these labels blur in practice.
However, little attention is paid to the fact that in the past refugees were considered as
migrants, with international attention focusing on securing their access to existing
migration channels Katy long (2013). According to the UNHCR Emergency Handbook, a
‘migrant' is fundamentally different from a refugee. Refugees are forced to flee to save
their lives or preserve their freedom, but ‘migrant' describes any person who moves,
usually across an international border, to join family members already abroad, to search
for a livelihood, to escape a natural disaster, or for a range of other purposes.
In the twentieth and twenty first centuries, large scale migration and displacement of
population has generally been due to political reasons. Migration, to some extent, largely
benefits the host country with the migrants providing new trades, cheap workforce and
new skills. Though beneficial, there are downsides and implications to huge migration.

2. Large scale movement can strain the health care and education services, housing
shortages, racial tension and the welfare system.
According to the 2012 world disaster report, over 72 million people were forced migrants
in 2011. Migration is a growing phenomenon that affects virtually every country. More and
more people are forced to leave their homes and communities because of conflicts,
persecution, slow and sudden onset disasters. The number of people forcibly displaced is
increasing as the drivers of forced migration becomes more complex. This among other
can be classified under forced migration.
The European Union is witnessing perhaps the largest scale of immigration wave ever,
with some 153,000 migrants who have been detected at its external borders since the
beginning of this year and arriving at its “gates”. The number of illegal border-crossing
detections in the EU started to surge in 2011, as thousands of Tunisians started to arrive
at the Italian island of Lampedusa following the onset of the Arab Spring…..The most
recent surge in detections along the EU's maritime borders has been attributed to the
growing numbers of Syrian, Afghan, and Eritrean migrants and refugees1. In their
exhausting escape from civil war, despair, famine and misery using dangerous routes,
every day they risk kidnapping, human trafficking, robbery, jail and even death. Even as
Europe wrestles over how to absorb the new arrivals, human rights activists and migration
experts warn that the movement is not likely to slow anytime soon. Intractable wars, terror
and poverty in the Middle East and beyond will continue to drive the surge. One additional
factor, say scientists, is likely to make it even worse: climate change.2
Example of forced migration in the past include the migration of Muslims and Hindu in
British India. The partition of British India in 1947 into Muslim-majority Pakistan and Hindu-
majority India led to one of the largest mass migrations in history. The break-up along
religious lines resulted in the movement of about 14.5 million people - Muslims going to
1
http://www.cfr.org/refugees-and-the-displaced/europes-migration-crisis/p32874
2 http://time.com/4024210/climate-change-migrants/
See more at: http://www.ifrc.org/en/publications-and-reports/world-disasters-report/world-disasters-report-2012-
--focus-on-forced-migration-and-displacement/#sthash.qxDeUiG2.dpuf

3. Pakistan from India and Hindus and Sikhs going in the opposite direction. The
consequences were in many cases disastrous, with the governments being unprepared
for such massive social upheaval: law and order broke down and huge violence sparked
off on both sides of the border causing between 200,000 and up to a million casualties,
around 12 million people left homeless and thousands were raped.3
Many of the early immigrants who landed on the American shores came in search of a
better life. Some came to take advantage of the many resources available. Others came
for religious and political freedom. However, most early immigrants did not come by
choice. Over a period of about 300 years, more than 10 million Africans were forced from
their homelands to North America and South America to become slaves (Jeremy Thornton,
2004).
Food insecurity and the lack of access to basic services such as health care have been
important triggers in the migration of Zimbabweans to South Africa. In 2009, Zimbabwe
was the most food aid-dependent country in the world, with seven million out of the
population of nine million considered food insecure. 15% of the adult population was HIV-
positive and 94% of the population unemployed. At the same time, the country faced
Africa’s worst cholera outbreak in over fifteen years in an epidemic that affected all
provinces. Zimbabwe’s fragile public service systems were simply unable to cope. People
fled these desperate conditions, with no question that their motive was to survive Ponthieu
and Derderian (2013).
Not all international migrations are forced. The last few centuries have also witnessed
large-scale voluntary migration of people from one country to another and from one
continent to another4. These migrations are termed ‘voluntary international migrations’ not
because there were no ‘pressures’ to move but because the people who migrated chose
to do so on their own5. Voluntary migration can be influenced socially or economically.
3
http://www.bmsworldmission.org/news-blogs/blogs/some-major-migration-events-over-recent-history
4
http://www.yourarticlelibrary.com/population-geography/forced-and-voluntary-international-migrations/43265/
5
http://www.yourarticlelibrary.com/population-geography/forced-and-voluntary-international-migrations/43265/

4. This can include access to health care, better living conditions, high wages and access to
quality education.
When countries such as Poland, Hungary and the Czech Republic joined the EU in 2004,
their citizens gained the right to move to the UK to live and work. This resulted in large
numbers of immigrants coming to the UK in search of work as the UK economy was
booming….Many found jobs, particularly in the construction and retailing trades, earning
up to five times as much as they did in their home countries. Many send money home to
their families6.
Discussion
Some have argued for a wide definition of humanitarian interventions in order to
understand the best ways to deal with the increasingly complex humanitarian crises in the
world today7. This argument is based on the fact that humanitarian activities and
international interventions today take many forms. Foreign aid and development programs
by individual states, the UN and non-governmental organizations (NGOs), diplomatic and
economic sanctions or attempts at third party mediation are all to be considered
humanitarian interventions in this broad context. This partially means that migrants not
fitting under this criteria were sidelined or receive less attention. Humanitarians should
consider all categories of migrants in giving assistance, such as medical services to
migrants still awaiting resettlement, integration aid to post-war returnees, or basic health
care for poor rural migrants.
Today, the reality of forced displacement is characterized by mixed flows, restrictive
migration policies and increasing connections between economic migration and political
flight. As a result, assisting forcibly displaced populations already means intervening in
different type of settings: camps, detention centres, transit locations and urban
environments, increasingly with challenges for human dignity and access to basic services
(Aurélie Ponthieu and Katharine Derderian, 2013).
6
http://www.bbc.co.uk/education/guides/z8g334j/revision
7
Bruce Jones, "Intervention Without Borders: Humanitarian Intervention in Rwanda 1990- 94," Millenium, 24, no 2
(Summer 1995).

5. The work of humanitarian organizations has traditionally emphasized the plight of uprooted
people whose movement is related to conflict, violence and persecution. The development
of international refugee law, and the efforts of the UN High Commissioner for Refugees as
the agency mandated to safeguard it, have been indispensable in strengthening and
sharpening international protection for a special category of uprooted people (Thomas
Linde, 2009).
Basic needs
The practical challenge presented by the sheer scale of the crisis should not be
underestimated. The volume of people moving, the diversity of their profiles, countries of
origin and vulnerabilities and the dynamic nature of their routes of entry and the
clandestine means they often use all present an incredibly complex and demanding
situation8. The migration flow is impacting transit countries, such as Turkey, Greece and
Libya, sometimes overwhelming national emergency response capacities. Recently, the
European Commission announced an initial €83 million worth of humanitarian funding for
emergency support projects to assist refugees.
The emergency support funding that is made available to Member States of the EU, whose
own response capacities are overwhelmed by urgent and exceptional circumstances, such
as the sudden influx of refugees, addresses the most urgent humanitarian needs. The
assistance is complementary to Member States actions and provided in close coordination
with the countries concerned, as well as the Commission humanitarian partner
organisations such as UN agencies, non-governmental organisations and international
organisations. This funding can be used for the provision of basic necessities such as food,
shelter and medicine9. This collaboration and coordination ensures diversification of
interventions, maximum use of resources thus enabling the migrant population to benefit
from the aid.
Health
8
https://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/9913.pdf
9
http://ec.europa.eu/echo/refugee-crisis_en

6. According to the WHO health of migrants report by the secretariat, several basic principles
influence the development of a public health approach for migrants. The main public
health goal is to avoid disparities in health status and access to health services between
migrants and the host population. The second, closely associated, principle is to ensure
migrants’ health rights. This entails limiting discrimination or stigmatization, and removing
impediments to migrants’ access to preventive and curative interventions, which are the
basic health entitlements of the host population. The third principle, associated with
migrations resulting from disaster or conflict, is to put in place life-saving interventions so
as to reduce excess mortality and morbidity. The fourth principle is to minimize the
negative impact of the migration process on migrants’ health outcomes.
Migrants often have to deal with poverty, marginality and limited access to social benefits
and health services, especially during when they arrive in a new environment. Women and
children are vulnerable to abuse and are more likely to suffer communicable diseases and
psychological problems than any other group. Migrants travel with their epidemiologic
profiles, perhaps previous infections or carriers of infectious agents and traditional-based
health beliefs.
Also, they carry the vulnerability present in their original communities. If, for instance,
immunization coverage is low in the country of origin or return, the original population risk
will be carried to the destination country until coverage of migrants reaches the same level
as that for the host population. Similarly, if the prevalence of a given communicable
disease or any neglected disease is higher in the country of origin or return, there is an
increased likelihood among migrants of being affected by the condition and/or transporting
it across borders. Conversely, when diseases have a high prevalence in destination
countries, migrants may become affected and take them back to their country of origin or
return. There is also evidence that certain non-communicable diseases, such as
hypertension, cardiovascular diseases, diabetes and cancer, are an increasing burden on
migrant populations and impose considerable demands on health systems of destination
countries (WHO, 2007). Promoting and implementation of migrant friendly health services
for migrants, especially the most vulnerable, capacity building, establishing minimum

7. standard of health care, health promotion and prevention initiatives that reach the migrant
community.
Training and sensitization of stake holders and policy makers involved directly with migrant
health services. It is important for humanitarian actors to understand the culture, religion
and gender composition of the migrant population to ensure percolation and acceptance
of interventions. Creation of humanitarian coordination networks, partnership with
academic institutions and promote collaboration with key institution to research on the
effects of migrant health, their determinants and training health professionals about
diseases and pathologies that prevail in the country of origin or return.
Women & Children
Many migrants and refugees, after treacherous land and sea journeys, require basic
humanitarian assistance, such as provision of basic health care, clean water, food and
shelter. Majority of these displaced people are children who have special protection needs.
Amid this crisis, children are the most vulnerable of all. Many are travelling with their
families, while many others are on their own. Every one of them is in need of protection
and entitled to the rights guaranteed under the Convention on the Rights of the Child.
Migrant children and women, especially those migrating without documentation, are
vulnerable to trafficking, abuse and exploitation. In countries of transit and destination,
migrants and their families often find themselves victims of discrimination, poverty and
social marginalization10. Humanitarian organisations should ensure that children rights
and needs are paramount in interventions and programmes in response to such crisis.
Humanitarian workers should offer children friendly spaces where the children can benefit
from psychosocial support, age appropriate diets and women can rest and nurse their
babies.
When people are on the move and reach geographical areas different from those of their
home country, they are more likely to experience disrupted or uncertain supplies of safe
10
http://www.unicef.org/emergencies/index_85510.html

8. food and water, especially under difficult and sometimes desperate circumstances. In
addition, basic public services – such as electricity and transport – can break down. In
these conditions, people may be more prone to use inedible or contaminated food
ingredients, cook food improperly or eat spoilt food. Refugees and migrants typically
become ill during their journey, especially in overcrowded settlements. Living conditions
can lead to unsanitary conditions for obtaining, storing or preparing food, and
overcrowding increases the likelihood of outbreaks of food and waterborne diseases.
It is important to prevent the development and spread of foodborne and waterborne
diseases among refugees and migrants, especially during their stay in camps, where these
diseases can easily attain epidemic proportions, especially in spontaneous settlements.
Information about safe food handling practices, such as WHO's Five keys to safer foods,
should be disseminated to both refugees and migrants and the providers of food. Access
to sanitary facilities, including hand-washing, and sufficient amounts of safe drinking-water
is critical for the prevention of food- and waterborne diseases, and water, sanitation and
hygiene facilities at border points and reception centres should be thoroughly assessed.
Human rights
Migrants on their journeys, face immense challenges; For example during the migration of
Zimbabweans to South Africa…..criminal gangs present along the border- rob migrants of
their belongings or sexually assault them; men are often forced to rape women
accompanying them, or otherwise face rape themselves according to Ponthieu and
Derderian (2013). This together with the deplorable and substandard conditions, exposes
the immigrants to HIV/AIDs, TB and other communicable diseases. Due to the very limited
access to clean water, lack of sanitation facilities outbreaks of diseases like cholera and
dysentery accelerate the mortality rate.
Migrants need access to a formal status to be legally allowed in the country so they are
not forced to cross the border irregularly and be exposed to this extreme violence. Access
to both emergency shelter and primary health care should be ensured for survival migrants
and refugees.

9. Conclusion
Humanitarian organizations dealing with migrants have long prioritized such people
according to legal and institutional categories, therefore focusing on those fleeing conflict,
violence or persecution. As a way of change, movements like the Red Cross and Red
Crescent recommended to take an inclusive approach towards addressing the
humanitarian dimension of migration, irrespective of the status of the migrants during the
30th International Conference of the Red Cross and Red Crescent.
Humanitarian organisation for example; UNHCR and its partners, at the onset of such
crisis, priorities health preventive measures including emergency are measles
immunization, nutritional support, control of communicable diseases and epidemics,
implementation of the reproduction health measures and public health surveillance. As the
situation stabilizes these services are enlarged. In more developed and urban settings,
public health priorities among adults shift toward cardiovascular and chronic diseases and
cancers11. Reconfiguring understandings of longer-term refugee protection to facilitate
movement and prioritize the securing of sustainable livelihoods would both better protect
refugees’ human dignity and better reflect the reality of people’s movements in conflict and
crisis (Katy long, 2013).
While aid agencies and government work towards lasting solutions to the influx of
migrants, humanitarian workers are charged with ensuring that the migrants have right to
basic human needs and their rights promoted. As much humanitarian services cannot
really change the root causes of displacement and migration, humanitarian actors should
assist people fleeing man-made or natural disasters irrespective of their nationality,
religion, gender, ethnic origin or political affiliation.
11
http://www.unhcr.org/pages/49c3646cdd.html

10. References
Halvorsen, Kate, 'Protection and Humanitarian Assistance in the Refugee Camps in
Zaire: The Problem of Security', in Howard Adelman and Astri Suhrke (eds.),The Path of
a Genocide: The Rwanda Crisis from Uganda to Zaire. The Path of a Genocide: The
Rwanda Crisis from Uganda to Zaire. New Jersey: Transaction Publishers, 1999.
Katy long, Migrat Stud (2013) 1 (1): 4-26. doi: 10.1093/migration/mns001 First published
online:
Jeremy Thornton (2004), Immigration and the Slave Trade: Africans Come to America
(1607-1830), pg 5.
Forced Migration Online, What is forced migration?,
http://wwwforcedmigration/whatisfm.htm (last visited 29 September 2009).
Prunier, Gérard (1998), The Rwanda Crisis: History of a Genocide. The Rwanda Crisis:
History of a Genocide, London: Hurst & Company.
Rutinwa, Bonaventure (1996), 'The Tanzanian Government's Response to the Rwandan
Emergency', Journal of Refugee Studies Journal of Refugee Studies, vol. 9, no. 3.
Thomas Linde (2009), Humanitarian assistance to migrants irrespective of their status –
towards a non-categorical approach, Volume 91, Number 875, September.
https://books.google.co.za/books?id=f5rGUapfO4cC&printsec=frontcover&dq=Jeremy+T
hornton+Immigration&hl=en&sa=X&redir_esc=y#v=onepage&q=Jeremy%20Thornton%2
0Immigration&f=false
United States Census (2011, May 23rd) Census Bureau Reports Housing is Top Reason
People Moved Between 2009 and 2010. Retried
from:http://www.census.gov/newsroom/releases/archives/mobility_of_the_population/cb1
1- 91.html
WHO Health of migrants; Report by the Secretariat, 122nd Session 20 December
2007.Provisional agenda item 4.8
http://www.who.int/hac/techguidance/health_of_migrants/B122_11-en.pdf
UNHCR Refugee Handbook: https://emergency.unhcr.org/entry/44938/migrant-definition
Van Hear N, Nyberg-Sørensen N(2003). The Migration-Development Nexus. Geneva:
International Organisation for Migration; 2003.
https://www.iom.int/key-migration-terms
http://www.bbc.com/news/world-europe-34131911