Post Publication Independent Review of
"Refugee and migrant health in the COVID-19 response"
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Post Publication Independent Review of "Refugee and migrant health in the COVID-19 response"
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Post Publication Independent Review of
Refugee and migrant health in the COVID-19 response
Hans Henri P Kluge, Zsuzsanna Jakab, Jozef Bartovic, Veronika D'Anna, Santino Severoni
Published: March 31, 2020 DOI: https://doi.org/10.1016/S0140-6736(20)30791-1
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30791-1/fulltext
Review Comments:
1. Quote "Measures to respond to the COVID-19 pandemic are a focus of communities in countries, but preparedness plans should consider refugees and migrants and their needs. Evidence shows that this vulnerable population has a low risk of transmitting communicable diseases to host populations in general.4 However, refugees and migrants are potentially at increased risk of contracting diseases, including COVID-19, because they typically live in overcrowded conditions without access to basic sanitation. The ability to access health-care services in humanitarian settings is usually compromised and exacerbated by shortages of medicines and lack of health-care facilities. Moreover, refugees typically face administrative, financial, legal, and language barriers to access the health system.4" End of Quote.
The authors are putting forward a point of concern, which may require coordinated activity from multiple facets of Govt. Agencies to handle this concern, especially with relation to the COVID-19 outbreak.
Authors are citing reference 4, which is a WHO report titled "Report on the health of refugees and migrants in the WHO European Region: no public health without refugee and migrant health (2018)" available at http://www.euro.who.int/en/publications/html/report-on-the-health-of-refugees-and-migrants-in-the-who-european-region-no-public-health-without-refugee-and-migrant-health-2018/en/index.html
1a. The WHO report also brings out points of concern.
Quote "In addition, and with the aim of harmonizing refugee and migrant health policy globally, WHO is now preparing a global action plan on the health of refugees and migrants, in line with the health dimensions of the United Nations Global Compact on Safe, Regular and Orderly Migration and the Global Compact for Refugees, in close collaboration with the International Organization for Migration, UNHCR, other partner international organizations, Member States and other relevant stakeholders, as well as refugees and migrants themselves.
Refugees and migrants enjoy the same human right to health as everyone else. One key priority is enhancing social protection for refugees and migrants, including developing sustainable financial mechanisms, both nationally and internationally, to provide for universal health coverage and social protection. Another key priority is reducing the xenophobia, discrimination and stigma often experienced by refugees and migrants, through actions such as advocacy and evidence-informed communication with both refugee and migrant communities and host populations.
These high principles provide the background to this report, which shows the progress made so far in responding to these health challenges, and what more needs to be done. I am delighted that the WHO European Region has led the way, and I hope that this report will inspire yet more progress in the coming months and years.
Zsuzsanna Jakab
WHO Regional Director for Europe" End of Quote
Reading the WHO report with the following article from the Indian Express, https://indianexpress.com/article/cities/mumbai/maharashtra-residents-dont-want-shelter-homes-for-migrants-in-their-areas-claim-it-puts-them-at-risk-6337688/ seems to indicate that some concerns raised in the WHO report may be valid in INDIA too.
Suggested that INDIA may lead the world in establishing a separate new Department for Migrants & their welfare, which can also serve as a Nodal Agency for all concerns regarding Migrants, inclusive of content in news-item at https://www.ndtv.com/india-news/shut-down-public-interest-litigation-shops-centre-to-supreme-court-2205739 , so that the other teams entrusted with assignments on handling the COVID-19 outbreak can continue their service without hassles, while the new Department for Migrants can help ensure social protection, sustainable financial mechanisms, universal health coverage, including relief and care during such outbreaks as the COVID-19 and further attend to legal aspects too.
2. Quote "Basic public health measures, such as social distancing, proper hand hygiene, and self-isolation are thus not possible or extremely difficult to implement in refugee camps. If no immediate measures to improve conditions are put in place, the concern about an outbreak of COVID-19 in the camps cannot be overstated. Site-specific epidemiological risk assessments must be done to determine the extent of the risk of COVID-19 introduction and transmission in such settlements, together with case management protocols and rapid deployment of outbreak response teams if needed." End of Quote.
Quote "Additionally, states of emergency and lockdowns to deal with the pandemic have affected refugee and migrant volunteer community service provision for this population group." End of Quote
The authors observations may need to be given attention.
3. Quote "As governments tighten border controls and implement other measures in response to COVID-19, they need to consider the impacts on refugees and migrants and ensure that such actions do not prevent people from accessing safety, health-care services, and information." End of Quote.
Quote "There must be no forced returns and refoulement justified by or based on fears or suspicion of COVID-19 transmission, especially because there is estimated to be low risk of transmitting communicable disease from refugee and migrant populations to host populations in the WHO European region.4 Yet migrants and refugees are often stigmatised and unjustly discriminated against for spreading disease and such unacceptable attitudes further risk wider public health outcomes, including for host populations, since refugees and migrants could be fearful to seek treatment or disclose symptoms.6" End of Quote.
Quote "Refugees and migrants must be included in national public health systems, with no risk of financial or legal consequences for them. This approach is of the utmost importance, as there can be no public health without refugee and migrant health." End of Quote.
In short, the suggestions of the authors may have to be handled by the Ministry of Social Justice & Empowerment. Consequently, the new Department for Migrants & their Welfare (outcome of Review Comment 1a) may be part of the Ministry of Social Justice & Empowerment.
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