I realized that until recently, I held the typical stereotype of a person who is a “migrant”, to be in the large majority, male. Stories and photographs on migrant workers in all parts of the world with their hard labor working and living conditions contributed to this stereotype. While many human migrations are still dominated by men, increasingly, more and more women are amongst those seeking to flee one country, for another, which brings about a need to have an increased awareness of health issues related to women, amongst all the men, women and children who are migrating.
About three years ago, in the European “migrant crisis”, over 70% of migrants into Greece and Italy were adult men. Levels of migration are increasing across the globe, and with this, the gender gap has gradually decreased. In the Mediterranean at least, men make up only around 40% of arriving migrants. Three quarters of Syrian refugees are either women or children under the age of 18. Forced migrations in particular, involve more women and children. Women are also involved to a greater extent in migrations involving economics and climate change affecting the environment. Increasingly women’s health issues require more attention. Women travelling from one culture to another are especially vulnerable in many ways. For example, in the culture in which they are leaving, perhaps they have little control over their healthcare decisions, but the culture in which they are entering, requires a greater responsibility to seek and access health care, with little knowledge of how to do that. Women’s reproductive health care needs are often particularly overlooked, from travelling on the road, to refugee camps, to the new fragile circumstances in which they have landed. Poor hygiene in migration facilities expose women to an increased risk of not only infections in general, but urinary and gynecological infections as well. And if women are pregnant and migrating, inadequate prenatal care is likely a given, and birthing facilities will be scarce. Pregnant women seeking asylum can have high risk pregnancies due to the exposure to malnutrition from a long and arduous journey, physical and emotional stress, and perhaps the stress and trauma from previous treatment in the countries in which they left or escaped. Women also face sexual violence and in fact this is why some have left, but the journey also puts them at risk of rape and violence. According to Amnesty International, 80% of women experience rape and sexual assault during the migration process. This is especially true in asylum seeker settings where women are in cells alongside many men and without safe havens, including safe bathrooms.
Women who are from countries that practice genital mutilation can have significant birthing complications. Pregnant migrant women are more likely to suffer complications during pregnancy and postpartum as well.
And then there is the unthinkable tragedy of human trafficking in which the majority of victims (79%) are women and girls, and most commonly for the sex trade, in which is rape and sexual violence are common. This trauma obviously affects not only their psychological health but can also be the cause of sexually transmitted infections, including HIV.
Migration is definitely on my mind, and I’m thinking it’s on most people’s minds these last two months of October and November 2018. I’m talking about the journey that began from the city of San Pedro Sula in Honduras on October 13, and about 2,700 miles from where thousands of these women, men and children are today, in late November, in Tijuana. Not only are all of these fellow world citizens suffering losses of their country, their culture, family, and maybe even their children, they are experiencing anxiety, depression, trauma, fear and uncertainty, but perhaps feeling guilt for having left others behind. The journey has also been fraught with respiratory infections, influenza, gastrointestinal illnesses, dehydration, malnutrition and injuries.
I’ve read that Mexico City’s health ministry had deployed 51 doctors, 14 epidemiologists, 37 nurses, 14 psychologists, and 12 dentists to provide free care. It set up mobile consultation rooms, mobile dental clinics and a mobile pharmacy at the stadium where the migrants were resting while in that city. Non-profit organizations have also been on site, on the road, and now in Tijuana. Fleeing persecution, poverty and gang violence in their home countries of Honduras, Guatemala, and El Salvador, they seek refuge.
I try to imagine, what would make me leave my home and work and culture and people behind to pack what I could into a backpack and start walking 2,700 miles. It could only be something intolerable, terrible and/or dangerous.
My thoughts and emotions are troubled, as to what to do with these several thousand migrants, predicted to reach 10,000, and likely not to end there, travelling in large numbers to provide safety from traffickers and gangs. Men, women, children, infants, elders…..all suffering and deprived of what I consider to be an acceptable quality of life, let alone a healthy life on any level.
Being a naturopathic physician holds me accountable to trying to relieve suffering, which means having or striving for the knowledge, ideas, strategies and solutions which bring about improvement if not relief from that suffering.
With the help of conversations with friends, I’ve only come up with this so far:
· It’s wrong for so many people on this planet to be suffering while others are basking in comforts providing more than enough, and even others indulging in excess wealth and abundance- and likely somewhere along the way, at the expense of others.
· Migration must be safer and healthier for all, and in the area of women’s health, and given the increasing number of women and girls migrating and seeking asylum, much more needs to be done to protect the medical needs and wellbeing of women and girls.
· I can focus on kindness and support of those in need close at hand.
· I can support organizations that provide insight, strategies and action plans to help solve this world wide human planetary problem.
· I can vote my conscience such that lawmakers of all kinds attend to these national and international matters of humanity, in a well thought out, all- encompassing strategy, from problem source to problem solution.
· I can be generous with what I have, such that those in need close to me and my world can have a safer, healthier life with opportunities.
· I can continue to stay educated on these matters and step up and into places that create solutions rather than create fear and complaining.
· I can continue to wrestle with what makes sense— I, or my fellow well off global or American citizens cannot take care of everyone and this will for sure be an ongoing global issue. But surely, there must be a balanced, effective and comprehensive plan that is part of an evolutionary process for humankind.
· Much like the 1950s, when the people of America sent flour in an envelope to President Eisenhower, to symbolize feeding the Chinese people rather than bomb them, (and he listened and did not go to war), perhaps there could be a repository of sending a key to our homes…. symbolizing a comprehensive solution that could include providing a home for an asylum seeker for a select amount of time, while concurrent programs provided temporary health care and funds, education and jobs. Wouldn’t this make being human great again?
