|No to Mandatory Health Testing on Migrant Workers|
COLOMBO 21 August, 2007: In conjunction with the 8th International Congress on AIDS in Asia and the Pacific (ICAAP), CARAM Asia launched its State of Health Report on Mandatory Testing. This publication comes at a critical time as more barriers are being erected to make it more difficult for migrants, who make up the lower socio-economic classes, to find work and a right to work productively.
Governments’ use of public health/security and economic arguments to rationalise mandatory health screening policies are simply not justifiable. By ensuring that migrants who fail their medical test are barred from entering the country or are deported if found unfit, governments are seen by their citizens as protecting the country from the threat of disease, even though there is limited chance of migrants intermingling with the greater society and more often nationals of that country may already be infected with HIV and be the real cause of the diseases spread.
Spanning sixteen countries, this was the first time two destination countries from the Middle East, namely Dubai and Bahrain, were included in CARAM Asia’s regional qualitative research. The other 14 origin and destination countries were Bangladesh, Cambodia, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand and Vietnam.
Employing participatory research methods, migrants’ direct experiences with mandatory health testing were collected at all ends of the migration continuum - prospective migrants at their country of origin, migrants working at destination countries, and returnee migrants including those living with HIV and those who were deported as a result of testing. Through analysis of the results by CARAM partner organisations and migrants, a "Migrant-Friendly" Testing Framework was developed.
"The main finding of the research is that the practices of mandatory testing for HIV and other health conditions as a screening tool for the entry of migrant workers into destination countries is discriminatory, dehumanising and results in the violation of basic rights, especially the right to health, "said Andrew Samuels of Community Development Services, Sri Lanka and a member of CARAM Asia.
"Migrants are discriminated and treated differently from the general population, falling outside the protection of prevailing laws and policies on HIV in both origin and destination countries, "said Jonanthan Castaneda, a Filipino returnee positive who is directly involved in undertaking the State of Health research in the Philippines.
National laws and policies do not consider migrants’ well-being and generally do not take any responsibility for maintaining and protecting migrant workers’ health and welfare in the destination country. At all points in the migration process where medical testing is required, migrants’ basic rights are effectively stripped away as laws and ethical standards of practice regarding HIV testing are overlooked.
Sending countries willingly submit to destination countries’ demands for mandatory health testing, making their own laws on HIV irrelevant. Once they have reached the destination country, migrants must again undergo mandatory health testing that includes HIV. Under conditions of mandatory health testing, it was found that standard components of HIV testing are discarded in both origin and destination countries: there is no explicit consent taken before undergoing testing; migrants do not receive any pre-test or post-test counselling; migrants have no control over the confidentiality of their results, often with results given directly to recruitment agents or employers; and although there are health services available, migrants, prospective migrants and returnee migrants are not referred to those services when they are found to have an exclusionary condition, including those who are HIV positive.
There are about 53 million migrant workers in Asia right now. For a comprehensive approach to contain HIV/AIDS, the health of not only local populations but also migrant communities needs to be addressed. Migrant communities deserve special attention as they are a high-risk group and are vulnerable to HIV infections due to their relative lack of access to health care services in destination countries.
For these reasons, CARAM Asia and partner organisations call on the cessation of the practice of mandatory testing and related deportation, or at a minimum, for governments and parties involved in recruitment and testing practices to observe and integrate the "Migrant-friendly" Testing Framework into current practices by: following established standards of informed consent, ensuring provision of pre-test and post-test counselling, protecting confidentiality, and providing proper referral to those who need support or treatment. Medical testing should not be used as a screening mechanism to determine which migrants are allowed to work; it should be used to improve migrants’ health by acting as a gateway to access health services and treatment.
CARAM Asia’s annual State of Health of Migration (SOH) research turns to the migrant community itself to identify key issues and concerns in undergoing mandatory testing which have negatively impacted on their ability to access adequate health care and information. Through this report, migrant workers played a part in shaping the future by contributing and sharing their experiences as well as suggesting changes to the policies affecting the migration process.
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