Why Migrant Vulnerability Is a Community Health Issue

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  • 2016•09•12

    Michaella Vanore

    Photo: Mustafa al-Sarout / Aleppo Media Centre

    World leaders gather in New York on 19 September 2016 for a summit on large movements of refugees and migrants. Through this blog series the United Nations University Migration Network (UNU MN) will reflect on the challenges and opportunities of the summit from various critical perspectives: migration governance and policy; forced migration; migration and environment; migration and health; migration and culture; and migration and development. The series will culminate in a single summary post shortly after the summit.


    In the weeks approaching the one-year anniversary of the death of Alan Kurdi, another picture — again of a child in crisis — drew the world’s attention back to the heavy toll of insecurity for some of the most vulnerable populations. In contrast to the picture of Alan Kurdi, which inspired a call for more inclusive humanitarian responses in the face of escalating flight, the images of five-year-old Omran Daqneesh, dazed and dust-covered in an ambulance after a Russian airstrike in Aleppo, have provoked a different response.

    Shortly after the video was released, a UN envoy cut short an ad-hoc meeting on strategies to de-escalate violence long enough to deliver humanitarian aid, citing the “pointlessness” of such talks. The images of Omran Daqneesh have become a symbol of the pointlessness, of the stagnation of assistance strategies, of the continued loss of life despite and sometimes because of international interventions. The upcoming Summit for Refugees and Migrants will take place against that backdrop – amid the sentiment that our current assistance regimes have only succeeded in perpetuating the status quo.

    In preparation for the summit, several documents have been released that address key pillars of the international response to large movements, including through support of better-managed, regular migration and by supporting a more comprehensive refugee response framework. These documents — chief among them the summit outcome document— directly address how the international community can better support mobile populations in crisis. Its careful wording suggests that what we can expect from the summit is exactly what we have already seen: namely, compartmentalisation of refugees and migrants into two discrete streams of populations with different levels of ‘deserved’ assistance.

    Despite the recognition in the outcome document that refugees and migrants share many of the same vulnerabilities and challenges, at least in transit if not in the circumstances that shaped their movements, the document and its two annexes emphasise the separation of the two groups. From a programming perspective this is understandable, as identifying members of these groups may make for more effective targeting of assistance and more efficiency in the use of assistance resources. At the same time, however, this distinction artificially separates members of these two groups from the economic, social and political contexts from which they leave and to which they arrive.

    The many aspects of health

    From a vulnerability perspective, these two groups are much more alike than different; both are likely to have experienced significant losses to their social and economic capital, given their movements from one society to another. The disruption of place-specific resources, including community support networks, can lower the capacities of both groups to cope with shocks when they do occur. Such individuals and households are often received into communities that are underequipped to address their unique vulnerability profiles, which may entail not only differences in economic resources but in more intrinsic, personal resources, such as bodily health. Physical and psychosocial health outcomes may also be complicated by attitudes and behaviours about health from both migrants and the communities into which they move; this in turn complicates the strategies that communities need to adopt to protect migrants from further vulnerability.

    The need to support receiving communities is recognised in the preparatory documents, yet the wider roles of communities in shaping vulnerability outcomes of ‘genuine refugees’ or other members of mixed migratory flows is not addressed in much detail. Similarly, only certain members of mobile populations are named in discussion of vulnerability and its reduction. The unique constraints and needs of children, particularly those who are unaccompanied, are noted several times in the documents, and the needs of women and older persons are also periodically named. One may wonder where men of prime working age are in the identification of vulnerability – and the answer is nowhere. Men are almost implicitly assumed to not need specified assistance, despite their (in some cases) higher exposure to risks and need for tailored interventions.

    Based on these observations, the summit could address several areas to help transform the ambiguous desires outlined in the outcome document into meaningful commitments. These areas include:

    • Recognition that distinguishing between refugees and other types of migrants can obscure the vulnerabilities experienced by members of these groups, particularly in terms of erosion of place-specific capital;
    • Recognition that community context is essential in building individual-level resilience, as local-level services and structures offer the first point of contact between mobile populations and the state (meanwhile, informal networks are often essential fallbacks when state support is limited). This also means recognising pre-existing risks within receiving communities, particularly those that are already plagued by high levels of uncertainty and insecurity;
    • Recognition that for migrants (of any category) to be contributors to sustainable development and inclusive growth, individual-specific vulnerabilities must be addressed and met with tailored assistance packages, including those that facilitate local-level integration.

    Such suggestions are not novel or radical, but they do call for a more nuanced understanding of the interactions between migrants of all types and the environments in which they live. The image of Omran Daqneesh is a symbol not only of humanitarian paralysis but also of the risk of separating the individual from the wider context of their movements (or indeed, lack of movement). Looking at this picture, one must wonder why Omran and his family remained so long in a city in perpetual crisis. Why did they stay? Had they left, where would they have gone, and what kind of life would they have built there? These questions are at the crux of the discussion we should be having come September 19.


    Summit Series #1: What Will be the Legacy of Alan Kurdi’s Death?
    Summit Series #2: How to Walk the Talk to End Forced Migration?
    Summit Series #3: Migration and the Power of Culture
    Summit Series #4: Why Migrant Vulnerability Is a Community Health Issue
    Summit Series #5: Migration and Climate Change: Shoring Up Communities and Commitments
    Summit Series #6: Why It’s Time to Get Serious about Migration and Development
    Summit Series #7: The New York Declaration: What Next for Refugees & Migrants?