On need for policy interventions
AJOY MEHTA: What are the kind of policy interventions that we are looking at when we look at the health of migrants? First and foremost, let us not look at it as an enforcement issue or demographic danger. It is a human problem that needs to be dealt with compassion. Mumbai provides free healthcare in its corporation hospitals, which are well stocked in terms of human resource and equipment, but how many migrants know that medical care here is free? Even if they knew, how many migrants would walk into a municipal hospital and demand the service?
On gender specific issues
DR VANDANA PRASAD: Single-person migration is mostly male, but we have women who come as construction workers, teachers and nurses for the rest of their families. So the economic distress has a strong kind of feminisation to it. That has also translated into health issues because we know that malnutrition and anaemia amongst women are very high in India. Also, when migrants went back home, in many places they were welcomed, and panchayats made efforts to take them back. In many places, it was the opposite. So arranging for community-based facilities for quarantine, isolation, particularly with respect to migrants who are coming back, is important.
On the alienation of migrants
DR PAVITRA MOHAN: What we were seeing (last March) was not so much affected by Covid, but was related to the closure of all health services, absence of transportation, an acute shortage of food, which led to an increase in diseases like tuberculosis. Government services were focused either on Covid or nothing, and because of that childbirth significantly increased at home, leading to an increased risk of maternal deaths, etc. In some areas, we saw what is known as a syndemic, where Covid was there, but it was also associated with a sharp increase in tuberculosis. In high migration areas, the malaria epidemic also started rising with very limited access to care.
In villages, we saw a one-and-a-half times increase in malnutrition levels among children.
For the next several months, when Covid, even in the cities, declined before the second wave, one of the things that was a remnant of the first wave was the way migrants were treated when they returned. In general, they don’t really feel assimilated in the cities. But through this time, they felt additional alienated. That had a enormous effect prior to the second wave, when immunisation was becoming promoted. That alienation from the program led to a lot of distrust and failure to accept vaccines. Reclaiming of trust amongst the migrant population is incredibly crucial.
On neighborhood participation
UMA Mahadevan: We’ve been speaking about neighborhood-based healthcare services. My group has made a platform for a pandemic response, connecting requests for assist with the offices of assistance, mapping of all the government facilities, service delivery units, nearest anganwadi, nearest Primary Health Center, post workplace, bank branch, police station, Indra canteens. It’s feasible to connect with nearby civil society groups who may well be in a position to assist. It ought to be doable and in (distinct) languages. We can have get in touch with centres and migrant resource centres and can give welcome kits to all migrants with particulars of the nearest services.
On universal wellness coverage
K Srinath REDDY: It’s not definitely helpful for us to say that we ought to only examine what occurred to them (migrants) through the Covid period. That was an acute exacerbation of lengthy-standing neglect. There are a quantity of sections of our population who are essentially deprived of critical wellness services, in terms of accessibility, proper care and affordability. That is why we get in touch with for universal wellness coverage, not merely to safeguard human productivity, which appears to be the preoccupation of these who look at migrants as a human resource, but also hunting at it as an critical human proper.
On the will need for improved living circumstances
Dr Pavitra Mohan: Living circumstances are one of the incredibly central determinants of the wellness of the migrants. You can’t speak of wellness if 50 individuals are living in a space without the need of water, without the need of a toilet, without the need of ventilation. In instances of Covid, we have understood the worth of ventilation. But, prior to that, a lot of them had been suffering from tuberculosis. Maybe, subsequently, we can believe of what are the policy techniques to market secure, safe and healthier housing. Most created nations have invested in secure housing for migrants and for the population in the cities and that has been central to how public wellness created. The second is working circumstances. We see so numerous instances of silicosis in south Rajasthan, exactly where individuals are dying in their 30s and 40s since they have been involved in stone carving or mining.
The third is access to healthcare. It is not portability alone since, as a citizen of the nation, wellness is a basic proper. Ideally, you ought to not will need to carry something. The policy ought to be towards universalising access to healthcare for migrants, irrespective of irrespective of whether the documentation is there or not.