122. Migration and catastrophes, medical and occupational health considerations

From greek.doctor
  • General about migration
    • 3,5% of the world population lives outside their home country
    • Legal migration
      • Healthy migrant effect = legal migrants are usually young and healthy people and therefore healthier than the population they migrate to
    • Illegal/irregular migration
    • Nearly half of migrants are hoping to find work
    • Migrants are essential to uphold the population in Europe as the fertility rate is low
  • Health considerations of immigration into EU
    • Most immigrants are from Syria, Afghanistan, Iraq, etc.
    • The prevalence of certain diseases may be many times higher in the country of origin than the host country
      • TB, AIDS, etc.
    • Certain diseases from the country of origin may be much less common in the host country
      • This makes it less likely that physicians will recognize the disease
      • There will also be less experience in treating the disease
    • Certain diseases may manifest differently in different ethnicities
      • For example, varicella in blacks
    • Migrant reception centres are good places for outbreaks
      • Measles, pertussis, cholera, etc.
      • Due to under-immunization, poor hygiene, close contact, etc.
    • Vaccine-preventable diseases (VPD)
      • Communicable diseases which are eradicated in the host country but not in the country of origin
      • Diphtheria, pertussis, measles, poliomyelitis, etc.
      • Some of the countries which are the only ones in the world with certain VPDs have large out-migration
        • For example, Sudan and Afghanistan have many cases of poliomyelitis
      • Due to anti-vaccination movements the vaccine coverage of certain diseases (especially measles) is poor in certain regions of the EU, providing good grounds for an outbreak
      • The vaccination coverage of many countries of origin is poor
        • HAV, HBV, polio
    • Vaccination of children of foreign nationality
      • Migrant children who stay in Hungary for more than 3 months should receive the outstanding, age-appropriate vaccinations according to the national schedule
      • Not all countries include migrants and refugees in their national immunization programmes
    • Health care workers should be completely immunized according to their national schedule
    • Upon entry, the migrants only undergo a brief ectoparasite screening before being placed in the community
      • Reception centre in Debrecen is an exception; they undergo more rigorous screening of STDs, HIV, salmonella, HBV, HCV, TB, etc.
  • Migrant and occupational health
    • Includes both occupational health issues of the migrant workforce and the occupation health of those working with migrants
    • Occupational health of those working with migrants
      • Department of Public Health at POTE has since 2013 conducted research in national migrant infrastructure and the occupational health of staff who work with migrants
        • 40% of the study population are sometimes exposed to human samples (blood, urine, faeces) at work
        • 35 – 50% of the study population experienced verbal violence regularly
        • 50% of the study population said that they have poor awareness of symptoms of infectious disease
        • When asked about mode of transmission of certain infectious diseases, only 45% could answer more than 75% of the questions correctly
    • Occupational health of the migrant workforce
      • Migrant workers are subject to uncertainty, poor working conditions, low wages
      • They’re often overqualified for their low-skilled jobs
        • Migrants are overrepresented in low-wage, low-skill jobs
      • They have little knowledge of their employment rights
      • Migrant workers are overrepresented in industrial accidents and occupational diseases like hearing loss, silicosis, musculoskeletal disorders, etc.
      • An Italian journalist pretended to be a Romanian illegal worker in a tomato field in Italy
        • He had no water or electricity and lived in poor hygienic conditions
        • He worked 14 hours a day
        • Two men slept on one mattress on the floor
        • Men had to provide the boss a woman to screw in order to get a job
      • Prevention/improvement
        • Provide migrants with information on their employment rights
        • Protect the health and working conditions of migrants
        • Provide better integration of migrants and their families
        • Train health workers on working with migrants