Summit Spotlight: Hon. Éctor Jaime Ramírez Barba on Migrants Health

Hon. Éctor Jaime Ramírez Barba UNITE Member from Mexico

SUMMIT SPOTLIGHT An interview with UNITE Member from Mexico, Hon. Éctor Jaime Ramírez Barba, on Migrants Health In this first interview ahead of the UNITE Global Summit 2024, Hon. Éctor Jaime Ramírez Barba discusses the significant health challenges faced by migrants, particularly in Mexico. He highlights the barriers to accessing adequate healthcare and stresses the need for more inclusive migration policies and coordinated efforts to address these urgent issues.

What is your experience related to migrant health? What is the situation among the Mexican population/emigrants?

EJRB: I am aware of the health issues faced by migrants, particularly considering my background as a physician and former Secretary of Health and Social Development in Guanajuato, a state with high rates of migrant outflow.

Additionally, I serve as a federal deputy for the National Action Party and as secretary of the Health Commission in the Chamber of Deputies, an institution from which we have analyzed migration law.

This reality has allowed me to understand the complexities faced by our compatriots when migrating, as well as the difficulties experienced by those entering our country on their journey to the United States, and the importance of implementing appropriate policies to protect their health.

The situation of Mexican migrants, particularly those seeking better opportunities in the United States, is alarming. Many of them face barriers to accessing health services, partly due to their migration status and lack of information about their rights.

Furthermore, Mexico has a "Comprehensive Healthcare Plan for the Migrant Population", which aims to ensure that all migrants have access to dignified and timely health services during their transit through our country. This plan seeks to address urgent needs, such as medical and psychological care, in addition to eliminating the discrimination and stigmatization they face in accessing these services, but we are far from reaching the goal.

The largest group of migrants entering the United States comes from Mexico. The Mexican population in the United States represents 11% of the total population of that country. This figure includes 11.4 million Mexican immigrants and 22.3 million U.S.-born individuals who identify as Mexican-American.

As a public servant, I believe we must ensure that health policies include migrants, whether they are nationals passing through Mexico or from other countries.

Although our country's Migration Law guarantees access to medical care, in practice, many migrants do not receive the care they require, especially upon leaving the country.

EJRB: Migration policies have a decisive influence on the health outcomes of migrants, and it is essential that each migration strategy includes a health component to be effective.

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To what extent do migration policies influence health outcomes among migrants?

In Mexico, for example, the Migration Law guarantees migrants access to health services regardless of their migration status, which facilitates timely and adequate medical care.

This legal framework has been essential for improving the well-being of those who migrate, particularly in crisis contexts, such as the migrant caravans from Central America, which have become constant in recent years in our country. Or in those border municipalities, where large groups of migrants have settled irregularly, and therefore, without access to basic services such as public health.

Undoubtedly, inclusive policies that eliminate bureaucratic and administrative barriers are vital to reduce discrimination and stigma faced by migrants. In Mexico, the "Comprehensive Healthcare Plan for the Migrant Population" aims to institutionalize actions so that medical care is provided equitably.

In this sense, migration policies oriented towards health should be generated from various areas and in a coordinated manner between the federation, states, and municipalities.

For example, public health programs should be aligned with migration policies and include awareness campaigns and prevention of risks and diseases, helping migrants understand their rights and access to available services during their displacements or when settling in a region.

Also, there should be collaboration between different levels of government and health institutions. This ranges from primary care to specialized tertiary services in critical situations.

Migration policies should also implement actions that integrate psychological and support services, especially for those in vulnerable situations. And include components of epidemiological surveillance and public health monitoring to address disease outbreaks.

For all of the above and to obtain results, migration policies should direct resources to communities with high migrant density, improving health infrastructure and available services.

What are the primary health needs of migrants, and what can be done to improve it?

EJRB: Considering Mexico's situation, the main health needs of migrants encompass various aspects necessary to ensure their physical and mental well-being during their journey and when settling in new places far from home.

These needs include: 1. Immediate Medical Care. Thousands of migrants each year require urgent medical care services due to pre-existing health conditions, accidents, or acute illnesses acquired during their journey. This involves not only hospital care but also easy access to specialized medical units and pre-hospital services.

2. Mental Health. Migration, especially under conditions of violence, extortion, or where organized crime is present, can result in high levels of stress, anxiety, and mental health disorders. Therefore, there is a need to increase access to psychological services and emotional support that can help migrants cope with their traumatic experiences.

3. Disease Prevention and Health Promotion. It is urgent to structure and expand disease prevention programs, such as vaccination, nutrition, and education on healthy practices, which can be effective in mobile populations.

These initiatives should include information on how to prevent common and contagious diseases, including gastrointestinal diseases, respiratory infections, dengue, and even sexually transmitted diseases that can arise in migration situations.

4. Access to Medications. Many migrants lack timely and continuous access to treatments and medications, such as those necessary for chronic conditions (e.g., diabetes, hypertension, or HIV). It is essential to enable channels for the regular supply of medications during their transit.

5. Information and Education. A critical aspect is the lack of information about health rights in the host country and the availability of services.

Therefore, we must develop educational materials in migrants' languages and conduct informational campaigns to help improve their access to primary and specialized health services when necessary.

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6. Living Conditions. Finally, considering that migrants face precarious living conditions, which can negatively affect their overall health, it is crucial to ensure access to clean water and basic sanitation services.

It is also essential to promote awareness and education among the resident population about the importance of including migrants in the community and health services, including public hospitals and clinics.

How can healthcare systems become more inclusive, respond to, and accommodate the needs of migrant populations?

We must train health professionals on cultural diversity, sensitivity, and human rights issues.

This training should include how to address the special health conditions faced by migrants and eliminate biases in their care.

EJRB: It is essential to make amendments to laws that explicitly guarantee the health rights of migrants. This would include eliminating any provisions that limit access to healthcare based on immigration status and ensuring the explicit inclusion of migrants in public health laws, such as Mexico's General Health Law. Specific programs aimed at migrant health care should be institutionalized, integrating them as an essential part of each country's migration policy. This would ensure that there are resources and standardized procedures to address their health needs, as intended with the "Comprehensive Health Care Plan for the Migrant Population”.

It is crucial to eliminate bureaucratic and legal barriers that impede access to health services for migrants. This involves simplifying administrative processes, providing accessible documentation that explains the rights and services available, and facilitating their integration into the health system.

A proactive approach is required to assess the health needs of migrant populations, develop demographic studies and health surveys that identify prevalent conditions, access barriers, and the type of care they require, thus allowing for proper service planning.

Health systems must be prepared to respond quickly to caravans and migratory flows, such as those occurring in our country.

This involves establishing mobile health units and temporary care centers that provide medical services.

It is important to ensure that there are adequate resources for psychological care, which may include helplines, counseling services, and emotional support programs.

Collaboration between government agencies, NGOs, and international organizations should be encouraged to create a coordinated approach to migrant health care.

Finally, it is vital to include representatives of the migrant community in the health policy design process. Their perspective can provide valuable insights into their needs regarding the health services they require.

What is a critical action/policy that global policymakers could do to improve health outcomes in your area?

EJRB: One action that global policymakers could undertake to improve health outcomes for migrant populations is to provide training to health professionals in each country on cultural diversity, human rights, and sensitivity to migrants' needs. This would ensure that medical staff can provide appropriate and unbiased care, understanding the complexities migrants face and their healthcare backgrounds.

International organizations could establish adequate and sustainable funding for health programs specifically aimed at migrants. This includes resources for direct medical care for migrants, as well as for the development of preventive programs such as vaccination or nutritional support, ensuring that health services are accessible and of high quality.

Global policymakers should insist on establishing or facilitating regional agreements that address migrant health.

These agreements should include coordinated protocols for health care and public health measures that apply to migrants in transit and those settling in another country.

Why do you believe the UNITE Global Summit 2024 is a pivotal platform to address these critical issues? What are your hopes for the outcomes of the summit?

It is essential for the international community to conduct periodic evaluations of public policies and existing legislation on migrant health in each country. This would allow for the identification of gaps in care and structural barriers, as well as the establishment of recommendations based on international best practices.

EJRB: The UNITE Global Summit 2024 represents a high-level platform to address critical issues related to migrant health and human rights worldwide. This event brings together international specialists, government officials from around the world, activists, and policymakers, creating a dialogue space that fosters cooperation between countries and organizations.

Promoting research on migrant health would help generate reliable and relevant data to inform evidence-based policies and enable countries to make better decisions.

Global efforts should focus on fostering the creation or improvement of health infrastructures in areas with a high concentration of migrants, such as the northern border of Mexico. This includes clinics and hospitals, as well as the social infrastructure that facilitates access to health services, such as transportation and services like water and housing.

Finally, I believe it is pertinent to support the development and training of Non-Governmental Organizations (NGOs) or universities focused on migrant health care in countries like Mexico, as we have thousands of volunteers, including doctors, dentists, psychologists, and social workers, but not all have resources or training, despite their goodwill.

The summit has been noted for its focus and dedication to the most challenging global issues, and migrant health is no exception. By emphasizing evidence-based strategies and international best practices, it ensures that debates and decisions are supported by reliable data and proven outcomes.

As a federal legislator in Mexico and a member of the Health Committee of the Chamber of Deputies, I see the UNITE 2024 Summit as an invaluable opportunity to address the serious migration situation facing Mexico, especially concerning health needs, migrant caravans, and the irregular settlements of these populations along our borders.

The discussions to be held will allow for the identification of innovative approaches and effective solutions that other countries have successfully implemented. This is very important for countries like Mexico, as it serves as a guide for creating a legal framework and public policies that truly address the complexities migrants face in their transit through our country and their access to health services.

I would like to be part of the creation of alliances and programs that share resources and knowledge, facilitating the implementation of policies that respect and promote human rights, including the right to health.

The UNITE Global Summit 2024 has the potential to be a catalyst for positive change, fostering a global approach to improving migrant health in the context of an increasingly interconnected world and a growing migration crisis. ■

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