How do we protect migrants while fighting misconceptions about their health? This question was the focus of a conference in Mendrisio, Switzerland, that aimed to raise public awareness about a highly topical and sensitive issue.
The Migration and Health Conference was organized by the Department of Health and Social Affairs and the Department of Institutions of the canton of Ticino, a member of the WHO Regions for Health Network. Ticino is dedicating a number of health promotion and disease prevention projects to the health needs of migrants.
According to WHO’s “World report on the health of refugees and migrants” (2022), 1 in 8 people leave their countries either as migrants or as refugees due to external factors such as conflict, persecution, violence, insecurity, environmental degradation or lack of prospects. While there is no evidence that refugees and migrants spread disease in their host countries, it is clear that the burden of noncommunicable diseases is greater among them.
Increasing understanding of migrant health
Santino Severoni, Director of the WHO Global Health and Migration Programme, presented data from the “World report on the health of refugees and migrants”. Yet he also pointed to a lack of baseline data on international legal standards and their reflection in the legal frameworks of destination countries.
Emilio Vercillo, a former researcher with SaMiFo, a health centre for asylum seekers and refugees based in Rome, Italy, spoke of 3 important things to know about migrant health.
First, the trauma experienced by migrants during long journeys is the cause of injury.
Second, it is not inevitable that a violent event will have a psychopathological effect. Only a traumatic event can cause trauma. Furthermore, trauma is a person-specific phenomenon: 2 people who experience the same event or situation may not react in the same way. What is traumatic for one person may not be traumatic for another.
Third, the development of psychological distress depends on previous life experiences. There is no link between a specific trauma and the manifestations of post-traumatic pathology. Similarly, there is no direct causal link between other manifestations (such as depression, behavioural disorders and the abuse of psychotropic substances) and a violent event; these have other origins, such as loss, cultural distance, denied protection and the availability of substances.
The early detection of pathology is fundamental to health outcomes. It must be timely as well as selective, and cannot be based solely on narratives about violence suffered.
Integrating migrants
In 2016 the Council of States of Ticino set up an intersectoral and interdisciplinary group chaired by Ticino’s Health Promotion and Evaluation Service from the Department of Welfare and Health. The group aimed to:
- support and facilitate networking among services and organizations involved in taking charge of and integrating migrants into the canton; and
- increase capacity for addressing needs and supporting targeted programmes on the prevention of risk behaviour and the control of health problems.
The establishment in 2022 of a task force on psychological support for the Ukrainian population in Ticino, coordinated by the canton’s sociopsychiatric organization, is a concrete result of the work of the group.