Migrants as 'vulnerable groups' in the COVID-19 pandemic: A critical discourse analysis of a taken-for-granted label in academic literature

Migration health ethics in Southeast Asia: a scoping review

Background

Asia hosts the second-largest international migrant population in the world. In Southeast Asia (SEA), key types of migration are labour migration, forced migration, and environmental migration. This scoping review seeks to identify key themes and gaps in current research on the ethics of healthcare for mobile and marginalised populations in SEA, and the ethics of research involving these populations.

Methods

We performed a scoping review using three broad concepts: population (stateless population, migrants, refugees, asylum seekers, internally displaced people), issues (healthcare and ethics), and context (11 countries in SEA). Three databases (PubMed, CINAHL, and Web of Science) were searched from 2000 until May 2023 over a period of four months (February 2023 to May 2023). Other relevant publications were identified through citation searches, and six bioethics journals were hand searched. All searches were conducted in English, and relevant publications were screened against the inclusion and exclusion criteria. Data were subsequently imported into NVivo 14, and thematic analysis was conducted.

Results

We identified 18 papers with substantial bioethical analysis. Ethical concepts that guide the analysis were 'capability, agency, dignity', 'vulnerability', 'precarity, complicity, and structural violence' (n=7). Ethical issues were discussed from the perspective of research ethics (n=9), clinical ethics (n=1) and public health ethics (n=1). All publications are from researchers based in Singapore, Thailand, and Malaysia. Research gaps identified include the need for more research involving migrant children, research from migrant-sending countries, studies on quality of migrant healthcare, participatory health research, and research with internal migrants.

Conclusions

More empirical research is necessary to better understand the ethical issues that exist in the domains of research, clinical care, and public health. Critical examination of the interplay between migration, health and ethics with consideration of the diverse factors and contexts involved is crucial for the advancement of migration health ethics in SEA.

A community psychology for migrant justice: Critically examining border violence and resistance during the COVID-19 syndemic

This article explores the magnifying lenses of the COVID-19 syndemic to highlight how people racialized as migrants and refugees have been-and continue to be-disproportionally harmed. We use empirical evidence collected in our scholarly/activist work in Europe, Africa, South Asia, and the United States to examine migrant injustice as being produced by a combination of power structures and relations working to maintain colonial global orders and inequalities. This is what has been defined as "border imperialism." Our data, complemented by evidence from transnational solidarity groups, show that border imperialism has further intersected with the hygienic-sanitary logics of social control at play during the COVID-19 period. This intersection has resulted in increasingly coercive methods of restraining people on the move, as well as in increased-and new-forms of degradation of their lives, that is, an overall multiplication of border violences. At the same time, however, COVID-19 has provided a unique opportunity for grassroot solidarity initiatives and resistance led by people on the move to be amplified and extended. We conclude by emphasizing the need for community psychologists to take a more vigorous stance against oppressive border imperialist regimes and the related forms of violence they re/enact.

Undervalued essential work and lacking health literacy as determinants of COVID-19 infection risks: a qualitative interview study among foreign-born workers in Sweden

OBJECTIVES

To investigate work and living conditions as determinants of COVID-19 infection risks in foreign-born workers in non-healthcare occupations.

DESIGN

Data were collected according to a qualitative design, using semistructured interviews. Verbatim transcripts of these interviews were analysed according to systematic text condensation.

PARTICIPANTS

We recruited foreign-born workers (n=15) and union representatives (n=6) among taxi drivers, bus and tram drivers, pizza bakers, cleaners and property caretakers, all indicated as risk occupations during COVID-19 in Sweden.

RESULTS

Four overarching themes were found: 'virus exposure at work', 'aspects of low status and undervalued work', 'lack of access to information' and 'foreign-born persons' position'. Virus exposure was frequent due to many social interactions over a workday, out of which several were physically close, sometimes to the point of touching. The respondents fulfilled important societal functions, but their work was undervalued due to low job status, and they had little influence on improving safety at work. Lack of health literacy limited foreign-born workers to access information about COVID-19 infection risks and protection, since most information from health organisations and employers was only available in Swedish and not adapted to their living conditions or disseminated through unknown channels. Instead, many turned to personal contacts or social media, through which a lot of misinformation was spread. Foreign-born persons were also subjected to exploitation since a Swedish residency permit could depend on maintaining employment, making it almost impossible to make demands for improved safety at work.

CONCLUSIONS

Structural factors and a lack of adapted information manifested themselves as fewer possibilities for protection against COVID-19. In a globalised world, new widespread diseases are likely to occur, and more knowledge is needed to protect all workers equally. Our results are transferable to similar contexts and bring forth aspects that can be tried in quantitative studies or public health interventions.Cite Now.

Strengthening the social resilience of people living at the intersection of precariousness and migration during pandemics: action recommendations developed in Munich, Germany

Introduction

An EU-funded project in five countries examined vulnerability mechanisms during the COVID-19 pandemic. The research team in Germany concentrated on people living at the intersection of migration and precariousness. The study aimed first to provide an understanding of how migrants living in precarious conditions in Munich had been affected by the pandemic, both from their own and from experts' perspectives. The second aim was to develop action recommendations to reduce structural vulnerabilities and increase resilience with a view towards improved pandemic preparedness.

Methods

The study followed a two-phase process. The first was a qualitative study based on interviews with 25 migrants and 13 experts. In the second, researchers developed action recommendations based on the vulnerability/ resilience factors that had been generated in the first phase. Three consecutive meetings with stakeholders (expert panel, focus group discussion with two migrant organization, meeting with the Munich Migration Council) were then held to further strengthen the draft recommendations.

Results

Content analysis revealed twelve vulnerability and eight resilience factors in three domains (COVID-19 prevention; human rights, living and housing environment; social support). Migrants had limited access to COVID-19 prevention measures; living conditions made outbreaks inevitable; uncertainty about legal status, employment, and housing, as well as stigma and discrimination, exacerbated their precariousness; social support had decreased; and resilience mechanisms had failed. The initial draft of recommendations contained 24 proposed actions. The meetings added recommendations such as enhancing psychosocial support, preventing ghettoization, improving social housing, preventing the interruption of language education in times of crisis, severe penalties for media stigmatisation and proactive truth-telling. The final list included 30 actions.

Conclusion

In Munich, the COVID-19 pandemic exacerbated vulnerability mechanisms commonly associated with being a migrant. The recommendations developed here speak to those vulnerabilities but need to be refined further to be more actionable and comprehensive. Nonetheless, the recommendations and the processes that led to them highlight the importance of migrant-inclusive approaches and empowerment in increasing migrants' resilience to future crises.

To stay or re-migrate after the pandemic shock? Labor re-migration intention to the coastal areas of Thừa Thiên Huế province in Vietnam

This study applied the extended theory of planned behavior (ETPB) to explore factors that shape the behavioral intention of migrant laborers returning to the coastal region of Thừa Thiên Huế province during the peak of the COVID-19 pandemic to remigrate. Data collection included 210 interviews with returned migrants aged 18 and above in 4 coastal communes of Thừa Thiên Huế province, in-depth interviews (8 key informants) and a group discussion (5 persons). Exploratory factor analysis and a multivariate linear regression model were applied to analyze the data. Results showed that in addition to individual socio-demographic characteristics (i.e. level of education, age, income level and sex), attitudes, subjective norms, perceived behavioral control, and perceived risk were also determinant factors of migrants' intention to remigrate. This research suggested that in order to build resilience of rural migration workers, related departments should seriously consider the following recommendations: (i) raise awareness and encourage young rural people to complete their education and necessary skills; (ii) organize related psychological training programs for rural laborers; (iii) raise awareness about the necessity to participate in social insurance; (iv) promote rural job creation programs suitable for low education and low-skilled rural laborers; (v) raise awareness for local people, particularly school children, about the value and opportunities of being smart farmers in the context of 4.0 technology and social risks at the destination for low education and low-skilled laborers; (vi) digitalize migration labor management and provide digital information services regarding job opportunities for rural laborers.

Vulnerability of migrant women during disasters: a scoping review of the literature

BACKGROUND

Disasters have an unequal impact on the population because of differences in conditions of vulnerability, exposure, and capacity. Migrants and women are among the groups that are at greater risk for and disproportionately affected by disasters. However, despite the large body of evidence that analyzes their vulnerability separately, disaster research that targets migrant women is scant. The aim of this scoping review was to analyze the published scientific literature concerning the vulnerability of migrant women and the consequent negative impact they experience during disasters.

METHODS

A literature search was conducted on December 15th, 2021 on Pubmed, Scopus, and Web of Science databases. No time filter was applied to the search. Information regarding the article's main characteristics and design, migrant women and their migration experience, as well as about the type of disaster was collected. The factors responsible for the vulnerability of migrant women and the negative outcomes experienced during a disaster were extracted and inductively clustered in main themes reflecting several vulnerability pathways. The review followed the Joanna Briggs Institute methodology for scoping reviews and relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

RESULTS

After full text review, 14 articles met the inclusion criteria. All of them adopted a qualitative methodology and focused on COVID-19. The pandemic negatively affected migrant women, by triggering numerous drivers that increased their level of exposure and vulnerability. Overall, six vulnerability factors have been identified: legal status, poverty conditions, pre-existing health conditions, limited agency, gender inequality and language and cultural barriers. These resulted in nine impacts: worsening of mental health status, poor access to care, worsening of physical health conditions, fraud, exacerbation of poverty, gender-based violence, jeopardization of educational path, and unfulfillment of their religious needs.

CONCLUSIONS

This review provided an analysis of the vulnerability factors of migrant women and the pathways leading to negative outcomes during a disaster. Overall, the COVID-19 pandemic demonstrated that health equity is a goal that is still far to reach. The post-pandemic era should constitute the momentum for thoroughly addressing the social determinants of health that systematically marginalize the most vulnerable groups.

Exploring the Mental, Social, and Lifestyle Effects of a Positive COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study

Migrants and refugees are among the vulnerable populations that suffered disproportionately from the COVID-19 crisis. However, their experiences with COVID-19 positivity status have not been investigated. This study explored the physical, mental, and psychosocial impacts of a positive COVID-19 diagnosis on Syrian refugees living in Jordan. Using a qualitative approach, twenty phone interviews were conducted with ten adult Syrian refugees living within the camp and ten refugees living in non-camp (host community) settings in Jordan. Follow-up interviews with five health care providers at a refugee camp were conducted to explore the services and support provided to the refugees with COVID-19 infection. The findings were thematically analyzed and grouped into major themes, subthemes, and emerging themes. Refugees living within camp settings had better access to testing, healthcare, and disease management and did not experience fear of being deported. Refugees in both settings suffered mental and psychosocial health impacts, social isolation, fear of death, and disease complications. COVID-19 infection has negatively impacted refugees' well-being with noticeable disparities across the different living conditions. Refugees living within host community settings may need more support for managing their condition, accessibility to free testing, as well as treatment and healthcare services.