Opinion: Covid-19 Raises Risks of Other, Lasting Health Issues Among Migrants

Cambodian migrant workers at the Poipet international border. (VOD)
Cambodian migrant workers at the Poipet international border. (VOD)

The disruption caused by Covid-19 pandemic represents a major public health challenge for migrant workers, their families, and the migrant labor community as a whole. Migrant workers are among the hardest hit by the pandemic since they have limited access to adequate health care services, employment benefits and sanitary living environments.

Migrant workers are found to commonly live and work in cramped areas where social distancing is almost impossible, thus increasing the risk of rapid transmission.

In Singapore, Malaysia and Middle Eastern Gulf countries where accommodations are normally provided by employers, migrant workers are still unlikely to be able to follow proper government guidelines. A single accommodation can have up to 80 occupants.

Many migrant workers did not have proper access to insurance and health care prior to the pandemic and as the outbreak worsens many have been left out of health care plans, while some are potentially scared to seek proper treatment because of their undocumented immigration status.

Fear of potential arrest, detention and deportation have been barriers for many undocumented Cambodian migrant workers in accessing Covid-19 tests, as well as proper medical treatment and vaccination. Meanwhile, approximately 49 percent of interviewed returned migrant workers in one United Nations rapid assessment were found to have problems accessing health care in Cambodia.

However, Covid-19 is not the only pressing public health issue for migrant workers and their families. The pandemic is raising the risks of other, indirect health impacts to the community that can have lasting effects even after the outbreak ends.

Food Insecurity and Malnutrition

Food security is a multidimensional concept that includes food availability, stability, accessibility and “utilization,” referring to eating practices, sanitation and other factors that affect how the body can absorb nutrients. Food insecurity happens when there are disruptions to those dimensions. The economic recession caused by the Covid-19 pandemic has heightened food insecurity for migrant workers and their households.

According to the U.N.’s Food and Agriculture Organization, the unemployed population and other vulnerable groups such as women and children are the largest victims of this problem across the world.

As the pandemic continues, millions of migrant workers have lost their jobs globally. In Cambodia alone, approximately 200,000 migrant workers have returned back home from neighboring countries as of June 2021.

Migrant workers’ families, who once depended heavily on remittances for their daily consumptions, paying off debt, and other necessities, are now facing the risk of food shortage. Children in migrant households are more likely to have smaller portions of meals or borrow food from other households in the face of food insufficiency.

Henrietta Fore, Unicef’s executive director, expressed her concern regarding the impacts of disrupted food security on children amid the pandemic, saying it causes more harm to the children than the disease itself.

A recent simulation conducted for 118 low-and middle-income countries suggests that disruptions in accessibility to food and health care could dramatically increase child and maternal deaths. The study, by Johns Hopkins University researchers, predicts up to 1,157,000 extra child deaths and 56,000 maternal deaths linked to such disruptions.

Food insecurity is also a major cause of malnutrition. It can further be associated with other lasting health effects such as anemia, cognitive problems, aggression and anxiety, and increased risk of some birth defects concentrated on children. Obesity, in the meantime, is also a concerning health problem linked with malnutrition.

Indirect health problems resulting from the Covid-19 pandemic, like food insecurity, could continue to affect migrant workers’ and their families’ health — especially their children — long after the pandemic ends.

Mental Health Challenges

While the spread of Covid-19 is taking a toll on migrant workers’ physical conditions, their mental health is also under pressure.

Pall Chamroen, a researcher from F1000Research, who previously researched the mental health status of Cambodian migrant workers in Thailand, told VOA that mental health problems are high among Cambodian migrant workers.

His research found that prior to the pandemic, the prevalence of moderate to high perceived stress was 68 percent, and symptoms of depression was 70 percent among the interviewed migrant workers.

He added that the economic pressure coupled with unemployment and indebtedness resulting from the pandemic could potentially increase the level of stress for the migrant workers.

A report conducted by the U.N. on returning migrant workers in Cambodia, found that among 1,054 respondents, 50 percent are in debt while 30 percent have no income at all. Such figures are especially alarming given how the economy might not be able to return to normal anytime soon. This means those returned migrant workers may continue to suffer financially, and therefore will continue to experience high levels of stress.

Rising suicide rates among migrant workers seen elsewhere amid the pandemic is also concerning. Prolonged periods of isolation coupled with movement restrictions are clearly worsening migrant workers’ mental health. In Singapore, for example, a spate of suicides and attempted suicides have heightened mental health concerns among thousands of low-paid workers who have been confined to their crowded bunk rooms.

“Many of the workers now say that the mental anguish is a more serious problem than the virus,” said Deborah Fordyce, president of migrant rights group Transient Workers Count Too, speaking about the issue in Singapore.

Other factors such as the constant fear of contracting the virus, losing loved ones to the illness, and being far away from home without any support from family members can also contribute to mental health deterioration.

The Rise of Physical Violence on Women

As the Covid-19 outbreak continues, many women migrant workers have lost their jobs and have had no choice but to return home. Among approximately 200,000 returned Cambodian migrant workers, 43 percent are women. They are more likely to remain unemployed and have no income, according to the U.N. in Cambodia.

Experts believe this loss of wages coupled with heightened stress within the household has the potential to lead to an increase in physical violence experienced by women migrant workers.

U.N. Women reported that the level of gender-based violence spikes when households face increased strain from health, security and financial worries. This report also found that migrant women are more likely to be confined or stuck at home with a potential perpetrator and may not be able to leave abusive relationships due to the movement restriction resulting from the pandemic.

Experts from the U.N. say they anticipate a rise in domestic violence because they have seen similar spikes in similar crises such as displacement or refugee movement.

When resources are scarce, families are facing unemployment and being stuck in tight spaces, the pressure rises. And so does violence against women.

Bunn Rachana, executive director of women’s rights organization Klahann, has told VOD that the pandemic has been disproportionately affecting women as many burdens have fallen on them. In the meantime, she acknowledges that none of the difficulties households face is an excuse for abuse.

“It is important to note that scarcity and hardship are not direct causes of, nor excuses for intimate partner violence,” Rachana said earlier this year.

“Rather, scarcity is one factor that increases the likelihood that a partner will actively choose to perpetrate violence, usually as an assertion of dominance and an attempt to feel in control.”

Gender-based violence is considered as a global public health challenge as it can lead to serious short- and long-term physical, mental, sexual, and reproductive health issues for women. Children within abusive households also witness psychological and behavioral disturbances which can affect their health and wellbeing.

Beyond the Pandemic

Mental health deterioration, food insecurity and gender-based violence are just a few among many indirect negative impacts associated with the ongoing Covid-19 pandemic.

In assessing and addressing the damage this pandemic has done, it will be crucial for the government, NGOs, relevant stakeholders and the general public to give more attention to these indirect, and therefore easy to overlook, problems — particularly within migrant worker families, who are already less likely to be able to access government assistance.

Government and relevant stakeholders must take steps to ensure that migrant workers and their families have proper access to proper social services and health care during the pandemic, in the recovery period and well into the future. Mental support systems in particular should be widely provided to the distressed migrant workers’ families along with other essential social protection programs.

Unlike the pandemic, which will go away some time in the future, the indirect health impacts that can come with it may impact Cambodians for years to come.

Thong Sariputta is a young research fellow at think-tank Future Forum. Her research interests include labor migration, human security and governance.

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