HUMAN MIGRATION AND HEALTH: AN EMERGING FIELD OF RESEARCH IN COLOMBIA

Julián A. Fernández-Niño Edgar Navarro-Lechuga About the authors

Human migration processes are as old as humanity itself and are mainly caused by climate change, wars and economic crises. These processes have become more frequent in the era of globalization, favoring the transnational flow of people, goods and services, and also leading to create regulations and limits for human transit between countries. Migration can occur harmoniously, when migrants are effectively integrated into the host society, strengthening cultural diversity, innovation and economic growth. But, in many other cases, especially when migration is "irregular", most immigrants tend to have low incomes, limited social networks, as well as difficulties in accessing health services and a decent job. They are also more vulnerable to the violation of their human rights, as well as to stigma, physical violence, discrimination and sexual exploitation.

Therefore, from a Global Health perspective, migration should be considered as a transversal determinant of health, as it provides the context, conditions and circumstances under which changes may occur in transnational health disease processes, including the transmission of infectious diseases, challenges to chronic disease care, mental health and violence, among others. In addition, the integration of immigrants poses social, cultural and economic challenges for host societies, their political systems, and in particular for health services. Furthermore, South-South migration involves different perspectives with relation to the traditional South-North migration, in which the host society always has a high degree of development that allows it to respond better to the needs and demands of immigrants. In Colombia, this process is evident in the massive diaspora of Venezuelan migrants, who are today more than one million people, posing an unprecedented scenario for the country and a challenge considering that funds for the health system are insufficient.

Consequently, for Public Health in Colombia it is important to study migration processes mainly with the following objectives: 1. To identify and measure emerging health inequalities between immigrants and local residents, and their impact on immigrants and the host society; 2. To analyze the challenges that health systems have to provide services, as well as to protect, improve and promote migrant health; 3. To monitor changes in the epidemiological profile after the migration process, especially the re-emergence of events of interest for public health, such as immuno-preventable diseases and infectious diseases in general, but also the burden of disease derived from deficits in care of chronic diseases; 4. To evaluate the status of mental health and, in general, the psychosocial vulnerability of immigrants regarding problems such as drug abuse, violence, sexual exploitation, and occupational risks; 5. To design, implement and evaluate interventions to improve migrant health; 6. To assess the economic impact of health care on immigrants to create cost-effective policies.

All these processes also require Health Information Systems that account for the health status, interventions and care provided to immigrants, as well as the social response to their needs. Therefore, the consolidation of the relationship between Human Migration and Health as a field of study for Public Health in Colombia is now an imperative need that may lead to generate information for Public Health decision-making based on evidence, in a multidimensional, dynamic and continuous way, within a transnational ethical framework based on human rights and equity in public health.

This effort should transcend the current situation of Venezuelan migration in a much broader context, which includes internal displacement, pendular flows, and human mobilization and its correlation with health from a global perspective that allows improving our responses at the national and local levels.

Instituto de Salud Publica, Facultad de Medicina - Universidad Nacional de Colombia Bogotá - DF - Colombia
E-mail: revistasp_fmbog@unal.edu.co