Lessons Learned: Central Asian Migration and Disparities in Public Health

Last month, the AFEW Culture Initiative team visited Moscow's Eastern European and Central Asian Regional HIV/AIDS Conference (EECAAC) together with AFEW International. The Conference crystallised the occasion for different communities, organisations and individuals to exchange their ideas and come up with workable solutions to the present HIV/AIDS epidemic wreaking havoc in the EECA region.

 Three women walking around the shores of lake Issyk-Köl at Cholpon-Ata, Kyrgyzstan. December 2017 © Juan Aguirre Fernández-Bravo

Three women walking around the shores of lake Issyk-Köl at Cholpon-Ata, Kyrgyzstan. December 2017 © Juan Aguirre Fernández-Bravo

AFEW International's director, Anke van Dam, together with the main coordinator of AFEW's regional office in Tajikistan, Saodat Oripova, presented the results of recent studies undertaken in collaboration between the two actors in the region. Their research focused mostly on international migratory flows between regions in Central Asia, traditionally a migratory hotspot at the core of the Asian continent. Interestingly, trends in migration have a very tangible impact on the lives of transnational workers and their health.

Due to legal and political barriers, access to testing facilities and outreach services remains very limited for labour migrants originating from Central Asia. The situation applies both for those who choose another Central Asian country as their destination, as well as for those who travel a longer way to settle in Russia and Ukraine — two of the most common choices for Central Asian migrants, owing to cultural, linguistic and historical ties.

"Unsurprisingly, when we fail to raise awareness of overarching issues such as HIV/AIDS, tuberculosis (TB) or viral hepatitis (HCV) among transnational workers, and limit accessibility for them get tested or seek counselling, the wedge between 'official' and 'unofficial' (disenfranchised) communities increases."

While abroad, stringent regulatory laws and widespread social stigma against migrants makes it hard for newcomers to settle through official government channels. The immediate harshness of their surrounding environment results in a vast number of labour migrants opting for the informal economy and unofficial channels, in order to be able to sustain a living.

As a consequence, the majority of testing facilities, public subsidies, informative outlets and outreach services — directed almost exclusively to registered 'citizens' through official channels — fail to reach labour migrants. Unsurprisingly, when we fail to raise awareness of overarching issues such as HIV/AIDS, tuberculosis or viral hepatitis (HCV) among transnational workers, and limit accessibility for them get tested or seek counselling, the wedge between 'official' and 'unofficial' (disenfranchised) communities increases.

"Two percent of female labour migrants returning to Tajikistan from Russia do so after being deported for having contracted chronic infectious illnesses, such as HIV/AIDS."

In most instances, when non-registered migrants contract HIV/AIDS, they are automatically withheld from life-saving antiretroviral (ARV) treatment and wider social security coverage or support systems. Moreover, contracting or living with HIV/AIDS is still seen as grounds for refusal of work permits and deportation in countries such as Russia, the destination of choice for 89% of all Central Asian migrants who leave their home country behind. In the words of Saodat Oripova, from AFEW Tajikistan, 2% of female labour migrants returning to Tajikistan from Russia do so after being deported for having contracted chronic infectious illnesses, such as HIV/AIDS.

With the goal of stopping the vicious poverty cycle for female migrants forced to return to Tajikistan, AFEW Tajikistan has put in motion a reintegrative programme. With help from their Amsterdam-based colleagues, professional skills workshops have been set up to allow returning women to take up their own work initiatives and resume life upon arrival. Informative workshops are likewise provided for those seeking referral to health services after having contracted HIV/AIDS or other chronic diagnoses while abroad.

[Text by Juan Aguirre Fernández-Bravo]