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From The Publisher

Lack Of Health Care Access Drives Global Migration

Affiliations
  1. Rabih Torbay is president and CEO of Project HOPE, in Washington, D.C.
PUBLISHED:Free Accesshttps://doi.org/10.1377/hlthaff.2023.00855

TOPICS

A record 108 million people worldwide had been forced to leave their homes by the end of 2022 because of the climate crisis, armed conflicts, persecution, and limited access to basic services, including health care, according to the United Nations High Commissioner for Refugees.

Rabih Torbay

Photograph by Project HOPE

Limited health care access is both a cause and an effect of our global displacement crisis. It’s often the war we don’t see—what a lack of essential needs such as water, food, shelter, and health care can do to a human being: mothers walking for miles through deserts for maternity care; older couples lined up for hours in the rain to take home jugs of drinking water; families huddling in tents bracing for a storm; doctors and nurses performing surgeries without proper sanitation, medical equipment, or pharmaceuticals.

As conflicts and climate disasters become more frequent and deadly, millions are being left with limited options to protect their families, too often driving them to embark on perilous journeys seeking refuge where they can access care and other essentials, often at the risk of their own lives.

This situation is worsened by the global shortage of health care professionals, especially in underresourced countries. The World Health Organization reports that fifty-five of the countries with the most fragile health systems currently face a critical shortage of skilled health workers. Much of this shortage is due to the migration of health workers to wealthier countries in the Middle East, Europe, and the United States, leaving significant gaps in essential care where it’s needed most.

During a recent visit to Haiti, I witnessed how political turmoil, conflict, and climate change can cause the collapse of a health system. Hospitals were in disarray, with beds teetering on cinderblocks; empty pharmacy shelves; and overworked, unpaid health care workers lacking adequate training. These dilapidated facilities reflect deeper underlying issues such as insufficient investment, limited infrastructure, and disrupted supply chains. Faced with such dire circumstances, many Haitians are left with no choice but to leave their homes in search of adequate health care elsewhere, which is why you’ll see pregnant Haitians cross the border into the Dominican Republic to seek medical care.

What is happening in Haiti is happening around the globe. At the US-Mexico border, for instance, you’ll meet individuals and families who have traveled far and wide—from Venezuela, Honduras, Guatemala, and elsewhere—to seek safety and basic services, including health care for their children.

Addressing the complex issue of forced migration requires a comprehensive approach that tackles the root causes, with a particular focus on improving access to health care. First, there must be a global commitment to invest in strengthening health and welfare systems in the underresourced countries from which many migrants originate, including a sustained investment in infrastructure, health workforce development, and adequate compensation for health workers. By doing so, we can help recreate the conditions that allow people to access health care and essential services, thereby allowing them to lead healthy lives where they always wanted to be: home.

We also need to support health workers’ welfare by breaking the stigma around mental illness and giving them the tools to process, navigate, and manage their own mental health as they care for our loved ones.

Last, international collaboration and support should prioritize building resilience in regions vulnerable to armed conflict and climate change to help prevent the erosion of health care access during crises and reduce the need for forced migration. This includes establishing early warning systems, enhancing emergency preparedness, and implementing recovery plans that prioritize health care infrastructure and services.

Through collective effort, we can build a future in which inadequate health care access no longer drives migration and health is a universal right.

   
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