Migrant Friendly Migrant Friendly TestingTesting

CARAM AsiaCARAM AsiaState of Health State of Health

ICAAP 2007ICAAP 2007

Migrant Friendly Migrant Friendly TestingTesting

……is based is based on the principles of on the principles of non-non-discriminationdiscrimination; ;

……is is responsive to the contexts of responsive to the contexts of migrantsmigrants; and ; and

……is is conducted in an enabling conducted in an enabling environmentenvironment that provides migrants that provides migrants the ability to make choices that the ability to make choices that support their health and well-beingsupport their health and well-being..

Non-discriminatoryNon-discriminatory

• Informed consent is obtained;Informed consent is obtained;• Pre-test and post-test counselling Pre-test and post-test counselling

is provided to all migrants;is provided to all migrants;• Confirmatory testing is ensured;Confirmatory testing is ensured;• Confidentiality of test results are Confidentiality of test results are

upheld;upheld;• Referral is available at all points.Referral is available at all points.

(Treated the same as the rest of the general public under prevailing laws and policies…)

Responsive to the context Responsive to the context of migrant workersof migrant workers

• Clinics are financially and Clinics are financially and geographically accessible;geographically accessible;

• Language and literacy are Language and literacy are accommodated;accommodated;

• Gender and cultural sensitivity Gender and cultural sensitivity are taken into account.are taken into account.

(Assistance is provided to counteract their vulnerable social position, which is most pronounced in destination countries)

Enabling environment Enabling environment for migrantsfor migrants

• Policies reflect rights enshrined in Policies reflect rights enshrined in international conventions; international conventions;

• Health education is provided to Health education is provided to increase awareness of rights and increase awareness of rights and health;health;

• Accessibility of testing without Accessibility of testing without monopoly.monopoly.

Ensures that migrants are able to make informed decisions in matters pertaining to their health and well-being

Medical testing should not be used simply Medical testing should not be used simply as a screening mechanism to decide who as a screening mechanism to decide who can work and who cannot. can work and who cannot.

Medical testing is foremost a process to Medical testing is foremost a process to prevent the occurrence of illness; and it is prevent the occurrence of illness; and it is a gateway to access healthcare services, a gateway to access healthcare services, specifically treatment and care. specifically treatment and care.

More than a screening process, medical More than a screening process, medical testing should be aimed at benefiting the testing should be aimed at benefiting the health and well-being of migrant workers health and well-being of migrant workers because they have a right to be healthy because they have a right to be healthy and they have a right to work productively. and they have a right to work productively.

TTo invite governments to o invite governments to cooperate in developing and cooperate in developing and

implementing migrant-friendly implementing migrant-friendly testing… testing… 

CARAM Asia hereby CARAM Asia hereby initiates the campaign:initiates the campaign:  

CARAM AsiaCARAM Asia RecommendationsRecommendations

to Promoteto Promote Migrant Friendly Testing:Migrant Friendly Testing:

Governments in origin and Governments in origin and destination countriesdestination countries

• Ratify the UN Migrant Workers Convention;Ratify the UN Migrant Workers Convention; • Address health rights of migrant workers Address health rights of migrant workers

through bilateral agreements and MoUs; through bilateral agreements and MoUs; • Institute specific laws and policies to Institute specific laws and policies to

uphold principles of migrant-friendly uphold principles of migrant-friendly testing; testing;

• Establish independent monitoring systems Establish independent monitoring systems that regularly monitor both government that regularly monitor both government and private facilities; and private facilities;

• Decentralise high-quality health testing centres.Decentralise high-quality health testing centres.

Governments in origin and Governments in origin and destination countriesdestination countries

Destination CountriesDestination Countries - Discard HIV status as - Discard HIV status as an exclusionary condition, and cease and an exclusionary condition, and cease and desist forcibly deporting HIV positive desist forcibly deporting HIV positive migrants. migrants.

Origin CountriesOrigin Countries - Unite to affect changes in - Unite to affect changes in the policies and practices of labour the policies and practices of labour recruitment to benefit and protect migrant recruitment to benefit and protect migrant workers’ rights and health by negotiating workers’ rights and health by negotiating with destination countries.with destination countries.

Origin CountriesOrigin Countries - Fulfill inherent - Fulfill inherent responsibility to protect nationals’ rights; responsibility to protect nationals’ rights; stop considering migrant workers as purely stop considering migrant workers as purely economic units. economic units.

Health testing facilities Health testing facilities (source and destination)(source and destination)

Strictly enforce confidentiality of test Strictly enforce confidentiality of test results;results;

Adhere to the practice of informed consent; Adhere to the practice of informed consent; Integrate pre-test and post-test counselling;Integrate pre-test and post-test counselling; Provide independent translation services Provide independent translation services

when needed or requested by migrant when needed or requested by migrant workersworkers;;

Establish a policy on the provision of post-Establish a policy on the provision of post-test counselling for every migrant worker on test counselling for every migrant worker on an individual basisan individual basis..

Health testing facilities Health testing facilities (source and destination)(source and destination)

Facilitate referral to services;Facilitate referral to services; Train staff on gender and cultural sensitivity;Train staff on gender and cultural sensitivity; Ensure that migrant workersEnsure that migrant workers can choose can choose aa

male male oror female doctor female doctor;; Make available separate restrooms and Make available separate restrooms and

cubicles for physical examinations;cubicles for physical examinations; Abolish all unnecessary health testing and Abolish all unnecessary health testing and

related practicesrelated practices (e.g. nudity or Depro-Vera); (e.g. nudity or Depro-Vera); Conduct independent, confirmatory tests Conduct independent, confirmatory tests

free of charge with a new blood sample.free of charge with a new blood sample.

The private sectorThe private sector• GAMCA should expand its well-established GAMCA should expand its well-established

monitoring system to include: informed monitoring system to include: informed consent, pre-test and post-test counselling, consent, pre-test and post-test counselling, confidentiality of test results, and a proper confidentiality of test results, and a proper functioning referral system in both origin and functioning referral system in both origin and destination countries destination countries

• Standardise and specify costs of health Standardise and specify costs of health testing, along with stipulations of costs testing, along with stipulations of costs potentially forfeited or borne by the migrant in potentially forfeited or borne by the migrant in the case of an unfit resultthe case of an unfit result

• Ensure recruitment agencies provide a full list Ensure recruitment agencies provide a full list of the costs involved when a migrant worker of the costs involved when a migrant worker applies for work abroad in a transparent applies for work abroad in a transparent manner manner

EmbassiesEmbassies

• Provide assistance for migrant workers who Provide assistance for migrant workers who get repatriated due to health conditions, get repatriated due to health conditions, including providing direct referral to health including providing direct referral to health facilities and treatment in the country of facilities and treatment in the country of origin;origin;

• Ensure embassy staff are versed in the Ensure embassy staff are versed in the related migration policies of the destination related migration policies of the destination country and receive sensitivity training on country and receive sensitivity training on issues of health, especially regarding STIs, HIV issues of health, especially regarding STIs, HIV and AIDS, to assist with proper health referral and AIDS, to assist with proper health referral and dignified repatriation. and dignified repatriation.

NGOs and CBOsNGOs and CBOs

• Sensitize employers and recruitment agencies about Sensitize employers and recruitment agencies about migrant-friendly testing, and advocate for changes in migrant-friendly testing, and advocate for changes in current testing standards;current testing standards;

• Challenge stigma and discrimination against migrant Challenge stigma and discrimination against migrant workers (especially in the media) and advocate for workers (especially in the media) and advocate for their health rights through reform of health testing their health rights through reform of health testing policies;policies;

• Support formal and informal migrant workers’ groups Support formal and informal migrant workers’ groups and assist them with integrating HIV awareness and and assist them with integrating HIV awareness and related policies into their work; related policies into their work;

• Establish culturally and linguistically appropriate HIV Establish culturally and linguistically appropriate HIV outreach programmes targeting both documented outreach programmes targeting both documented and undocumented migrant workers and assist with and undocumented migrant workers and assist with referral.referral.

International partnersInternational partners• Implement the framework for migrant-friendly testing Implement the framework for migrant-friendly testing

through formal and informal cooperation firmly rooted through formal and informal cooperation firmly rooted in bilateral, regional and multilateral mechanisms;in bilateral, regional and multilateral mechanisms;

• Ensure meaningful participation of migrant workers in Ensure meaningful participation of migrant workers in international forums on health testing and HIV issues;international forums on health testing and HIV issues;

• Stimulate both quantitative and qualitative research Stimulate both quantitative and qualitative research on health testing and its effects on the well-being of on health testing and its effects on the well-being of migrant workers and their families.migrant workers and their families.

• Increase and maintain awareness on issues of Increase and maintain awareness on issues of migration and HIV, and promote the rights of migrants migration and HIV, and promote the rights of migrants through formal campaigns, multilateral conferences through formal campaigns, multilateral conferences and by encouraging donors to support related and by encouraging donors to support related activities. activities.