REPORT BACK SEMINAR 17 SEPTEMBER 2009 MIGRATING POPULATION – economic crisis’s impact on migrants and AIDS Elijah FUNG St. John’s Cathedral HIV Education Centre

MIGRATION & MOBILITY-RELATED SESSIONS AT THE 9 TH ICAAP MIGRANT’S FORUM Breakout session of the Community Forum organized by CARAM - Asia ORAL ABSTRACT SESSION Migrant Workers – Safe Away from Home BOOK LAUNCH Living with Hope: Stories of Asian Migrants Living with HIV organized by CARAM-Asia SATELLITE MEETING HIV and Mobile Workers: Towards Public-Private Partnerships in the Maritime and Transport Sectors organized by IOM (International Organization for Migration)

- CONTINUED SKILLS BUILDING WORKSHOPS Empowering Migrants and other Marginalized Communities against HIV and AIDS through Participating Action Research organized by CARAM Asia ORAL ABSTRACT SESSION Protecting Migrants’ Rights to Health and Dignity SYMPOSIA HIV and National Borders: Building Research/Evidence on Mobility, Migration and HIV organized by IAS and AIDS Society Asia-Pacific

- CONTINUED COMMUNITY VOICES DIALOGUE - HIV+ Migrants Speak on Mandatory HIV Testing, Discrimination and Reintegration Issues organized by CARAM-Asia SYMPOSIA - The Impact of the Financial Crisis on Labour Migration and HIV organized by UNDP/ILO/UNAIDS/JUNIMA

MIGRATION & AIDS 191 million foreign migrants, globally, as compared to an estimated 150 million in 2000 (source: the Population Division of the United Nations (2006) ) undocumented migrants : million Women migrants: 48%

- CONTINUED PHILIPPINES In April 2009, migrant workers comprised 32% of the total documented HIV cases. BANGLADESH A high incidence of HIV amongst returning migrant workers with 50% comprising the total 219 confirmed cases in 2003.

- CONTINUED PAKISTAN 80% of the known HIV cases in December 1999 were deportees from the Arab States. INDONESIA Indonesia’s AIDS epidemic is among the fastest growing in Asia, especially among intravenous drug users and sex workers, with new infections among housewives of migrant workers also contributing to the known cases.

FINANCIAL CRISIS, MIGRATION, HEALTH AND HIV MALAYSIA 60,000 less foreign workers from March to December 2008 (source: Home Ministry) 70% of work permit approvals is reduced for foreign workers. 250 permits per day from Jan to Feb compared to 800 per day for same period in Cancelled work visas for about 55,000 Bangladeshi workers

FINANCIAL CRISIS, MIGRATION, HEALTH AND HIV PHILIPPINES 6,806 displaced and 4,495 returned to the Philippines as of 30 April 2009 (Source: Labour ministry) CHINA 25 million of the 70 million internal migrant workers who returned home after Chinese lunar new year, reportedly lost jobs

FINANCIAL CRISIS, MIGRATION, HEALTH AND HIV INDONESIA (many of them female workers in Malaysia Electronic sector) returned home Drop in deployment of household service workers in traditional markets like Hong Kong, Singapore, and Kuwait.

FINANCIAL CRISIS, MIGRATION, HEALTH AND HIV Reductions in public expenditures on AIDS prevention, care and treatment programmes which could increase HIV prevalence and shorten the life span of PLHIV Increase in the number of sex workers in less formal settings and in trafficking for commercial sex work. Increasing concerns that female migrants who lost their jobs may move into sex work E.g. In Cambodia, garment workers, mostly female, have lost their jobs. A recent study by the UN Inter-Agency Project on Human Trafficking found out that 58% of those entered sex work in the wake of the economic crisis, 19% of these women were former garment sector workers.

- CONTINUED “Undocumented migrant workers are more vulnerable to a lot of problems and challenges including getting infected with HIV because their rights are not protected”, said Rina (an HIV infected Filipino). The global recession will turn more migrants into undocumented migrants.

FINANCIAL CRISIS, MIGRATION, HEALTH AND HIV Migration itself is not a risk factor for HIV infection However, vulnerable and exploitative situations such as separation from families, social support systems, substandard living and working conditions and isolation contribution to the HIV infection. Host countries do not provide ARV treatment to migrants / referral Deportation for those infected migrants Other issues: language and cultural barriers lead to discrimination

RECOMMENDATIONS ESTABLISH PROTECTIVE MECHANISMS e.g. welfare funds, social insurance schemes & training programmes to help migrants returning home or to relocate on site. TRANSLATE REGIONAL & NATIONAL STRATEGIES FOR HIV include migrants & mobile populations into budgets and services that are designed to reach people on the move

- CONTINUED MAINTAIN AIDS PREVENTION PROGRAMMES & BUDGETS every $1 invested in prevention can save up to $8 in adverted treatment costs. INVOLVE WITH CIVIL SOCIETY ORGANIZATIONS to monitor the health seeking behaviour of migrants so that they do not have to sacrifice treatment for other basic necessities for themselves and their families.

WHAT ARE THE CHALLENGES TO HONG KONG?

FOREIGN DOMESTIC HELPERS (FDHS) POPULATION IN HONG KONG SOURCE OF INFORMATION: COMMUNICATIONS AND PUBLIC AFFAIRS, IMMIGRATION DEPARTMENT, HONG KONG As at the end of Month/Year PhilippinesIndonesiaThailandOther nationalities Total number for all nationalities Jan ,044125,1853,828 3,516259,573 Feb ,531124,7533,814 3,497258,595 Mar ,870124,7353,782 3,485257,872 Apr ,075125,5673,774 3,479258,895 May ,556126,3803,780 3,483260,199 Jun ,630129,6123,856 3,540265,638 Jul ,828129,1133,8063,528264,275

THE STORY OF AN INFECTED DOMESTIC WORKER “ The client and I have come to Kowloon Bay Health Centre for 2 times in this past week. Since they learnt that her visa will be expired on 20 or 21 September, they been giving her special arrangements. We met the doctor after meeting with the nurse the first day we came there. She preferred to have me as interpreter instead of interpreter was arranged by the health centre. They run some assessments and physical check ups on her but we still do not know how she got the infection. She consistently said that she had a pre-employment medical check up 2 years ago and the result of HIV antibody test was negative. She also informed us that she had sex with another Indonesian partner 3 years ago but using condom 100%. The doctor did not rule out that she might got the infection earlier and the previous test could be inaccurate (doctor mentioned that the HIV antibody tests may vary in term of sensitivity and specification). But with her stories and backgrounds, doctor said it is not possible to determine how she got infected. With her consent, the nurse there also run the tbc check by injecting protein under her skin. Another special arrangement was taken place in second day. Since it seems the client does not believe with the result, they did another test and the preliminary test showed that she is HIV positive. The next appointment is on 18 this month when they will get at least 90% of the blood result including the CD4 counts and doctor will prepare a referral letter for Indonesian unit. “

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