1. Women and Migration: Promoting health all through the migration experience Hacettepe University Symposium-11 march 2010 Blandine Mollard – Project Officer, Gender Issues Coordination, IOM

2. 2 ♦Overview of women’s migration today ♦Health challenges and opportunities posed by women’s migration ♦IOM responses and ideas for further action Outline

3. 3 At the Global level: close to equal numbers: Nearly as many women as men have migrated over the past 50 years. In 1960, women made up for 47% of migrants By 2010, 49% of all migrants are projected to be women

4. 4 At the regional level: high disparities Regions of destination: Africa (46.8%): steady increase in female migrants Asia (44.6%): Female migration dominate in some countries. Europe (52.3%): in 2010 female migrants will represent of all migrants Northern and Latin America and the Caribean: 50% Arab Region: male migrants far outnumber women Turkey: in 2010, 52% of all migrants will be women

5. 5 Voluntary migration: –Labour migrants (regular or irregular), long-term, seasonal/temporary –Secondary migrants within family regrouping Forced migration: –Refugees or asylum seekers –Victims of trafficking Migrate more and more independently How do women migrate? Forced movements hold gender specific risks for women

6. 6 Although women are affected by same push and pull factors as men: Poverty Conflict Labour market demand Wage differentials Networks and ties abroad Reasonsto migrate Reasons to migrate Gender strongly influences the conditions and outcomes of the migration process

7. 7 Gender as a determinant of migrants’ health status Gender influences Before migration: Gender influences education opportunities, access to information, health knowledge and status, family responsibilities and experience of violence/discrimination. Choice of migration channels– priority to smugglers, no information on asylum grounds,… Vulnerability to human trafficking, betrayal in the family/intimate partner. Levels of gender inequalities in CoO condition the migration experience.

8. 8 Gender as a determinant of migrants’ health status dual vulnerability as women and migrants In transit: w hen travelling, especially in cases of forced/irregular migration: dual vulnerability as women and migrants High risk of physical and sexual abuse from smugglers, other migrants, law enforcement and border management officials,… Reduced acess to hygiene facilities. No access to contraceptives or reproductive health services. Increased risk of HIV/AIDS or STI. In detention or in case of deportation, high risks of rape and increased vulnerability for pregnant women.

9. 9 Gender as a determinant of migrants’ health status In countries of destination: Gender influences Gender influences the type of legal status migrant women enjoy and the opportunities to integrate to the labour markert Migrant women concentrated in occupations poorly regulated, high level of health risks and injuries and exposure to psychological, physical and sexual abuse. Migrant women’s immigration status is often tied to their partner, father, or employer, creating dependance and reluctance to report domestic violence. Irregular migrants reluctant to acess health providers by fear of deportation.

10. 10 Gender as a determinant of migrants’ health status Gender influences Gender influences the opportunities women will have to integrate socially in host society Language proficiency and cultural barriers will impact the acess to health information and services. Lack of family planning services increase likelihood of unwanted pregnancies In countries of destination: Lack of migrant-friendly health services have disproportionate impact on women.

11. 11 Gender as a determinant of migrants’ health status In cases where integration is difficult In cases where integration is difficult, migrant women can be exposed to domestic violence or traditional harmful practices with important effects on their health –Forced and early marriages –Honour crimes –Dowry-related violence –Female genital mutilations In countries of destination: Those health consequences can strongly impede their integration

12. 12 Migration brings opportunities for health Migration influences Migration influences gender relations by either perpetuating inequalities or challenging them. Migrants’ remittances support health, food and education expenses, thus improving the well being of communities left-behind New roles and behaviours for migrants and families left behind: Income provider, greater participation in community decision-making; Migration triggers new norms in migrants’ families: Higher age of marriage, lower fertility, greater educational expectation for girls, greater labour force participation. UNDP Human Development Report 2009 Change of status of women within the household can lead to better health for her and her children but can also trigger gender-based violence.

13. 13 Obstacles to migrant women’s health  Most government health surveillance does not disaggregate by immigration status (lack of data)  Migrants not included in policies and programs  Lack of coordination across sectors (health, migration, labour, etc.)  Victims of trafficking often unidentified and not referred to appropriate health services

14. 14 IOM response Research and Policy guidance Health promotion for migrants –HIV/AIDS –Reproductive health –Prevention of SGBV Information campaigns to prevent trafficking Training for health providers Direct assistance to migrants victims of exploitation

15. 15 IOM study, “Stolen Smiles: Physical and mental health consequences of women and adolescents trafficked in Europe” trafficked women aged between 15-45, 92% of respondents forced into sex work 76% physically assaulted by traffickers 90% experienced sexual violence lack of “predictability” of violence Severe concurrent physical and mental health symptoms 44% diagnosed for an STI. 17% had at least one abortion during the time 95% showed signs of depression 56% showed symptoms qualifying for PTSD Key projects Research:

16. 16 Preventing human trafficking: Through its programme, IOM estimates a third of victims of trafficking are mothers. IOM launched a nationwide public information campaign to raise awareness of human trafficking’s impact on children and families. An advertisement entitled “Have You Seen my Mother?” was broadcasted on TV channels and cinemas throughout Turkey. IOM Turkey has facilitated and been managing the government owned 157 helpline for trafficked persons since May 2005. As of February 2010, 157 helpline coordinated the rescue of 165 trafficked persons in Turkey. Keyprojects Key projects :

17. 17 Key projects Research and guidance: Caring for Trafficked Persons: Guidance for Health Providers strengthen health system response provides evidence-based tools for health providers provides practical, non-clinical advice recognize some of the associated health problems identify safe and appropriate approaches to providing healthcare for trafficked persons.

18. 18 Key projects Training health providers Adressing Female Genital Mutilation In Geneva, as part of a project to address Female Genital Mutilation among 4 migrant communities, IOM has been informing and sensitizing health professionals. A symposium was held -to inform them of the consequences of FGM on women’s and girls’ reproductive, sexual and mental health, -to encourage the exchange of best practices in providing the best medical care, psychological support -to build networks for the protection of girls.

19. 19 Key recommendations Improve data collection Advocate for the inclusion of migrant women in policies and programs Remove barriers to SRH services for migrant women – regardless of immigration status Improve health response for the most vulnerable migrants (women migrants who are victims of violence) Develop initiatives to eradicate the culture of violence against women, as a root cause of trafficking and exploitation of women and girls. Train health providers to respond to GBV among migrants Promote regular migration for the benefit of all

20. 20 Key messages Women migrants may face multiple vulnerabilities and may suffer gender- based violence at all stages of migration Migration is not a health risk but the conditions surrounding the migration process can lead to increased vulnerability Need to tackles problems in accessing comprehensive reproductive health services affect the health of migrant women

21. Teşekkür Ederim !