1. Global Business Coalition Conference on TB/HIV Health Vulnerabilities of Mine Workers Natalie Ridgard Migration Health Project Officer International Organization for Migration 12 October, 2010 Johannesburg, South Africa

2. International Organization for Migration Intergovernmental organization established in 1951 Intergovernmental organization established in 1951 Committed to the principle that humane and orderly migration benefits migrants and society Committed to the principle that humane and orderly migration benefits migrants and society 127 Member States, 94 observers and more than 450 field locations 127 Member States, 94 observers and more than 450 field locations

3. IOM’s approach to Migration Health Migration Health: The physical, mental, and social well-being of migrant and mobile populations and host communities affected by migration. Human rights perspective Human rights perspective Consider public health needs of host communities and impact on communities of origin Consider public health needs of host communities and impact on communities of origin Address broader social determinants of health Address broader social determinants of health Focus on ‘spaces of vulnerability’ Focus on ‘spaces of vulnerability’

4. IOM’s Partnership on Health and Mobility in East and Southern Africa (PHAMESA) Overall objective: To contribute to the improved standard of physical, mental and social well being of migrants by responding to their health needs throughout all phases of the migration process, as well as the public health needs of host communities. Works with labour migrants and mobile workers, forced migrants and irregular migrants, and people affected by mobility. PHAMESA consists of five components – under the service delivery and capacity building component we implement our project model in two mine worker-sending sites in Lesotho and Mozambique (in partnership with TEBA Development).

5. Structural, environmental and individual drivers of health (HIV & TB) vulnerabilities of mine workers Environmental Factors Structural Factors Individual Drivers Masculine identity and gender inequalityMasculine identity and gender inequality Mobility is primary livelihood strategy High levels of gender inequality Lack of migrant health policies and guidelines Dangerous working conditions Time spent away from familiesTime spent away from families Boredom, loneliness and social exclusionBoredom, loneliness and social exclusion Limited access to health careLimited access to health care Availability of sex and alcoholAvailability of sex and alcohol TB co-infectionTB co-infection Partners of mine workersPartners of mine workers Low/inconsistent condom useLow/inconsistent condom use Poor education and HIV knowledgePoor education and HIV knowledge

6. IOM’s regional workshop on HIV in the mining sector Held in Maputo, 27 & 28 May 2010 Held in Maputo, 27 & 28 May 2010 Brought together stakeholders from 8 SADC countries – government, international organisations, NGOs, mine workers associations, unions, private sector Brought together stakeholders from 8 SADC countries – government, international organisations, NGOs, mine workers associations, unions, private sector Objectives: Raise awareness ; share lessons learned; identify gaps in research, policy and programmes; facilitate networking and outline key components of a regional HIV prevention and care programme in the mining sector Objectives: Raise awareness ; share lessons learned; identify gaps in research, policy and programmes; facilitate networking and outline key components of a regional HIV prevention and care programme in the mining sector

7. Workshop recommendations Harmonise SADC treatment protocols Harmonise SADC treatment protocols Address boredom and loneliness (recreational activities – alternatives to alcohol and sex) Address boredom and loneliness (recreational activities – alternatives to alcohol and sex) Government should improve and expand statistical data collection on migration Government should improve and expand statistical data collection on migration

8. Key workshop recommendations Address current accommodation system for mine workers Address current accommodation system for mine workers Improve referral system to ensure continuum of care for employees exiting the industry Improve referral system to ensure continuum of care for employees exiting the industry Get involved in improving compensation system Get involved in improving compensation system Address low uptake of VCT and ART Address low uptake of VCT and ART

9. Key recommendations for sectors employing migrants Strengthen public-private partnerships Strengthen public-private partnerships Use “spaces of vulnerability” approach in programming (SBCC; gender; access to health services etc.) Use “spaces of vulnerability” approach in programming (SBCC; gender; access to health services etc.) Improve access to and uptake of health care services Improve access to and uptake of health care services

10. Thank you Natalie Ridgard nridgard@iom.int