During the COVID-19 pandemic, migrants have often been denied rights and placed in situations which put them at heightened risk of infection. This webinar looked at migrant communities' explicit and implicit vulnerabilities in relation to COVID-19 and considered the ethics of implementing selective and restrictive public health measures for such communities.
Professor Lisa Eckenwiler, Department of Philosophy, College of Humanities and Social Sciences, George Mason University, Fairfax, Virginia, USA
Professor Vanessa Grotti, Associate Professor of Anthropology, Alma Mater Studiorum - Università di Bologna, Department of Cultural Heritage (DBC), Ravenna, Italy
Dr Thalia Arawi, Founding Director, Salim El Hoss Bioethics and Professionalism Programme (WHO Collaborating Center for Ethics), American University of Beirut, Beirut 1107 2020, Lebanon
Dr Jane Lim, NUS Centre for Biomedical Ethics, National University of Singapore, Singapore
Professor Lisa Eckenwiler introduced the seminar, noting that migrant communities encompass a broad range of people and contexts; however, most are marginalised, and subsist in substandard or hostile accommodation, precarious work, without documentation or recourse to public funds or even basic rights. To quote Michel Foucault and Michel Agier, most migrants exist in ‘carceral out places’ designed by states to ‘park and guard’ them. Stringent immigration policies which prevent relocation means this displacement can often occur over long periods of time. Migrants are therefore ‘vulnerable’ and live in varying states of precarity that exist due to structural inequities which have been exacerbated by the COVID-19 pandemic. This has led to disproportionate illness and death. Professor Eckenwiler argued that at this perilous point in history, we must urgently address what’s ethically warranted to halt the erosion of both ethics and migrant health, and prepare for a future where both migration and the threat to public health are dealt with effectively.
Dr Talia Arawi noted that the distinction between workers and migrant workers is morally questionable. After all, we are all human beings that exist with the same rights, including the right to dignity. The truth however is that migrant workers are often forgotten about, and exist as a crisis within a crisis. This is despite the fact that many are working on the ‘frontline’ in essential services. The COVID-19 pandemic exposed the structural inequalities migrant communities face, including stigma, discrimination, and unequal access to healthcare, vaccinations, compensations, and rights. While it is true that some migrants were unable to be relocated during the pandemic and became trapped, others underwent forced repatriations in a zeitgeist of rising xenophobia. Dr Arawi argued the term refugee has been distorted from its original meaning and now carries with it a tacit belief that refugees are perpetually displaced people; and people who simply cannot and should not live beyond their limitations. Drawing on Ghassan Kanafani’s novel Men in the Sun, which documents Iraqi refugees who die in an empty septic tank in the back of a lorry while being smuggled into Kuwait, she quotes the final line, when the smuggler finds them dead: ‘Why didn’t you knock on the side of the tank?’ She argued that migrants are disempowered; however they have a right to knock, and if they can’t knock we should knock on their behalf. How can we do this? Dr Arawi argued that standing up for migrants requires both moral courage and imagination. She concluded by stating xenophobia is a pandemic, only in this instance there is no attempt to find a cure. Quoting Aime Cesaire, she said ‘the work of man is only just beginning, and it remains to conquer all the violence entrenched in the recesses of our passions […] No race possesses the monopoly of beauty, of intelligence, of force. And there is a place for all at the rendezvous with victory.’
Professor Grotti started her presentation with a pertinent observation: Most of us will be able cross borders and reside in host or transit countries because we have passports, but those who don’t cannot. This is a fundamental inequity, which reveals that not all people are equal. The word ‘migrant’ as defined by the International Migration Organisation is an umbrella term that doesn’t have any legal seating; therefore it can encapsulate workers, asylum seekers, refugees and so on. Professor Grotti said that from 2020-onward, during the COVID-19 pandemic, she directly observed migrants facing a variety of challenges at the border, including access to healthcare and medicine, mistreatment, and infrastructure which includes formal and informal methods of detention or camps. However, borders are also laws, practices and policies: they exist on paper, but also in the way people treat other people, and finally in the infrastructure. Because migrants are fundamentally bonded by the right to mobility, which conflicts with the apparent necessity of states to account for and control all human beings, it places them at a disadvantage. Historic minorities who are nomadic or semi-nomadic who have refused the push to sedentarise, particularly during the COVID-19 pandemic, are now placed in a low socio-economic status and have poorer health outcomes. This is likely to affect second, third and even fourth generations. Professor Grotti argued that borders (as in the above definition) are often enforced in an arbitrary way which increases vulnerability among migrant communities, but also adds further risks to population health. For example, in the pandemic the knee-jerk reaction to restriction of freedom of movement didn’t stop border crossings, thereby forcing those making such journeys into increasingly perilous situations which often involved confinement and a higher risk of illness and death. Professor Grotti finished her presentation by reflecting on the right to health: health inequities can be solved via a universal system, free at the point of delivery and which doesn’t distinguish between levels of deservedness. This should exist as a constitutional right, and in many EU states it does. However, access wasn’t guaranteed in the respective countries, and a lack of communication, information and education among border officials meant migrants couldn’t access it. In conclusion, it’s high time we use the right words and concepts to name what we are observing. That this is not just random but rather the strengthening of arbitrary state of emergency measures which seek to contain people.
Dr Jane Lim finished the panel discussion by focusing on the migrant worker community in Singapore. Dr Lim noted that while migrant workers are integrated into the country labour force, accounting for 35-40% of it, they face other types of social and economic vulnerabilities. Most are low-wage workers, from LMICs. They tend to work in labour intensive sectors such as domestic work, construction, manufacturing, ship-building and ship repair. They also contend with various structural inequalities including the precarity of work, healthcare access, economic conditions, as well as various forms of explicit and implicit othering. All of this has been exacerbated by the COVID-19 pandemic. They also experienced differentiated pandemic policies as well as media narratives that stigmatised them. On the latter point, media analysis of local mainstream media, showed that ‘othering’ narratives occurred across contexts: the objectification of migrant workers as low-skilled labour, in the context of delayed economic outputs, and in the racialisation of migrant workers relating both to COVID-19 cases and vaccination uptake rates. However, the most salient example of vulnerability was their epidemiological vulnerability. In Singapore most migrant workers live in purpose built dormitories situated away from wider communities, and which can hold three to twenty-five thousand workers. These dormitories are designed for communal living but are always densely populated with between 12 to 20 individuals in a room. This made infection prevention measures ineffective, and transmission highly likely. Dr Lim argued it is no surprise that massive outbreaks of COVID-19 occurred in migrant worker dormitories and by May 2020 made up 90% of all COVID-19 cases. Lockdown followed, where migrant workers were confined to the room thereby increasing the risk of transmission further. On a brighter note, the COVID-19 pandemic compelled the government to change some of the physical infrastructure for the community. In September 2021, new policies were introduced to improve standards, including the creation of larger living spaces and improved ventilation. In November 2021, the country also introduced a new healthcare financing scheme for both employers and migrant workers which will hopefully serve to provide more affordable and accessible healthcare. On a smaller scale, ground-up initiatives include addressing food security needs, to advocacy and mental and emotional wellbeing are taking place. Dr Lim concluded with a final unanswered question: How do we formalise these initiatives and include migrant workers in decision-making processes to build resiliency and empowerment in the community? Furthermore, how can we be more proactive in creating inclusive and sustainable policies which safeguard migrant workers’ health in public health emergencies?
There are laws and regulations to safeguard migrant workers, and yet we keep seeing these laws and regulations being challenged and disrespected. What then is the relevance of the regulations, if those who breach laws are not held accountable?
Professor Grotti argued there is no single solution. Highlighting the recent influx of refugees in Europe in consequence to the Russian invasion of Ukraine, she emphasised the initialisation of a European Union directive which made it simple for refugees to enter a host country and access vital services. However, this directive has existed for three years, and, despite multiple refugee crises across the world, was never activated until now. It is arbitrary processes like this, for which we need to hold decision-makers to account. Dr Lim added to this, arguing that in regards to migrant workers, particularly in Singapore, there is a diffusion of responsibility amongst all the actors who are responsible. So while there is no simple answer, holding people to account at various points in the process is a starting-point. Professor Eckenwiler drew upon the work of Associate Professor of Sociology at York University, Fuyuki Kurosaw, stating that ethical arguments should be secondary to empathy which arises through a better appreciation of the physical act of labour itself. Civil society has a role in stimulating the moral imagination and compassion of all citizens through counter narratives, which truly depict the lives of migrant workers.
What resources do migrants have when their rights are violated, and what mechanisms can be used to ensure they are working?
Professor Grotti drew upon her research on access to sexual reproductive health during the pandemic. In Italy, rights available in law and provided by state and private clinics were noticeably reduced, preventing pregnant women from accessing terminations they were legally entitled too. In the case of the most vulnerable, they were reached by organisations who were monitoring them, and tentative new initiatives to plug the gap emerged. So there was an awareness of inequity, however, Professor Grotti said it was scary to observe how quickly some health problems became non-essential. Migrant communities bore the brunt of this.
Can you comment on different migrant categories, including migrant academics? If so, according to the evidence, are certain groups impacted by the COVID-19 pandemic differently.
Dr Arawi quoted Albert Camus’ Noble Peace Prize speech: ‘Each generation doubtless feels called upon to reform the world. Mine knows that it will not reform it, but its task is perhaps even greater. It consists in preventing the world from destroying itself.’ States have a difficult task ahead, in remoulding future generations perhaps in order to recognise that we are the same ephemeral humane finite beings. Professor Eckenwiler agreed, arguing that the differentiation of migrant groups is unhelpful, and commenting that we are bound together by the constitutions we share but also the ontological connections as fellow human beings.