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ICPD and the Issues Facing Women in International Immigration
GLBH 550: Women in Development Loma Linda University-School of Public Health July 11, 2008 T.Pruna
³Remember, remember always, that all of us, and you and I especially, are descended from immigrations and revolutionists. ³ -F. D. Roosevelt
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Introduction The 1994 Cairo International Conference on Population and Development (ICPD) was
the fifth intergovernmental population conference sponsored by the United Nations. The conferences developed from a concern of rapidly increasing populations. These inceasing populations were seen as hindering the development of countries by requiring more resources. Outcomes of these meetings were resulted in increased usage of contraceptives and family planning methods. The Cairo conference of 1994 however, took the conference in a different direction, mainly due to a large feminist influence from the many women headed NGO¶s that were present. During this conference, more emphasis was put on reproductive rights of women instead of population and family planning (Finkle and McIntosh, 2002). Emphasis was also put in recruiting the participation of NGO¶s. The conference developed a 20 year plan of action that changed its focus on women¶s needs instead of trying to reach a demographic target as had been done in years past (UNFPA, 1995). Goals of the conference included providing universal education, reducing child, infant and maternal mortality, reducing STI transmission and providing universal reproductive health care by 2015. II. International Migration Because of the progressive ideas of the women NGO¶s that were present during the Cairo conference, another topic of importance was introduced: international migration. International migration even got its own section in the Programme of Action. Although previous conferences had not addressed the issue of international migration, the 1994 conference recognized that international migration is a growing concern in these modern times and that policies need to be put in place to address the issues. Although Section X did not specifically address how
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immigration affects women, it focused on many subtopics such as human trafficking that are predominately women¶s issues. Even though there are many forms of migration, the reasons for international migration are usually the same: economic imbalance and poverty, human rights violations, lack of peace and insecurity in the home country (UNFPA, 1995). Migrants come in search for opportunities that are not available to them in their home country and thus the majority of international migration occurs from lesser developed to developed countries. Of the 36 million people who migrated between 1990 and 2005, 33 million settled in industrialized countries (UNFPA, 2006). International migration can be beneficial to both the country of departure and the host country if under the right circumstances. Expatriates frequently send remittances to the home country and this becomes an important part of the home country¶s economy. The host country on the other hand gains workers for their labor force and a culturally diverse country. Discussing the topic of international migration during a forum as large as ICPD was a big boost to the cause. It was an opportunity to bring up an issue that is well known but had previously not been talked about, especially the harm it causes women. Whatever the reason for international migration, policies need to be implemented to ensure that the host country can handle the influx of migration without harming their economy and that the home country does suffer from the loss of workforce. Cairo¶s ICPD made it an objective to solve the root of the problem of international migration and ensure that remaining in one¶s country and living a good life is a feasible option.
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Specific Issues in International Migration The issue of international migration has grown in importance even in the 14 years since
1994¶s ICPD. With modes of transportation more readily available and the increase of globalization, populations are more connected than ever before to other countries, thus making migration more within reach. International migration is at one of the highest rates in history with 191 million people living outside the country of birth. Women make up half of those numbers, with 95 million (UNFPA, 2006). Too often however, international migration goes wrong and robs the home country of needed human resources. Other detrimental effects result from human trafficking, whether voluntary or not, undocumented citizens and refugee and asylum seekers that put an extra strain on the host country to provide security and housing and can often lead to resentfulness and xenophobia from the host country. Trafficking One form of international migration is human trafficking. Human trafficking is not always forced. When a girl goes willingly to another country to seek opportunities, it is very often a result of trickery and deceit. A women¶s consent is therefore irrelevant and does not take away the title of human trafficking (The Lancet, 2004). Although sex trafficking is the most commonly discussed form of human trafficking, trafficking is not limited to sexual exploitation. Girls sign up through agencies or are recruited by acquaintances or even family members with the false promises of gaining employment as domestic workers, entertainers or models only to find out the truth upon arrival: they will be sex workers, the lucky ones will work in illegal sweatshops. They are turned into modern day slaves.
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Human trafficking is the third largest illicit business in the world and generates approximately 7-12 billion U.S. dollars per year. Once entering the new country, there is no way to return home, because women¶s passport and money are taken away upon arrival. Women make up 56 percent of forced economic exploitation and 98 percent of commercial sex exploitation (UNFPA, 2006). The United States Department of Stated estimates that the greatest amount of women come from Southeast Asia, over 225,000 per year, and 100,000 from Russia and the former Soviet Union (Miko and Park, 2000). Trafficking worldwide grew almost 50 percent from 1995 to 2000 (Rehn and Serliff, 2002). Those who become tangled in the net of sex trafficking face a myriad of mental and physical problems, including depression, physical abuse, STI¶s, and unwanted pregnancies to name a few. Even if girls escape the lifestyle of commercial sex worker, the effects remain with them forever. In a study released in the Journal of American Medical Association, Nepalese girls were repatriated after being trafficked to India as sex workers. Upon repatriation, 38% were diagnosed with HIV; the rates were higher among the younger girls (Silverman, Decker, Gupta, et al, 2007). The psychological effects of trafficking are in many cases harder to treat than the physical effects. Trafficked immigrant domestic workers are another group that fall into the genre of human trafficking. Latin American domestic workers represent 60 percent of all international migrants from Latin America (UNFPA, 2006). Although counter intuitive, domestic workers face the same amount of risk as do commercial sex workers. The vulnerability of domestic workers is magnified by the fact that workers are isolated within the home of their employers and out of view from outsiders. These women are often beat, denied food, or work for unfair wages. This form of abuse can be found everywhere and the United States is no exception. In June,
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2008, a millionaire couple from New York was convicted of exploiting two Indonesian housekeepers by enslaving and torturing them for years (CNN, 2008). The women were denied food, made to sleep on the floor and one was even forced to eat her own vomit. Brain drain One cannot discuss women¶s immigration without mentioning the other spectrum of the issue: brain drain of educated women. A big reason for immigration is due to lack of opportunities in the home country for women due to poor economic situations and the low status of women in the country. It is not just the poor that are emigrating from their home countries in search of better opportunities. This growing trend of feminization of immigration is shattering the stereotypical view of immigrants. It is generally believed that immigrants are poor and uneducated, but the majority of persons that emigrate are better educated than the rest of their home population (UNFPA, 2006). For professional women, immigrating to a developed country provides an opportunity to reach their full potential in their field. Many talented, educated women reach the ³glass ceiling´ and can only rise to mid-level jobs in their field, solely because they are female. Women very often receiv salaries less than their male-counterparts for performing the same job, a trend that can be seen even in the United States. This bias towards men leaves qualified women with two choices: settle for a position in which they are overqualified, or seek employment elsewhere. It is not surprising then that the emigration rate of highly skilled women is higher than that of highly skilled men, 17.6% and 13.1% respectively (Dumont, Martin, Spielvogel, 2007). In a study published in The Lancet, over 13,000 physicians trained in sub-Saharan Africa now work in Australia, Canada, The United Kingdom and the U.S (Mills, et al, 2008). Wealthier countries such as these have the resources to recruit physicians and it is because of this that
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developed countries maintain their high doctor to patient ratio. This action has the negative consequences for the home country because of the depletion of the number of trained personnel. The effects are particularly deleterious for countries in sub-Saharan Africa that have some of the highest infectious disease burdens in the world.
Refugees, asylum-seekers and displaced women Life in a refugee camp is difficult for everyone but women are particularly at risk. Women are more likely to be physically and sexually abused either from their husbands, from rebel soldiers or even peace keepers. An article in the British Medical Journal exposed many issues that are unique to women refugees. Women are often left out from training programs and left in a weak position to care for their families (Burnett and Peel, 2001). Even when women are given the opportunity to work, the new role can cause tension in the family. The stress of refugee life and the role reversals can lead to physical abuse from the husband due to his feelings of ineptitude. Because women tend to put their own needs behind that of their family¶s, their health may suffer. In one study performed on refugees, only 5% of women over the age of 50 had received a mammogram in their lifetime (Burnett and Peel, 2001). When health care is offered to refugee and displaced women, many decline because of the sex of the health care provider and the lack of sensitivity to the women¶s culture. The legal rights of women asylum seekers are often unfair and in many places she can lose her status if she separates from her husband. For this reason many women chose to endure the domestic violence they are victims of (Burnett and Peel, 2001).
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Health issues in documented and undocumented migrants Once an immigrant successfully enters the host country, legally or not, the troubles are far from over. For undocumented immigrants, the risk of deportation is constant fear. For mothers who have given birth to children in the United States, this fear is intensified by the very real possibility that they will be deported without their children. For first generation immigrants, documented or undocumented, the process of adjusting to the host culture can be difficult. Gender roles may be very different from their home country, especially for women. Even after receiving proper documentation, prejudices and stereotypes of the immigrant¶s culture will remain with them. Society may assume that they do not speak the host country language or that they are uneducated. It is not just social barriers that need to be overcome, but health issues must be addressed. Contrary to popular belief, immigrants do not always come into the host country as destitute underdogs, but often have an advantage, especially when it comes to health status. A study printed the International Journal of Epidemiology that was performed in Germany found that immigrants who entered the country were on average healthier than the host population. The mortality rate for immigrant men and women was significantly lower than the host population, 36 percent and 44 percent, respectively (Razum, Zeeb, and Rohrmann, 2002). Unfortunately, as the immigrant became acculturated to the lifestyle and habits of the home country, the health advantage diminished. After this initial period of superior health, the odds are reversed, especially in the United States. In another study released in the American Journal of Public Health found that health care expenditures are much lower for immigrants than they are for the host country population (Mohanty et al, 2005). This cannot be attributed to better health but rather to several issues such
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as poor access to healthcare, being uninsured, communication and cultural barriers and fear of deportation. Immigrants on average reported being in poorer health than their U.S. counterparts and yet sought care less often. This fact can be seen in the statistics for health expenditures. The health expenditures of U.S. born citizens was $1342 higher than for immigrants (Mohanty et al, 2005). Of greatest interest however was that even in the sectors that provided free care, immigrants were underrepresented. For immigrants, more money was spent on emergency department visits than in primary health care. Immigrants avoided seeking care until symptoms became more severe, usually because of fear of deportation and inability to pay. IV. Public health measures that need to be implemented At the 10 year ICPD review in 2004, officials recognized that international migration has grown to be a larger issue than it was in 1994. The goals were expanded upon but little has been done in the field of legislation and policy. Although international immigration was a section of the 1994 ICPD it was largely overshadowed by larger issues such as reproductive health. Officials stated that current policies need to be expanded to cover all the fields of migration including economic migration and family reunification. It was also suggested that policies would be stronger and more comprehensive if immigrants themselves played a role in the process (UNFPA, 2005). One section of migration that has seen little change is that of refugee and asylum women. Though it is becoming growing knowledge that women are particularly at risk for rape and violence in refugee camps, support for funding reproductive health (RH) initiatives in this field has been little. The lack of support is due to the increasing conservatism among government
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officials (Guy, 2003). Although RH is far more than just abortion services, many governments, including the U.S., will not provide funding for RH clinics if abortion services are provided. Ensuring that women who have been raped have access to critical healthcare services such as abortion is an integral part of improving the child and maternal mortality ratio, which is another topic discussed at the ICPD. These services are important especially since rape commonly leads to unwanted pregnancies which make the child more vulnerable for neglect. Additionally, policies need to be updated to improve the rights of women asylum seekers so that their status is not dependent on their husband or any other male. Based on the American Journal of Public Health article, immigrants do not place a disproportionate financial burden on the health care, because they seek care less often. This fact alone should help alter the negative opinions that many hold about immigration. More needs to be done to decrease this health disparity and to dispel the negative attitudes and assumptions that immigrants drain a countries resources. Further public health measures should include improving the security in refugee camps and changing protocol such as providing families with firewood and certain supplies to decrease the vulnerability of the women who typically are responsible for such daily duties (The Lancet, 2002). This would protect women from the threat of rape they encounter while doing these tasks. Measures should also be taken to improve women immigrant¶s attitudes toward healthcare. Many women feel it is not within their reach or they place their family¶s health above their own. ICPD called for countries to target the root problems of immigration and several countries did. Many Latin American countries are currently working on incentives as a way to lure immigrants back to their home country. Several Eastern European countries and Arab states
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have adopted programs to fight drug trafficking (UNFPA, 2004). Developed countries have also made strides and several are creating programs that recruit skilled laborers during labor shortages, similar to the Bracero program the United States created in the 1940¶s. A study performed by the United Nations Population Fund found that 73 percent of developing countries had taken some action in dealing with international migration since the 1994 conference (UNFPA, 2004). Although 37 percent of the countries developed legislation on international migration, little work has been done to focus specifically on the safety and rights of women. Only 10 percent of developing countries interviewed in UNFPA¶s survey had passed laws on human trafficking that specifically addressed women (UNFPA 2004). Even though some countries have tried to improve equal opportunity for immigrants in jobs and housing, the focus should be on improving equal opportunity so that women don¶t have to emigrate. V. Conclusion Many countries heeded the suggestions of Cairo¶s ICPD and made efforts to improve not only the status of immigrants but also the reasons that contribute to immigration in the first place. Despite the efforts and policies that have been implemented, little focus was given to women¶s immigration issues. Much work still needs to be done to improve the status of women so that they can reach their full potential without having to migrate thousands of miles in search of better opportunities. The Cairo ICPD cracked open the door and shed light on international migration but now, 14 years later, the door needs to be swung open and focus given to women¶s development. When women are given the same opportunities as men and equally empowered, each country will reap the benefits from the contributions they make.
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Burnett, A., and Peel, M. (2001, March 3). Health needs of asylum seekers and refugees. British Journal of Medicine. 322: 544-547. CNN. (2008, June 26). N.Y. millionaire gets 11 years in prison for enslaving workers. [online version]. Retrieve July 6, 2008 from http://www.cnn.com/2008/CRIME/06/26/sabhnani.sentence.ap/ Dumont, J., Martin, J., Spielvogel, G., (2007). Women on the move: The neglected gender dimension of the brain drain. Organization for Economic Co-operation and Development. Retrieved July 6, 2008 from http://ftp.iza.org/dp2920.pdf Finkle, J., and McIntosh, A. (2002, March). United Nations Population Conferences: Shaping the policy agenda for the twenty-first century. Retrieved June 25, 2008, from, http://www.arha.org.au/papersandarticles/op%20vol%202%20paper%202%20finkle%20 and%20mcintosh.pdf Guy, S. (2003). Refugees and the Cairo program of action in : The European Magazine for Sexual and Reproductive Health. 57: 14-15. Retrieved online at http://www.euro.who.int/document/ens/en57.pdf Miko, F. T., and G. Park. 2000. "Trafficking in Women and Children: The U.S. and International Response." Congressional Research Service Report. No. 98-649 C. Washington, D. C.: United States Department of State. Mills, E., Schabas, W., Volmink, J., Walker, R, Ford, N., Katabira, E., et al. (2008). Should active recruitment of health workers from sub-Saharan Africa be viewed as a crime? The Lancet. 371:685-688 Mohanty, S., Wollhandler, S., Himmelstein, D., Pati, S., Carrasquillo, O., Bor, D. (2005). Health care expenditures of immigrants in the United States: A national representative analysis. American Journal of Public Health. 95 (8): 1431-1437. Razum, O., Zeeb, H., Rohrmann, S. (2002). µThe healthy migrant effect¶, not merely a fallacy of inaccurate denominator figures. International Journal of Epidemiology. 29(1):191 Rehn, E. and Serliff E. (2002). Women, War and Peace: The Independent Experts¶ Assessment on the Impact of Armed Conflict on Women and Women¶s Role in Peace-building. United Nations Development Fund for Women. Retrieved July 5, 2008 from http://dagdok.org/pages/documents/pdf/unicef-WomenWarPeace%5B1%5D_64.pdf Silverman, J, Decker, M, Gupta, J., et al. (2007). HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women. Journal of American Medical Association. 298(5):536-542. The Lancet. (2004, February 14). Distortions and difficulties in data for trafficking, 363:566.
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The Lancet. (2002). Violence and internally displaced women and adolescent girls. 359:1782 United Nations Population Fund. (1995). ICPD Programme of Action. Retrieved July 3, 2008, from, http://www.unfpa.org/icpd/icpd_poa.htm United Nations Population Fund. (2004). State of the World¶s Population. Chapter 4 of The Cairo Consensus at Ten: Population, reproductive health and the global effort to end poverty. Retrieved July 7, 2008 from http://www.unfpa.org/upload/lib_pub_file/327_filename_en_swp04.pdf United Nations Population Fund. (2005). The world reaffirms Cairo: Official outcome of the ICPD at ten review. Retrieved July 5, 2008 from, http://www.unfpa.org/upload/lib_pub_file/404_filename_reaffirming_cairo.pdf United Nations Population Fund. (2006). A passage to hope: Women and international migration. Retrieved July 5, 2008 from http://www.unfpa.org/swp/2006/english/chapter_1/index.html
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