The world is experiencing the greatest forced migration crisis since World War II — originating in fragile states in the Middle East and Africa and now spilling over to Europe. Nearly 60 million asylum seekers, refugees, and internally displaced persons (IDPs) have fled their homes to escape conflict, violence, and starvation.
This global migration crisis shows no sign of abating, with intense political discord in host countries compounded by a failure of the international community to develop appropriate and sufficient strategies to assist the displaced. A divided European Union (EU) voted to distribute 120,000 asylum seekers, even though it currently hosts some half-million asylum seekers. The United States plans only to raise its annual refugee cap from 70,000 to 100,000 by 2017, which won’t make a dent in assisting the outpouring of humanity crossing international borders daily.
Mass forced migration poses major health hazards for those on the move, including increased risk of physical and sexual violence, mental distress, and scarcity of food, water, and shelter. The risk of epidemics is heightened through over-crowding, decreased hygiene, unsanitary conditions, and exposure to disease vectors (e.g., rats and mosquitos). Forced migrants also have limited access to preventative services such as vaccines, essential medicines, and basic health care, including safe childbirth. Lower-income states, with weak health systems, host the vast majority of migrants, which burdens their already fragile health and social security systems. However, even for those forced migrants who make it to high-income states, there are barriers to health care access such as culture, language, geography, and limited state benefits.
Sadly, international law is lacking when it comes to protecting this vulnerable group, providing “no comprehensive legal instrument at the international level that establishes a framework for the governance of migration.” Instead, international law and regional agreements impose a patchwork of binding and non-binding state responsibilities depending on the migrant’s legal status. Refugees have a range of entitlements once states have processed and affirmed their protection claims. Asylum seekers, however, have few rights unless they gain refugee status, and international law barely recognizes the plight of internally displaced persons.
Refugees And Asylum Seekers
The 1951 Refugee Convention and its 1967 Protocol offer the clearest international protections to forced migrants who meet the criteria to be considered a “refugee.” For these individuals, host countries are required to provide education, employment, and social security at levels equivalent to state nationals including health care access for injuries, maternity, sickness, disability, and old age.
Asylum seekers are individuals who have crossed an international border seeking protection as a refugee, but whose claims have not been evaluated under the Convention. State parties have an obligation to determine a claim for refugee status, but do so according to their own national systems. The current influx into Europe has become so chaotic and lawless largely because European states have not designated migrants from conflict states such as Syria as prima facie refugees. This means that each state is implementing its own process for determining the status of individuals under the Convention. These asylum seekers are left to languish without protection or many basic rights while host countries work through long queues of applicants.
The crisis in Europe is exacerbated by an interpretation of the Convention that asylum seekers must claim refugee status in the first safe state that they reach. Instead, many are attempting to cross multiple borders to reach countries such as Germany that are believed to be more hospitable to asylum seekers. Some European governments are forcibly returning asylum seekers to the first country they entered on the continent; instead, these states should process their claims for asylum taking into account their full circumstances according to the United Nations High Commissioner for Refugees (UNHCR) including issues such as family reunification, rule of law within a particular country, or any other “good cause.” These considerations along with the clear mandate in the Convention that states not punish asylum seekers because of their presence in a country make the current European situation even more unpalatable.
Internally Displaced Persons
Neither the Refugee Convention, nor any other international treaty applies to internally displaced persons (IDPs), even though internal displacement is the most common forced migration globally. IDPs flee for the same reasons as asylum seekers; ironically, however, they remain technically under the ‘protection’ of their home government, even where the violence prompting their exodus is state-inflicted, such as in Syria.
In the absence of binding law, the 1998 Guiding Principles on Internal Displacement requires states to provide basic necessities, such as food, water, shelter, clothing, sanitation, and medical services. Rather than “respecting life and dignity,” states routinely flout the Guiding Principles. States claim sovereignty to shield themselves from international intervention even for gross human rights abuses.
The international community has failed to confront the sovereignty argument. After all, the clear purpose of international agreements is to overcome state claims to sovereignty. Even the World Health Organization wrongly emphasized that humanitarian intervention should be undertaken “with the consent of affected States and in conformity with relevant provisions of international law.” Yet under the guiding principles, the international community has a duty to protect individuals suffering gross human rights abuses, including the right to health whether or not the state consents.
A Turning Point For Europe
The Schengen Agreement guarantees passport-free movement across most of the bloc, which EU Commission President Jean-Claude Juncker called, “a unique symbol of European integration.” Police barricades and security fences, along with detention camps, have strained the principle of a border-free Europe. Seeking to impede travel from Hungary and Austria, Germany and Slovakia issued border controls, with the Netherlands and Poland considering similar action. In June, France prevented mostly African migrants from entering via Italy. The Schengen Agreement permits only temporary border restrictions for national security purposes. Although this is a political crisis, it is hard to justify labeling it as a national security threat.
Beyond the Schengen Agreement, EU members are contravening multiple policy directives. The Reception Conditions Directive requires states to respect migrants’ “fundamental rights,” with detention a “last resort.” The Dublin Regulation places the responsibility for examining an asylum claim “with the member state which played the greatest part in the applicant’s entry or residence in the EU.” The Asylum Procedures Directive ensures consistency across the bloc for reception and processing of asylum claims. Although these directives are non-binding, they ought to have deep influence on political strategies to the crisis.
The highly divergent national rules for entry of asylum seekers, police barricades, detentions centers, and the forced removal of asylum seekers all place the European project at risk, with no accountability for evading EU rules.
There is one certainty, which is that vulnerable populations will continue to flee violence either within their country or across borders. Without a comprehensive international system holding states accountable, the health and lives of millions are in peril, while international aid organizations are unable to effectively function. The sheer scale of forced migration, along with its potential to spread infectious diseases, is a matter not only of the right to health, but also of global health security to prevent the reemergence of diseases such as polio.
Many asylum seekers will eventually receive refugee protection status; it serves the national interests of host countries to ensure a system of universal health coverage including prevention and treatment. And it is very much in the international community’s interests to build health system capacity to prevent public health emergencies of international concern. Pro-active protection of health and security should be an obligation under international law, but it also is a moral imperative.
from Health Affairs Blog http://ift.tt/1KOsKjk
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