Medical Healthcare

Medical 2

The challenges.
One major challenge is that South Africa’s healthcare facilities are unable to access health records of people moving within the country.

The result is that clerks and healthcare providers are forced to spend time trying to trace client records. Very often they can’t, and have to open a new file and begin the process again. Not only does this take up time, but it also means that the needs of all who migrate are compromised.

This has implications for accessing testing and treatment. Migrants struggle to continue treatment and care because health facilities in different locations are not linked, and – for those moving into and out of South Africa – treatment regimens across the region differ.

In the case of TB and HIV, long treatment regimens are needed and there’s a risk of treatment being disrupted due to migration. This has implications for resistance and – in the case of HIV – increasing the risk of onward transmission.

The consequences are dire for patients, as well as the broader population.

Tied to this is the fact that migrants may find themselves living and working in environments in which they are at higher risk of acquiring HIV than the general population. These include commercial farms, mining communities and urban informal settlements. In the context of migrant labour, many people work in dangerous and exploitative conditions, that are associated with occupational health risks including injuries linked to working in the mining and agricultural sectors.

Another challenge relates to antenatal care and childbirth. Many South African women living in urban areas choose to return to their rural homes to deliver their babies. This can lead to a chain of events that affect both the mother and the child. For example, women may miss antenatal care visits because they’ve moved away from the first clinic they visited. Then after the baby is born, it can mean that their babies aren’t entered into the vaccination system when they return to the city.

The movement of people also makes it hard for the country’s health system to respond to non-communicable diseases like heart disease and diabetes. These too require long-term, chronic treatment and support.

Added to this is the fact that migrants face multiple forms of violence. For foreign nationals, various forms of structural, physical, and verbal xenophobic violence are persistent.

Some international migrants may be undocumented and experience further stress due to fear of arrest, detention and deportation. This is further coupled with xenophobic violence – and the fear of violence – which negatively affects migrants’ mental and psychosocial well being.

People seeking asylum based on sexual orientation or gender identity are also likely to experience violence in South Africa.

By establishing a national migration and health task team, South Africa could develop a similar approach that engages with internal and international migration.

South Africa’s healthcare system can’t afford to ignore migration.

31 July 2019 – Sasha Frade, Jo Vearey and Stephen Tollman.

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