A good response to the challenges faced by migrant groups requires good preparedness : preparedness is the basis for building adequate capacity in the medium and long term , requiring robust epidemiological data on the refugees and migrants , careful planning , training and , above all , adherence to the principles of human rights .”
Being sensitive to the health needs of migrants cannot be overlooked , researchers say . As Wickramage , et al . ( 2018 ) observe , “ We recognize that being a migrant is not in itself a risk to health : it is the conditions associated with migration that may increase vulnerability to poor health . Owing to the ways in which people move and the spaces they traverse or at which they arrive , migrants may reside in - or pass through – ‘ spaces of vulnerability ’ – key spaces associated with potentially negative health outcomes – including along transport corridors , urban slums , construction sites , commercial farms , fishing communities , mines , and detention centers . Such spaces may contain a combination of social , economic , and physical conditions that may increase the likelihood of exposure to violence and abuse and / or acquisition of communicable or non-communicable disease . The daily stressors that may be experienced in these spaces are increasingly acknowledged to affect emotional wellbeing and mental health .”
SHEA ’ s Trini Mathew emphasizes that “ Healthcare facilities must educate staff about being able to provide care in a culturally sensitive manner so that we are not creating even more duress for these individuals who have already faced lot of stress . We are all stressed about COVID-19 , but to those who have already endured difficult conditions and potential trauma in other places I think we must be much more sensitive . The individuals who migrate may have faced moral injury on a different level than that we may ever understand and comprehend . Therefore , it behooves us to be much more culturally sensitive when asking questions so that we can meet their needs effectively and timely , especially to diagnose infections .”
In the busyness and preoccupation with COVID-19 , it may be all too easy to forget about other important public health issues like migration . As WHO notes , “ Responding quickly and efficiently to the arrival of large groups of people from abroad requires effective coordination and collaboration between and within countries as well as between sectors . A good response to the challenges faced by migrant groups requires good preparedness : preparedness is the basis for building adequate capacity in the medium and long term , requiring robust epidemiological data on the refugees and migrants , careful planning , training and , above all , adherence to the principles of human rights . Defining contingency scenarios to adequately address current or potential large influxes of refugees or migrants into a country will improve coordination among the numerous stakeholders involved , improve resilience and avoid overloading of health systems .”
The prickly political issue of undocumented immigration must be viewed from the lens of potential public health impacts and discussed openly without prejudice .
As Dallas , et al . ( 2018 ) observe , “ The hazard for the spread of infectious disease is elevated in the presence of any human migration , but especially that of undocumented immigration . Migrants , documented and undocumented , carry with them elements of their past , including disease . If immigrants to the United States are not regulated in a public health sense , then what they bring with them , especially in terms of health status , cannot be regulated either . Logically , undocumented immigration could then result in the undocumented spread of infectious disease , which is a formula for creating significant impediments to the role of public health protection . The spread of Hansen ’ s disease ( HD ) and the concern of herd immunity are examples of how undocumented immigration impacts public health in the United States . Undocumented immigration has the potential to put the United States at risk for outbreaks of infectious disease , while simultaneously masking the individual source of the threat . This makes mitigation of the potential danger that much more difficult to achieve .”
The researchers continue , “ Higher levels of infectious disease have been recorded as a recurrent factor in the presence of undocumented immigration . Several studies on this issue report that these individuals may carry diseases of which they are unaware , indifferent to , or for which they cannot allocate diagnosis or treatment . Therefore , when individuals migrate from one nation and enter another they may unintentionally share TB or other infectious diseases … Diseases that were previously exempt from the United States can now be found in persons arriving as undocumented immigrants within the borders . For instance , in 2007 , a disproportionate incidence of HD ( commonly known as leprosy ) was reported in the state of California . Only three of the 42 cases recorded in California in 2002 were found in native-born citizens , and the rest were found in immigrants . If diseases such as HD mostly originate from countries outside the United States , how can undocumented people with the disease be treated ( for their benefit ) and be prevented from infecting others if their presence in the nation is unknown ?”
While legal immigrants are required to be screened for diseases such as active TB , plague , cholera , and other specific diseases before entering the U . S ., obviously undocumented immigrants are not . Studies have indicated that undocumented immigrants do not seek medical care until forced by a medical emergency , attributable to many reasons including the fear of legal retribution such as deportation or a lack of financial means .
Some experts point to how undocumented immigration could potentially impact herd immunity – now known as community protection – which is the specific threshold percentage of immunity required within a population for that population to be