By Andrea Cortinois and Denise Gastaldo, Editors
With this post, the Global Migration and Health Initiative (GloMHI) launches a series of original contributions, a collection we call ‘Echoes.’ On a monthly basis, we will host original contributions by migrants, advocates, community workers, students, educators, policy makers, and applied researchers, from all over the world, who want to share ideas that contribute to an in-depth understanding of migration and its articulations with health, from multiple perspectives and disciplines.
GloMHI, as a group of scholars and advocates, is interested in understanding the complexity of the migration phenomenon, its global determinants, and migration as a determinant of health. Our vision is at the same time simple and trying: health for all, regardless of birthplace. The reference to the 1978 Alma Ata Declaration is transparent. We chose this vision to attract attention to one of the fundamental contradictions illuminated by migration: the one between the responsibility nation states have to protect and promote health as a fundamental human right and the way they construct their identity, on the basis of the inclusion/exclusion, belonging/being foreigner oppositions, and on the protection of borders. If governments have a responsibility for the health of their people, as the Declaration states, who will protect millions of non-citizens/denizens worldwide?
We try to step back and reflect on this phenomenon from a comprehensive perspective. We believe migration is one of the defining phenomena of our time, directly and closely related to some of the central existential challenges we are currently facing as a species, including climate change, environmental degradation, and resource depletion. Understanding migration, today, requires moving beyond a narrow focus on immigrant health, to recognize this phenomenon as a global one, with global causes and consequences.
Meaningfully contributing to the debate on migration, today, means challenging many of the clichés that limit our vision. Migration is not a crisis for the wealthy countries of Europe, North America, or Australasia. Migration is a crisis for the hundreds of millions of people on the move, as much as for their families, communities, and entire societies in countries of origin. Migration as a determinant of health cannot be understood purely in terms of health risks and protective factors directly related to the various phases of the migration trajectories: pre-departure; transit; short- and long-term destination situations; and return. It is essential, instead, to look at migration through an intersectionality lens, delving deeply into the complex identities of migrants, understanding their individual and collective lived experiences, reflecting on the contextual factors that shape those experiences, and exploring both the obvious and less obvious social costs of migration. Debating migration and the challenges it creates is an exercise in futility unless the historical and political economy factors at the root of this phenomenon, such as colonial rationalities, are openly and thoroughly addressed.
We hope to contribute to this debate by giving space to the voices and showcasing the work of many who strive to understand a phenomenon that is changing our societies in profound ways and that, we believe, will only increase in size and significance, over the next decades.
Andrea A. Cortinois, PhD
Assistant Professor, Dalla Lana School of Public Health
University of Toronto
Toronto ON M5T 3M7
Denise Gastaldo, PhD
Lawrence S. Bloomberg Faculty of Nursing
University of Toronto
Toronto ON M5T 1P8