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A Must Read for Seasoned Migration Journalists

Below are the full details of the charter relating to the use of terminology as launched at International Organisation for Migration (IOM), in Tunisia on Tuesday December 10, 2019.

Charter for ethical reporting on migration

The Migration Media Charter is a collaborative effort between journalists, migrants and people working in migrant policy organisations, compiled by Migrants’ Rights Network and People & Planet.

The Pledges

1. Drop the word ‘illegal’

2. Migrants are not to blame

3. Migrants are neither ‘deserving’ nor ‘undeserving’

4. Put migrants on platforms and in newsrooms

5. Cover the positive stories of migration

6. Interview respectfully

7. Stay with the story

8. Headline responsibly

9. Raise awareness of the root causes of displacement

10. Interrogate the immigration enforcement industry

1. Drop the word ‘illegal’

Currently, ‘illegal’ is the most common precursor to ‘immigrant’ in UK newspaper headlines.

Not only is it dehumanising when referring to a human being – their identity seemingly criminalised – but also inaccurate: the majority of cases are processed through civil rather than criminal courts.

Using ‘illegal’ exposes people suspected of being undocumented to misrepresentation or abuse.

The word ‘illegal’ must never be used to describe any migrant, unless it is in a direct quote.

Journalists should not divulge the migration status of any person they report on without the full, informed consent of the subject.

Ask yourself: How is an interviewee’s migration status relevant to the story? What better terms can be used for migrants without the correct documentation?

2. Migrants are not to blame

Media coverage around migration often suggests it contributes to an overall decline in living standards – from public service and housing shortages to community tensions and violent crime.

Migrant workers have been blamed for depleting wages and labour quality for non-migrant workers because they will accept lower pay and conditions, despite most people having little say over their specific terms of work.

Calls to slow labour decline or improve access to local services by tightening immigration controls ignore the evidence that restricting ‘official’ avenues through which some people can migrate may force others to use ‘unofficial’ migration channels, leading to a larger pool of precarious people vulnerable to poor living and working conditions.

Migrants are not to blame for low wages, job scarcity, housing shortages or exhausting public services.

Journalists should frame migration issues responsibly, and consider placing the duty for the quality of labour conditions or local services away from migrants towards those with the power to change it.

Ask yourself: How can the story be reframed in a way that does not place blame on migrants seeking a better life? What are the structural causes of low pay or overextended local services?

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3. Migrants are neither ‘deserving’ nor ‘undeserving’

Migrants escaping persecution are often portrayed as more deserving of public support than those deemed as migrating simply for ’economic’ reasons.

Notwithstanding that fleeing poverty or moving in search of a dignified life are basic human rights, the simplistic categories of ‘deserving’ and ‘undeserving’ migrants misrepresent the myriad reasons why people choose to migrate – for example, the economic causes of migration may have been exacerbated by environmental devastation or political conflict at home.

People rarely migrate for a single reason and should not to be artificially divided – implicitly or explicitly – into ‘deserving’ or ‘undeserving’ categories.

Journalists should recognise the negative connotations of using terms such as ‘economic migrant’.

Ask yourself: What reasons drive people to migrate other than the purely economic?

Is your subject happy to be termed an ‘economic migrant’ or can they be better described?

4. Put migrants on platforms and in newsrooms

The underrepresentation of migrants in the media has allowed negative reporting to go unchecked, leading to a one-sided, ‘us’ versus ‘them’ migration narrative to take root.

Considering that the ‘immigration debate’ dominates the headlines, accompanying stories are rarely written by those with direct experience of migration.

An increased representation of Britain’s migrant community across the industry will better reflect diversity of opinion and help address the imbalance in migration coverage.

Media outlets can benefit from a more diverse workforce and set the standard by hiring more journalists with direct experience of migration, including writers of colour.

The industry should improve access to journalism schools or spokesperson and media training for people from migrant backgrounds.

Ask yourself: How is migration coverage affected by the lack of migrant representation in the media?

What additional support for migrant journalists can be provided by the industry?

5. Cover the positive stories of migration

While it is important to raise awareness of the injustices faced by migrants, it can be easy to slip into a narrative of victimisation.

Migrants are not simply passive subjects – they are in charge of their actions and movements, playing a proactive role in our communities, often leading struggles against the oppression they may face.

The media can help audiences better understand the reality and complexity of migration in the UK by carrying the positive stories or offering migrant communities the opportunity to relate their own experiences unfiltered.

Media outlets pursuing migration stories should build positive relationships with migrant community networks and invite them to contribute to coverage.

Journalists should consider integrating everyday examples of migrant agency into their reporting of migration where possible.

Ask yourself: In what ways can I enrich my story by speaking to people with direct experience of migration?

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How can I ensure my subject is not viewed simply as a ‘victim’ but rather a person with agency?

6. Interview respectfully

Many migrants interviewed by journalists have subsequently felt unhappy with how their lives have been portrayed – their stories published out of context, in some cases carrying identifiable information putting them at risk.

The informed consent of interviewees must always be granted – building trust between journalists and migrant communities will lead to richer stories and make future collaboration more likely.

Ensure that all interviewees are made aware of the full scope of the story being written.

Journalists should make every effort to run the story past their interviewees before submission.

Ask yourself: What support services can be provided to avoid traumatising interviewees?

Are any details included which may put interviewees at risk once the story is published?

7. Stay with the story

The circulation of misleading, often inaccurate information around migration policy in the press may stem from a lack of awareness of the legal, social and economic causes and consequences.

Media has a duty to consider the human cost of political decision-making and keep audiences informed of new research, legislative changes and the implications for migrants.

Media outlets should raise awareness of significant policy shifts that may have gone unnoticed and consider their impact upon migrant communities.

Journalists should build relationships with specialists, especially those in migrant-led organisations, with whom they can consult when considering evidence or seeking advice on migration stories.

Ask yourself: How will a government policy announcement affect the lives of migrant communities upon implementation?

How have the lives of migrant interviewees changed six months on from a story?

8. Headline responsibly

Provocative headlines reporting inflammatory statements around migration often set the agenda for public discussion and significantly impact on migrant communities.

Ill-informed comments from publicity-seeking figures have all too often guided the press narrative on migration as under-resourced reporters have little time to research issues, go out into the field, or build relationships with experts and migrants themselves before submitting stories.

Journalists should consider the intent of the people they platform and the consequences for migrant communities once their stories are published.

Media outlets must ensure that a lack of resources or staff will not affect the accuracy of their migration coverage.

Ask yourself: In what ways are the people you platform experts in migration matters and why is their perspective in the public interest?

Will more time and support for your story produce a fairer portrait of migration?

9. Raise awareness of the root causes of displacement

While immigration garners vast media attention, the root causes of why people migrate is often missing from coverage.

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Migration is a legitimate strategy for escaping hardship – offering audiences regular, considered coverage of the systemic causes of displacement not only helps improve understanding among the general public, it also encourages a culture of empathy towards those who migrate.

Media can play a role in normalising discussions around the histories of social conflict, economic instability, military intervention and environmental insecurity inextricably connected to contemporary migration.

Journalists reporting on individual migrants or specific patterns of migration should make every effort to sensitively outline the full context as to why people have migrated.

Ask yourself: What are the reasons behind migration which migrants themselves had no control over? Have people migrated from a region where economic and environmental insecurity or social and political instability are prevalent?

10. Interrogate the immigration enforcement industry

At vast public cost, the state and private companies work together to build and maintain detention centres for migrants, many of whom have fled war or torture and often suffer debilitating mental and physical health.

The system of detention, deportation and wider immigration enforcement displays a lack of accountability, denying journalists and civil society access to facilities and leaving migrants vulnerable.

Detainees witness riots, assaults and suicides, there is a shortage of care or community work experience among front-line staff, and public servants are co-opted to report on those deemed to have infringed immigration guidelines.

Media outlets and civil society should put more resources into interrogating the immigration enforcement industry and the decades-long increase in the incarceration of migrants.

Reporters should consider seeking access to immigration detention centres, and where possible build relationships with detainees and those affected by broader immigration enforcement policies.

Ask yourself: How am I able to speak to migrants with experience of detention or deportation? Which public bodies cooperate with the immigration enforcement industry and to whom are they accountable?

By signing up to these principles, I am committing to upholding them in my work.

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Opinions

Promoting migrant-inclusive data to help achieve the Sustainable Development Goals

GMDAC – The new guide centres on nine SDGs focusing, among others, on hunger, poverty, education, and gender equality. Photo: Julie Batula/IOM

Berlin – The International Organization for Migration (IOM) is launching a new guide to help practitioners disaggregate data related to the Sustainable Development Goals (SDGs) by migratory status, to address the needs of migrants and highlight their contributions to sustainable development.

To date, disaggregation of global development data by migratory status remains low. Migrants are largely invisible in official SDG data. As the global community approaches 2030, very little is known about the impact of the 2030 Agenda on migrants. Despite a growing focus worldwide on data disaggregation, namely the breaking down of data into smaller sub-categories, there is a lack of practical guidance on the topic that can be tailored to address individual needs and capacities of countries.

Developed by IOM’s Global Migration Data Analysis Centre (GMDAC), the guide titled ‘Leave No Migrant Behind: The 2030 Agenda and Data Disaggregation’ centres on nine SDGs focusing on hunger, education, and gender equality among others. The document is the first of its kind, in that it seeks to address a range of different categorization interests and needs related to international migrants and suggests practical steps that practitioners can tailor to best fit their context.

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“Thanks to the support from Statistics Sweden, GMDAC launched on 14 April a new guide on how to disaggregate SDG indicators across topics such as poverty and health by migratory status,” said Frank Laczko, IOM GMDAC Director.

“Inclusive data is critical to ensure migrants are not left behind in achieving the SDGs.”

The guide also highlights the key role disaggregation plays in understanding the many positive links between migration and the SDGs, highlighting migrants’ contributions to the 2030 Agenda.

The guide outlines key steps for actors to plan and implement initiatives by looking at sex, gender, age and disability, in addition to migratory status. These steps include undertaking awareness raising, identifying priority indicators, conducting data mapping, and more.

“We believe that being able to shed light on the situation of vulnerable groups, such as migrants, in the 2030 Agenda is essential to ensure inclusive development,” said Cathy Krüger, project manager at Statistics Sweden. “We were very happy to support IOM in this work because of their broad and on-the-ground experience in the field. We hope the guide will help countries make progress in following migrants in the Agenda, and also act as a good example for other vulnerable groups.”

READ  Promoting migrant-inclusive data to help achieve the Sustainable Development Goals

COVID-19 has laid bare deepening inequalities around the world, reminding us how important it is for policy to be inclusive for all populations and communities, including many migrants who, in many settings, have faced heightened risks and negative impacts related to the pandemic. To leave no one behind, migrants must be considered across efforts to achieve the SDGs, and this begins with disaggregated data.

Support Voice for African Migrants


Support VOICE FOR AFRICAN MIGRANTS journalism of integrity and credibility.

Good journalism costs a lot of money. Yet only good journalism can ensure the possibility of a good society, an accountable democracy, and a transparent government.

For continued free access to the best and latest migration, trafficking, displacement and humanitarian reports including thorough investigative reports in these areas, we ask you to consider making a modest support to this noble endeavour.

By contributing to VOICE FOR AFRICAN MIGRANTS, you are helping to sustain a journalism of relevance and ensuring it remains free and available to all.
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Opinions

A crisis of care: Sexual and reproductive health competes for attention amid conflict and displacement in Mali

Introduction

National healthcare systems rarely prioritize sexual and reproductive health (SRH). This is a challenge for women and girls worldwide, including in Mali. There, nearly a decade of conflict has created a protracted humanitarian crisis, decimating the healthcare system and limiting the availability of SRH services. Meanwhile, political uncertainty following a coup in August 2020 has focused international efforts on addressing security and stabilization, at the expense of humanitarian needs. The lack of donor funding has exacerbated the situation, including the dearth of SRH services. For women and girls who have been forcibly displaced by conflict and instability, the challenges are particularly pressing.

As of March 2021, more than 311,000 Malians were internally displaced, and the country hosted almost 50,000 refugees from neighboring countries. More than 7.1 million people—some 35 percent of the entire population—were in need of humanitarian aid, of which 1.5 million people had experienced gender-based violence (GBV) and 1.8 million people required health assistance. Displaced communities, both internally displaced people (IDPs) and refugees, often do not have the means to pay for SRH or other healthcare services and often cannot travel to health facilities. This is also true for most other women and girls in rural parts of Mali. Furthermore, even if women and girls can afford services and are able to travel to health facilities, many lack comprehensive SRH care.

The COVID-19 pandemic has worsened access to SRH services because women who fear contracting the coronavirus are hesitant to seek care. Moreover, public health efforts advising women and girls on how and when to seek SRH services are limited. Many SRH professionals cannot effectively operate during pandemic travel restrictions, and funding has been redirected to COVID-19 response efforts. The lapse in SRH care will inevitably lead to a cascade of additional health problems, including increases in the number of unintended pregnancies, maternal deaths, and sexually transmitted diseases.

It is important to address the barriers to SRH for the displaced and for other vulnerable populations of Malian women and girls, particularly those in need of humanitarian assistance. The situation in Mali is extremely fragile, marked by an intensification of armed violence and increased intercommunal conflict and the emergence of a new interim government in the wake of a coup. In the midst of this flux, it is essential that the Malian government and its humanitarian partners do not lose sight of the imperative to provide women and girls with access to sexual and reproductive health.

The Malian government is ultimately responsible for providing health services to its citizens. However, the international community will need to support the government’s healthcare efforts, as well as services provided by humanitarian aid agencies. The United States is the largest humanitarian donor in Mali—providing $74.3 million of the $474.3 million called for in the 2020 UN humanitarian appeal. However, that appeal was only 48 percent funded. This is significantly lower compared to neighboring crises. In Niger, the 2020 UN humanitarian appeal was almost 75 percent funded, while in Burkina Faso it was nearly 84 percent funded.

Donors need to move quickly to close the pledging gap between Mali and other crises in the Sahel. As part of this effort, they must also prioritize funding for routine health services like SRH, even as they continue to respond to the COVID-19 pandemic. The UN Office for the Coordination of Humanitarian Assistance (OCHA) has requested $563 million for the 2021 Humanitarian Response Plan in Mali. Of this, health programming amounts to just $26 million, but there is no indication that much, if any would be spent on SRH. Nevertheless, donors have yet to allocate any money for healthcare.

If donors fail to support healthcare in Mali—through humanitarian aid and government services—the consequences will be serious, especially for women and girls. Donor governments and international institutions such as UN agencies must create long-term, flexible funding strategies that prioritize SRH. They need to allocate resources to the government of Mali, but also to local non-governmental organizations (NGOs) and other civil society groups, including those led by women.

Sexual and Reproductive Health Needs in Mali

Sexual and reproductive health needs in Mali—for the displaced and general populations—include four main areas: family planning, prenatal and postnatal care, abortion access, and support for survivors of GBV. Family planning refers to practices that allow a woman to anticipate and determine her desired number of children. It usually refers to the use of contraception, but can also include the treatment of involuntary infertility, or challenges conceiving when one wants to have a child. Structural factors, including insufficient healthcare facilities, and social factors, including young women’s lack of autonomy, often determine a woman’s family planning choices. For example, it is common in Mali for a woman’s husband or mother-in-law to make healthcare decisions on her behalf.

Prenatal, also called antenatal, care refers to all the care a woman and her unborn child receive while she is pregnant, and postnatal care refers to the medical care she and her newborn receive for at least six weeks after birth. Improving access to these types of care is extremely important in Mali, which ranks among the countries with the worst infant and maternal mortality rates in the world. In 2019, there were, on average, 60 infant deaths for every 1,000 babies born. In 2017—the latest year for which data is available—562 Malian mothers died in childbirth for every 100,000 live births. In 2018, less than 50 percent of women received antenatal care, and just over 50 percent received postnatal care. Rates of assisted deliveries in many regions are low, and unassisted deliveries are dangerous—increasing the probability of maternal or infant mortality and birth-related health complications. Indeed, pregnancy-related deaths remain common.

Health care support for survivors of GBV is also lacking. According to the government, approximately 85 percent of Malian women have experienced GBV, including female genital mutilation, forced marriage, beatings, forced pregnancy, and rape. Notably, about two-thirds of these cases occur within family structures. And rates of GBV in April 2019 compared to April 2020 rose by at least 35 percent. Yet, support services are insufficient, and stigma against survivors remains high. Furthermore, some religious leaders opposed a 2019 law drafted by the Malian Ministry for the Promotion of Women, Children and Families focused on preventing, mitigating, and effectively managing GBV in Mali. Due to this opposition, the legislation never reached Parliament. Without legislation outlawing violence against women, it is difficult for women and girls to pursue legal recourse and access protection when harmed. In light of this setback, the Malian government should in the first instance, make health care support to survivors a high priority, while simultaneously support improvements in the legal system to better protect women.

The international community and local civil society also have important roles to play in assisting GBV survivors. They can do so in several ways. First, they need to strengthen referral pathways, which are mechanisms through which service providers communicate and coordinate between one another regarding GBV cases. Second, they should work to improve GBV survivors’ access to psychosocial trauma counseling. Third, they should invest in programs to counter the stigma GBV survivors face.

Healthcare Capacity  

The Malian healthcare system is built of public, private, and community-based facilities. While there are three public hospitals in the capital of Bamako, those with financial means usually obtain their healthcare through private hospitals, pharmacies, midwives, and doctors. Those without such means and most people residing outside of the capital, including IDPs, have little choice and rely largely on a network of community health clinics known in French as Centres de Santé Communautaires (CSCOMs). The centers receive government subsidies and funding from NGOs, but they rely on patient fees to cover most of their costs.

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The CSCOMs are often the first point of contact for patients, especially for women in rural areas who do not have other options. They also provide care for many lower-income women who cannot afford hospitals or private provider fees. However, CSCOMs are often under-staffed and under-supplied. Individuals might also seek care directly from NGO-run services and in some cases, independent midwives. Even with these various healthcare providers, as of 2018 there were still only 3.14 health professionals per 10,000 people in Mali. The World Health Organization (WHO) recommends that, at minimum, there be seven times that number of health professionals per 10,000 people.

Mali’s prolonged conflict has also extensively damaged the country’s healthcare infrastructure. In the northern and central parts of the country where the conflict has been most acute, as of mid-2018, 17 percent of health structures were no longer functioning in line with national standards. Midwives tend to be concentrated in urban areas like Bamako, Koulikoro, and Segou, leaving other more rural regions without coverage. Overall, the lack of qualified health personnel—particularly those providing SRH care—is significant. As a result, in 2018, 97.4 percent of births in Bamako were assisted compared to only 20 percent in rural areas. It is likely that with increased conflict and the spread of the COVID-19 pandemic, even fewer women receive medical assistance at birth now. In an interview with Refugees International, a physician in Bamako noted how long distances between sparse healthcare facilities in rural regions limit women’s access to family planning services.

In another interview, a Malian midwife indicated that many organizations that offer door-to-door, community-based services or mobile care do not cater directly to IDPs, who often reside with host families or in displacement camps. Furthermore, the cost of procedures and availability of services are often inconsistent between health centers, with many difficult for IDPs to afford. As a result, female IDPs who do not have access to CSCOMs, NGOs, or mobile care, are more likely to self-administer care without adequate supplies or medicine.

To address this discrepancy between rural and urban areas and increase access to SRH services for displaced communities, the government should promote door-to-door services. They should also prioritize community-based services rather than facility-based services in remote areas and to displaced communities, thus reaching some of the most underserved populations. NGOs that provide healthcare should also consider and/or expand their door-to-door service provision and outreach.

On an urgent basis, the government should allocate more funds to train midwives and doctors at the municipal level and ensure they work throughout the country, especially in remote regions. These midwives and doctors should be prepared to work in facilities such as CSCOMs and also conduct community outreach by providing some basic door-to-door services. The government should also train community health workers to conduct awareness raising campaigns and provide basic care. Although some international organizations train healthcare workers, an activist in Mali told Refugees International that “the government directs those trained workers in parts of the country where they are not needed most.” The government of Mali should map out existing services to identify regional gaps and work to address these.

Sexual and Reproductive Health in National Policy

In 2019, Mali’s then-President Ibrahim Boubacar Keïta announced that the Malian government would provide free primary health care to all children under five and pregnant women. The initiative would also provide free contraceptives nationwide. To implement these important and historic commitments, the government planned to increase the number of healthcare professionals. Following through on these commitments would drastically improve the lives of women and make Mali a healthcare leader in Africa. In a press interview at the time, Mali’s former Health Minister, Samba Ousmane Sow acknowledged the scale of the challenge: “We needed to do this a long time ago. Mali is among the top three countries with the highest infant mortality rate. Mali also has very weak health indicators when you talk about malnutrition, poor family planning, poor sexual reproductive health and primary healthcare like pre- and post-natal consultations, simple deliveries, and routine immunizations.”

This Presidential Initiative is already being piloted in some areas of the country. The goal is to provide nationwide coverage by 2022. However, Mali still needs to raise $120 million in funding to fully execute the plan. Donor countries should provide funds to help Mali reach this goal. But even with the requisite financing, implementation also will require additional healthcare personnel. The government must prioritize training healthcare workers and ensure that they are present in rural and conflict-affected areas for this plan to succeed.

Ongoing conflict and instability present another obstacle. In an August 2020 mutiny, Malian soldiers detained the president until he announced his resignation on national television. Now, with a military-backed interim government in power, it is unclear whether realizing the this consequential healthcare initiative will remain a priority. International actors should strongly encourage the interim government to maintain momentum on this policy initiative and provide financial support to encourage full implementation of the plan. As international organizations and donor countries provide funding, they should enforce strict tracking mechanisms, and funding should be contingent on transparent and equitable service delivery. They should also ensure that they align new funding with ongoing humanitarian funding for IDPs.

 

SRH Awareness and Formal Education

Studies find that higher levels of formal education correlate with improved sexual and reproductive health for women and girls. As women and girls become literate and further their education, they are better able to understand information about SRH. They often have increased confidence that improves their ability to make independent decisions. Unfortunately, although Mali has made progress on female education over the last 20 years, girls still have less access to education than boys. The correlation between education and improved SRH is, naturally, stronger in schools that educate young people about it. Studies from around the world support this observation, including research conducted in rural Uganda where there are similar demographics and socioeconomic issues to that of Mali. However, Mali’s current school system has no formal nationwide SRH curriculum.

Mali is missing a huge opportunity to educate young people about SRH directly through the school system. In fact, in December 2018, the Malian government announced plans to cancel the “Comprehensive Sexual Education” program for primary schools after a proposed sexual education textbook for adolescents evoked opposition from religious leaders.

Knowledge of SRH

There is a significant rural-urban divide in SRH awareness. Public health messages regarding SRH services tend to reach urban, educated, and wealthier women more effectively. This is likely because their access to better education and healthcare enables them to comprehend and follow disseminated information and advice more easily.

Healthcare providers such as doctors and midwives—particularly those in the private sector—have taken on a significant role in educating Malians about SRH. These healthcare professionals inform their patients about SRH and travel to other regions to train community health workers and educate populations, usually at their own cost. However, a Malian midwife told Refugees International that the COVID-19 pandemic has hamstrung these efforts. Fear and lack of funding have significantly reduced their ability to work. This makes educating vulnerable populations such as displaced women particularly difficult.

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To ensure all Malians have equal access to information on SRH, it is important that donors and international aid agencies fund and implement initiatives such as mobile or door-to-door education campaigns to increase knowledge in remote areas and include displaced people. They should also provide financial and logistical support to doctors and midwives who travel throughout the country, especially in light of the added challenges caused by the pandemic. This is essential, as more than 50 percent of the almost 20 million people in Mali live in rural areas that have limited internet access and healthcare facilities.

Many individuals—especially those who do not learn about SRH in school or who are not literate—usually instead learn about SRH through informal conversations, television shows, radio, social media, and interactions with health care professionals. The media thus plays an important role in SRH education. Malians use radio, television, and social media to raise awareness about SRH, especially among young people. The popular television show “C’est la vie” is an example of a nationwide program that educates the general public about SRH.

In rural communities where television or internet are more limited, radio is usually the best way to communicate and raise awareness. Radio programs are effective because they are often interactive, and young people enjoy calling in and listening to broadcasts. The radio station “Voix des jeunes” broadcasts evening programs in different local languages featuring health providers from local youth centers discussing themes related to SRH. It is important that radio shows broadcast SRH-focused programs in multiple local languages and that public education initiatives utilize social media and messaging platforms such as Facebook and WhatsApp to reach both rural and urban audiences.

Several private-sector efforts have also focused on promoting SRH education, particularly in rural and suburban areas. For example, the cell phone company VOTO Mobile has been broadcasting SRH information via mobile networks in its service zones. It specializes in delivering interactive voice calls and mobile text messages in local languages. VOTO should expand these efforts, and other companies should replicate these kinds of initiatives, ensuring that they include IDPs and refugees. The Malian government and international organizations should also explore avenues for collaboration between the public and private sector to expand these efforts and reach more people.

While amending the education system and including SRH in school curriculums would be beneficial, the Malian government, UN agencies, NGOs, and private companies should simultaneously support short-term initiatives that focus on strengthening and sharing information outside of schools. 

Availability of Contraception 

Women’s decisions about the type of contraception to use, if any, are complex. Available forms of contraception in Mali include condoms, contraceptive injections, implants, and intrauterine devices (IUD).

The venue in which a woman receives care can often determine her choice of contraception. According to several midwives the Refugees International team interviewed, most women would prefer long-acting reversible contraceptives (LARCs) such as IUDs because they are effective and do not require much effort after the initial insertion. However, most CSCOMs do not have the equipment or the trained personnel to administer LARCs, leaving women to travel, often to faraway hospitals, or to seek a private provider to get them.

Those options are not accessible to many women, especially IDPs. Thus, despite their preferences, most women who use contraceptives use short-acting ones, such as pills, injections, or condoms, which are cheaper and more readily available. These methods can also be conveniently and discretely picked up during routine trips to the market, for example, making them easier to obtain in light of the stigma around SRH and women’s lack of decision-making power over healthcare decisions. As cost and access to a provider are key determining factors in choice of care, facilities without doctors and midwives should prioritize stocking and distributing short-term methods. Where doctors and midwives are available to administer LARCs, government or NGO programs should subsidize their cost.

Self-Administered Care

A lack of formal healthcare leads many women to self-administer SRH care. Self-care is the practice of an individual, family, or community promoting or maintaining health without the support of a qualified healthcare provider. A midwife explained that it is common for women to attempt to self-administer certain kinds of care, such as injectable contraception, and seek a midwife’s help only if complications arise. In some cases, self-administered SRH care is successful; however, it can be extremely dangerous. For example, women can experience adverse reactions if incorrectly self-administering prenatal care in the form of traditional herbal remedies.

Self-administered abortion is also common because of Mali’s restrictive abortion laws, which prohibit all abortions except in cases of rape or where a pregnancy threatens the mother’s life. According to a private report produced by CARE and the Malian government, in 2017, an estimated 80 percent of abortions in the country were performed outside the formal health system. The unsafe methods used include ingesting dangerous chemicals or high doses of pharmaceuticals; introducing foreign objects into the cervix; or having an unqualified worker perform the abortion. All of these methods are high-risk and extremely dangerous. To reduce unwanted pregnancies in the first place, the Malian government and aid agencies should ensure that public clinics, mobile clinics, and pharmacies are reliably supplied with contraception. In addition, short of legislation to decriminalize abortion, the Malian government, UN agencies, and NGOs need to ensure that women have access to a full range of SRH services and information about their options during pregnancy. In line with current Malian law, these options should include abortion if the woman or girl has been raped, experienced incest, or the pregnancy puts her life at risk.

Effects of COVID-19

The COVID-19 pandemic has severely taxed an already struggling healthcare system in Mali. Movement restrictions, long wait times at hospitals, and financial burdens caused by the pandemic have made it more difficult for women to get care. Moreover, many people do not feel comfortable seeking care from hospitals or other health facilities because they fear they could be infected there. A midwife in Bamako with whom Refugees International spoke explained that these fears, combined with superstitious beliefs that prematurely talking about pregnancy can bring bad luck, have significantly reduced women’s intention to seek SRH care.

This reality underscores the need for aid agencies to better understand the context and concerns of Malians—especially women and girls—when making decisions about funding, service provision, and SRH services. By doing so, organizations can promote appropriate and efficient service provision for all Malian women and girls, including the tens of thousands of female IDPs.

Although many Malians fear approaching health facilities during this pandemic, the government, with the help of NGOs and UN agencies, has taken some measures to protect both healthcare workers and patients against the transmission of COVID-19. For example, as of September 2020, UNICEF had trained more than 4,000 health and community workers on Infection Prevention and Control Measures. The agency has also provided the National Institute of Public Health with 15,000 COVID-19 screening tests together with surgical masks, hand sanitizers, gloves, and other personal protective equipment (PPE). Additionally, as of March 29, 2021, the COVID-19 Action Fund for Africa (CAF)—made up of 30 different organizations—had already delivered or committed to delivering more than 7 million PPE, almost 80 percent of what is needed in the country.

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Despite these measures, the government of Mali and other partners working to provide healthcare need to ensure that healthcare providers have accurate information about how COVID-19 spreads and take the necessary precautions to ensure that they and their patients stay safe. This includes consistently using the PPE that organizations have provided to Mali and when possible, practicing social distancing. It also includes effective community surveillance so that if people, especially pregnant women, have COVID-19 symptoms, they can be referred to testing and healthcare facilities if necessary. Government representatives should also conduct site visits to monitor how well CSCOMs and other healthcare facilities are maintaining infection prevention and control measures.

 

Recommendations

Prioritizing SRH is always important. It is especially crucial in Mali where birthrates and infant and maternal mortality rates are so high. Mali is dealing with overlapping crises including political turmoil and an interim government, conflict, displacement, chronic poverty, and the COVID-19 pandemic. Surely, the Malian government is grappling with competing priorities. However, it is also clear that SRH education is imperative and that most Malian women and girls do not receive the SRH services they want and need. This is especially true of displaced women and girls who often live in hard to reach areas and need targeted outreach. This includes door-to-door SRH education and service provision as well as GBV programs, given their heightened risk. They also need subsidized contraception because they often have less economic opportunities than their non-displaced counterparts, and the pandemic has further impacted their already limited livelihoods. Therefore, the Malian government must incorporate SRH into all COVID-19 response plans. Furthermore, the government—with the assistance of international organizations, NGOs, and donors—must develop plans to improve the quality of and access to SRH in all parts of Mali long after the pandemic subsides.

The government of Mali should:

  • Provide support to survivors of gender-based violence (GBV) including comprehensive sexual and reproductive health (SRH) care and improve coordination vis-à-vis GBV cases. When women and girls survive incidents of GBV, they almost always need SRH services to mitigate the negative health effects resulting from the violence. Displacement increases the risk of experiencing GBV, therefore it is especially important to include internally displaced people (IDPs) in these efforts.

  • Promote door-to-door healthcare services and SRH information sharing in remote areas and to displaced communities. Large portions of Malians live in rural areas, especially IDPs. There are few healthcare facilities in these regions, and the ones that do exist are often understaffed and under-resourced. It is important to train and deploy healthcare professionals to engage with people where they are by conducting mobile outreach.

  • Dedicate more funds to train SRH care providers, including midwives, nurses, gynecologists/obstetricians, and anesthesiologists. Ensure that they work throughout the country, especially in remote, underserved, and conflict-affected areas. To make certain that these trained healthcare providers are working where they are most effective, map out existing SRH and overall healthcare services to identify regional gaps.

  • Improve girls’ access to school, adopt SRH curriculum, and collaborate with the private sector to educate youth about SRH. Create a public school SRH curriculum and conduct an outreach campaign to religious leaders, encouraging them to support the curriculum. At the same time, build upon the success the private sector has had in information sharing by subsidizing their efforts to educate youth on SRH.

  • Subsidize the cost of long-acting reversible contraceptives (LARCs) where there are doctors and midwives to insert them. Where there are few doctors or midwives, assign trained healthcare professionals to work in those areas and build local capacity.

  • Ensure women have access to a full range of SRH services and information about their options during pregnancy, including abortion when appropriate. Although Mali has restrictive abortion laws, the government should allow doctors and midwives to provide information about legal abortion services and provide these services when the woman meets the legal criteria and decides to pursue this option.

  • Work together with international organizations and NGOs to conduct information campaigns about the importance of SRH; where women and girls can receive SRH services; and what measures health centers are taking to operate safely during the pandemic. Mitigate widespread public fear of seeking care in healthcare facilities during the pandemic by disseminating accurate information on the spread of COVID-19 and the safety precautions being taken in healthcare facilities. All of these information campaigns should explicitly include IDPs.

UN agencies and humanitarian organizations should:

  • Strengthen referral pathways to facilitate GBV survivors’ access to relevant service providers that provide psychosocial care, clinical management of rape, sexual and reproductive health care, and shelter. Do this by ensuring that service providers meet regularly, appropriately and systematically share case information, and ensure that even if someone is displaced, her case management continues.

  • Support short-term initiatives that focus on strengthening and sharing SRH information outside of schools. These include outreach by healthcare professionals, television and radio, and social media campaigns spearheaded by private companies. In addition to basic SRH education, they should also complement the government’s efforts by conducting information campaigns about the importance of SRH; where women and girls can access SRH services; and what measures health centers are taking to operate safely during the pandemic.

  • Provide contraception directly to public clinics, mobile clinics, and pharmacies. Because most women, especially IDPs, receive their care from these providers, it is important to assist the government in ensuring that these locations are fully stocked with short-acting contraceptives.

Donor governments and institutions should:

  • Fully fund the request from the UN Office for the Coordination of Humanitarian Assistance (OCHA) for $563 million for the 2021 Humanitarian Response Plan in Mali. Immediately fund the $26 million OCHA has requested for healthcare and ensure that at least some of it is directed to SRH.

  • Allocate financial resources to the government of Mali, but also to local non-governmental organizations (NGOs) and other civil society groups, including those led by women. Local organizations are on the frontlines of healthcare information sharing and provision, especially in rural and conflict-affected areas where most IDPs live. And women-led organizations are likely better equipped to provide SRH services and information because they personally understand the importance of SRH as well as the challenges associated with SRH in Mali.  

  • Provide funding to help the Malian government reach the $120 million necessary to successfully implement the 2019 Presidential Initiative focused on women and children’s health. This will provide free contraception, healthcare to children under five, and healthcare to pregnant women beginning in 2022. If implemented, it will dramatically improve the health and well-being of all Malian women and girls, including IDPs.

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Asylum seekers especially those living in the big camps were deprived of their rights in so many ways during the lockdown

Rex Osa, is the Co-Ordination Activist of the Network Refugees4Refugees  (R4R),  a grassroots network of politically active migrants who are committed to promoting and empowering migrants’ self-determination and self-organization. The organization, founded in 2010 has its office in Stuttgart, Germany.

He spoke with voiceforafricanmigrants.com about the plight of Africans seeking asylum abroad especially Germany and effects of the COVID 19 pandemic on the migrants’ community. Excerpts:

Could you tell us about yourself and your organisation, Refugee4Refugee Network?

I’m a Nigerian by birth. We are engaged in creating platforms for migrants exchange and support them in their struggle for a life in dignity and equality. The Network R4R was born out of many years of active engagement and experience with a mixed network of different anti-racist and pro-migrants’ network.

What motivated you to establish the organisation?

Based on experiences gathered from my intensive engagements with migrants’ solidarity movements, there was an urgent need to develop a grass-root platform for awareness exchange on the actual situation of asylum with Germany in focus. This was based on an understanding of the fact that most asylum seekers do not have prior political experience cannot understand that the reason for their flight is connected to a global political complex for which Germany is a beneficiary. The Network R4R was meant to promote this awareness through routine exchange activities to reach asylum seekers wherever they may be. This initiative is partly an outcome of the Break Isolation 2010 Campaign that was championed by The VOICE Refugee Forum and The Nationwide Karawane Network.

How would you describe the experiences of Africans seeking asylum in Germany?

The situation of asylum seekers in general is quite traumatic. Despite scandalous and regretful racist tradition, asylum seekers in Germany are continually confronted with a hostile so-called ‘welcome culture’. The reality of such deceptive role model democracy has led many asylum seekers into mental and physical limbo.

While the German constitution explicitly projects dignity and equal rights for everybody, the German racist status quo is institutionalized through official arbitrariness at the local administrative level.

Asylum seekers have to face challenges of isolation and control through so-called special laws that are merely obligation and sanctions. By an attitude of continued amendments of the immigration laws, German apartheid laws are reproduced as beautified repression and thus making it more complicated to understand even for lawyers themselves.

Seeking asylum means giving up your rights and forcing you to live at the mercy of the German social welfare at all costs. Asylum entrapment in Germany is the worse in Europe. It’s a life in limbo without a predictable end. People are living in this situation for up to 30 or more years.

How would you describe the experiences of Africans in various camps in Germany since the outbreak of COVID 19?

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The Coronavirus Pandemic has actually exposed Germany’s discriminatory policies for asylum seekers. Despite massive criticism and experts’ advice to decongest the refugees’ camp as social distancing could not be possible, Germany was always determined with maintaining its policy of isolating asylum seekers, thus depriving them of possibilities to protect themselves from the COVID19 virus. Our experiences from the several outbreaks of the COVID19 virus in camps, the attitude of the German government confirmed an interest to only protect the society while the camps were serving as an experiment center for further handling of the Coronavirus situation.

Did African migrants get fair treatment from their host (Germany) during the period of lockdown?

Asylum seekers especially those living in the big camps were deprived of their rights in so many ways during the lockdown. People were not prepared because they were not informed in advance. Persons who were infected were left to live amongst those who were known not to be infected. Adequate information was not provided for the camps and as such promoting conspiracy theory. During such lock down in camps, the expectation for the inhabitants to eat good food so as to build their immune system was not possible as there was no provision for such necessities.

You have been assiduously working to assist African migrants facing challenges, how easy has this been?

Nothing is actually easy although there are quite enormous challenges in the area of offering care and struggling for your rights as a migrant in a country like Germany. I’m anyways used to the challenges based on my having passed through the process and experiences from the cases I accompany on a day to day basis.

You imagine engaging in severe political activities and representing migrants and refugees at different level of political exchange; spontaneous presence at locations where asylum seekers are facing state repression and abuses from time to time. Most draining is the routine counselling and accompanying of migrants and asylum seekers in different situation on a daily basis. Most of these persons are not known to me personally.

It’s really not easy going through daily experiences of terrible situations, but I feel happy and fulfilled engaging my experience and knowledge to impact on peoples’ lives. People wonder how I am able to cope with the trauma from the different cases. Even when I feel shocked at hearing some terrible circumstances, the shock is quickly absorbed by my personal experiences and other terrible situations that I had handled in the past.

Many Nigerian deportees have always alleged that they were put in hand and leg cuffs while  returning to the country. How true is this and does it not amount to abuse of their rights?

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The German government has also confirmed the use of force during its deportation enforcement operations. Although they would claim that it was necessary to protect the passengers onboard the charter deportation or passenger flight to the destination countries. It is scandalous and shameful to see that Germany is engaging in such magnitude of violence like the use helmet, electric shock, indiscriminate use of medication etc. Many have been killed in such operations in the past, you can imagine the consequences for some after their arrival at the deportation destination. Children are made to go through such experiences of violence with their parents and others during the deportation operation. It’s nothing short of the slavery days’ experiences being reproduced by the so-called civilized Germany.

How well would you say African envoys have been protecting the interest of African migrants in Germany?

It’s actually sad to see how our country’s government continues to play the stooge to the colonial masters. While we dwell on respecting the so called Vienna Consular agreements even beyond reasonable doubts, a country like Germany will never betray its citizens in the name of the so called agreements. Country diplomats are expected to likewise play that game of priority for its citizens against the European order.

We have seen situation where country delegations are invited to identify persons through akzent, facial or physical appearance in an effort to obtain deportation documents. Such situations have led to the deportation of persons to wrong country of origin. There are also situations where people are deported without valid documents and are received at the deportation destination country.

Our envoys cannot guarantee the reality that the embassy’s premises remain a territory of the country hence any citizen that runs in there for safety can be protected.

We saw Germany deporting migrants in the face of the ravaging Coronavirus pandemic, was this a good decision?

Deporting people at the peak of the Coronavirus outbreak was a clear show of the German arrogance and re-enforcement of their colonial power. Imagine Germany being one of the major Coronavirus hotspots enforcing deportation to countries with very low infection rates and lacking adequate health care alongside struggling to survive the terrible consequences of the Coronavirus pandemic. The claim to help develop African countries means exporting coronavirus to Africa.

Africans are often seen as needless pests by many host countries. Does this mean Africans add no value to their host countries?

It must be clearly understood that most of those persons propagated as economic migrants are in actual sense migrant labour force. Migrants are actually doing much to developing both transit and destination countries by different means.

In the past, asylum seekers were prohibited from working as part of the government’s efforts to deprive them from integrating themselves in the society. The plan was meant to keep them isolated in isolated communities so as to cover up the face of German State abuses on migrants. With minimum wage raging from more than 7 euros/hour, asylum seekers were compelled to work for 1 euros/hour and not more than 100 hours monthly.

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Through years of struggles and scandals, many asylum seekers are taking up paid jobs and paying taxes as well as contributing into pension scheme for which quite a huge number may not benefit from.

People are continuously deported with no opportunity to demand for their tax refunds and at least their own contribution to the pension scheme.

What can African government do to address the menace of irregular migration?

In the first place, do we even have our own defined migration policy outside the drafted policy of the imperialist countries?

It is really pathetic to realise that our position in global migration policy making is nothing to write home about. We play the stooge game with our position compromised for development help as bait for more cooperation with policies of the exploiting countries.

 

What would migration look like post COVID 19?

The Coronavirus pandemic has been really challenging. The impact has enormously affected the world’s economy. No doubt, the migration trend will be really explosive as the unbearable situation would cause people to see no perspective in their home countries.

What is your advice to African itching to leave the continent for greener pastures abroad?

Migration is also a unique experience and an entitlement for every human. All human has the right to have a dignified life and the choice depends on a personal decision. The number of Europeans who are migrating are enormous if not more than that of Africans. No one intends to leave his country of birth forever. People are migrating either because of protection needs or to gain experiences etc.

Our network is committed to disseminating up to date information on migration and situation of migrants at different levels.

 

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