Migration: Terms, Migration: Terms, concepts and concepts and

numbersnumbers1st Advanced Course: 1st Advanced Course: ““Health on the move”Health on the move”

January 14 & 15 2012January 14 & 15 2012

Ioanna Kotsioni, Phd, MscIoanna Kotsioni, Phd, Msc

MigrationMigration

The movement of a person or a group of The movement of a person or a group of persons, either across an international persons, either across an international border, or within a State. It is a border, or within a State. It is a population movement, encompassing population movement, encompassing any kind of movement of people, any kind of movement of people, whatever its length, composition and whatever its length, composition and causes; it includes migration of causes; it includes migration of refugees, displaced persons, economic refugees, displaced persons, economic migrants, and persons moving for other migrants, and persons moving for other purposes, including family reunification. purposes, including family reunification.

►Immigration Immigration - A process by which - A process by which non-nationals move into a country for non-nationals move into a country for the purpose of settlement.the purpose of settlement.

►Forced migration Forced migration - A migratory - A migratory movement in which an element of movement in which an element of coercion exists, including threats to coercion exists, including threats to life and livelihood, whether arising life and livelihood, whether arising from natural or man-made causes.from natural or man-made causes.

Migration: as old as human Migration: as old as human historyhistory

►Migration is by no means a new Migration is by no means a new phenomenonphenomenon..

►Migration is a fundamental process Migration is a fundamental process that redistributes people around the that redistributes people around the globe.globe.

►Human history has, to a large extent, Human history has, to a large extent, been shaped through the movement of been shaped through the movement of populations.populations.

1 out of 7 a migrant1 out of 7 a migrant

► IIn 2010, the total number of n 2010, the total number of international migrantsinternational migrants in the world in the world was estimated at was estimated at 214 million214 million people people (IOM, 2011). (IOM, 2011).

►TThe number of he number of internal migrantsinternal migrants iis s estimated estimated at at 740 million740 million (UNDP, 2009). (UNDP, 2009).

► In total,In total, around a billion around a billion people (roughly people (roughly one in seven of the world’s population) one in seven of the world’s population) are migrants.are migrants.

Estimates of different Estimates of different categoriescategories

►Migrant workers ~ 100 million (2009)Migrant workers ~ 100 million (2009)

► Refugees ~ 15.4 million (2010)Refugees ~ 15.4 million (2010)

► Asylum seekers ~ Asylum seekers ~ 845,800845,800 (2010)(2010)

► Trafficked personsTrafficked persons – including adults and – including adults and children in forced labour,children in forced labour, bonded labour, and bonded labour, and forced prostitution forced prostitution - - ~~ 12.3 million 12.3 million ((20102010). ). AAlmost 2 out of 1,000 people are victims oflmost 2 out of 1,000 people are victims of traffickingtrafficking..

Estimates of different Estimates of different categoriescategories

► In 2010, the estimated number of In 2010, the estimated number of displaced persons due to naturaldisplaced persons due to natural disasters was over 42 million. The disasters was over 42 million. The large majority (38 million) were large majority (38 million) were displaced by climatedisplaced by climate change-related change-related disasters (primarily flooding and disasters (primarily flooding and storms)storms)..

Migration: a complex Migration: a complex phenomenonphenomenon

►Migration is the outcome of a range of Migration is the outcome of a range of factors including social, economic, cultural, factors including social, economic, cultural, political, as well as environmental, that political, as well as environmental, that shape an individual’s decision to move.shape an individual’s decision to move.

► People migrate for different reasons. Some People migrate for different reasons. Some out of free will in search of better out of free will in search of better opportunities for themselves and their opportunities for themselves and their family, and others forced by conflict or family, and others forced by conflict or disaster in search of safety. disaster in search of safety.

““Mixed” migrationMixed” migration

► In recent years migration flows have In recent years migration flows have become more complex and comprise become more complex and comprise heterogeneous groups of individuals.heterogeneous groups of individuals.

►Human migration rarely hasHuman migration rarely has a single a single cause and it is cause and it is often often hard to hard to distinguishdistinguish voluntary andvoluntary and forced forced movement.movement.

““Mixed” migrationMixed” migration

Increasingly difficult Increasingly difficult to dto distinguishistinguish r refugeesefugeesfrom from otherother mmigrantsigrants::

►Many Many ““pushpush”-”- ““pullpull”” factors factors..

►Host countriesHost countries may not recognize may not recognize:: – – Generalized violenceGeneralized violence – – Breakdown of civil orderBreakdown of civil order – – Internal conflictsInternal conflicts as legitimate ground for grant refugee as legitimate ground for grant refugee

status.status.

Migration: more complex Migration: more complex today?today?

► As a result of technical advances in As a result of technical advances in communications, migratory behaviour has communications, migratory behaviour has diversified to include short and long term diversified to include short and long term relocation, permanent migration and circular relocation, permanent migration and circular migration back to the place of origin. migration back to the place of origin.

► After World War II, countries of origin were After World War II, countries of origin were mostly in Europe, and destinations included mostly in Europe, and destinations included the Americas and Australia. Today, most the Americas and Australia. Today, most countries are at the same time countries of countries are at the same time countries of origin, transit and destination (eg. Greece). origin, transit and destination (eg. Greece).

Immigration: is it really a Immigration: is it really a threat???threat???

► Immigration is essential for sending Immigration is essential for sending countries, to assist home communities with countries, to assist home communities with remittances.remittances.

► It can also be useful to receiving societies, It can also be useful to receiving societies, to compensate for demographic trends and to compensate for demographic trends and skill shortages.skill shortages.

► Europe, today, faces a serious demographic Europe, today, faces a serious demographic challenge. Its population is ageing. Net challenge. Its population is ageing. Net migration flows are necessary to moderate migration flows are necessary to moderate the negative repercussions of aging.the negative repercussions of aging.

Europe’s demographic Europe’s demographic problemproblem

► Europe is the continent with the lowest total fertility Europe is the continent with the lowest total fertility rate (on average 1.5 children per woman). At the rate (on average 1.5 children per woman). At the same time life expectancy is increasing.same time life expectancy is increasing.

► By 2050, the oBy 2050, the old-age dependency ratio (the number of ld-age dependency ratio (the number of people 65 and over relative to those between 15 and people 65 and over relative to those between 15 and 64) is projected to double, meaning that 64) is projected to double, meaning that in thein the EU EU only only twotwo persons of working age persons of working age will correspond will correspond for every for every elderly citizen.elderly citizen.

► The repercussions for labour and growth will be The repercussions for labour and growth will be dramatic. Public spending will also come under serious dramatic. Public spending will also come under serious strain. It is estimated thatstrain. It is estimated that the effect of an aging the effect of an aging population alone would increase health care public population alone would increase health care public spendspendiing by ng by at least at least 2 percentage points of GDP by 2 percentage points of GDP by 2050. 2050.

Europe’s demographic Europe’s demographic problemproblem

► It should be stressed that these It should be stressed that these projections are based on the assumption projections are based on the assumption that net migration inflows to the EU will that net migration inflows to the EU will cumulate to 40 million persons by 2050. cumulate to 40 million persons by 2050.

►A A contradictioncontradiction: While net migration is : While net migration is necessary for the region’s survival, the necessary for the region’s survival, the dominant public rhetoric in most dominant public rhetoric in most European countries is that European countries is that “Europe “Europe cannot afford no more immigrants”.cannot afford no more immigrants”.

Are developed countries really Are developed countries really faced with an “invasion”?faced with an “invasion”?

► It is estimated that only 37% of migration is It is estimated that only 37% of migration is from developing to developed countries.from developing to developed countries.

► The biggest refugee camp in the world: Dadaab The biggest refugee camp in the world: Dadaab in Kenya. in Kenya. Almost Almost 400,000 displaced people, the 400,000 displaced people, the vast majority from war-torn Somaliavast majority from war-torn Somalia. .

► ““Arab spring”: Resulted in Arab spring”: Resulted in nearly 800,000 nearly 800,000 migrants migrants - who fled - who fled Libya and TunisiaLibya and Tunisia. Of those . Of those only 50,000 reached the EU - only 50,000 reached the EU - Italy and Malta Italy and Malta ..

A shift towards more A shift towards more restrictive policiesrestrictive policies

The increasing use of the term “irregular” (or The increasing use of the term “irregular” (or illegal) migration parallels the adoption of illegal) migration parallels the adoption of increasingly restrictive migration policies in Europe increasingly restrictive migration policies in Europe and the U.S. and the U.S.

U.S. and Europe spend U.S. and Europe spend around around $9 billion on $9 billion on migration migration management annuallymanagement annually..

► Stricter border controls (at land and at sea)Stricter border controls (at land and at sea)► Increased and prolonged use of administrative Increased and prolonged use of administrative

detention detention ► Cooperation agreements with countries of origin Cooperation agreements with countries of origin

and transit and transit ► Emphasis on returns Emphasis on returns ► European Border Management Agency (Frontex)European Border Management Agency (Frontex)

The human cost of restrictive The human cost of restrictive migration policiesmigration policies

► IndividualsIndividuals, including those, including those fleeing persecution fleeing persecution, , have have extremelly limitedextremelly limited means of legally means of legally travelling to travelling to the EUthe EU. .

► This often means people take life-threatening This often means people take life-threatening risksrisks,, being forced to use smuggling networksbeing forced to use smuggling networks..

► The number of migrants who died along the The number of migrants who died along the European borders, since 1998, is estimated at European borders, since 1998, is estimated at 17,738. Most died trying to cross the 17,738. Most died trying to cross the Mediterranean. In 2011, alone, around 2,000 Mediterranean. In 2011, alone, around 2,000 deaths were recorded.deaths were recorded.

Irregular migrationIrregular migration

► Irregular (illegal) migration – a contested Irregular (illegal) migration – a contested termterm

►Data show that most irregular immigrants to Data show that most irregular immigrants to Europe and the USA have entered on a visa, Europe and the USA have entered on a visa, hence legally, and then have overstayed or hence legally, and then have overstayed or engaged in illicit work and became irregular. engaged in illicit work and became irregular. Often they might have been able to Often they might have been able to regularise or re-entered on a new visa and regularise or re-entered on a new visa and therefore acquired legal status again. therefore acquired legal status again.

Greek emigrationGreek emigration

Two recent waves of mTwo recent waves of mass emigrationass emigration:: one one from the late 19th to the early 20th century, from the late 19th to the early 20th century, and another following World War II. and another following World War II.

► In the period 1890-1914, almost a sixth of In the period 1890-1914, almost a sixth of the population of Greece emigrated, mostly the population of Greece emigrated, mostly to the United States and Egypt. to the United States and Egypt.

► Following World War II Following World War II ((between 1950 and between 1950 and 19741974)), , mmore than one million Greeks ore than one million Greeks migratedmigrated to Western Europe, the US, to Western Europe, the US, Canada, and Australia. Canada, and Australia.

Immigration to GreeceImmigration to Greece

► In the aftermath of the Eastern bloc collapse, In the aftermath of the Eastern bloc collapse, Greece, received increased migratory flows from Greece, received increased migratory flows from Eastern European countries and quite abruptly Eastern European countries and quite abruptly became a net immigration country.became a net immigration country.

► According to the According to the 20012001 census, the census, the foreign foreign population of Greece population of Greece amounted to amounted to 796796,,713713 persons persons (7.3% of the total population). The vast majority, (7.3% of the total population). The vast majority, 750,000, were third country citizens. 750,000, were third country citizens. Of thOf thoose, se, 2,927 were registered as refugees.2,927 were registered as refugees.

► More than half, 55.7% originated from Albania More than half, 55.7% originated from Albania (among them about 185,000 ethnic Greeks). The (among them about 185,000 ethnic Greeks). The second largest group came from Central and second largest group came from Central and Eastern Europe. Eastern Europe.

Immigration to GreeceImmigration to Greece► In the last decade, Greece is experiencing the arrival of In the last decade, Greece is experiencing the arrival of

new migration flows, originating from Asian and African new migration flows, originating from Asian and African countries, i.e. Afghanistan, Pakistan, Iran, Iraq, Somalia, countries, i.e. Afghanistan, Pakistan, Iran, Iraq, Somalia, Nigeria.Nigeria.

These migratory flows differ from the ones of the 1990s, These migratory flows differ from the ones of the 1990s, mainly in the following:mainly in the following:

► They include more people from war-torn and unstable They include more people from war-torn and unstable countries and therefore more persons potentially in need countries and therefore more persons potentially in need of international protection.of international protection.

► These migrants endure longer and more dangerous trips These migrants endure longer and more dangerous trips as they need to use the services of smuggling networks.as they need to use the services of smuggling networks.

► For these migrants Greece is not so much a final For these migrants Greece is not so much a final destination but more a first stepping stone into Europe. destination but more a first stepping stone into Europe. However, because of the Schengen and Dublin However, because of the Schengen and Dublin regulations they find themselves “stuck” in Greece.regulations they find themselves “stuck” in Greece.

Immigration to GreeceImmigration to Greece

Migrants of the recent influx are more likely to present Migrants of the recent influx are more likely to present increased medical, including mental health needs:increased medical, including mental health needs:

► Many come from countries with poor health care Many come from countries with poor health care coverage (eg. inadequate vaccination).coverage (eg. inadequate vaccination).

► Many come from conflict and violence ridden areas and Many come from conflict and violence ridden areas and may have been direct victims or witnessed violence.may have been direct victims or witnessed violence.

► They often had to make long trips in extreme conditions They often had to make long trips in extreme conditions and/or to spent prolonged periods of time in transit and/or to spent prolonged periods of time in transit countries with insufficient access to medical care.countries with insufficient access to medical care.

► When in Greece, incarceration, very poor living When in Greece, incarceration, very poor living conditions and obstacles in accessing health care can by conditions and obstacles in accessing health care can by further risk factors for their health and wellbeing.further risk factors for their health and wellbeing.

Immigration to GreeceImmigration to Greece► In 2008, the migrant population was estimated at In 2008, the migrant population was estimated at

11,,246246,,000000 ( (1111..3% 3% of the total populationof the total population.. Of whom Of whom 339339,,000 (2000 (2..9%) 9%) were of Greek origin and “irregular” were of Greek origin and “irregular” migrantsmigrants about about 167167,,000 (1000 (1..5%)5%). More recent estimates . More recent estimates calculate the population of “irregular” migrants between calculate the population of “irregular” migrants between 250,000 and 400,000 persons.250,000 and 400,000 persons.

► The population census of 2011 will provide us with more The population census of 2011 will provide us with more updated and accurate data.updated and accurate data.

► The migrant population in Greece is characterized by a The migrant population in Greece is characterized by a younger age structure (65,7% of the migrants belonged younger age structure (65,7% of the migrants belonged to the age group of 15-44 years of age while the to the age group of 15-44 years of age while the corresponding percentage for the Greek population was corresponding percentage for the Greek population was 42,7%).42,7%).

Immigration to GreeceImmigration to Greece

► The migrant population in Greece has also been The migrant population in Greece has also been characterized by high participation in the labour market characterized by high participation in the labour market (51,45%).(51,45%).

► Very high concentration in manual professions (Very high concentration in manual professions (70%70% of of the total migrant working population). Of those 40% the total migrant working population). Of those 40% employed as unskilled labour and most of the rest in the employed as unskilled labour and most of the rest in the construction sectorconstruction sector. .

► For most their occupation in Greece does not correspond For most their occupation in Greece does not correspond to their educational qualifications. to their educational qualifications. 66%66% were employed at were employed at jobs requiring less qualifications.jobs requiring less qualifications.

► Many have social insurance. InMany have social insurance. In 2003, 13% 2003, 13% of those of those insured in IKA were foreigners.insured in IKA were foreigners.

► They are now increasingly affected by the economic They are now increasingly affected by the economic crisis.crisis.

Immigration to GreeceImmigration to Greece

► Most importantly they face increasing anti-migrant Most importantly they face increasing anti-migrant sentiments which have also resulted in serious racist sentiments which have also resulted in serious racist attacks. The role of public rhetoric and the media is attacks. The role of public rhetoric and the media is instrumental in producing and reproducing stereotypes and instrumental in producing and reproducing stereotypes and a climate of insecurity, especially at times of crisis.a climate of insecurity, especially at times of crisis.

► However, one should bear in mind that historically the However, one should bear in mind that historically the settled populations have always feared newcomers.settled populations have always feared newcomers.

► Fear of migrants rests upon the fear of change, and Fear of migrants rests upon the fear of change, and especially changes to culture. Culture is, however, not a especially changes to culture. Culture is, however, not a fixed concept. fixed concept.

► Cultures change continuously over time. The cultures as we Cultures change continuously over time. The cultures as we know them today are the result of centuries of migration. know them today are the result of centuries of migration.

► Societies with a rich diversity of skills and experiences Societies with a rich diversity of skills and experiences are better placed to stimulate growthare better placed to stimulate growth through their through their human resources.human resources.

► Yet migration remains highly politicized and oftenYet migration remains highly politicized and often negatively perceived, despite the obvious need for negatively perceived, despite the obvious need for diversification in today’s rapidly evolvingdiversification in today’s rapidly evolving societies and societies and economies.economies.

► Nevertheless, international migration is likely to Nevertheless, international migration is likely to increase in scaleincrease in scale and complexity due to growing and complexity due to growing demographic disparities, new global and political demographic disparities, new global and political dynamics,dynamics, technological revolutions and social technological revolutions and social networks, with profound impacts on the socio-networks, with profound impacts on the socio-economiceconomic and ethnic composition of societies. and ethnic composition of societies.

► This will result in new policy challenges related to the This will result in new policy challenges related to the way migration is experienced by the communityway migration is experienced by the community at at large. In this context, the image of migrants in their large. In this context, the image of migrants in their home and host societies acquireshome and host societies acquires fundamental fundamental importance.importance.

By way of conclusion By way of conclusion (World Migration Report 2011, IOM)(World Migration Report 2011, IOM)

Food for thoughtFood for thought

Ο παππούς μας ο «λαθρομετανάστης»…Ο παππούς μας ο «λαθρομετανάστης»…

► Αρχές του Αρχές του 2020ουου αιώνα αιώνα: : εμφανίζεται στις εμφανίζεται στις εφημερίδες για πρώτη φορά η λέξη εφημερίδες για πρώτη φορά η λέξη «λαθρομετανάστης» που αναφέρεται «λαθρομετανάστης» που αναφέρεται αποκλειστικά σε Έλληνες μετανάστες στις ΗΠΑ.αποκλειστικά σε Έλληνες μετανάστες στις ΗΠΑ.

► Τέλη του 20Τέλη του 20ουου αιώνα αιώνα: : η απαξιωτική λέξη η απαξιωτική λέξη «λαθρομετανάστης» χρησιμοποιείται ευρέως και «λαθρομετανάστης» χρησιμοποιείται ευρέως και από την επίσημη πολιτεία για να χαρακτηρίσει από την επίσημη πολιτεία για να χαρακτηρίσει τους άτυπους (τους άτυπους (irregular) irregular) μετανάστες.μετανάστες.

Migration and healthMigration and health

► Migration is, in itself, not a risk to health.Migration is, in itself, not a risk to health.

► I.e. “Healthy migrant” effect.I.e. “Healthy migrant” effect.

► However, migration practices and policies However, migration practices and policies may render migrants more vulnerable. may render migrants more vulnerable. Migrants, and especially those on irregular Migrants, and especially those on irregular status, are exposed to numerous health risks status, are exposed to numerous health risks during their travel, as well as in destination during their travel, as well as in destination countries. (eg. poor living conditions, countries. (eg. poor living conditions, violence, limited access to the healthcare violence, limited access to the healthcare system).system).

Migration and healthMigration and health

►Governments face the challenge of Governments face the challenge of responding to the health needs of responding to the health needs of migrants. migrants.

►Failing to do so is not only an infringement Failing to do so is not only an infringement on the universal right of an individual to on the universal right of an individual to healthcare, but may have serious public healthcare, but may have serious public health repercussions, and can exacerbate health repercussions, and can exacerbate inequalities and marginalisation.inequalities and marginalisation.