Damaging, unsubstantiated untruths concerning migration and health abound. These have become accepted as true and used to support policies of exclusion. Exploitation of public fears regarding migration brings with it racism, prejudice, xenophobia and hate crimes.
Everybody, regardless of where they are from, will have their own unique story that impacts their current and future health. Migrants' health is shaped by a number of wide-ranging factors, from their pre-migration experiences, their experiences during and after migration to the UK, their work, education and socio-economic status and their ethnicity (Fernández-Reina, 2020).
The terms ‘refugee’, ‘asylum-seeker’ and ‘migrant’ describe people who have left their countries and crossed borders. Distinguishing between these terms is important as there are legal differences. A refugee is a person who has fled their own country because they are at risk of serious human rights violations and persecution there. An asylum-seeker is a person who has left their country and is seeking protection from persecution and serious human rights violations in another country, but who has not yet been legally recognised as a refugee and is waiting to receive a decision on their asylum claim. Seeking asylum is a human right. There is no accepted legal definition of a migrant across nations. Generally, migrants are people who are staying outside their country of origin, who are not asylum-seekers or refugees (Amnesty International, 2023).
The United Nations High Commissioner for Refugees (2023) has stated that, globally, there were 32.5 million refugees and 4.9 million asylum-seekers in mid-2022, plus many millions of stateless people.
Migration is not as overwhelmingly negative as the political narrative suggests. Migration primarily occurs between low-income and middle-income countries. Some leave their home country because they want to work, to study or join family, while others may feel they have to leave because of poverty, political unrest, armed conflict or natural disasters. Some people no longer feel safe and may have been targeted because of who they are or what they do or believe – for example, for their ethnicity, religion, sexuality or political opinions.
Being a migrant is a key determinant of health and wellbeing. Refugees and migrants are among the most vulnerable members of society, they have to deal with xenophobia, discrimination, poor housing and working conditions and unsatisfactory access to health services, even though they frequently experience physical and mental health problems (World Health Organization, 2023).
The UK has a duty to provide refugee- and migrant-sensitive healthcare services. Refugees and asylum-seekers who have an active application or appeal are fully entitled to free NHS care. With regard to refused asylum-seekers, this is more complicated. The four UK nations provide guidance and advice regarding service provision related to each jurisdiction (British Medical Association, 2022). Migrants can have complex health needs and nurses may be required to assess these needs and offer treatment.
Migrant journeys all start with the hope for a better future, they can also be filled with danger and fear. Some become a target for human trafficking and other types of exploitation, some are detained by the authorities as soon as they arrive in a new country. Some migrants end up feeling alone and isolated, they may have lost the support networks that we might take for granted such as our communities, colleagues, relatives and friends. Nurses must bear this in mind and offer holistic and person-centred care. This is key to support resilience and to help migrants adjust to life in the UK.