What We Can Do to Bring About Change in a Broken Migration System

Two weeks after the tragedy that occurred on the border fence separating the cities of Nador and Melilla, we still do not know how many people died and whether their deaths were caused by the crush or by beatings. On both sides of the border, reports of the tragic event were quickly buried by news of the NATO summit and a fusillade of unproven insinuations about the role of organised criminal groups and the alleged violence of the victims. But people in cities all over Spain raised the cry of “Black lives matter” and demanded an urgent response to address the many unanswered questions, starting with the identities of the 23 people whose deaths have been confirmed. 

One of the most tragic aspects of the recent events in Melilla is that what happened was not an exception but rather business as usual in a system designed to stop migratory flows at all cost. The Missing Migrants Project, an initiative of the International Organization for Migration (IOM) supported by international cooperation, has recorded the deaths of 49,353 people on migratory routes since the project started in 2014. Half of these deaths occurred on routes in and around the Mediterranean. The rhetoric about safe and legal channels for migrants is not borne out by the realities of a model that ensures that the process for obtaining a visa is a lottery that has condemned half a million men, women and children in our country to a life without any legal status whatsoever.

The rhetoric about safe and legal channels for migrants is not borne out by the realities of a model that ensures that the process for obtaining a visa is a lottery that has condemned half a million men, women and children in our country to a life without any legal status whatsoever.

What this means is that any analysis of the management of our borders must be based on the recognition that the existing model is not working. Nothing can be “satisfactorily resolved” by a model that amplifies the risks of migration and reduces the opportunities it could afford. In addition to denouncing these humanitarian abuses and clearly defining red lines with respect to the rule of law, we also urgently need to find ethical, political and institutional alternatives that will break the vicious circle of violated freedoms and wasted opportunities in which we are currently trapped. 

All of us have a role to play in meeting this challenge to establish a standard for collective decency and intelligence. ISGlobal is not an activist organisation and nor should it be, but one of the most radical ways we can engage in the process of transforming the current migration model is to put scientific and political knowledge at the service of good ideas. Our starting point is simple: the right to health is a basic human right that should never be contingent on the privilege of holding a passport. When people travel, their right to health travels with them and must be guaranteed at every stage of their journey, irrespective of their legal status at any point along that route. Moreover, we believe that equity and equal access are necessary prerequisites for a smart and effective health care system, as we have seen during the pandemic.

The right to health is a basic human right that should never be contingent on the privilege of holding a passport.

The problem is that ensuring such access is easier said than done. Even in places where access to health care services is guaranteed by law, practical obstacles can be insurmountable. And that is an area where we can help. Dr Ana Requena has been working for years to improve the available data on the health of migrant populations; this information is essential for the provision of health care services that meet the real needs of our society. Knowledge-based policies save lives and optimise public resources, as our Chagas and international health teams have demonstrated in their work in Barcelona. In Morocco, through the Mediterranean Health Observatory, we are currently working with the Ministry of Health to identify good practices and to help the relevant authorities improve health care coverage for migrant populations.

Knowledge-based policies save lives and optimise public resources.

In Latin America, we are working to change policies that affect the health of migrants as co-leaders—together with Lancet Migration and the Pan American Health Organization—of a working group that will make recommendations to the Ibero-American summit of Heads of State and Government scheduled to take place in 2023.

In the future we can do much more. The debate on how to manage human mobility is one of the pivotal ethical and political challenges of our time and nothing suggests that things will get any easier in the near future. ISGlobal can contribute to the development of a cosmopolitan approach that considers access to health care as an individual right for migrants and as a necessity for societies rather than as a benefit conceded graciously by host governments. And we are willing to engage in debates on other complex topics involving global health and migration, such as the challenges presented by health worker mobility, the improvement of information systems, and the mental health needs of vulnerable migrant populations. Not forgetting, of course, the representation of migrants’ own voices in debates on issues that affect them. 

An immense amount of scientific, political and civil society work remains to be done in every one of these areas. Let’s work together to make events like the tragedy in Melilla the exception rather than the rule.