Maldives situation on “Health and Migration”

By Dr. Santosh K. Yatnatti, ISECN Southeast Asia Regional Coordinator

The Maldives country is a group of tiny coral islands located in the Indian Ocean.1 Maldives health care delivery system is organised into a four tier referral system. Island level health services are the basic units, where the cases can be further referred to atolls, regions and central higher centres according to the condition of the patient. 2

In 2008, the constitution of Maldives was reframed with special focus on the decentralization of the health care delivery system and privatization of health services.3The main focus was to ensure equitable access to health services and to promote health for all. Currently, Maldives is facing an epidemiological transition from control and prevention of communicable diseases to non-communicable diseases.4 The deaths due to non-communicable diseases constitute 70% of all deaths. However, Maldives has achieved 5 out of 8 Millennium development goals and has set an example for other South East Asian countries. 4

Maldives is facing a serious threat with respect to climate change. The rise in sea level has posed a threat to the people of Maldives, leading to the forced migration of citizens to other countries.5 This will lead to a state called “climate refugees”, which would raise conflicts in the local population and also in the countries of relocation.5

Basic conflicts may arise on the fight for resources and the sources to sustain livelihoods.5 In addition, culture also could be one of the factors that trigger conflict. The International Organisation on Migration (IOM) predicts that the people who are forced to migrate normally choose places where they have similarities in their culture and ethnicity or follow old colonial relationships. In the current situation, the ideal countries for migration would be India and Srilanka, which are places that have cultural similarities and might reduce ethnic conflicts.5

The International Organisation for Migration (IOM), along with the United Nations Security Council (UNSC), has recognised the migration of large populations from Maldives to other countries as a threat to international peace and security.6 They have also emphasized that the conflicts due to forced migration of Maldivian people depends upon the political and social aspects of the place where they choose to migrate to.

Youth migration and human trafficking are also issues within the Maldives country.7On one end, migration offers valuable opportunities for the development of communities and society at large. On the other end, it may pose risks in terms of inequalities, discrimination and exploitation. In Maldives there is a large population of expats concentrated in Male city. For every three Maldivians there is a migrant. The majority of the migrants are from Bangladesh and India, who come to work in construction companies and to pursue education. However, the expats are facing difficulties in obtaining access to health care services.7

The International Labour Organisation (ILO) is actively involved in Maldives. In order to address the migration and human trafficking issues, there is an ongoing project headed by the ILO on rights of labour and labour market governance.8 The ILO is supporting Maldives in framing the labour laws, capacity building of the government, workers and employers organisation, drafting the first industrial relations act, developing labour inspection and employment policies. In addition, the ILO is planning to develop the first decent work country programme for Maldives that will work towards solving migrant workers and human trafficking issues.8

To conclude, the major alarming issues affecting the Maldives are future climatic refugees, youth migration and human trafficking. The youth migration and human trafficking issues are dealt with by the International Organisation for Migration (IOM) and the International Labour Organization (ILO). However, there is no proper propaganda or solution for the climatic refugee state at the moment. Maldives has to start making policies and negotiations with the countries they choose to migrate to in near future. Therefore, this issue should be comprehensively dealt with in coordination with all major World organisations working for health, justice, migration and global peace. The ultimate goal should be to relocate the people of Maldives to a better place where they can live healthily, happily and peacefully.

References

  1. Maldives country. Wikipedia source. [Internet] (Available from https://en.wikipedia.org/wiki/Maldives last accessed on 12/11/2016)
  2. Maldives Health Profile 2014 by Government of Maldives. [Internet] (Available from http://www.health.gov.mv/publications/13_1395305886_Maldives_Health_Profile_2014_final_final.pdf last accessed on 12/11/2016)
  3. Constitutionof theRepublic of Maldives2008-Presidential note. [Internet] (Available from http://www.presidencymaldives.gov.mv/Documents/ConstitutionOfMaldives.pdflast accessed on 12/11/2016)
  4. Maldives country cooperation at a glance –World Health Organisation. [Internet] (Available from http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_mdv_en.pdflast accessed on 12/11/2016)
  5. The Maldives and Rising Sea Levelsby Justin Hoffmann [Internet] (Available from http://www1.american.edu/ted/ice/maldives.htmlast accessed on 12/11/2016)
  6. Rising tide of migration accompanies sea level rises, as predictedMay 2, 2016 by Eric Holthaus. [Internet] (Available from http://phys.org/news/2016-05-tide-migration-accompanies-sea.htmllast accessed on 12/11/2016)
  7. Youth Migration: Moving Development Forward. [Internet] (Available from http://countryoffice.unfpa.org/maldives/?publications=7598last accessed on 12/11/2016)
  8. ILO Country Office for Sri Lanka and the Maldives (CO-Colombo). [Internet] (Available from http://www.ilo.org/colombo/lang–en/index.htm last accessed on 12/11/2016)
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