“Governments are not motivated to fix migrants’ issues because the money they send home keeps their economies running” Credit: Shutterstock
by Marty Logan (kathmandu)
Inter Press Service
KATHMANDU, Feb 19 (IPS) – As involuntary migration rises around the world, partly in response to the impacts of climate change, justice for those leaving their homes and families to earn a living is largely missing, said activists meeting at the World Social Forum (WSF) in Kathmandu on Sunday.
In various sessions, participants from Europe, northern Africa and Latin America detailed governments squeezing doors shut on migrants trying to enter their countries. Disturbing stories from Asia focused on individuals falling victim to employers and traffickers as their governments looked the other way while profiting from migrants’ income remitted home.
The WSF ends in Nepal’s capital Kathmandu on Monday. During the annual event global activists gather to discuss issues ranging from education to debt relief, legalization of sex work, and poor farmers’ lack of control over their land and resources.
“One of the women we talked to told us that she had to sleep with six to seven men daily for six months. The saddest part is the employer’s wife regularly gave her a pill so she wouldn’t get pregnant,” said a researcher with the Bangladeshi organization OKUP. “Another worker was diagnosed with colon cancer: his employer sent him home without paying a single bit of his salary.”
OKUP hosted the session, Climate Change, Migration and Modern Slavery, to share its report documenting the treatment given to migrant workers from coastal regions in Bangladesh who were forced to leave after the impacts of climate change destroyed their farms and other livelihoods.
Research found that 51% of households migrated after being hit by cyclones, floods, salt water intrusion in their fields, erratic rainfall and other climate disasters. “There is no sustainable adaptation opportunities for them. In most cases people receive assistance from the government after disasters, but there is no sustainable assistance. That’s why people rely on loans to rebuild their houses or restart their farming activities,” said OKUP Chairperson Shakirul Islam.
“Before they can repay the money they experience the next cycle of climate emergency,” he added, making them desperate to go earn money elsewhere in the country or abroad.
Eighty-six percent of those displaced migrate within the country; 14% internationally. En route 90% face excessive fees, 81% do not get a promised work permit and 78% have their salaries held back. “I strongly believe that the same situation is present in other countries in South Asia,” said Islam.
Shakirul Islam, Chairperson of the Bangladeshi organization OKUP, (standing far right) introduces the session Climate Change, Migration and Modern Slavery at the World Social Forum on Sunday, Feb. 18. Credit: Marty Logan/IPS
Malaysian activist Sumitha Shaanthinni Kishna cautioned the group to not blame climate change for the migrants’ problems. “The fear I have is governments using climate change to justify migration. They will say ‘that’s why we have to send our migrants out’. They have done this to justify migration due to poverty.
“The discussion has to be that climate change is real and how the government’s policies are contributing to climate change,” added Kishna, from the organization Our Journey, which provides legal support to migrants and refugees.
In another discussion in another classroom just minutes later and only metres away, activists from India were learning about a hotline created after COVID-19 to help migrant workers in distress. In less than one year, the Migrant Assistance and Information Network has responded to 800-plus calls, said its director, Dr Martin Puthussery.
The cases include 40 deaths (19 accidents, 15 accidents, 6 suicides), 20 instances of forced labour and 16 cases of legal aid or mediation, involving wage theft, delayed payments illegal confinements and imprisonments.
During the question-answer session a participant from northern Bihar state noted that migration is a must because “everything is closed down. Where do the people of Bihar go to earn their livelihood?”
“Can we ourselves create small industries?” she asked. “We can’t depend on the government.”
Governments are not motivated to fix migrants’ issues because the money they send home keeps their economies running, said Arie Kurniawaty from Solidaritas Perempuan in Indonesia at one of the day’s last sessions, Call for Migration Coordination within the WSF in Kathmandu.
“The basic problem is the perspectives of our governments, which think that migrant workers are a commodity… They will try to send many migrant workers abroad without considering if their situation will be good or bad,” added Kurniawaty.
Other speakers in the session, which covered France, Africa, Palestine and Latin America as well as Asia, noted rising numbers of migrants but increasing hostility to them, led by governments.
In Latin America, governments’ actions are linked to rising racism and xenophobia, said Patricia Gainza from the World Social Forum on Migrations. “This is nothing new but in this case we’ve had some very bad decisions by governments, like Peru, who invite people to come but later, for political reasons, pushed them out.”
In Europe, the New Pact on Migration and Asylum, of December 2023, “encourages informal and confidential agreements between European countries and migrant-sending countries that are not legally binding, so that the European Parliament will not have to ratify them,” said Glauber Sezerino of the Paris-based Centre de Recherche et d’Information pour le Développement. “The pact tries to encourage more and more of this kind of agreement, so you can expect more violation of human rights” of migrant workers, he added.
In North Africa, governments are increasingly dominating debate on migration policies, “leaving little room for civil society,” said Sami Adouani of FTDES Tunisia. In February 2023, a xenophobic speech by Tunisian President Kais Saied targeted migrants from sub-Saharan Africa. That triggered an exodus but also “exposed those remaining migrants to more institutional violence,” he added.
Girls wait for their vaccination cards to be updated after receiving the HPV vaccine at BP Koirala Cancer Hospital in Bharatpur, Nepal, 10 July 2023. Credit: Marty Logan/IPS
by Marty Logan (chitwan district, nepal)
Inter Press Service
CHITWAN DISTRICT, Nepal, Jul 31 (IPS) – As Dipak Subedi was organizing a vaccination programme against the human papillomavirus (HPV) in the city of Bharatpur in Chitwan district of southern Nepal he was getting phone calls from neighbouring districts asking if he had extra doses available — people were willing to travel for hours to get their girls vaccinated against HPV, which causes cervical cancer, the deadliest form of cancer for women in Nepal.
Callers had heard about the campaign, which started in 2022, after the city posted the news on its Facebook page, says Subedi, senior public health officer and chief of the Bharatpur public health promotion section. Unfortunately he had no extra doses to meet the demand. “With such demand if the HPV vaccine was to be included in our regular vaccination programme we could get more than 90% coverage,” he adds in an interview in his office in Bharatpur, a city of 370,000 people best known for its location near Chitwan National Park.
Most people approached for this article who were connected to the Bharatpur campaign, or to previous small-scale pilot projects in Nepal, noted similar high demand. In recent years the Nepal Government has pledged repeatedly to provide the HPV vaccine for national distribution but has yet to do so.
Awaiting GAVI response
Earlier this month a national campaign moved a step closer when the child health and immunization section of the health department submitted a request to the global vaccine alliance GAVI for 1.6 million doses. The response should be known by September; if positive, vaccination could start in 2024.
Cervical cancer is the fourth most common form of cancer among women globally and the leading cause of cancer-related deaths for women in 36 countries in Africa, Asia and Latin America. The World Health Organization (WHO) reported recently that 604,000 new cases of cervical cancer were reported globally in 2020 and that 342,000 women died from the disease – a staggering 90% of the new cases and deaths occurred in low and middle-income countries.
HPV is the virus that causes most cases of cervical cancer and is responsible for the majority of sexually transmitted infections of the reproductive system. The HPV vaccine has been shown to prevent up to 90% of HPV-related cancers and pre-cancerous injuries. WHO says that eradicating cervical cancer will require vaccinating 90% of all girls worldwide by the age of 15.
The burden of the disease in Asia is high. In 2020, China and India alone accounted for 40% of global cervical deaths (17% and 23% respectively), according to The Lancet journal. In Nepal, there were an estimated 14.2 cases per 100,000 women in 2020, versus the WHO target for 2030 of less than 4.0. The disease kills about 1,500 women in the country each year, reports the HPV Information Centre.
In 2020, researchers predicted that without any intervention, a total of 170,600 women in Nepal would die from cervical cancer by 2070 and 318,855 by 2120. But according to the UN Population Fund, HPV vaccination could prevent nearly 38,737 cervical cancer deaths in Nepal by 2070, and 165,115 deaths by 2120.
About 400-500 new cases are diagnosed at the BP Koirala Cancer Hospital in Bharatpur alone every year, says Dr Asmita Rana, the head of the hospital’s department of cancer prevention control and research.
Rana is managing the vaccination campaign that includes Bharatpur and two other municipalities, distributing 12,500 doses to girls ages 11-13, two doses each. While the first phase was a big success, the second one has faltered, she says in an interview in her office. That’s mainly because phase one was implemented at the community level (schools and health facilities) by municipal staff. Phase two was centred around the hospital, meaning that caregivers (school officials and/or parents) had to take time to transport children to and from the facility.
Staff members in the hospital’s department of cancer prevention control and research discuss vaccination with a girl about to be receive her second dose of the HPV vaccine, at BP Koirala Cancer Hospital in Bharatpur, Nepal, 10 July 2023. Credit: Marty Logan/IPS
Schools the preferred site
Asked what she has learned from the campaign, Rana says she would do all phases through schools next time to ensure participation. “That would be a more appropriate way to follow up those girls… rather than at the health facilities.”
The second learning is that raising awareness ahead of time is key, says Rana. “From my experience I can say that if we do an awareness programme ahead of time — tell them something about the vaccine, about HPV, and the effectiveness of the vaccine for preventing cancer, then they will be quite positive and participating.”
Even if people are initially sceptical, “gradually when we explain to them that it’s a very good vaccine, it’s free of cost — although it’s expensive if you have to buy it — and will prevent your daughter from getting cervical cancer in the future, most of the people are convinced.”
The vaccine is available at private health facilities in Nepal but two doses costs around 10,000 rupees (US$76). The country’s per capita income was about $1,300 in 2022. Neighbouring India started producing its own vaccine, Cervavac, in 2022. Its price is $4.88-$9.76 for two doses. South Asian neighbours Bhutan, Sri Lanka and the Maldives have launched national vaccination programmes while Bangladesh has done pilot projects.
It’s surprising to hear that vaccine hesitancy hasn’t been a minor issue in the campaign. One school did refuse to participate, says Rana, after they were told that parents had to sign consent forms. “They were thinking ‘it’s like a new Covid vaccine and it’s being tested via our girls’; they were not aware that the vaccine had been approved years before. I tried so hard to convince them but they would not come.”
School nurse Sudeepa Poudel also faced some resistance, but says she overcame it after talking to doubting parents. “They say ‘we were never vaccinated but we are fine till now — why do our kids need to be vaccinated’?… Some parents are easy to convince but many are not because they’re illiterate, so I have to take time to explain carefully to them; sometimes it takes two sessions. After that explanation they easily accept it.”
Poudel works at a secondary school in Bharatpur from where 25 girls were vaccinated earlier this year. Beforehand she spent one hour explaining the process to students. “I conducted classes for those students who were going to be vaccinated as well as those younger students (9-11) who might receive the vaccine in the future, explaining the purpose of the vaccine, where it comes from, how it’s managed, possible side-effects, etc.”
Just down the hall from Rana’s office at the hospital is the room where the vaccine is given. During one recent morning girls arrive in small groups and take turns sitting in a chair and rolling up their sleeves, while caregivers look on.
Later outside the room, three girls from a high school in Bharatpur shake their heads when asked if their shoulders hurt where they got the injection. They had no hesitation getting the vaccine, they add through an interpreter. “We got information from the school nurse and teachers so we are confident,” says one.
Girls from Aadikabi Bhanubhakta Higher Secondary School pose with their caregivers after vaccination, at BP Koirala Cancer Hospital in Bharatpur, Nepal, 10 July 2023. Credit: Marty Logan/IPS
3 reasons for support
“We’re doing this for three reasons,” adds another: to prevent genital problems, or issues having children, and because getting cervical cancer would interfere with menstruation.”
The father of one of the girls says he learned about the vaccine from his daughter, via news reports and social media before being contacted by the school. “I talked to the school nurse… Yes, I’m positive — both my wife and I are positive — because there is news about this vaccine being very good. I don’t know much about the technical part,” he adds, “but I feel good doing this for my child.”
HPV is spread through sexual contact, but Rana says that most Nepalis don’t interpret that to mean their daughters should be vaccinated before they become sexually active, which might be one reason there is little resistance to campaigns. “Their understanding is that it’s early marriage that would expose girls to HPV rather than premarital sex, because that was the experience of women who are now developing cervical cancer, who are around 40-45 years of age,” she says.
“Sometimes people do ask explicitly about the impact of premarital sex, but they do not resist having their girls vaccinated when we explain,” she adds.
At Bharatpur municipality Subedi says his team easily overcame hesitancy they encountered from parents during recent campaigns for Covid-19 and routine immunization for children under 2 years. “There are some rumours and misconceptions, but we can tackle that — I don’t think it’s a big deal. We can convince them. In every vaccination campaign we do the coverage rate is very high.”
Nepal’s health department has prepared an awareness module in preparation for HPV vaccination being added to the national vaccination programme, says Dr Abhiyan Gautam, head of the child health and immunization section. It will be part of what he calls a demonstration campaign ahead of the programme, which will distribute 20,000 doses in various parts of Nepal, still to be identified.
1st time under federal system
A trial phase is needed, adds Gautam, because the health system was reorganized after Nepal enacted federalism in 2017. “We haven’t conducted such a campaign at the local area… so this is a new concept for us,” he says. “The district recording and reporting system is also quite different now… at the operational level we have to be sure that the system will work, so we’ll be piloting first.”
The same system will be used for the national programme, if GAVI approves the request. “We are hopeful that we’ll get the vaccines,” says Gautam. “What we do know is that whenever we operate a vaccine programme GAVI provides some vaccines to Nepal. We submitted our application – now the ball is in their court.”
In response to a query, GAVI said that it does not comment on current applications.
The planned programme will include girls ages 10-14, in classes 6-10, rather than the 9-14 age group recommended by WHO. Gautam says this is to conserve limited resources. “Our national immunization advisory committee recommended 10-14 based on the country situation: if we go to 9-14 our operational costs will almost double.”
If Nepal launches the national programme, the immunization chief anticipates the same results as a previous government-run pilot project in 2016. “The vaccination coverage was very good (97%) because people demand the vaccine when they know about it… Poor people may not go to private settings to get vaccinations but even rich people are waiting for the national programme.”
This feature was supported by the Sabine Vaccine Institute and Internews.
A meeting of the Human Rights Council in Geneva. Credit: UN / Jean-Marc Ferré
by Marty Logan (kathmandu)
Inter Press Service
KATHMANDU, Nov 25 (IPS) – Human rights defenders are alarmed at what appears to be a new process permitting countries to keep confidential their responses to UN experts about allegations of human rights abuses.
A page on the website of the UN human rights office hosts letters (known as “communications”) from human rights experts, or “special rapporteurs”, to those alleged to have committed the abuse — usually a government. In most cases the page also hosts the response, but in some recent instances a placeholder document has appeared that says, “The government’s reply is not made public due to its confidential nature.”
Replies from at least four governments — Ecuador, Guatemala, India and Nepal — and one non-government entity, UK-based tobacco company Imperial Brands PLC, show this form letter.
That withholding of information, say the defenders, is unacceptable because the person who sent the allegation of a human rights violation, sometimes at the risk of personal harm, deserves to know how the government is responding.
“There is a lot of effort from the side of those sending information about incidents of human rights violations happening to them, and they send these to the rapporteurs even knowing that there can be risk to their lives,” says Victoria Tauli-Corpuz, executive director of the Philippine human rights organization Tebtebba, which works for the rights of Indigenous Peoples.
“Part of the process of resolving issues brought before the special rapporteurs is for the victims to read the response of the state, which will be the basis for the next steps they can take. Withholding publication of responses is a dead end for potential resolution of issues,” added Tauli-Corpuz in an email interview. She was the UN special rapporteur on the human rights of Indigenous peoples from 2014 to 2020.
The UN Office of the High Commissioner for Human Rights (OHCHR), which hosts the webpage, did not respond to requests for comment about the apparent change in process.
Communications can also include objections to laws or practices that contravene human rights standards. In 2021, a total of 1,002 communications were sent from experts to 149 countries and 257 “non-state actors”, which include businesses and international bodies and agencies, says an OHCHR report. Of those communications, 651 received replies.
The 1,002 communications concerned 2,256 alleged victims. No statistics are available on how many requests were made for communications to be kept confidential, adds the report.
One Nepal-based defender says she’s not surprised that states have asked for confidentiality, but was startled to hear that it was granted. “Individuals and organizations seek help from the UN because their government does not respond to these issues… they should be receiving updates,” says Mandira Sharma, a human rights lawyer who has experience with UN human rights bodies. “Otherwise why would anyone engage?”
“Unless there is very critical information that would put someone’s life at risk they should be able to make the information public,” added Sharma.
It is not unusual for a reply from a government to include information that is redacted.
There should be a space for human rights experts and countries to have private conversations about allegations, says Sarah M. Brooks, Programme Director for the organization International Service for Human Rights.
“But the communications process is premised on information coming from the ground, from victims and advocates, who often take great risks to share it with the UN. To then hold state responses confidential aligns neither with the purpose of the communication procedure, nor the principle of actually respecting and empowering victims in its conduct,” she said in an online conversation.
“To bend to states’ requests to hold certain information confidential — in other words, to not share possibly life-saving information with victims, family members and lawyers — would be a grave error on the part of any UN actor,” added Brooks.
