Migrant Friendly Testing CARAM Asia State of Health ICAAP 2007

Migrant Friendly Testing …is based on the principles of non- discrimination; …is responsive to the contexts of migrants; and …is conducted in an enabling environment that provides migrants the ability to make choices that support their health and well-being.

Non-discriminatory Informed consent is obtained;Informed consent is obtained; Pre-test and post-test counselling is provided to all migrants;Pre-test and post-test counselling is provided to all migrants; Confirmatory testing is ensured;Confirmatory testing is ensured; Confidentiality of test results are upheld;Confidentiality of test results are upheld; Referral is available at all points.Referral is available at all points. (Treated the same as the rest of the general public under prevailing laws and policies…)

Responsive to the context of migrant workers Clinics are financially and geographically accessible;Clinics are financially and geographically accessible; Language and literacy are accommodated;Language and literacy are accommodated; Gender and cultural sensitivity are taken into account.Gender and cultural sensitivity are taken into account. (Assistance is provided to counteract their vulnerable social position, which is most pronounced in destination countries)

Enabling environment for migrants Policies reflect rights enshrined in international conventions;Policies reflect rights enshrined in international conventions; Health education is provided to increase awareness of rights and health;Health education is provided to increase awareness of rights and health; Accessibility of testing without monopoly.Accessibility of testing without monopoly. Ensures that migrants are able to make informed decisions in matters pertaining to their health and well-being

Medical testing should not be used simply as a screening mechanism to decide who can work and who cannot. Medical testing is foremost a process to prevent the occurrence of illness; and it is a gateway to access healthcare services, specifically treatment and care. More than a screening process, medical testing should be aimed at benefiting the health and well-being of migrant workers because they have a right to be healthy and they have a right to work productively.

To invite governments to cooperate in developing and implementing migrant-friendly testing… To invite governments to cooperate in developing and implementing migrant-friendly testing… CARAM Asia hereby initiates the campaign: CARAM Asia hereby initiates the campaign:

CARAM Asia Recommendations to Promote Migrant Friendly Testing:

Governments in origin and destination countries Ratify the UN Migrant Workers Convention;Ratify the UN Migrant Workers Convention; Address health rights of migrant workers through bilateral agreements and MoUs;Address health rights of migrant workers through bilateral agreements and MoUs; Institute specific laws and policies to uphold principles of migrant-friendly testing;Institute specific laws and policies to uphold principles of migrant-friendly testing; Establish independent monitoring systems that regularly monitor both government and private facilities;Establish independent monitoring systems that regularly monitor both government and private facilities; Decentralise high-quality health testing centres.Decentralise high-quality health testing centres.

Governments in origin and destination countries  Destination Countries - Discard HIV status as an exclusionary condition, and cease and desist forcibly deporting HIV positive migrants.  Origin Countries - Unite to affect changes in the policies and practices of labour recruitment to benefit and protect migrant workers’ rights and health by negotiating with destination countries.  Origin Countries - Fulfill inherent responsibility to protect nationals’ rights; stop considering migrant workers as purely economic units.

Health testing facilities (source and destination)  Strictly enforce confidentiality of test results;  Adhere to the practice of informed consent;  Integrate pre-test and post-test counselling;  Provide independent translation services when needed or requested by migrant workers;  Establish a policy on the provision of post-test counselling for every migrant worker on an individual basis.

Health testing facilities (source and destination)  Facilitate referral to services;  Train staff on gender and cultural sensitivity;  Ensure that migrant workers can choose a male or female doctor;  Make available separate restrooms and cubicles for physical examinations;  Abolish all unnecessary health testing and related practices (e.g. nudity or Depro-Vera);  Conduct independent, confirmatory tests free of charge with a new blood sample.

The private sector GAMCA should expand its well-established monitoring system to include: informed consent, pre-test and post-test counselling, confidentiality of test results, and a proper functioning referral system in both origin and destination countriesGAMCA should expand its well-established monitoring system to include: informed consent, pre-test and post-test counselling, confidentiality of test results, and a proper functioning referral system in both origin and destination countries Standardise and specify costs of health testing, along with stipulations of costs potentially forfeited or borne by the migrant in the case of an unfit resultStandardise and specify costs of health testing, along with stipulations of costs potentially forfeited or borne by the migrant in the case of an unfit result Ensure recruitment agencies provide a full list of the costs involved when a migrant worker applies for work abroad in a transparent mannerEnsure recruitment agencies provide a full list of the costs involved when a migrant worker applies for work abroad in a transparent manner

Embassies Provide assistance for migrant workers who get repatriated due to health conditions, including providing direct referral to health facilities and treatment in the country of origin;Provide assistance for migrant workers who get repatriated due to health conditions, including providing direct referral to health facilities and treatment in the country of origin; Ensure embassy staff are versed in the related migration policies of the destination country and receive sensitivity training on issues of health, especially regarding STIs, HIV and AIDS, to assist with proper health referral and dignified repatriation.Ensure embassy staff are versed in the related migration policies of the destination country and receive sensitivity training on issues of health, especially regarding STIs, HIV and AIDS, to assist with proper health referral and dignified repatriation.

NGOs and CBOs Sensitize employers and recruitment agencies about migrant-friendly testing, and advocate for changes in current testing standards;Sensitize employers and recruitment agencies about migrant-friendly testing, and advocate for changes in current testing standards; Challenge stigma and discrimination against migrant workers (especially in the media) and advocate for their health rights through reform of health testing policies;Challenge stigma and discrimination against migrant workers (especially in the media) and advocate for their health rights through reform of health testing policies; Support formal and informal migrant workers’ groups and assist them with integrating HIV awareness and related policies into their work;Support formal and informal migrant workers’ groups and assist them with integrating HIV awareness and related policies into their work; Establish culturally and linguistically appropriate HIV outreach programmes targeting both documented and undocumented migrant workers and assist with referral.Establish culturally and linguistically appropriate HIV outreach programmes targeting both documented and undocumented migrant workers and assist with referral.

International partners Implement the framework for migrant-friendly testing through formal and informal cooperation firmly rooted in bilateral, regional and multilateral mechanisms;Implement the framework for migrant-friendly testing through formal and informal cooperation firmly rooted in bilateral, regional and multilateral mechanisms; Ensure meaningful participation of migrant workers in international forums on health testing and HIV issues;Ensure meaningful participation of migrant workers in international forums on health testing and HIV issues; Stimulate both quantitative and qualitative research on health testing and its effects on the well-being of migrant workers and their families.Stimulate both quantitative and qualitative research on health testing and its effects on the well-being of migrant workers and their families. Increase and maintain awareness on issues of migration and HIV, and promote the rights of migrants through formal campaigns, multilateral conferences and by encouraging donors to support related activities.Increase and maintain awareness on issues of migration and HIV, and promote the rights of migrants through formal campaigns, multilateral conferences and by encouraging donors to support related activities.