Migrants’ situation in Thailand is precarious. Due to their tenuous legal status and numerous barriers that limit access to health services and legal mechanisms, migrants endure poor working and living conditions without being able to receive full or proper treatment for related health conditions. With a sense of loss of control over their life, and without being able to access health information and services in their own language, migrants’ vulnerability to HIV and other reproductive health conditions increases, as does their susceptibility to contagious diseases and other health problems.

The Department of Population, in collaboration with UNFPA, conducted the first phase of the Cross-border Migration and Reproduction Health Study in Tachileik, a township along the border with Thailand in 1999 and the second phase in two township namely Kawthaung, Township in the south along the border with Thailand and Muse Township, on the border with China in April 2000.

Migrant health issues have risen on the agenda of policymakers in the Asia-Pacific region in recent years, generating momentum at the very highest levels of government. The challenge now is how to translate this momentum into visible changes on the ground. Despite progress on both policy and programmatic fronts, Asian migrant workers continue to face challenges in accessing health facilities and services at all stages of migration – before departure, while in transit, at destination and upon return.

International migration is a key factor behind the socio-economic development of South and South-West Asia, one of the fastest growing subregions in the world economically. Historically, international migration has acted to alleviate population pressures and unemployment while remittances from overseas migrants have contributed to poverty reduction and helped ensure relative macroeconomic stability even during times of crises. 

There are a growing number of people migrating between Bangladesh, Nepal and India. Mobility has long been linked with heightened vulnerability to HIV & AIDS. While overall HIV prevalence is low in Bangladesh and Nepal, there is a growing concern that vulnerable mobile populations are forming a bridge between high prevalence areas of India and low prevalence areas in Bangladesh and Nepal. Enhancing Mobile Populations’ Access to HIV & AIDS Services Information and Support (EMPHASIS) is a regional program being implemented by CARE Bangladesh, CARE India and CARE Nepal and led by CARE International UK (CIUK) to reduce AIDS related vulnerabilities among mobile populations crossing the borders of Bangladesh and Nepal into India. This 5-year (August 2009 – July 2014) program, is funded by the Big Lottery Fund (BIG) of United Kingdom.

Mobility is not a new phenomenon in South Asia, and national, regional and international mobility is on the rise. Over the last few decades the demand for labour from India’s growing economy, in particular, has pulled people from neighbouring countries: Bangladesh, Nepal, Pakistan and Sri Lanka. The rise of HIV in the region is also not a new phenomenon: current HIV trends reveal that South Asia is home to 2 to 3.5 million of the estimated 33.3 million people living with HIV (PLHIV) worldwide (UNDP, 2010) and the sheer numbers of PLHIV in the region make HIV a major public health concern.

Various surveys and studies (e.g. Barbora et al., 2008; Theime, 2006) reveal that migrants are disadvantaged relative to the native population in terms of employment, education and health. While their contributions are often key to the survival of families and communities back home, those who move and those who remain face many vulnerabilities. 

This Project Briefing explores the experiences of these people as they migrate, drawing on findings from a baseline study on their vulnerabilities, particularly to HIV and AIDS, as they move between their communities of origin in Nepal and Bangladesh to India. Although the baseline used quantitative and qualitative approaches, stories of harassment and violence emerge mostly from the qualitative elements.

Enhancing Mobile Population’s Access to HIV & AIDS Services, Information and Support (EMPHASIS) program. This program seeks to reduce the vulnerability of mobile populations to HIV & AIDS along two mobility routes between Bangladesh and India and Nepal and India. The objectives of this study were to understand the vulnerabilities faced by mobile populations by exploring the volume, pattern and drivers of mobility.