 |
||
|
||
COVER STORY |
|
||
|
||
COVER STORY |
MIGRATION Amid an increase in
mobility and migration, a growing number of young villagers are finding new ways of
improving their livelihood. As most of the migrant population are illiterate and unaware,
however, the HIV virus is fast spreading through this group into the rural hinterland as
well as in urban areas. The economic benefits generated by greater mobility and migration
are immense, but they risk being doomed by a growth in HIV infections. Considered an
economic boon for rural areas, migration could turn into a bane in terms of its long-term
economic implications for the country By KESHAB POUDEL Jeevan Khadka (identity changed), 28,
returned from the United Arab Emirates a month ago after working for five years in the
Gulf state. Following a weeklong treatment at a hospital in Dubai, the commercial capital
of the UAE, his employer ordered him to return home and provided an additional salary of
two months, airplane ticket and some bonus money.
Bewildered by the sudden change in
his employer's attitude, Khadka was unprepared for the bigger shock he received at Dubai
International Airport, when a Nepalese colleague revealed the reason for his departure:
Khadka had contracted the HIV virus. A resident of Balewa village of Baglung
district in mid-western Nepal, Khadka returned to Kathmandu with a total amount of about
Rs.200, 000 in hand. To understand his plight, he began retracing his steps. Six months
ago, Khadka had come to Nepal on a four-month vacation. Before returning to Dubai, Khadka
and a friend who lived in Kathmandu had spent a night with a girl. That was the first time Khadka had made
such a "mistake", but it ended up ruining his life. He lost a good job in Dubai
where he earned the equivalent of more than Rs.40,000 per month. The sole breadwinner of
his family, Khadka is left weighing the economic fallout of his behavior. "I know what my mistake was, but I
cannot tell this to my family members," said Khadka, a father of two children.
"Neither can I explain the disease to my family nor can I tell them why I had to
return so abruptly from Dubai," he added. For now, Khadka seems determined not to go
back to his village, fearing he might infect his wife. But he cannot avoid a bigger
challenge. "I am worried about my seven family members. Who will feed them now?" In a sense, Khadka was lucky to have been
working in the UAE, where the medical facilities are impressive. Many young Nepalese
migrants working in the cities of the kingdom and parts of India return home without
knowing they have been infected with HIV. Studies have shown that a large number of migrant workers are carrying HIV to rural areas, infecting their wives and other people. People in Kathmandu are particularly vulnerable, as the capital has changed from being an isolated traditional town to bustling hub for internal and external migrant workers. There are countless people who risk falling into the trap Khadka currently finds himself in.
From HIV-infected girls returning home from
brothels in India to male migrants converging from all parts of the country,
Kathmandu has become a transit center for many. Rapid urbanization has brought its ills.
Until a decade ago, commercial sex workers, cabin clubs, dance restaurants and massage
parlors were non-existent in the capital. Amid the increase in the number of migrant
workers in the carpet, garment and construction industries, the sex industry has thrived.
A disease that was once considered too alien for Nepal's traditional society has become a
real threat. Experts insist that intervention should
focus on the migrant population. "We must take the initiative to prevent HIV
infections among migrant workers. Since migration is required to boost economic
activities, we must prepare a strategy to generate awareness among these workers,"
says Dr. Ram Hari Aryal, a leading demographer. "The migrant workers are particularly
vulnerable to HIV because they fall in the 15-49 age group." As more than half of Nepal's population is
below 40 years, a mobile and economically active group, spread of infections will have
far-reaching consequences for the kingdom's long-term economic prospects. It would affect
the infant mortality rate, life expectancy and other demographic patterns. "The spread of HIV/AIDS in any country
can be characterized as a major threat not only to the health of the individuals affected
but also to the viability of households, the well-being of local communities and even the
development of the wider economy," said David Seddon, a British scholar, in his
article, "HIV/AIDS in Nepal: The Coming Crisis." Seddon adds: "Widespread poverty and
the lack of local sources of income force men and women to migrate from the rural areas of
Nepal in search of employment. Many of these migrants have been drawn into the rapidly
expanding nexus of the sex industry in Nepal or India, either as a commercial sex workers
or (in the case of male migrant workers) as their clients, and have been infected with
sexually transmitted diseases including the HIV virus."
Migration is one of many social
phenomena that are contributing to the spread of HIV. According to studies, high rates of
HIV are found among migrant workers. Although migration and mobility are not risk factors
in themselves, they have led to increased vulnerability. And this is where Nepal's is
particularly susceptible. Seasonal movements and long-term labor
migration to India and Gulf countries are necessary for the economic survival of many
households in both rural and urban areas. As thousands of Nepalese men and women live away
from their families, studies have revealed, isolation promotes unsafe sexual practices. Officials have begun zeroing in on the
migrant population within the country. "We regard migrant population as a high-risk
group. Our new strategy includes plans and programs for young migrants," said Dr.
Shayam S. Mishra, director of the National Center for AIDS and STD Control. Migration has transformed the population
composition of Kathmandu valley in the last decade. In the 1990s, many rural youths were
hired in the carpet, garment and construction industries in the capital, while countless
others converged on the city for menial work. The remittances of migrant workers play an
important role in the rural economy. The National Living Standards Survey (NLSS 1996)
suggests that 23 percent of all household surveyed receives remittances. The remittances
amounted to more than quarter of total household income. The survey suggests that 26
percent of remittances came from urban areas within Nepal, 33 percent from other rural
areas within Nepal and 33 percent from India. These figures underscore the importance of
migration and mobility to the wider economy. As flocks of rural people continue to be
lured to Kathmandu for better opportunities, the already cramped infrastructure in coming
under greater strain. The spread of HIV infection among Kathmandu's young population has
come as another burden. The urban population in Nepal was a little more than 10 percent 25
years ago. It is projected to rise to 30 percent by 2015. The population of Kathmandu
valley will rise by several folds because of the persistence of migration. This change
will place enormous strains on existing social services and other infrastructure, perhaps
even in ways that are barely imaginable today.
As migrant populations have become an
important part of the economic transformations occurring around the world, there is a
greater awareness of the need to put greater emphasis on population and development
policies. With the support from UN agencies like UNFPA, UNAIDS, WHO, ILO and UNICEF and
other donor agencies, steps are being taken to focus program on migrant workers. Although reliable figures are not
available, it is estimated that several hundred thousand Nepalese men migrate to India for
employment each year. Many other men migrate to urban areas within Nepal. Programs must go
beyond targeting migrant men at their place of origin and their destination, and must also
address prevention. According to Seddon's "Foreign Labor
Migration and the Remittance Economy of Nepal", a study conducted in 1997 with
support from Jagannath Adhikari and Ganesh Gurung, migrant workers bring about Rs.60
billion to Rs.70 billion in remittances. According to official reports, there are 400,000
Nepalese are working in Gulf and East Asian countries. There are an estimated 2.4 million
Nepalese migrant workers in India. "As a large number of people are
migrating from rural to urban and urban to abroad as workers, there is more vulnerability
of HIV infections among the young population, which will have negative impacts on
productivity," said Timothy T. Carrington, senior public information officer at the
World Bank, at a recent seminar organized by the World Bank Institute and South Asia
Sector Human Development on fighting the HIV/AIDS pandemic through information and
strategic communication held at Bentota, Sri Lanka. Along with Nepalese migrants, there are a
large number of Indian migrant workers in Nepal. As Kathmandu valley is home to all kinds
of internal and external migrants, it provides fertile ground for the spread HIV. According to the New Era/Family Health
International Survey, overall HIV prevalence was 2.3 percent in the general male
population. This was primarily fueled by migration, with 3.7 percent of international
migrants infected, three percent of internal migrants and only 0.7 percent of
non-migrants. The same pattern can be seen with the prevalence of any STI: almost one in
five 19 percent of international migrants are infected with any STI, compared to eight
percent of internal migrants, and 8.9 percent of non-migrants. According to the study, migration
destination is important for HIV infection. Where men migrated to make a large difference
in whether they are infected or not. Men who migrated to high-prevalence areas in India
were much more likely to be HIV infected. Men who went to Mumbai were most infected,
followed by those who had worked in the state of Maharashtra.
More than 80 percent of the people
live in rural areas which are much poorer than the cities and many want to leave the
countryside to seek better opportunities. Despite the wishes of the rural people, the vast
majority of them cannot afford to migrate to urban areas, as it is too expensive to
survive there. Internal migrants are much like international migrants - they are
encouraged to move by demand-pull, supply-push factors. Dire conditions in the villages
prompt the rural exodus. In the rural areas, incomes have stagnated and most young people
migrate to Kathmandu valley and other urban areas to perform menial and other jobs. Male migrants are often employed in
construction, while female migrants often find jobs in the carpet and garment factories.
Migrants in Kathmandu earn Rs.80 to Rs.160 (US$ 1 to US$ 2) a day, far more than they
could earn in farming or in other jobs in the villages. As salary is low in the city, most
migrants could not save the money to send back to villages. If the job is available
abroad, particularly in India, they spare no effort to go there. With the upsurge of insurgency and
uncertainty in rural hinterland, a large number of the rural population has left the
villages, creating more problems in the city. Almost all migrants, whether internal and
external, maintain their links to the villages. "Because of opportunities in urban
areas, rural to urban migration takes place with increased tempo. Therefore, it is natural
that in developing countries, urbanization is considered as a symbol of development,"
according to Nepal Population Report 2002, published by Ministry of Population and
Environment. In a span of 40 years, Nepal's urban
population increased from 3.6 percent of the population to 13.2 percent of the population.
This is an increment of 400 percent. Many urban areas, including Kathmandu valley, lack
basic amenities such as sewerage, supply of potable water, sanitation and garbage
disposal, telephone, transportation and electricity. As the population grows, the
available facilities are inadequate. Migration is not only shaping the
population composition and economic changes in the rural areas but is also making the city
more vulnerable to HIV/AIDS. Migration is as old as human roaming in search of food.
Demographers view migration as a natural and predictable response of human society.
Significant economic, demographic and socio-political differences between areas have
prompted large-scale migration. Because of employment opportunities in urban areas, rural
to urban migration takes place.
According to a study conducted by Bal
Kumar K.C., Bhim Prasad Subedi and Yogendra Gurung on "Migration Patterns in Nepal:
Streams, Characteristics and Reasons", throughout the history of migration in Nepal,
of the four streams of migration i.e., rural to rural, rural to urban, urban to urban and
urban to rural, the rural to rural migration has dominated the flow of migration in Nepal.
This survey paper, presented at the National Seminar on the Dissemination of findings of
Migration Situation in Nepal prepared for MOPE and UNFPA in 1998, showed that 92.7 percent
of the total migrants have their origin in rural areas and only 7.3 percent in urban
areas. Likewise, in terms of destination, 68.8 percent were destined to rural areas
whereas only 31.2 percent towards urban areas. The survey revealed that majority of
in-migrants had left their place of origin due to reasons related to the place of origin
(push factors). Among the push factors, lack of job opportunities was the main. Lack of
educational facilities and business opportunities were also notable reasons for compelling
a considerable number of individuals to leave their place of origin. Similarly, other push
factors included migration of family, social conflicts and absence of relatives at the
place of origin. Studies have shown that an overwhelming
majority of migrants were females. Unmarried migrants constituted 11.3 only. About 55
percent migrants were aged between 15 to 39 years. Only 40 percent of the total migrants
were literate. An overwhelming majority of females were illiterate. Among the literate,
those with secondary education had the largest proportion. The proportion of those having
bachelors degree or higher was negligible. According to a study conducted by Family
Health International, other highlights of data presented showed that Nepalese male migrant
workers, particularly those who go to work in the Indian state of Maharashtra and the city
of Mumbai are fueling an HIV epidemic in the far west. Other research also showed that the
migrant wives are vulnerable to a host of sexually transmitted infections from their
husbands. Domestic and international migrations are
important components of the socio-economic situation of many rural areas. Almost every
family has a migrant member. Poverty is the main underlying factor for sampled workers to
migrate especially to Delhi, Mumbai and Punjab. Another study has shown that the commercial
sex work exists in as many as 12 different forms and professions. As many as 175 cabin
restaurants, 40 massage parlors, 61 dance restaurants and 29 other business shops or
locations have been mapped in the course of the study that promote commercial sex.
Majority of the girls working in the cabin entertain the clients for extra income. Regular
clients of sex workers are from different cross sections of the population and not
restricted to truckers, migrant laborers and army and police personnel. Therefore, further
scaling up of existing intervention programs including media coverage are required to
encompass much wider target audience. Studies have shown that the percentage of
men who report having sex with sex workers in the past years has dramatically increased -
from 42 percent of transport workers in 2000† to 61 percent in 2001, and 10 percent
of laborers in 2000 to 30 percent in 2001. This possibly reflects that more commercial sex
venues have recently appeared. While migration continues to play an
important role in accelerating economic growth, it could equally prove to be a bane if
migrant workers are not made aware about the epidemic of HIV. 'There Is A Clear Link Between Migration
And HIV/AIDS' — Dr. RAM HARI ARYAL
Dr. RAM HARI ARYAL,
who holds a Ph.D. in population, is a leading Nepalese demographer. Joint secretary at the
National Planning Commission, Dr. Aryal spoke to SPOTLIGHT on various issues of migration
and its implications. Excerpts: How do you see the increased
prevalence of HIV/AIDS and migration? HIV/AIDS and migration are interlinked. As
our fertility rate is high, so is the structure of young-age population. One of the major
problems of population in terms of economic, social and demographic dimensions is the age
structure or the composition of the population. Our fertility was high in the past and it
is still high. Over 62 percent of the population is below 24 years. One of the characters
of this age population is high mobility. Young people do have many aspirations and demands
and these people always flock together from one part to another in search for the
employment. Migration is always age selective. What is the age ratio of male
migration? The migration of male population remains
higher. In our context, mostly young people go to India and Gulf countries. The same rule
is applicable to urban migration. The migrant population always has high aspirations and
stakes. This group is immature. How vulnerable are these groups to
HIV/AIDS? This is the group most vulnerable to
HIV/AIDS. There is a close relation between HIV/AIDS and mobility, as a large number of
young are carriers as well as receivers. This is why migration is regarded as a main
factor spreading HIV/AIDS. Is there a clear link between
HIV/AIDS and migration? There is a link between migration,
population growth and the HIV/AIDS. If we want to reduce the risk of HIV infections, we
must sensitize the population of the young age groups who migrate to different parts of
the world. We cannot stop internal migration, as it would be against human rights. We can
control internal migration through balanced development. Because of poverty, many groups
cannot migrate. What mechanisms could be effective
to prevent HIV infections? We must launch awareness programs about the
infection of HIV/AIDS to the target population. We have to mobilize community-based
organizations to generate awareness among the young population. Migration is always
age-selective, so it also changes the composition of the population. The migrant
population in Kathmandu valley is in the 19-39 age group. What are the challenges in urban
areas? One of the biggest challenges in the urban
areas is uneven distribution of population. Places like Kathmandu have many pull factors.
Unless we enhance pull factors in rural areas, migration will continue. Migration has led
to haphazard urbanization and unplanned development. Many people come to grasp
opportunities in the urban areas. During the Dashain festival, we can see Kathmandu as
calm and quiet, since a large number of people go home. There will always be pressure for
resources in urban areas. How do you see the long-term
implications of mobility and migration? Mobility always helps to increase economic
prosperity, and high productivity of young people is important for the country's all-round
development. If HIV/AIDS infections increase in this group of people, however, it will be
disastrous for the country. The same group of population who help to uplift the national
economy may prove to be a liability to the country. What impact would HIV/AIDS have on
the wider population? If mortality goes up among the 15-49 age
group, it will be disastrous for the national economy. It will have a negative impact on
life expectancy. If adult mortality is high, it will have disastrous consequences. We must
launch programs to protect the adult population. We need to link HIV/AIDS programs with
migration. You cannot stop internal migration. In Indonesia, for instance, the government
has implemented a successful program for the transmigration, providing basic facilities in
different parts of the island. |
Send your feedback to the
editor: spotligh@mos.com.np |
