- Health workers represent a sixth of all COVID-19 cases, and a disproportionate portion of that group are migrant health workers.
- We need to have solidarity with migrant workers and provide them with better working conditions. Solidarity involves assisting and supporting others because we recognize something shared between us like our common humanity.
- Migrant health workers need more personal protective equipment, living wages, less immigration barriers, and the right to raise concerns without fear of reprisal.
- Lisa A. Eckenwiler is a Professor of Philosophy at George Mason University, Vice-President of the International Association of Bioethics, and a Member of the Independent Resource Group for Global
- This is an opinion column. The thoughts expressed are those of the author.
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Recently the World Health Organization reported that health workers represent 1 in 6 reported cases of COVID-19 infection, part of what has been described as an “unprecedented, massive worker safety crisis.” Migrant health workers make up many of these cases.
Filipinos represent 4% of nurses in the United States but 31% of COVID-19 deaths among the profession. Black, Asian, and Minority Ethnic (BAME) health workers in the United Kingdom’s National Health Service have become ill and died in disproportionate numbers. Haitians, many of them asylum seekers, have endured illness and death since the virus gripped Quebec’s long-term care settings.
The US and many other high-income countries have long relied on foreign-born and educated nurses, nurse aides, doctors, and others working in long-term care, hospitals, clinics, and more. As COVID-19 has unfurled, migrant care workers across the world have served on the front line of crisis response and suffered for it.
Migrant care workers’ heightened risk of exposure for themselves, their families, and their communities is not coincidental. It is a reflection of structural health vulnerabilities that are born from stereotypes, workplace conditions, systemic poverty, immigration processes, housing costs, and other historic systems of oppression.
These workers are often reluctant to raise concerns about inadequate supplies of necessary resources for fear of sanctions that range from discrimination to deportation. Those working in long-term care often live on the edge of poverty and ill health, with low wages, few benefits, and some of the highest occupational risk there is. Psychological stress suffered by health workers of all kinds, especially migrants, in this context is unprecedented.
Why we need solidarity
Why should our concern for this heightened loss of life and opportunity among these healthcare workers go beyond regret or pity?
A key reason draws from the ethical notion of solidarity. Solidarity involves assisting and supporting others because we recognize something shared between us like our common humanity, or our need for care when we are sick and as we age. At its core, solidarity is the belief that people are fundamentally embedded in social relationships and cannot truly exist as individuals without relying on others, especially given our need for care in the face of illness and other hardships. If anything, the COVID-19 pandemic reminds us of our shared frailty as humans and our need for care.
Solidarity with migrants — and all health workers — requires providing adequate personal protective equipment (PPE), better staffing ratios, decision-making power over patient care and matters of management, the right to raise concerns without fear of reprisal, and living wages and fair benefits that afford ample social and economic protection, such as sick leave and health insurance, and moreover, are more befitting skilled work involving vulnerable people.
Furthermore, it requires reforming immigration and asylum processes that can pose barriers, like long waits to obtain visas. Many thousands of refugees and other immigrants with health degrees already living in “destination” countries like the US work in jobs below their level of education, or want to work but are unemployed due to complexities of licensing requirements. Better coordination at the federal level, between the Department of State, Health and Human Services, and Citizenship and Immigration Services — in addition to better global governance over so-called human health resources, could also show solidarity.
There are also self-interested reasons for showing concern for workers’ conditions and their health. When facing a contagious disease, heightened risk for anyone translates into heightened risk for everyone. If a nurse has access to an N95 mask, it doesn’t just protect them — it also inhibits the spread of infectious particles to patients (who may not even be in for COVID-19) and their families, filtering 95% of airborne particles. When we don’t protect our healthcare workers, entire communities are at greater risk of infectious transmission. The tragic loss of elders in nursing facilities across Quebec and the loss of life in the Filipino community make clear precisely this threat to public health.
While there is an ethical imperative to show solidarity through specific actions promoting collective safety, self-interest should provide more motivation. The lives of Filipino nurses, Haitian nurse aides, and Nigerian doctors and their families are interwoven with the lives and health of elderly Quebecois and Americans, and in turn, their communities. To protect migrant care workers as well as ourselves we must provide them with sufficient PPE, living wages, better representation so that they can voice concerns, and more. This is not just a need in the time of COVID; it is a long-term effort to re-imagine how we care for people. Our health is, and has long been, interdependent. We are bound to one another.