A Mail & Guardian Critical Thinking Forum held in Johannesburg on August 14 in association with the United Nations Population Fund (UNFPA), the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), the International Organisation for Migration (IOM) and loveLife, examined the challenges faced by young migrants in accessing health facilities.
Media personality Faith Mangope moderated the panel, which comprised Plaxcedes Mapako, representing the Centre of Immigration Studies, Pretty Yende, a multi-award winning young South African opera singer, Dr Jonathan Ndzi, the regional coordinator for East and Southern Africa at the UNFPA, Tendayi-Rita Muteerwa, a project officer at the IOM and Nomxolisi Malope, who oversees the design of new projects at loveLife.
Dr Julitta Onabanjo, the country representative of the UNFPA, started proceedings by positioning the importance of youth migration in aiding development.
"This is critical especially when viewed in the light of the millennium development goals (MDG) and the role the youth will play in help meeting them. Youth migration is not something that is only restricted to movements outside a country, but it happens within its borders as well. We realise that young people move a lot and that they want to do so," she said.
According to Onbanjo, adolescents account for up to 12% of global migration figures. The reasons for this vary from moving with their parents, searching for jobs and study opportunities, and fleeing from natural disasters or violence in their home countries.
"More cost-effective transport also aids young people in moving towards a better life. However, they are still vulnerable and there is an element of vulnerability with them moving. Globally, we have the responsibility to listen to their concerns and to help reinforce the vitality of young people."
For her, South Africans are very articulate and vocal on issues of migration and development. She views it as a human right for young people to engage in the dialogue about these issues and is something that should happen around the world.
"We are living in a globalised and connected world where 15 to 24 year-olds have become powerful agents for change," said Dr Erick Ventura, the country representative from the IOM in his welcoming address.
"27-million migrants can be classified as youths. We all have a responsibility to engage and empower them to fulfil their potential. Safe migration needs to be promoted to reduce the potential for exploitation and abuse. Already, we are seeing more than 16-million girls between 15 and 19 years giving birth in developing countries.
“A key agenda of the MDG is access to healthcare. Our youth represents the most interconnected generation of all, but they need to be made aware of the risks as well as the opportunities that lie in migration."
Defining an immigrant
Traditionally, migration has been dominated by males looking for jobs in mining areas with women tending to gravitate towards informal sectors in cities. But at first glance, it is very difficult to explain to people what a refugee or a migrant looks like.
"Human rights apply to all people. You should not have to make a distinction between migrants and non-migrants especially if our services and policies are correct. If we deny young people access to services based on their migration status, then we are doing them irreparable harm. In my experience though, it is people who tend to be the biggest barriers to providing services to migrants," said Ndzi.
"You cannot define a migrant. But often it is how structures are put in place that defines people and creates specific attitudes towards them. Take the borders of a country for example, just because I am on the other side of one does not make me any less of a human than you," she said.
Providing for human needs
For Mapako, many of the needs that are important in life are most faced by women, and healthcare services should reflect that.
"Women are more vulnerable than men. It is the woman who goes out and looks for basic services, it is the pregnant mother who goes to the clinic and looks for help and it is the mother who takes care of her child,” said Mapako.
But arriving in a different country exposes you to a new way of doing things and you have to adjust.
"You get fresh opportunities but there are also many difficulties to overcome such as language and cultural differences. One needs to adopt to the new culture and attitudes of people. But the challenges should never define you as an individual," added Muteerwa.
Yende moved from the small town of Piet Retief to the bustling metropolis of Milan in Italy to pursue her dream of singing opera, she has a keen appreciation of what it takes to adjust.
"The biggest difficulty for me was the language barrier. I did not understand anybody and it felt like all my senses were being shut down. There was no warm African sun, the people were different and the food took some time to get used to," she said.
But she has learnt a lot in the five years since she moved to Italy becoming the first artist in the history of the Belvedere Competition in Vienna to win first prize in every category and recently appearing as Musetta in La Boheme.
A leap of faith
Some might say that South African youths are hesitant to move to new places.
However, Muteerwa said that the more exposure they got to different things, the easier it becomes to understand new ways of thinking.
"Once you start travelling you learn to easily adapt and change to other ways of doing things."
Ndzi feels that South Africans travel enough domestically to get an appreciation for new experiences.
"Young people are keen to travel and they want to move around and do different things. Adolescents are curious and want to explore things when they move. But they often take risks in the work direction. They might get access to premature sexual experiences, especially in the rural areas that lack services. Moving to cities could result in better education by being exposed to more information on family planning and the like."
Malope also felt that there is a lot of internal migration happening in South Africa. "Young people move to the bigger cities looking for employment opportunities and want to study. They are always going to where there are the best opportunities for them and these exist in the cities."
Making informed decisions
But it might not be that easy.
"People are afraid of taking risks and not everybody is willing to take it. Some young people might be intimidated by new things and feel comfortable in the familiar," she said.
One of the things that might help to address this is to provide young people with information so they can prepare themselves to migrate. But migration also seems to be a mental thing with a lot of sub-conscious boundaries.
"The trend in South Africa is that young people move to Gauteng, Limpopo and the North West to work at a variety of industries," said Muteerwa.
But access to healthcare remains a challenge.
"If you are a foreigner, getting quality healthcare means you have to pay significantly. The attitudes are that you are a person from outside the country and that you do not belong there. There is definitely a negative attitude towards immigrants in South Africa," said Mapako.
Malope argued that health workers know what to look for in patients when providing healthcare.
"Whether it is the shade of your complexion, your accent, or your language, these are all things that set you apart from the rest. Clinics need to be able to provide services for migrants that specifically address the needs of the youth," she said.
For Ndzi part of the way forward is to move beyond identifying patients and people based on their identity numbers.
"You should be able to get information on issues like HIV and Aids irrespective of where you are from. But it goes beyond that. Working with young people is a speciality. It is something that cannot be taken for granted. The people who are able to do this need to be dedicated to assisting the youth," he said.
It is not an easy road that lies ahead for young people who want to migrate in search of new opportunities. But it seems how we all respond to them will help make the process that little bit easier.