Meet AIM Grant Recipient: CARAM Asia

Earlier this year, Global Health Council awarded its first-ever Advocacy in Motion (AIM) Grants to five civil society organizations. These grants are intended to support advocacy and health equity, as well as amplify the voices of local and regional organizations. This month we are featuring one of our winners, CARAM Asia.

Established in 1997, CARAM Asia works for the promotion and protection of migrants’ labor and health rights, with a focus on HIV and AIDS issues. It operates as a regional network comprised of 42 member organizations in 18 origin and destination countries across Asia and the Middle East. Over the years, CARAM has conducted various regional research studies to overcome the knowledge gap related to migrant workers’ health and rights issues. 

We recently spoke with CARAM’s Regional Coordinator, Musarrat Perveen, to learn more about the organization and its work. 

Can you tell us a bit about your organization?

CARAM Asia’s secretariat is based in Kuala Lumpur, Malaysia. We are an NGO in Special Consultative Status with the Economic and Social Council of the United Nations. Our projects cover a number of areas, such as awareness-raising, capacity-building, advocacy, research, and the provision of services and assistance—including psychosocial and legal aid to beneficiaries.  

We have four taskforces dedicated to our key areas of focus: Migrant Workers’ Rights; Migration, Health, HIV and Well-Being; Migration, Development and Globalisation; and Migration, Climate Change and Humanitarian Crisis. The task forces are comprised of CARAM network members, which have expertise on the related areas.  

What are the biggest health challenges that migrant workers face?

Migrant workers often face challenges in accessing healthcare and services. They may be exposed to exceptional occupational hazards, face social exclusion and discrimination, or experience language barriers and interpersonal challenges—all of which affect their health and ability to access health services. Meanwhile, isolation and stress may lead migrant workers to engage in behaviors that increase HIV risk. Policies regulating migrant workers often neglect migrants’ health and are designed with the assumption that people won’t experience sex, pregnancy, marriage, or have children while working in the country. 

To address this, CARAM Asia’s network advocates for migrant-friendly national policies and our member organizations engage with other relevant sectors to improve the accessibility and affordability of health services for migrants—with a focus on empowering migrants to prevent HIV infection by avoiding high-risk behaviors.

How has COVID impacted your organization and the community it serves?

Like other parts of the world, Asia was severely affected by COVID-19. All the partners in our network experienced government-issued lockdowns and movement control orders, which meant people could only travel 10 kilometers from their homes with the sole purpose of buying food. Therefore, CARAM Asia Secretariat and all our project partners were forced to work from home with limited resources. Our in-person meetings, awareness-raising sessions, and sensitization workshops were delayed definitely. There was a lot of fear, anxiety, and uncertainty about when the situation would improve.   

During that time, most migrant communities were experiencing a hunger crisis due to a lack of work and no paid leave. Some of our partners were able to reach out to migrant workers online and via helplines to provide pandemic information, identify those in need of emergency support, and refer the most vulnerable migrant families for food assistance. 

 Can you tell us more about the pandemic’s effect on migrant workers?

Many migrant workers had families in their home countries who were struggling because their governments failed to provide cash grants, loans, food, and necessary medical supplies during the pandemic. Meanwhile, migrants were increasingly unable to send funds back home due to lockdowns, wage cuts, and delayed wages. Some workers were stuck without pay and unable to return home due to canceled flights and international travel restrictions. 

Many migrant workers were—and still are—unable to practice social distancing in their congested living and workspaces. The hygiene standards of many migrant dwellings are appalling, and those workers were extremely vulnerable to STDs and COVID-19. During the pandemic restrictions on local travel, it was almost impossible for our partners to reach out to community members who needed help while they were quarantined.  

What is the biggest challenge your organization is facing today?

Some of the biggest challenges that CARAM Asia is working to address include: the nonrecognition of migrant workers’ vulnerability to HIV and AIDS, discriminatory policies and practices which criminalize migrant workers due to HIV-positive status (oftentimes leading to arrest and deportation without any referral to healthcare services), lack of access to health services, and lack of awareness about HIV prevention. 

As a regional network, CARAM also experiences challenges in obtaining financial support from funding organizations to sustain its operations.  

How are you hoping the AIM Grant will help your organization?

It will help us strengthen our capacity and research-based advocacy work while expanding our efforts to achieve ‘health for all’—especially for migrants. We believe the research will help us build connections with key health stakeholders, enabling CARAM and its partners to form working relationships to move closer to health for all. Through advocacy messages and the involvement of advocacy partners, we also hope the grant will help ensure the incorporation of migrants’ health rights and HIV vulnerabilities into the implementation of universal healthcare (UHC).

What does “health equity” mean to you?

Health equity means equal access to standard health services for all human beings, regardless of race, skin color, religion, or immigration status.  

What are some actionable steps you think global health decision-makers can take to increase health equity?

• Build capacity and include inputs from diverse beneficiaries in problem identification regarding health equity before making policies.
• Expand technical and financial support to Regional Networks and CSOs/NGOs working on the ground, so they can ensure the implementation of health equity goals. 
• Facilitate connections between governments and advocacy stakeholders to ensure the inclusion of health equity in the laws/policies of respective countries.
• Influence migrant workers’ receiving countries to remove discriminatory health policies that not only exclude migrant workers but criminalize them when they become HIV positive. 
• Influence funding organizations to provide more support in this area.   

What is the most important message you want to give to global health decision-makers?

To achieve UHC, we need an international effort that includes top decision-makers agreeing on multilateral action. The road to UHC must go through all countries because the world is more globalized than ever, and it will be even more globalized in the future. Therefore, we must focus on changing the way people access health information and services on a cultural and lifestyle level.

Support innovation, gather data on various societal groups, and advocate on regional, national, and global levels. Sustain and scale up resources, identify new collaborations and commitments with global multinational corporations, and amplify your impact by developing a coalition of actors working on health equity.