NCDs and Migration in the Sahel: The Physical and Mental Tolls

 

Workers carry the aid provided by the World Food Programme (WFP) for distribution in Pissila, Burkina Faso. Jan 24, 2020.  Photo provided by VOANews.

NCDs and Migration in the Sahel: The Physical and Mental Tolls

 

The pressures of being a migrant in the Sahel can increasingly take their toll on the body and mind. This section of the continuing “NCDs and Migration in the Sahel” series will examine the physical and mental impact that living as a migrant in the Sahel has brought.  This section will first brief how strenuous activity may push a human body to its limits physically, and the potential health liabilities this may bring. Secondly, it will examine mental strain and its impact it has on the resolve of migrants, and the liabilities it brings to the health of migrants. Both physical and mental impacts will shed light on increased rates of untreated or unidentified NCDs in the Sahel. Following the briefings on general impact, this section will identify some specific problems and causes of these strains in the Sahel region and provide suggestions to how they may be managed through both a policy perspective and a relief perspective.

 

Background into Physical and Mental Tolls

                Throughout most of the word physical activity is shown to be a positive indicator to the health of a person. If the person is physically active the risk of many NCDs and health ailments is reduced significantly. It is so much so that for many medical journals and independent studies the top recommendation for prevention of heart disease, high blood pressure, obesity, diabetes, and many more is to simply ensure a minimum amount of physical activity is met for each day. These recommendations are correct and sound medical advice to many people; however, this advice is tailored to those who are not forced to commit to strenuous activity daily. When a person is made to commit to repetitive tasks to survival it takes a different toll on the body. Simply put, too much strenuous activity without proper care and nutrition can increase the risk for NCDs such as asthma, hypertension, arthritis, etc.  An independent study published through the US National Library of Medicine examined the effects of excessive and repetitive physical activity as a risk factor for hypertension and related diseases. (Zhu, Z, Et. al.) The study was conducted 8206 subjects, split by 4110 males and 4096 females, aged 15-45. The subjects were monitored on activity level per week with intensity metrics built into the study. The results found a steady rise of pre-hypertension and hypertension with increasingly vigorous or strenuous activity. The average rate of pre-hypertension and hypertension for the entire study was 45.7% and 5% respectively, however for those who hit the highest level of strenuous activity this rose to 47.8% and 8.2% respectively. This statistic represents a clear correlation between increasing strenuous activity and hypertension rates per person.

 

*South Sudanese migrants making a daily water run.

 

Physical Tolls on Displaced Peoples

                In the Sahel, migrants are commonly subject to a variety of strenuous activities. Some of the most common activities are prolonged walking periods, typically due to original displacements, transporting goods by hand, fetching supplies such as water, etc. These walking periods are again exacerbated by the previously mentioned nutrition issue, but also by the lack of proper footwear and a lack of medical availability.  One testament from a Malian man taken from the International Organization for Migration (IOM) reads “I crossed the border with my animals, my donkeys, my children and my wife. I traveled to Timbuktu crossed the river and came down to Burkina. I walked every day until sun set and after I would go to bed. The journey took three months.” These conditions for prolonged periods can cause irreversible damage to the human body. While hypertension itself may be manageable, unchecked like so many cases in the Sahel are, can lead to heart failure, weakened kidneys, aneurysms, dementia, and many other potentially fatal diseases. An excerpt from the 2012 WHO report on the “Sahel Food and Health Crisis: Emergency Health Strategy” explains the average Sahel ranking on health care efficiency to be between rank 162-178 out of 191 countries. Some of the key areas of need are better data conglomeration, lack of supplies, lack of health awareness, and most critical to the pertained topic, barriers to access for exposed groups such as women, elderly, children, and migrants (refugees or displaced peoples).  It is important to note that while these issues are incredibly important and deserve recognition, the faults do not entirely lie with the government itself, rather a mixture of less efficient use of funding, climate issues, and influx of refugees, rebel groups and political instability amongst other contributors. The situation remains dire from its 2012 state, meaning more resources, policy change and aid must be redirected to alleviating the pressures of the crisis.

 

Mental Tolls on Displaced Peoples

                In addition to physical tolls on the body, mental tolls can build and effect NCDs on the body, especially for migrants. Some of the more common mental health ailments for migrants tend to be PTSD if they experienced any trauma, were subject to conflict or forced displacement, or even the feeling of hopelessness for their current situation. In addition, depression, anxiety, addiction, and more are also common amongst migrants in all walks of life. These mental health issues can be brought upon by any of the reasons or can be largely unrelated in origin. However, most of these issues face the same problem, no being properly addressed medically. Worse of, they are commonly put in the background in comparison to more apparent physical and nutrition-based issues. Being put in the background or feeling as if mental health is less important than food security is a common feeling for many who suffer. What needs to be known is that mental health in these situations is not attempting to be more important than the obvious issues of food scarcity and obvious physical issues, rather they simply need to be addressed in some capacity and attended to whenever possible. Forcing the issue further into the background may only exacerbate the problem rather than taking a few moments to attempt to address it.

                According to the article “Integrating Mental Health with other Non-Communicable Diseases” by Dan Stein, et.al. Many mental health disorders commonly share risk factors with NCDs and often lead to one another. The most common mental health condition, depression, has been shown to worsen both the risk of developing, and the severity of arthritis, asthma, cardiovascular disease, cancer, diabetes, etc. As mentioned, depression and PTSD among migrants worldwide has become more apparent. Studies pertaining to Syrian refugees, Iraqi refugees, and Yugoslavian refugees have all reported increased cases of helplessness, hopelessness, and feelings of depression. While the data is not currently available, by extrapolating from similar situations we can infer there are many undiagnosed and untreated cased of mental illness occurring through out the Sahel migrant community.

 

Acknowledgement of Gaps in Research

                The research presented is not without its own gaps. While efforts have been made to ensure each detail is relevant, a lack of exact data on migration issues in the Sahel have left some sections to refer to similar situations and research. This leads to potential shortfalls or non-perfect info. This does not make the findings irrelevant, rather they have room for improvement if better data would become available.

 

Future Issues and Policy Recommendations

*A large mobile water tank placed nearby to a migrant camp. Methods like this can help eliminate and mitigate the physical strain of constantly making a tiresome walk for needed water.

 

              What can be done to help? There are many options to help alleviate the physical and mental tolls being taken on migrants to help prevent further distress. The simplest issues and policy redirections remain largely the same to the nutrition portion. Alleviating the strains on necessities such as food, water, and shelter remain the best ways to reduce strain physically and mentally. However, pertaining more closely to what is realistic there are other, faster options than resettling millions of migrants.

               

                 The first issue to address is strenuous activity. While policy change may be impossible for establishing where migrants start from and end, it can help to eliminate the additional walking once at a migrant camp. To do this the resources needed must be brought to the migrant camp, or close to it without the need for migrant’s involvement. Several short-term piping systems, wells, and water sanitation treatment facilities are possible to be implemented to help solve the issue. These concepts are also more cost-efficient long term. By providing the extra funding to establish the infrastructure needed in the immediate future, NGO’s and government can save money on continued delivery of water. This money can then be reallocated to other aid projects rather than a continuous funding of short-term solutions. This requires a sharp short-term increase in spending which can be difficult to accomplish, however the benefits for all parties involved is positive. The second recommendation again requires high levels of cooperation between NGOs and state government. A long-term programme providing health records and identification to each migrant is needed. While the system is unlikely to be perfect, keeping a detailed record of what ailments a person has developed on record immediately can help health care services to provide immediate attention where needed, and have knowledge of potential troublesome areas in the future. This would require a photo ID and health check up to each migrant, containing basic info on the person, and must be shared with all Sahel countries in collaboration to ensure wherever the migrant decides to travel to next they will have a formal record available.  Lastly awareness and education are vital. Education facilities on the most common NCDs, how they are developed, and how to identify and treat them is important. While a health care worker may not be available, help amongst each other is better than no help. This can be achieved by establishing an open class/demonstration where information is taught, and by the government dedicating established visiting times to address any urgent care and long-term care concerns they can. While not perfect by any means, these concepts can help relieve some strains from the migrants physically and mentally and help prevent development of NCDs in the Sahel.

 

               Matthew Da Silva is a graduate from the University of Toronto with a specialty is political science and international relations, and a certificate in global perspectives. During his education Matthew grew more interested in creating public and international policy to improve the lives of people worldwide. He now attends Munk School of Global Affairs and Public Policy, UofT, studying global affairs. After a mentorship with the Canadian Food Inspection Agency he began to engage in health policy. He hopes to provide meaningful work and continue learning from this opportunity.

 

***We would like to recommend a look at a previous blog post Shelly Mckee for more information on mental health awareness.

 https://www.engageafricafoundation.org/blog/view/blog-4-mental-health-recommendations

 

 

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