According to The World Health Organisation in the year 2021 there are an estimated 272 million international migrants and almost 500 million internal migrants. Millions have been driven away due to conflict, violence, climate change and weather related hazards. But the overwhelming reasons most migrants leave their home are related to work, family or study. India continues to be the main origin of international migrants, with 17.5 million Indian born people living abroad. Both Mexico and China have more than 10 million former residents spread around the world.
The United States is the primary destination for migrants, though as a proportion of its population, the United Arab Emirates has the largest migrant contingent with many people moving to the region for work. Nearly 17% of people now living in Equatorial Guinea are migrants. Turkey is the biggest host nation taking in millions of refugees, particularly from Syria.
In five years more than 30,900 people have lost their lives trying to reach other countries. The Mediterranean sea remains the deadliest route, claiming the lives of nearly 18,000 people. Since 2014, over 1,800 deaths have been recorded along the border between the United States and Mexico.
Warning Such mobile populations have common skin infections. Often they did not have skin disease on leaving their country but acquired conditions such as scabies or fungus infections form poor housing conditions and overcrowding. Lack of acceptance and malnourishment, in part due to often poor adaptation to food in the host community are other issues. The health facilities available may not have the drugs to treat the condition and consequently visits to local traditional health practitioners are common. Nomadic people tend to have close contact with animals and so cattle ringworm is prevalent. There are frequent changes of sexual partners in remote areas and no access to condoms, as well as a lack of help for menstrual hygiene. When all goes well, consequent longer life expectancy especially in urban areas, Migration from rural to urban areas and sedentary lifestyles, transition from a Mediterranean to a Western diet, control of infectious diseases contribute to the rising prevalence of hypertension and diabetes.
Action In most countries the laws support, receiving primary health care services and the right to emergency care. Guidelines to management, assessment of cultural differences, cultural competence, identification of torture, dealing with immigration control have been published in The International Journal of Dermatology, the Community Dermatology Journal and are on this website. The most helpful skill for managing migrants is to speak their language and get a full history, Aldo Morrone, Director, Institute of Dermatology, San Gallicano, Rome and his textbook on Migrant Dermatology with Roderick Hay and Ben Naafs are great resources. When assessing skin conditions due to torture, be sure to record a full history and use photography for thorough documentation.