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Persian Gulf Migrants

Kenva Smith

Sam Houston State University

HLTH 5351: Immigrant and Refugee Health

Dr. Adannaa Alexander

December 3, 2023
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Persian Gulf Migrants

In the past few decades, there has been a notable surge in immigration and migration to

countries near the Persian Gulf, and to some extent, Lebanon and Jordan (Galea et al., 2022;

Cholewinski, n.d.). This phenomenon can be attributed to various factors, with the primary driver

being the discovery of oil, leading to rapid development of the economy, a need for

infrastructural expansion, and an increase in international engagement. The Persian Gulf,

bordered by Iran, Iraq, and six Arabian nations constituting the Gulf Cooperation Council

(GCC), including the United Arab Emirates, Saudi Arabia, Oman, Kuwait, Qatar, and Bahrain,

has become a focal point for this migration trend (Cholewinski, n.d.).

The migration wave has contributed to a notable increase in ethnic diversity, as foreign

nationals flock to these regions in search of employment opportunities. Some examples of

representing countries include the United States, Nepal, India, Bangladesh, Indonesia, Pakistan,

Sri Lanka, Cameroon, Uganda, Nigeria, and the Philippines. The main reason for migration was

job security and financial support. Qatar's population has surged twenty times since the 1960s to
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reach 2.2 million, with migrants constituting approximately 78% and comprising 94% of the

country's workforce (Galea et al., 2022). This influx of migrant labor has significant economic

implications, as evidenced by the migrants earning approximately 124 billion USD in

remittances for themselves and their families in 2017 alone (Cholewinski, n.d.).

Many Arab states maintain relatively lenient entry requirements for migrant workers, a

contrast to the restrictive Kafala system, which imposes limitations on rights, contract durations,

and visas, giving sponsors/employers control over movement and employment conditions (Galea

et al., 2022; Cholewinski, n.d.). Low-skilled migrants, primarily in construction and domestic

work, face heightened health risks exacerbated by inadequate access to healthcare services and

human rights violations (Galea et al., 2022). The oil and gas, transportation, and agricultural

sectors heavily rely on migrant labor, highlighting the multifaceted nature of migration dynamics

in the Persian Gulf and neighboring regions (Galea et al., 2022).

Migration Framework

The socio-ecological model is the most appropriate framework for this case study

population on Persian Gulf migrants. This model proves vital for understanding the mental and

physical health of migrants due to its consideration of diverse factors. Multiple factors that

intricately influence the well-being of individuals within the migrant population include social

relationships, neighborhoods, institutions, living conditions, and social and economic policies.

Notably, robust social relationships play a crucial role in mitigating mental health challenges

during the adaptation period, providing essential support and identity, act as protective factors

against issues like alcoholism, domestic violence, and separation anxiety (Galea et al., 2022).
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Neighborhoods and living conditions further shape the physical health outcomes of

migrants. Environmental factors, including violence, food accessibility, walkability, and public

transportation, contribute positively or negatively to their health. Inadequate housing, often a

result of limited financial stability upon arrival, poses direct health risks such as overcrowding

and exposure to pesticides, mold, and mildew.

The impact of social and economic policies on migrant health is substantial, with both

positive and negative consequences. Restrictive host country policies regarding immigration

status, social safety nets, insurance coverage, and discrimination can impede well-being. Barriers

like lack of insurance, high healthcare costs, limited access, transportation difficulties, and

language barriers compound challenges in healthcare access. The absence of inclusive social

safety net programs may exacerbate health disparities by restricting access to housing, food, and

medical assistance. Institutions and organizations, including workplaces, medical facilities,

religious entities, and cultural groups, also play pivotal roles in shaping migrant health outcomes

(Galea et al., 2022). Using this framework can assist in understanding the intricate health

dynamics of Persian Gulf migrants and offer valuable insights for targeted interventions and

support mechanisms.

Analysis

Within the context of the socio-ecological model, the experiences of Persian Gulf

migrants are shaped by the interplay of social relationships, neighborhoods, living conditions,

and social and economic policies. Entry into these countries is marked by liberal policies,

contributing to visible disparities in living conditions and wealth among diverse migrant groups

and disparities in comparison to the native population (Cholewinski, n.d., Galea et al., 2022).

The migrant's country of origin determines their health risks, with those from economically
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developed nations experiencing better health and living conditions in contrast to those from less

developed countries (Galea et al., 2022). While the economic benefit of migrant labor is evident

through remittances, it comes at the cost of heightened risks to mental and physical health due to

demanding jobs, prolonged working hours, and taxing conditions (Galea et al., 2022).

The socio-ecological model emphasizes the relationship between personal, social, and

cultural factors, underlining the need for comprehensive, socially informed mental health

interventions (Galea et al., 2022). In GCC countries, nationals are awarded free mental health

care, whereas migrants are charged a small fee (Muhammad et al., 2014). Epidemiologically, the

higher rates of psychiatric morbidity among migrants compared to natives reflect health

disparities, demanding a culturally sensitive, multidisciplinary approach. Moreover, workplace

harassment, social isolation, and stress contribute to poor mental health, leading to early

repatriation due to untreated or inadequately treated mental illnesses (Muhammad et al., 2014).

Similarly, an interview with 42 Nepali men working in Gulf States revealed

multifactorial stressors contributing to poor mental health, emphasizing the significance and

effects of social relationships and social and economic policies on the mental health and

experiences of migrant laborers. Seeking assistance from authorities and civil society

organizations was seldom successful, highlighting the scarcity of available resources and the

ambiguous responses concerning eligibility for assistance, further illustrating the disparities and

human rights violations that migrant laborers in this region are subjected to (Mak & Roberts,

2021).

Social and economic policies of the kafala system significantly shape the experiences of

migrant workers, create power imbalances, and restrict movement (Gabeilly, 2021; Robinson,

2022). The sociological implications of limited civic rights and transparency exacerbate migrant
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issues, leading to security-focused resolutions rather than labor-centric interventions, with lasting

effects despite partial reforms (Gabeilly, 2021). Furthermore, fear of deportation, restricted rights

advocacy, and financial dependencies persist, highlighting the continuous impact of social and

economic policies on the lives of migrants in the Gulf (Gabeilly, 2021).

Additionally, Human Rights Watch (HRW, 2023) underscores epidemiologic risks where

insufficient protection for migrant workers during extreme heat in GCC countries, exposing them

to heat-related illnesses and death. Despite measures like summer work bans, outdoor workers

still face extreme temperatures due to inadequate enforcement. An HRW interview with 90

workers in Qatar revealed chronic health conditions from heat exposure, emphasizing

insufficient resting areas and accommodations. Financial obligations and fear of income loss

compel workers to ignore health issues, highlighting the influence of social and economic

policies on migrants' lives (Human Rights Watch, 2023). Inadequate governmental enforcement

of regulations contributes to health hazards, showcasing the intersection of economic pressures,

living conditions, and sociological factors, with insufficient resting areas inhibiting recovery and

financial demands compelling continued labor despite heat-related health problems (Human

Rights Watch, 2023).

Recommendations

An initial recommendation is to strengthen the mental health support services by

developing and implementing targeted mental health support services tailored to the unique

needs of Persian Gulf migrants. This initiative should involve increasing access to culturally

competent mental health professionals, including trained interpreters, trans-cultural psychiatrists,

and psychologists. It would also be beneficial to establish confidential counseling services, and

helplines, and conduct mental health awareness campaigns. I would also recommend
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collaboration with local and international organizations to create a robust network of mental

health resources that migrants can readily access, addressing stressors related to isolation,

adaptation challenges, and workplace pressures.

Another recommendation is the collaboration with governmental and non-governmental

entities to improve working conditions for migrants, by focusing on reforming or replacing

systems like the kafala system. The collaboration should promote fair labor practices, reasonable

working hours, and safer conditions, especially for outdoor and domestic workers. I would also

recommend the governmental enforcement of existing regulations, the introduction of new

protective measures, and the establishment of strict oversight to ensure compliance. Additionally,

I propose the implementation of comprehensive orientation programs for all incoming migrants.

These orientations would provide printed literature in multiple languages outlining available

resources, types of assistance, and civic social organizations that can support migrants in their

transition and integration processes. These orientations can also raise awareness about common

scams to prevent their recurrence, contributing to a comprehensive strategy aimed at addressing

both immediate and long-term well-being, fostering a healthier and more equitable living and

working environment for migrants.

Conclusion

In summary, the surge in migration near the Persian Gulf in recent decades, driven by

economic development in predominantly oil-rich countries, has led to notable demographic

shifts. The GCC nations have become focal points for this trend, with significant economic

implications as migrants constitute a substantial portion of the workforce and population. The

socio-ecological model provides clarity in understanding the challenges faced by migrants by

underscoring the influence of social relationships, neighborhoods, living conditions, and social
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and economic policies. Disparities in wealth and living conditions, influenced by lax entry

policies and economic variations between developed and developing migrant countries of origin,

shape their experiences. The multifaceted nature of migration dynamics, including the Kafala

system's impact, is evident, affecting social relationships, power dynamics, and movement

restrictions. Mental health disparities, workplace challenges, and related health risks underscore

the need for targeted interventions and support mechanisms. Recommendations for improvement

include strengthening mental health services and collaborative efforts with entities to reform

working conditions, prioritizing fair labor practices, and comprehensive orientation programs for

incoming migrants to foster a healthier and more equitable living and working environment.

References

Chaabna, K., Cheema, S., & Mamtani, R. (2017 June, 20). Migrants, healthy worker effect, and

mortality trends in the Gulf Cooperation Council countries. PLOS ONE, 12(6).

https://doi.org/10.1371/journal.pone.0179711

Cholewinski, R. (n.d.). Labour migration in the Arab States. International Labour Organization.

https://www.ilo.org/beirut/areasofwork/labour-migration/WCMS_514910/lang--en/

index.htm

Galea, S., Ettman, C. K., Zaman, M. H., & Kristiansen, M. (2022). Persian Gulf Migrants. In

Migration and health (pp. 307–313). essay, The University of Chicago Press.

Gebeilly, M. (2021, October 21). Five reasons why it’s hard to stop migrant abuse in the Gulf.

Thompson Reuters Foundation. https://news.trust.org/item/20211021095547-uv9m8

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Human Rights Watch. (2023, May 31). Gulf states: Migrant workers at serious risk from

dangerous heat. https://www.hrw.org/news/2023/05/31/gulf-states-migrant-workers-

serious-risk-dangerous-heat

Mak, J., Zimmerman, C., & Roberts, B. (2021). Coping with migration-related stressors - a

qualitative study of Nepali male labour migrants. BMC Public Health, 21(1).

https://doi.org/10.1186/s12889-021-11192-y

Robinson, K. (2022, November 18). What is the kafala system? Council on Foreign Relations.

https://www.cfr.org/backgrounder/what-kafala-system