New Study Examines Distress Migrants' Right to Healthcare in Ecuador
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The protracted political and economic crisis in Venezuela has led to the displacement of millions of people, with nearly 8 million distress migrants seeking refuge across the Americas. Distress migrants, characterized as migration stemming from refugee, survival, and forced circumstances, face increased vulnerability to illness and lack of access to health care.
In a new study recently published in Health and Human Rights, Community Health Education doctoral student Mariana Pinto-Alvarez and colleagues set out to examine how the Ecuadorian health system is responding to the needs of migrant populations arriving in poor health conditions.
Ecuador, which has a longstanding tradition and legal framework that upholds the rights of migrants and promises equitable access to health care for all, has felt the impact of this migration surge, with an estimated 500,000 Venezuelan migrants remaining in the country over the past decade. With approximately 60% of the population—including most migrants—depending on the Ministry of Health (MoH) network for free health services and faced with its own financial crises, Ecuador’s public system has been left with limited resources to provide needed services.
Pinto-Alvarez, who earned her MD and MPH degrees from Pontificia Universidad Javeriana in Colombia, along with senior author and faculty mentor Daniel López-Cevallos and Irene Torres, technical director of the non-profit organization Fundación Octaedro in Ecuador, conducted interviews with government officials, health care providers, and representatives of international cooperation agencies and migrant organizations. They found that despite Ecuador’s commitments, significant gaps exist in the implementation of protection mechanisms for distress migrants.
“Our findings show that access to health care for distress migrants in Ecuador depends on a complex interplay of legal protections, delivery system challenges, and specific vulnerabilities,” notes Pinto-Alvarez. “While the country’s legal framework promises extensive protections of the right to health of migrants, including access to health care, the translation of these rights into effective practice remains uneven, signaling gaps in the availability, accessibility, and quality of health services for distress migrants.”
Distress migrants face systemic obstacles, including documentation requirements, and discriminatory practices, and the allocation of limited resources further impeded access. Challenges in health care delivery, particularly in specialized care, exacerbate the difficulties faced by migrants, who often arrive in poor health.
Nevertheless, the researchers found potential pathways to health care access via social and nongovernmental organizations. Torres notes that “whether the public or the private health sector can provide adequate access, however, will depend on the promotion of a more inclusive and culturally sensitive approach to health care provision—one that acknowledges and responds to the specific experiences and needs of migrant populations.”
Ultimately, they conclude, more comprehensive approaches are needed to promote a more equitable health system that addresses the specific experiences and needs of distress migrants in Ecuador.
“While the problems we documented pertain to Ecuador, other countries in the region with similar fragmented healthcare systems are facing the same challenges,” notes López-Cevallos. “These problems are emblematic of a growing healthcare crisis across the Americas. We must act now to find solutions to ensure that our most vulnerable populations remain protected.”