Borders of Health Citizenship: Exclusion along the Dominican-Haitian Border

• In Event: National and Transnational Global Health Policy: Towards a Healthier World

Abstract

Context: With increasing migration push factors including climate change and political instability, the world’s migration profile is quickly shifting. Many world regions are experiencing an uptick in south-to-south migration flows, which poses a special set of problems for migrants who attempt to access health rights in countries that are unwilling or unable to provide health services to non-citizens.

Methods: Using original surveys on health care access from four total rural border sites, this paper compares across the national border between the Dominican Republic and Haiti in order to investigate the politics of inclusion in/exclusion from various forms of primary health care in the border area.

Findings: Sometimes crossing a national border to do so, border residents access a variety of health services, including those provided by NGOs, foreign aid, government, and charity. The implications of this style of access have profound consequences for the future of health and health care in an increasingly unstable world system.

Conclusions: By navigating the myriad of health services available in the border area, residents in both the DR and Haiti form overlapping political relationships with different health services providers. These forms of “Health Citizenship” help to describe the state of human rights in a world which remains oriented around the rights of the citizen.

Author

• Lucia Vitale, University of California, Santa Cruz