Migration and Health among Female Porters (Kayayei) in Accra, Ghana

Abstract

The thesis aimed at contributing to the emerging body of knowledge about migration and health linkages, with a focus on migrant female porters (Kayayei) in Accra, Ghana. Several studies that have so far given attention to female porters have focused mainly on their livelihoods, with only cursory remarks made on the health of these migrants. Also, some existing studies have largely examined the health of migrants without reference to the entire migration process. Employing both quantitative and qualitative methods of data collection, this study has provided both empirical depth and theoretical clarification on the migration dynamics of female porters, their health seeking behaviours, and the multiple factors that hinder their access to health. Migration is seen by the female porters as a means to gain autonomy in their lives, a means of livelihood diversification. The migration process of female porters is enabled by social networks with varying levels of social capital which facilitates movement and settlement. Social networks provide safety nets for female porters as it increases their social asset base. The reasons for their migration are related to the declining importance of agriculture and the non-availability of jobs at their origin which can be blamed on the liberalization of the Ghanaian economy The working and living arrangements and work environment of the female porters constitute the major sources of health risks. The nature of their work also exposes them to physical stress, particularly waist and neck pain, and accidents resulting normally in sprains and fractures. The poor living environment is the major cause of diseases such as malaria, typhoid and cholera. Sleeping in the open in front of shops exposes them to mosquitoes, while the lack of decent bathrooms, toilets or hygiene in general exposes them to skin infections and water related diseases. Sleeping in the open also exposes them to the harsh weather conditions and also to rapists. The poor working and living conditions also provide possibilities for illnesses contracted at the origin to thrive and become complicated. The majority of the female porters sought health care in avenues other than health facilities. These avenues included drug peddlers, local herbalists and Chemists‘ shops. Those who used traditional medicines mostly brought them along from the origins in the north, particularly in cases where they were already ill before migrating. Generally, female porters visit health facilities when their conditions become serious. Migrants‘ age, levels of education and marital status were generally found to have a positive effect on health-seeking behaviour. Thus the combinations of individual and local dynamics of the Kayayei communities at their destination in Accra have a great influence on their well-being, which translates into influence on their health and health seeking behaviour. An integrated approach aimed at addressing these complex and multidimensional problems requires national and local policies that are multidimensional in nature and seek to capture the different aspects of vulnerabilities that affect the health of female porters at their destination.