A/HRC/23/41 rarely considered an urgent health issue.79 Such insufficiencies lead to unacceptable gaps in the implementation of minimum health guarantees for irregular migrant workers. 80 Further, the denial of access to health care until an emergency situation arises is incongruent with the right to health and counter-intuitive,81 as it imposes longer-term health and financial costs for individual migrant workers and society. 41. Policies linking access to health systems with immigration control discriminate against irregular migrants. In some countries, health-care providers are required, under threat of criminal sanction, to report irregular migrants to immigration authorities,82 which may lead to detention and deportation. As a result, instead of seeking formal channels of care83, irregular migrant workers resort to unsafe and illegal options. This renders them vulnerable to abuse, exploitation and increased health risks. Administrative barriers 42. The right to health obligates States to protect migrant workers against non-State parties that restrict their access to health care. Migrant workers are often refused health services, particularly specialized referral services on the basis of income qualification, and sometimes even because of incomplete paperwork. 84 For irregular migrant workers, administrative barriers associated with their uncertain legal status are often an impediment to health care.85 Additionally, issues such as limited office hours or caps on the number of applications processed,86 may also act as barriers to access. Language and cultural barriers 43. A right to health approach requires States to disseminate culturally appropriate health-related education and information to both regular and irregular migrant workers. Anti-immigrant austerity measures in some States, however, have reduced subsidies for interpretation and translation services in health-care settings.87 Lack of familiarity with the local language may put migrant workers at a disadvantage, as they may not be able to sufficiently describe symptoms to enable accurate diagnosis and quality treatment.88 Furthermore, an inability to understand health-related information and education may result in migrant workers unwittingly engaging in risky health behaviours. States should therefore 79 80 81 82 83 84 85 86 87 88 Ibid., p. 9. Ibid. Anahi Viladrich, “Beyond welfare reform: Reframing undocumented immigrants‟ entitlement to health care in the United States, a critical review”, Social Science & Medicine, vol. 74, Iss. 6 (March 2012), p. 824. PICUM, Access to Health Care, p. 45 (see footnote 76). Heide Castañeda, “Illegality as risk factor: A survey of unauthorized migrant patients in a Berlin clinic”, Social Science & Medicine, vol. 68, Iss. 8 (2009), p. 1559; IRIN, “South Africa: Migrants‟ health care hit by deportations”, (Johannesburg, 20 December 2011), available from http://www.irinnews.org/Report/94511/SOUTH-AFRICA-Migrants-health-care-hit-by-deportations. Richard Mines and others, Pathways to Farmworker Health Care, Case Study No. 1: The East Coachella Valley, A baseline report of the Agricultural Worker Health Initiative (California Institute for Rural Studies, September 2002), pp. 20-21; Médecins du Monde, European Observatory on Access to Healthcare, Access to healthcare for undocumented migrants in 11 European Countries 2008 Survey report (September 2009), p. 69. PICUM, Access to Health Care, p. 8 (see footnote 76). Ibid. IOM, “Health in the Post-2015 Development Agenda”, p. 4 (see footnote 75) Solidaritas Perempuan, State of Health of Indonesian Migrant Workers: Access to Health of Indonesian Migrant Workers, 2005 Report (2006). 13