This thesis explores and analyses the manifold relations between migration and health, what I call the migration-health nexus, in the contemporary Nicaraguan context. The study is based on fieldwork in León and Cuatro Santos and a mixed-methods approach combining qualitative in-depth interviews and quantitative survey data. In the thesis health is “traced” within the migration process; i.e. in places of origin, during travel, at the destination and after return, including the situation and consequences for both migrants and family members to migrants (“left-behinds”). The study shows that migration-health relations in Nicaragua are connected to broader economic, social and political factors and to the country’s historical experiences of colonization, neo-colonization and structural adjustments. Contemporary Nicaraguan migrations are primarily related to the strategies of making a living and the struggle for a better life (i.e. a practice of mobile livelihoods). In the study setting health concerns were both indirectly embedded in people’s mobile livelihoods, as well as directly influencing decisions to move or to stay, and migration involved both advantages and disadvantages for health. Through migration, women could see an end to physical violence and sexual abuse. Internal migrants could improve their access to health care and medicine. Vulnerabilities related to the unpredictable nature conditions could be avoided through moving. And, through the money made from migrant work people’s everyday lives and health could be improved, in terms of better nutrition, housing, and access to education, health care and medicine. However, remittances do not necessarily lead to development, as they are used to compensate for the lacking public sector in Nicaragua. Under these circumstances, I argue that the Nicaraguan population is not guaranteed their social rights of citizenship. I also argue that the negative aspects surrounding migration must be taken into account when discussing the development potentials of migration and remittances. Both internal and international migrants in this study experienced stress while moving to a new place. International migrants had difficulties accessing health care in the destination, particularly those lacking documentation. The separation within families due to migration often caused emotional pain. Family members left behind did not rate their physical health as good as often as non-migrant families. The vulnerability, stress experiences and sufferings of migrants and left-behinds varied, however. I therefore conclude that social differences (in terms of e.g. gender, class, skin colour, and legal immigration status) are key for the enactment of the migration-health nexus, and that an interplay of individual, social and structural factors influence the outcome.

Denna uppsats undersöker sjukhuskuratorers förhållningssätt till och arbete med vuxna i papperslöshet, samt hur detta kan påverka målgruppen, socialt arbete, sjukvården och samhället i stort. Uppsatsen är kvalitativ, baserad på intervjuer med 12 sjukhuskuratorer i Sverige. Tematisk analys har genomförts på intervjuerna och Judith Butlers teorier om sårbarhet och sörjbarhet har använts för att teoretisera resultatet. Sjukhuskuratorers vård till vuxna i papperslöshet varierar mellan vård som inte kan anstå och vård efter behov. Inte alla sjukhuskuratorer vet vilken vård som kan ges. Sjukhuskuratorers erfarenhet av mötet med samt ideellt engagemang för målgruppen, ger mer behovsinriktad vård. Att vårdmängd beror på vilken sjukhuskurator vuxna i papperslöshet möter, synliggör sjukhuskuratorsrollens handlingsutrymme. Sjukhuskuratorer slussar patienter till externa stöd- och vårdsammanhang. För vuxna i papperslöshet är dessa sammanhang oftast frivilligorganisationer och religiösa samfund. Olika förståelseramar tycks verksamma. Svenska offentliga myndigheter verkar inom ett normativt ramverk, där rättighetstillgång sammanlänkas med personnummer. Ett alternativt ramverk finns inom frivilligorganisationer, religiösa samfund och däri engagerade personer. Här gäller mänskliga rättigheter. Sjukhuskuratorers arbete befäster eller utmanar dagens normativa ramar. / This thesis examines hospital social workers (HSW) approach to and work with adults in undocumentedness, and how this may affect the target group, social work, healthcare and society at large. The thesis is qualitative, based on interviews with 12 HSW in Sweden. Thematic analysis was made on the interviews and Judith Butlers’ theories on precariousness and grievability was used to theorize the result. HSW care for adults in undocumentedness varies between treatment that cannot be deferred and care as needed. Not all HSW know what care to give. HSW experience of meeting with and non-profit involvement for the target group, provides more need-oriented care. That amount of care depends on which HSW adults in undocumentedness meet, makes the work discretion in the HSW role visible. HSW refer patients for external support and care. For adults in undocumentedness available contexts for this are mainly voluntary organizations and religious communities. Different frames of understanding seems to be working. Swedish public authorities operate within a normative framework, where access to rights are linked to social security number. An alternative framework exists within voluntary organizations, religious communities and people therein involved. Here human rights are applied. HSW work consolidate or challenge today's normative framework.