Structural violence and the nation state: HIV and labour migration from Pakistan to the Persian Gulf

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This paper examines the biopolitics of HIV and labour migration from Pakistan (a country classified by UNAIDS as at ‘high risk’ of a generalised epidemic) to the countries of the Gulf Cooperation Council (GCC). The remittances by the labour migrants in the Gulf are an invaluable source of foreign exchange for Pakistan and a large number of households are entirely dependent upon them. At the same time, the National AIDS Control Programme regards Gulf migrants as a key risk factor for an HIV epidemic. The majority of HIV positive people in clinics comprise Gulf returnee migrants and their family members. This paper suggests that in the process of migrating, prospective migrants are subjected to structural violence that increases their HIV vulnerabilities. In this process, they are subjected to regimes of medical inspection, reduced to their certifiable labour power, inscribed with nationalist ideologies identifying HIV as a disease that strikes ‘the other’, and exposed to exploitation that increases their vulnerabilities. After migration, they are made to undergo compulsory periodic medical examinations in the GCC and, if found to be HIV positive, they are forcibly deported without papers, proper diagnosis or healthcare – only to return as ‘failed subjects’. Taking a disaggregated view of the state, the paper argues that, in order to be effective, debates on structural violence and the HIV epidemic must make explicit the role of the state in producing migrants’ vulnerabilities.
Original languageEnglish
Pages (from-to)209-220
JournalAnthropology and Medicine
Issue number3
Publication statusPublished - 2013


  • Pakistan
  • structural violence
  • state
  • labour market


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