Issue 12: May, 2021
Staff
Xander Starobin: Co-Editor-in-Chief, Web Design
Avery Wang: Co-Editor-in-Chief, Layout
Maya Britto: Contributor, Communications
Diya Britto: Contributor, Social Media
Jade Xiao: Contributor
Julie Chen: Contributor
Marin Theis: Contributor
Wongel Gebru: Contributor
In this issue...
We're covering the devastating aftermath of a fire in a Rohingya refugee camp and new occurrences of a mysterious coma-like condition in Swedish refugees. To commemorate Mental Health Awareness Month, we're also exploring the lack of mental health support in refugee camps and how to combat substance abuse in refugee communities.
Monthly U.S. Migration Policy Update
By Diya Britto
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On April 17th, President Biden signed an order maintaining former president Donald Trump’s yearly refugee acceptance cap at 15,000. This order directly contradicts Biden’s campaign promise to significantly raise the refugee cap. Facing harsh backlash from his own party, Biden then reversed the decision, pledging to set an increased and final refugee cap for this fiscal year by May 15th.
Biden has also failed to shut down migrant detention centers as quickly as he promised he would during the campaign. The majority of detention centers that ran under former President Trump still run today.
Biden ordered US Immigration Agencies to terminate the use of the terms “alien,” “illegal alien,” and “assimilation." They will be replaced with “noncitizen” or “migrant,” “undocumented noncitizen,” and “integration” respectively. The US Immigration and Customs Enforcement states that they have taken this action to “help rebuild public trust and reshape the agency image.” These changes in government agencies' vocabulary, however, do not have a direct effect on those agencies' actual policies.
Devastating Fire in Rohingya Refugee Camp Displaces Thousands
By Julie Chen
On March 22, a massive fire set aflame the Kutupalong-Balukhali refugee camps in Cox’s Bazar, Bangladesh. The United Nations High Commissioner for Refugees (UNHCR) report estimated that 48,000 Rohingya refugees lost their shelter from the fire and were displaced. Housing more than 600,000 refugees, this Rohingya refugee camp is one of the world’s largest, and UNHCR Bangladesh has appealed for $5.9 million to help recover from the immense damage.
According to a statement by the UNHCR, the fire devastated more than 9,500 shelters along with more than 1,600 of the refugees' facilities, including hospitals, learning centers, aid distribution sites, and a registration point for the camp. As of March 23, the UNHCR disclosed that 560 people were injured during the chaos, and an additional 400 were reportedly missing. Enamul Hoque, a Rapid Response Team leader at Oxfam, an international charitable organization, said in a press release, “The worst affected areas have been reduced to ash—the only things left standing are shelter foundations and bits of household metal like pots and sewing machines. The level of destruction is unlike anything our team has seen before.”
Many organizations, such as the UNHCR, lend their support to Bangladesh by sending them medical supplies and emergency provisions. UNHCR supplied 3,000 blankets, 14,500 solar lamps, 10,400 kitchen sets, and 11,500 mosquito nets in the immediate aftermath of the fire according to their briefing. With Oxfam’s assistance, emergency water and sanitary equipment soon became available again, and the organizations started setting up emergency latrines, tap stands, water tanks, and jerry cans. “We have to act quickly to rebuild not only homes, but the entire infrastructure of damaged areas,” said Snigdha Chakraborty, Bangladesh’s manager of Aid Agency for Catholic Relief Services. “Rebuilding latrines, wells, and bathing spaces is crucial to saving lives and preventing disease.”
Moreover, the Rohingya refugee camp’s previous insufficiencies may have also intensified the fire’s dire impacts. A report from The International Rescue Committee (IRC) stated, “Early reports indicate that newly installed barbed wire fencing seriously restricted the ability of refugees to flee the fire, including especially vulnerable women and girls.” Jan Egeland, the Norwegian Refugee Council secretary-general, agreed that this fencing worsened the disaster. Furthermore, the center’s shelters are constructed with flimsy and inadequate materials, allowing fires to sweep through the area that comprises 26 total camps.
The main inhabitants of these camps are the Rohingya, a Muslim ethnic minority originally from the Rakhine State, Myanmar. To avoid Myanmar’s government with a Buddhist majority, who employ violence against this Muslim group, many of the Rohingya have crossed into Bangladesh, seeking aslyum. Amidst the Rohingya genocide by the Myanmar military, the UNHCR reported that over 742,000 refugees have fled to Bangladesh since 2017.
At the Bangladeshi refugee camps, however, Rohingya refugees are not always provided with adequate living conditions. According to a report from Doctors Without Borders (MSF), the military and police presence at the camps have increased recently along with a growing presence of armed groups. MSF has reported more cases of kidnappings, violence, and extortion as a result. With the arrival of COVID-19, refugees live under more restrictions and have limited contact with international humanitarian organizations. Doctors Without Borders revealed in their briefing that they have already reduced the quantity and array of health services for the Rohingya refugees because of the camps’ strict regulations.
With the limited access to sufficient health care and inadequate living conditions, the Kutupalong camp in Cox’s Bazar leaves their Rohingya refugees facing a challenging dilemma, especially after the recent fire: whether to stay in Bangladesh or depart for somewhere else. Resorting to risky options, some refugees leave for Malaysia on dangerous journeys or relocate to Bhasan Char, a remote island in the Bay of Bengal with lacking medical services. “Everything has gone,” said Mohammed Salam, a 50-year-old refugee. “I, my wife and my six sons, are still sleeping under the sky. I hope I’ll get a tent today.”
Already having fled Myanmar in 2017, Ro Arfat Khan lost another family member when the fire set blazed across the refugee camps. “Nobody helped us. If the Bangladesh government wanted, they could’ve stopped the fire.” The flames destroyed his limited belongings in the camp, and “now,” he said, “it’s all gone.”
Shahriar Alam, the junior minister for foreign affairs in Bangladesh, said shortly after the blaze that a committee will investigate it and release a report. Nevertheless, the recent fire only reminds the Rohingya refugees of the international community’s failure to provide them safety. Refugee International, a global humanitarian group, said in their statement, “This tragedy is an awful reminder of the vulnerable position of Rohingya refugees who are caught between increasingly precarious conditions in Bangladesh and the reality of a homeland now ruled by the military responsible for the genocide that forced them to flee.”
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Resignation Syndrome Mystifies Doctors and Reveals Life-Threatening Stress of Asylum Process
By Avery Wang
New reports of refugee children from Sweden falling into coma-like states are mystifying doctors.
The condition, called resignation syndrome, causes a coma-like state that may last anywhere from a few months to several years, according to an article published by neurologist Suzanne O’Sullivan in The Times. Symptoms have been documented in children ranging from ages 7 to 19, but the condition seems only to affect children in one region of the world: Sweden.
Brain tests have revealed that the children are responsive to waking and sleeping, despite being unresponsive, unconscious, and in a seemingly catatonic state.
In her report, O’Sullivan recounts a child’s description of his unconsciousness. “He had felt as if he were in a glass box with fragile walls, deep in the ocean. If he spoke or moved, he thought, it would create a vibration, which would cause the glass to shatter. ‘The water would pour in and kill me,’ he said.”
According to an article from Doctors of the World, children who suffer from resignation syndrome are bedridden and fed through a feeding tube while doctors and their families monitor them. Physiological therapists manually ensure they are mobile during part of their day, in hopes of the day they’ll emerge from their coma-like state.
Medical professionals “believe that trauma is a key factor in the onset of the syndrome,” the article states and that the stress of the asylum application process and the prospect of returning to the country they fled could be a cause for the condition.
Many children first began to exhibit symptoms of a withdrawal process after their families were notified that they were denied asylum by the Swedish Migration Board or while they were awaiting an asylum decision.
The children’s recovery seems to be dependent on creating a sense of security and safe environment, or by resolving their family’s asylum claims, according to the same article by Doctors of the World.
In 2017, according to a BBC news article, children with resignation syndrome were accused of faking their condition to secure asylum and gain a sympathetic advantage. These accusations have not been proven, and doctors insist that elementary school-aged children do not have the ability to maintain a consistent state of unconsciousness for such a long period of time.
The first cases of resignation syndrome were reported in Sweden in the 1990s, with cases slowly increasing by the mid-2000s. Between 2003-2005, there were 424 known cases of resignation syndrome, according to an article from the New York Post.
The condition has been linked to pervasive refusal syndrome, which is characterized by a “profound and pervasive refusal to eat, drink, talk, walk and engage in any form of self-care,” according to a report published on the Cambridge Core database.
However, there were only been a handful of pervasive refusal syndrome cases in the 1990s, and none were among asylum seekers.
In the past two years, 169 cases of resignation syndrome were documented, according to a report from Sweden’s National Board of Health.
Mental Health Support in Refugee Camps Falls Far Short of Camp Needs
By Jade Xiao
Despite significant mental health challenges, many refugees lack proper mental health support due to insufficient funds in refugee camps, cultural or language barriers, and distrust of officials and experts. According to a report from the Mental Health Foundation, refugees and asylum seekers are five times more likely to suffer from mental health conditions due to trauma during pre- and post-migration. 61% of refugees will face higher rates of severe mental distress such as depression, PTSD, and anxiety disorders compared to general populations.
The Refugee Health Technical Assistance Center classifies the refugee experience into three categories - preflight, flight, and resettlement. During the preflight phase, refugees often experience or witness traumatic events such as the death of loved ones, genocide, murder, rape, political or social unrest, and physical or psychological violence. Some children are forced to witness and participate in highly violent behavior as child soldiers.
Following refugees' departure, the flight stage includes the arduous and precarious journeys, refugee camps, or detention centers that exacerbate refugees' distress. Camps often have safety and security problems, with unstable access to basic needs such as food, shelter, and water. According to a report from United For Sight (UFS), a nonprofit organization for Global Health, “daily hassles of living in refugee camps, such as waiting in line at the water tap, also negatively impact mental health.”
The final resettlement phase continues to increase psychological stress due to uncertainty and acculturation. Many refugees face discrimination that restricts their social and economic opportunities and poses great challenges in beginning a new life. They need to assimilate and acculturate with an entirely foreign culture, language, and environment, while attempting to uphold their origins and traditions.
The continuous accumulation of stressors makes refugees much more vulnerable to mental health disorders, especially post-traumatic stress disorder (PTSD), depression, and anxiety. According to UFS, “PTSD is an anxiety disorder which often occurs after witnessing or experiencing an event that is personally threatening. The most common symptoms of PTSD are repeated reliving of the event, avoiding anything or anyone that might elicit memories of the event, and excessive awareness and response.” Data from a report by the Center on Human Rights Education approximate that 10 to 40% of refugees suffer from PTSD, while 50 to 90% of refugee children experience some symptoms, varying due to the difference of refugee camp conditions and children's experiences.
Depressive and anxiety disorders ranges from 5 to 15% of all refugees and up to 40% of refugee children, and can lead to “persistent sadness, hopelessness, feelings of guilt or helplessness, thoughts of death or suicide, and restlessness.” The unpredictability and foreign settling may inflict adjustment disorders and somatization, aggravating the refugee’s mental health and hinders their success in resettlement and future development.
Children are exceptionally at risk of mental health disorders and emotional or behavioral problems. Many are orphaned after losing loved ones and often experience violence, suffering from the separation, and enduring precarious journeys alone. Some may have been forced to participate involuntarily in militias and armies; these coerced experiences are extremely traumatic to the child soldiers, who often need disarmament, demobilization, and reintegration (DDR) programs. Lastly, second-generation refugees are also prone to mental health disorders, especially behavioral conditions such as substance abuse and eating disorders, according to the USF.
Multiple factors prevent refugees from obtaining adequate support. Many camps do not have sufficient resources, prioritizing the basic necessities and cutting funds from mental health care. Language barriers between the refugees and the staff members limit communication and restrict the refugee’s opportunities to seek help. Many cultures also stigmatize mental health disorders, disregard therapy as an effective treatment, and only encourage seeking help for physical health issues. Finally, there is often a mistrust towards the camps and the hosting government due to the refugees’ past experiences, preventing refugees from acknowledging their needs and seeking treatment.
In the article “The Increased Vulnerability of Refugee Population to Mental Health Disorders,” studies show a “correlation of depression and anxiety disorders with post-resettlement hardships in regards to finding employment and adapting to a new environment culturally and linguistically.” As the number of refugees and asylum seekers continues to rise, it is critical that they have access to reliable mental health support systems.
Substance Abuse in Refugee Communities
By Maya Britto
Refugee populations are particularly vulnerable to the development of mental health disorders, and many fall prey to substance abuse in the process. However, those affected do not have access to drug treatment programs, and studies regarding the effects of substance abuse on refugee populations, in particular, are lacking.
Note: You can learn more about mental health within refugee populations in the above article and in issue 5 of our newsletter.
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Alcohol addiction is the most prevalent type of substance abuse observed in refugee communities. A 2016 study regarding the “Epidemiology of Substance Use Among Forced Migrants” revealed that harmful alcohol use “ranged from 17%-36% in camp settings and 4%-7% in community settings,” among other findings related to alcohol and illicit drug use among refugees, internally displaced persons (IDPs), asylum seekers, and deportees.
Other substances used by refugee communities include khat, opiate, and benzodiazepines. The khat plant, which can be used as a stimulant drug, contains leaves and buds that can be chewed. Its use is a part of social traditions in certain countries in the Middle East and Eastern Africa.
Opium, on the other hand, is a depressant drug that can be smoked or ingested in the form of a pill. Both have hazardous long-term effects on the human body.
Drugs in Refugee Communities
According to a report from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), a European Union agency, many studies show that ethnic minorities, as refugees tend to be, are more vulnerable to illicit drug use and are aggravated by their inability to access drug treatment centers.
However, other studies show that people belonging to ethnic minority groups consume less alcohol than native-born populations, even though they experience more mental health challenges.
Ethnicity and alcohol/drug use do not share a “unidirectional relationship,” and results vary between different ethnic groups. The same EMCDDA report asserts that various factors including relationship status, cultural and religious influences, employment status, physical and mental conditions, and monetary status are all associated with drug use among refugees. For example, immigrants from Yugoslavic countries, Somalia, and Iran are more prone to substance abuse behaviors due to tendencies of high alcohol, khat, and opium consumption respectively within those regions' populations.
A Lack of Information and Healthcare
Most studies on asylum seekers’ drug and alcohol use are insubstantial as a result of poorly mapped data collection groups that are too heterogeneous to create valid generalizations. Furthermore, very few studies include refugee populations from low and middle-income countries. As a result, these countries do not have sufficient treatment centers and programs to address substance abuse.
Though high income countries are more capable of providing these services to the refugee populations they host, other factors affect accessibility. Cultural, linguistic, and systemic barriers make it difficult for those affected to receive effective treatment. According to an EMCDDA report, generally refugees and migrants who are female, older, and poorer underutilize available healthcare services.
The Battle Against Drug Abuse Is Global
According to the 2019 World Drug Report by the United Nations Office on Drugs and Crime, 35 million people around the world struggle with drug use disorders, but only 1 in 7 receive adequate treatment.
In the United States, May is mental health awareness month. Providing mental health support is the most fundamental step in combating substance abuse, and consistent studies regarding the mental health conditions of refugee communities are imperative to help them in particular. You can make this happen and support refugees while also continuing the conversation surrounding mental health by educating yourself and your loved ones on the importance of mental well-being, and donating to any of the organizations listed below.
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