As violence and insecurity continue to cause mass displacement within Syria and across the Middle East region, over 4.39 million Syrians will have been registered as refugees by the end of 2015. More than 51% are children aged 0-17; half are girls and women. The humanitarian needs are enormous and Europe continues to struggle under the pressure of the migrant crisis.
This is the first mass transnational flight of modern times, and it has divided the world into two warring ideological camps: one calls on governments to increase intake quotas and settle more migrants for the time being, while another – despite accusations of heartlessness – insists that affected countries should not take in any more refugees from the war-torn Middle East and that the rules of the Schengen zone must be respected.
Many people changed their attitudes toward refugees after distressing pictures of a drowned Syrian boy washed up on a shore went viral. The public debate on the refugee crisis was starting to shift – for the better – until the Paris attacks, which sparked an outpouring of anti-refugee sentiment and put peaceful resettlement at stake. Amidst the refugee hysteria, state leaders should not belabor the obvious complexity of ‘refugeeness’ as they are unwilling to admit whether this crisis is a result of our inaction. We could have guessed this would happen, but we didn’t do much to prevent the crisis at an earlier stage. The time has now come to realize that it was also our past colonial aspirations, something we’ve tried to hide for so long, that instigated this whole mess.
As a health policy researcher, I am most concerned with the potential public health crisis that we cannot afford to ignore. Refugees do not arrive healthy. On the contrary, they are people who have experienced physical and psychological trauma due to torture, war, prolonged poverty, and poor access to health care. As a result, many migrants have health and wellbeing problems on arrival, including high levels of preventable illnesses and associated mortality. Refugees and asylum-seekers also have very high rates of suicide. A person with mental health condition who does not speak any language other than their own may (and often are) not be able to access any social support and psychotherapy programs. Not to mention, there is virtually no data on preexisting medical conditions of these people. We don’t know whether the newly arrived migrants and asylum-seekers have ever been vaccinated or if they are spreading infectious diseases as we speak.
The statistics on health of Syrian refugees in Iraq, Jordan and Lebanon are striking: communicable diseases prevail (72.1-89.6%), followed by non-communicable diseases (7.4-21.8%), injuries (1.0-4.8%) and mental illnesses (0.5-1.4%). Thus, an increased understanding of the health needs and potential barriers to accessing health care, as well as the infrastructural and security challenges facing transit and host countries that support refugees, is critical toward ensuring an optimal allocation of sparse resources, improvement of refugee health, and better migrant integration.
As part of the Developed World, Europe is seen as a safe haven for all vulnerable groups and minorities. However, many refugees have yet to receive equitable treatment. Countries considered vanguards for liberal democracy, such as Germany and Sweden, are overwhelmed by a massive influx of arrivals that have put a strain on their asylum systems. Refugees, themselves minorities when abroad, count among their numbers youth, women, people with disabilities, and LGBTI individuals who often experience difficulties in understanding and accessing available public services. Local cultural norms, language barriers, and differences in societal values may limit their ability to interact with those who would otherwise assist them.
Little is known about refugee minorities. While a daunting task, it is essential that research institutes and aid agencies begin gathering data on issues concerning these groups and that this data is shared. The dire conditions they have survived and the grave uncertainties that they must face undermine all dimensions of human security (from the personal to economic, health, and food security). The refugees should be viewed as active recipients of aid, as well as people who can develop their own survival strategies and perform their own self-advocacy.
Maintaining global peace and security is important. We thought we were winning the war against poverty and inequality and were debating over what our next battle would be. But it seems this deadly combat is far from over. As global citizens we have to take action now rather than later and accept the Syrian people fleeing never-ending war, poverty, injustice and devastating violence.