THIRTY FOURTH ISSUE
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4. UNIVERSAL HEALTH COVERAGE AND THE REFUGEE CRISIS ZAREEN CHIBA
10. THE CRISIS THAT INVOLVES YOU. 14. CRACKS 28. THE REFUGEE CRISIS: SHARON TIRADO
MADISON MELTON
BEHIND THE VEIL BIANCA BARSAN
24. REFUGEE CRISIS IN ITALY;
AN INCREASING PHENOMENON. EDGARDO SCHIENA
refugee crisis
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The Hepatitis E ward at MSF's hospital in Batil refugee camp, Maban county, South Sudan Photo credit: Corinne Baker/MSF
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UNIVERSAL HEALTH COVERAGE AND THE REFUGEE CRISIS
| ZAREEN CHIBA
Universal Health Coverage and the Refugee Crisis
A summary of health provision and relevant barriers for refugee populations
R
ecently, the war in Afghanistan re-entered international headlines after the US government issued a wave of airstrikes on Kunduz, destroying a Doctors Without Borders hospital with no prior notice. Similar war crimes have been consistent in the West Bank. The United Nations Relief Works Agency is the largest provider of primary healthcare for displaced individuals, and due to direct or collateral crossfire, only 13 out of 21 health clinics remain in operation, leaving thousands of internally displaced refugees without access to primary healthcare.
CHIBA, ZAREEN @Zarcchi
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It is distressing to know that this year entails the highest volume of forcibly displaced people in the history of mankind. This fact was issued by the United Nations Refugee Agency, with accompanying estimates of 59.5million victims and continually rising global trends of those displaced by war. “Globally, one in every 122 humans is now either a refugee, internally displaced, or seeking asylum. If this were a population of a country, it would be the world’s 24th biggest”, remarked UN High Commissioner for Refugees Antonio Guterres earlier in June of this year. Achieving Universal Health Coverage is particularly difficult for countries which are the first point of contact for refugees. Temporary border camps are subject to electricity shortages and breakdowns in water, sanitation and waste management systems. Aside from the obvious logistical damage,
these also pose as significant risks to public health as they are fundamental systems to health care provision. One cannot get operating lights to function if there is no electricity; stagnant water breeds cholera; no water rears dehydration and death. As a result, acute health problems may only be addressed after weeks to months after the refugee crisis begins after basic infrastructure is put in place, leaving primary health facilities overwhelmed but unable to act. There are several priorities that primary healthcare workers address According to “Refugee and Immigrant Health: A handbook for Health Professionals” (Kemp et. al), these are, 1) to identify communicable diseases that are public health risks, and 2) eliminate health-related barriers to successful adaptation. Hepatitis, parasitism and tuberculosis are significant threats to the population health of refugees, and have been proven to be devastating past conflicts such as the Gulf War.
UNIVERSAL HEALTH COVERAGE AND THE REFUGEE CRISIS
Palestinian refugees from Syria receive medication from a UNRWA clinic . November 2013. Photo credit: Ramiro Cordoba/UNRWA Archives
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Barrier less u socioc thems or con the d centre refuge somew gap, p (for an ISM’s S Side o may in their c or dru to rap condit HIV.
CHIBA, ZAREEN @Zarcchi
Finally or po psycho familie worke case s refuge theore deliver review that h
rs to successful adaptation are universal as they are based on the cultural nature of the refugees selves, and the context of the disaster nflict. They may be logistical, where distance or number of healthcare es is disproportionate compared to ee populations. This problem can be what mitigated by NGOs filling the policy changes and appropriate aid n elaboration on this, read my article in September issue, titled The Punishing of Philanthropy). Sociocultural barriers nclude a lack of patient knowledge on conditions, leading to no follow-up ug refill compliance, which may lead pid deterioration of health as seen in tions such as active tuberculosis and
y, mental barriers including mistrust ost-traumatic stress disorder, which ologically prevent patients or their es from approaching healthcare ers. With an increased number of studies of healthcare infrastructure ee camps for evaluation, only now are etical models of universal healthcare ry in conflict situations being applied, wed and improved upon, revealing health is now beyond the bounds of
UNIVERSAL HEALTH COVERAGE AND THE REFUGEE CRISIS
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medicine but in the comfortably discussed in the spheres of security, politics and law enforcement. While Palestinian and Syrian refugees stand as the hot topic of the day, the world will eventually experience viewer fatigue as it looks on shifting numbers of death tolls and economic damage estimates. With the mention of such individuals, the discussion often turns in the direction of a heated debate on Middle Eastern (and now European) border politics. This group of people have been subject to label after label, vulnerable to the whim of politicians and the media in their framing of these human beings to suit the convenient political agenda at the time. However, I appeal to you, the reader, to remember that the next time you come across news of the refugee crisis, remember that this group of people live resiliently and bravely against the high risk of acute morbidity and mortality, and are not a pawn in your dinner table political debates. Remember also the healthcare workers, logisticians, engineers and security staff who have devoted their practise to ensure that refugees and displaced individuals enjoy the human right to health despite a multitude of barriers in every direction.
The crisis that | 10
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involves YOU.
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TIRADO, SHARON @shatirado
might not be the right person to talk about the refugee crisis. To be honest I haven’t even met any refugee and never experienced any similar feeling to the pain that thousands of people are living. But on the other hand, without any doubt, the refugee crisis has created a worldwide movement not only rising awareness of what is happening, but making everyone involved in this historical moment. The other day I read a quote that said: “No one puts their children in a boat unless the water is safer than the land” (Anonym). The quote kept me thinking. It caught my attention not only because it reminds me of the well-known picture that turned viral in a few hours of a dead kid, but also because it reminded me of a particular chapter of my country’s past which is quite similar.
THE CRISIS THAT INVOLVES YOU.
The Infamous Syrian migrant boy lying on the beach on his way to Canada. Photo Credit: http://static.independent.co.uk/s3fs-public/thumbnails/image/2015/09/02/13/syrian-migrant-boy-turkey.jpg
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SHARON TIRADO
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to their daughters and sons but with the tranquility that they would have a better and brighter future.
So where is the relation between the refugees crisis and Cuba? Where is the connection? Did I just mix up When the regime of Fidel Castro was two completely different stories? So only getting started, many disasters here is the answer: we all might be happened among them the “Peter refugees someday. Pan’s kids Operation”. Drowned in the desperation of a communist We might be refugees because of regime where food started to become many reasons, that’s alright, but at the a scare resource, parents would send end, at some point of our lives we their kids to the United States. The end up fighting for a brighter future, agreement between Cuba and United for a better living, to achieve bigger States established that kids would be dreams… The crisis of refugees sent to U.S. not coming back to their nowadays reminds me how powerful home country and being adopted by a human being can be when fighting American families or the American not only for survival but fighting for Government itself. their families’ future. But the refugee Many families sent their kids to the United States, and it was painful to see how mothers would say goodbye
crisis is more than that, because from my point of view it not only involves the refugees but all worldwide citizens.
THE CRISIS THAT INVOLVES YOU.
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SHARON TIRADO
Moroccans Lie Face down in Rabat’s Beach in Solidarity with Syrian Refugees
All wars have been different. So I am not trying to put all wars in the same box. Instead, I am trying to say that anybody might, someday, be a refugee. It does not matter where you come from, whatever your beliefs, if you are white or if you are black; there is never enough safety on the world we live in. We cannot ignore the headlines in
the papers, we cannot ignore families suffering with dignity crying for help, we cannot ignore the long queues waiting for food, but we can join them. We, that have a house where to sleep. We, that have something to eat everyday. We, that have the possibilities that other families are only dreaming. We that have the power to help, why don’t we do it?
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do not know what it is like to feel home crumbling beneath your feet. To run, to follow, to flee with whoever and whatever is being pushed and pulled alongside you. To feel the spray of the ocean in a boat that, in ordinary times, would never be called seaworthy. To know that you might die. To know that your children might die and that there might be nothing you can do to protect them. To leave home and know you may never come back, that to your children it might only be a place of stories, a place of origins but never identity.
CRACKS
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MELTON MADISON
CRACKS MELTON, MADISON @nomad_melton
Those are all things I cannot understand, but I must try to understand the things I can’t through the things that I can. I know what it feels like to miss a home that is no longer there. A home that is given its fourth and most important dimension by the people who share it, but who have all also moved on so that the space is no longer the same. Space is place plus meaning, and the meaning is always so easily swept away in the currents of personal and political history.
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I know what it feels like to recognize that a place can never be quite the same again, but to miss it in spite of myself. To turn my attention away from the dimension of love and relationship and to turn towards the backdrop of all of those experiences: the smells, textures, and foods that are almost a good enough substitute. When I was sixteen, there was an abandoned construction site that my friends and I spent time in on a few occasions. Clearly the funds for the project had run out and it was left, a model of urban decay with water on the floor that caught the sunlight through the gaps and angles of unfinished concrete. Five years later I was driving through that same city for the first time again in years, and by chance passed that same plot to see a shopping mall sprung up from forgotten walls of concrete. As quickly as it appeared in my mirror it was gone again, as briefly as it had once been a place with meaning it
CRACKS
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MELTON MADISON
had grown into something new. I cannot imagine what it must be like to see this process in reverse. To love something that is whole and constructed, and then to come upon it again in ruins. They are both a loss, but a loss of destruction is no doubt worse than a loss of creation. There is so much I cannot understand, but each time a home is changed or left behind, there are cracks. I have cracks where others have holes, but I can only begin to see by pushing my own cracks apart. When people are forcibly resettled, the experts say that it can be a traumatic experience even if one is moving no further than the other side of a river. And pushing these cracks apart further still until I can see the holes that they can become, even if the images behind them are, to me, still only blurs. And that is all I can say. MELTON,
MADISON @nomad_melton
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behind the veil BARSAN, BIANCA @biancaomikami
F
THE REFUGEE CRISIS: BEHIND THE VEIL
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BIANCA BARSAN
living conditions in poorly improvised camps. These or a few months were measures taken by now, the topic of the sothe likes of Hungary, for called refugee crisis has instance, who has done its taken over the media best to prevent refugees and has since sparked from getting inside its various reactions and borders. Sadly, the obvious behaviours in response fact here is that at the to its unfolding. As a EU core of Europe’s negative citizen, watching the response lies a general news coverage on the overwhelming feeling of subject has made me really islamophobia and fear of aware of the multitude Islamization of Europe, of issues arising when a so-called threat to we are faced with such Christianity. Therefore, a complex phenomenon. the refugee crisis is Having said this, what I only a crisis as it brings actually mean is that I was this ‘threat’ into our life shocked at the majority universe, our countries, our of the negative reactions cities, and to deal with it coming from Europe: is to deal with the above tear gas, attacks, harsh mentioned feelings.
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To begin with, we can assume such fears are grounded in nothing but the anxiety of the unknown, of the “Other�, which constitutes the object of anguish and fear only insofar as people have little knowledge of it. We are told on TV that Muslims are terrorists, that they are the bad seed as compared to white, western populations. Yet we are the ones who are unable to make the distinction, we are unable to decide for ourselves, since
mass media coverage tells us already who is dangerous and who is a victim. Take for instance the case of Anders Breivik, the mass shooter in Norway, or Dylann Roof in the United States, who took the life of nine innocent black people in Charleston earlier this year: they have both been described by the media as having a mental handicap, as people with a very unstable mind, despite their reasons having been purely racist or xenophobic. Now think of this: what if Dylan Roof and Breivik had
THE REFUGEE CRISIS: BEHIND THE VEIL
been Muslims? The hatred the media instills in us is already taking incredible proportions, yet it somehow succeeds in manipulating opinions to this point, this point where we have the opportunity of showing the world, and especially the non-Christian world, that we are not xenophobic and that above all our differences, saving and nourishing lives is our ultimate goal as human beings. We need to keep in mind that these people, these refugees, are not tourists,
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BIANCA BARSAN
nor are they illegal aliens as some may call them, but rather they are people fleeing their homes from war, discrimination, abuse, lifethreatening conditions. They are not coming to Europe on a holiday, nor out of desire to be here. We need to realise that no mother or father will put their child on a boat, on a dangerous sea route which they pay extortionate prices for, only for the fun of it. Risking their lives is a little price for them to pay, which says a lot about where they are coming from. Yet, for some reason, they arrive in the EU and are received as
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greedy economic migrants, as threats, we think they cannot be integrated, we are scared they will build mosques and teach our children about the Jihad. We need to open our eyes and minds and look past skin colour and head veils; we need to reach out and do our best to help those who really need it. We need to rid ourselves of this fear and stop perpetuating misconceptions and prejudice, not build walls as high as the skies and spread tear gas hoping they will ‘go back to Syria already’.
BARSAN, BIANCA @biancaomikami
THE REFUGEE CRISIS: BEHIND THE VEIL
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BIANCA BARSAN
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Refugee Crisis in Italy; An Increasing Phenomenon SCHIENAS, EDGARDO @Eschienas
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REFUGEE CRISIS IN ITALY; AN INCREASING PHENOMENON. |
efugees have always been present in our many societies all over the world. Since ancient times, people have always felt the necessity to migrate to different places to adapt themselves to new cultures and way of living. Migration can be forced or voluntary, but in both cases people are forced to physically move from their home country. As soon as you migrate to another place, you officially become a refugee. Refugees can be divided into two different categories; legal refugees with all the necessary documents to establish their new roots in the new country and undocumented refugees, people that unfortunately have no possibility of getting any type of document. In the past decade the movement of refugees has drastically increased throughout all Europe, where more than 500,000 people migrated
EDGARDO SCHIENA
from their home countries just in 2015. Italy, in this case plays a vital role in this massive movement of refugees in all Europe, as it is the easiest and closest country to reach for thousands of people. In the Mediterranean area, Italy is the closet country to Africa, and this give the possibility to refuges to leave Africa and reach Europe throughout Italy. The island of Lampedusa is the favorite destination for refugees, as it just a couple of hours away from Tunisia and Libya. In the last couple of years, with the tormented situation in the middle east after the great revolutions, especially in Syria, Egypt and Libya, the flow of refugees in the Mediterranean has drastically increased, and by predicting the future situation, this is just the start. In this case, refugees seek the only access to Europe
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throughout the closest point to their homes; Italy. People are so desperate for their situation back home that they are ready to risk their lives through bloody and terrible long journeys hoping to find a better life. Most of them reach Italy with boats, subject to disastrous travelling conditions and most of the times forced by the human trafficking organized crime. Throughout this difficult journey from Africa to Italy across the Mediterranean, most people reach destination, but many others don’t. It is really common to open Italian news and read about huge amount of refuges dead in the attempt to reach the peninsula. Just this year, I have been witness of hundreds of different pieces of news reporting such deaths, mainly caused by the overcrowded boats and poor travelling conditions. Most refugees come from Northern
Africa, from the countries that are currently the most unstable ones after the revolutions happened in the last past years. People are migrating for political instability, corrupted and violent governments, poor living conditions in search of a better and stable life far away from their tormented home countries. Most people arrive with the hope of going in countries such as France, Germany and Spain, but most of the times they are forced to stay in Italy also against their will. This is due to the fact that other European countries are denying access to refugees and so Italy is forced to welcome more and more refugees everyday without the possibility to spread them throughout all Europe. Just in the last couple of months, the European Union has accepted access of refugees in all over Europe in order to help the
REFUGEE CRISIS IN ITALY; AN INCREASING PHENOMENON.|
critical situation Italy is living now. With lack of money and especially space, Italy is force to carry out a tremendous amount of work in order to try to help each refugee that touches the ground of the peninsula. Refugees, in my opinion, have the right to escape from their countries to seek a better life and we have the duty to help each and one of them. But Europe has to realize that it is an increasing phenomenon and that Italy can’t make it by itself. In order to succeed, all European countries have to seek a way in which they can collaborate in order to help each refugee that comes to Europe. A human life is the most precious thing in the world and everybody deserves to preserve their own life, especially people that most need it.
Refugee Crisis in
EDGARDO SCHIENA
SCHIENAS, EDGARDO @Eschienas
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