Refugee Care Displaced but Not Forgotten

who in your family

was a refugee a migrant

a foreigner think back in your history

and you’ll likely identify

one of your forefathers or mothers who

came to this country

because of war because of hunger

persecution

or natural disaster this was the

situation with my father george come

nellis in the upper left

he grew up in nazi occupied greece

a time when one athenian in five

died of starvation greece following

world war ii was not much better off

there was civil war being fought

throughout the country

and my father arrived in the united

states in 1952

with no money no english

and no friends and it’s a similar

situation today with some

70 million people the population of the

entire southern united states

fleeing from their homes because of

hunger

natural disaster persecution war

more refugees than at any other time

since the end of world war

ii now i use the word refugee

to mean someone who has passed from one

country across a border into another

country

refugees are protected by the united

nations convention of 1951

which specifies that refugees

are to be provided their human needs

and they are not to be forcefully pushed

back into the countries from which they

fled

most refugees today are women

and children they’re traveling with no

money

no documents no friends

now in the same breath we also have to

talk about idps

that is internally displaced persons

these are those who have been pushed

from their homes but they are still

within the same country

often the situation of idps is often

even worse than that of refugees

because they are not afforded the united

nations

defined rights of refugees

ours is today a world in motion

there are central americans fleeing

crime and poverty moving northward

in east africa and west africa those

al-shabab

and boko haram who kidnap their

daughters

who forced their sons to be child

soldiers

in myanmar there’s the six million

rohingya people

selected for ethnic cleansing expelled

from that country

moving eastward toward thailand and

westward toward bangladesh

to say nothing of today’s catastrophe

in syria yemen and the sudans i’m a

physician

with the institute for international

medicine

and my view on this is these are

problems of truly

biblical proportions some of you are

familiar with the

history of the ancient israelites the

patriarch jacob

was living in cana there was no food

was famine in the land and jacob was

hungry

he heard that there was food in egypt

and so he sent two sons down to see if

this was true

the boys came back with an encouraging

report yes there is

food and there’s also an invitation to

come

live in egypt and so jacob took his

entire family

about 70 persons and they traveled into

the land of the pharaohs

what happened next a new pharaoh came to

power

one who was not familiar with jacob and

he

pounced on the hebrew people he enslaved

them

for 430 years they worked the fields and

they did the construction

for the egyptians until under moses

they left egypt and back to the land of

the hebrews

it’s no surprise that hebrew scripture

is replete

with instruction about the treatment of

foreigners

leviticus declares when a foreigner

resides among you in your land

do not mistreat them the foreigner

residing among you must be treated as

your native born

love them as yourselves for

remember you yourselves were foreigners

in egypt

and i am the lord your god

the institute for international medicine

was founded

18 years ago with the mission of

equipping health care professionals with

the unique skills

to serve the world’s most forgotten

people

those who are disabled elderly

chronically ill veterans

victims of war and disaster my role at

the institute for international

medicine today includes the middle east

and this is a picture

of islamic state control five years ago

northern iraq great swaths of either

eastern syria

controlled by islamic state and

everywhere they arrived

the schools were closed the women were

shuttered

businesses shut down and anyone who

resist

executed some 12 million people the

population of

ohio fled eastward

toward iraq westward towards jordan

seeking refuge

one of them was amar i met amara at this

time last year

in northern iraq he is a yazidi

yazidi people are a unique

religious minority identified by islamic

state as

satan worshippers

so of course you can do anything you

want to with the satan worshiper they

killed them by the tens of thousands

amar is one of the fortunate ones he

left with his family

five years ago and he’s been living in a

tent

hosted by the unhcr the united nations

high commission for refugees he’s an

attempt where it’s 140 degrees in the

summer

and below freezing in the winter a tent

among some other tents

among tens of thousands of

tents imagine yourself

being tasked with responsibility to

provide care for

ammar and thousands of his refugee

neighbors

where would you possibly begin

well international refugee care can be

divided into four phases

and we’re going to touch on these one by

one the first

phase is pre-emergent that is

you see a conflict brewing and before

people are forced from their homes it’s

time for intervention it’s time to send

in your negotiating team

find a just resolution to this potential

conflict before the most

vulnerable are forced from home it’s

also a time for you to develop your

teams

and to stage your supplies because if

this

fails then people will begin to arrive

hundreds a day thousands a day

you’re in the emergency phase what will

they immediately need

shelter food

water how much water does a refugee need

well we know the human body requires a

half a gallon a day

but you also need food for bathing

cooking toileting

in all at least five gallons per person

per day

these people will be sick what are the

diseases of refugees

they are the diseases of poverty

pneumonia dysentery

malaria in some regions they will have

chronic health problems

they’ll have myocardial infarctions and

strokes and asthma attacks

women will deliver their babies yes

refugee women will deliver at nine

months just like everyone else

so you as their leader must be prepared

to deliver their babies to manage the

obstetric complications

to care for the newborns

hunger will underlie all of this food

insecurity

is one of the definitions of refugee

status

and then there will be epidemic diseases

vulnerable people

living in close proximity they’ll get

scabies

measles covet

all of this will require your leadership

now let’s fast forward three or four

months

the crisis is abating fewer people are

arriving

but there’s no resolution no one’s going

home

and now it appears that these people

will be with you for months or even

years

you’re in the maintenance phase what

else will they need

well children will need school adults

will need

opportunity to earn income

communities will need to learn to live

together

security and conflict is a big problem

in refugee communities

we have traumatized people who are

living in close proximity with one

another

who are inevitably going to get into

arguments

they are also particularly susceptible

to influence from outside forces

forces will come in and try to recruit

refugee people

for their various factions this will

require

your attention and then where are you

going to locate these people

now amar lives in a desert there’s

plenty of space

but there’s no food there’s no water

there’s no jobs there’s no schools

these must all be trucked in or bust out

and for this reason many international

refugee care

leaders prefer to locate them in urban

areas

where there is infrastructure

but this is accompanied by host refugee

conflicts

local parents will begin to say there’s

too many refugee kids in the school and

my

children are not getting enough

attention

local workers will say oh we’ve got a

glut of

low income laborers and we’re losing our

jobs

you’ll have to attend to those kind of

relationships as well

and at the same time someone maybe even

you

is trying to find a long-term solution

to what caused these people to flee in

the first place

what are the options some refugees will

stay on

in their host country this is a mars

plan

islamic state doesn’t control territory

anymore but they continue to

control the minds of many people

and omar is convinced that if he returns

to syria he will be killed

he’ll stay on indefinitely

a very small number will immigrate to a

third country

western europe even the united states

but most refugees like ammar’s son

simply want to return

home in peace

now what can you do on behalf of amar

and his family

first up track the international news

choose a source that regularly updates

you on what’s happening

around the globe especially with

vulnerable people

and then as you are informed express

your values

to your political leaders that our

nation reflects care towards these

most vulnerable people on the planet

look for opportunities to serve those

who have been resettled in your

community

now in recent years we haven’t had many

new international refugees

but those who are already here continue

to need

assistance with improving their language

skills

finding a job helping their children do

well in school

you could volunteer your service

two half days a month with a reputable

refugee resettlement agency in your city

providing direct care and intervention

on their behalf

now you could even step it up even more

you could get an advanced

degree in refugee care

and then pursue a career with one of

these

renowned healthcare refugee

resettlement organizations like the

united nations

refugee agency and as you do all of

these things

on behalf of the world’s most vulnerable

remember the admonition

to love them as yourself for you

or someone in your family like my father

was once a migrant a foreigner

or a refugee

you