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