̽��ֱ�� of Cambridge - refugee

Syrian aid: lack of evidence for ‘interventions that work’, say researchers

fpjl2 — Thu, 04 Feb 2016 11:44:33 +0000

In the fifth year of the Syrian refugee crisis, donors and humanitarian agencies still remain unsure about which policies and interventions have been most effective, and continue to rely on a largely reactive response, say a group of researchers, aid workers and Syrian medical professionals.

Response approaches to date have often been short-termist, sometimes duplicating work and have very little evidence of effectiveness or impact, they say.

As national leaders and UN delegates gather in London today for the Support Syria Donor Conference, members of the Syrian Public Health Network warn that unless aid is provided on condition of evidence-gathering and transparency so funding can be directed to interventions that work, the health, education and livelihoods of refugees will continue to deteriorate.

They caution that Syrians in neighbouring countries such as Lebanon and Jordan – where services are stretched to breaking point – will suffer the most from ineffective interventions unless governments and NGOs of wealthy nations to do more to link allocation of donor funds to evidence, something that Network members have highlighted in a briefing for the UK's Department for International Development.

“A focus on health and health services is notably absent in the donor conference agenda yet it is a fundamental determinant on the success of education and livelihoods policies,” said Dr Adam Coutts, Cambridge ̽��ֱ�� researcher and member of the Syria Public Health Network.

“What funding there is for refugee healthcare risks disappearing unless governments insist on an evidence basis for aid allocation, similar to that expected in domestic policy-making.

“It is estimated that there are now over 4.3 million Syrian refugees in neighbouring frontline countries, and over half these people are under the age of 18. This level of displacement is unprecedented and given how short funds are, we need to be sure that programmes work,” said Coutts, from Cambridge's Department of Politics and International Studies.

“New ideas and approaches need to be adopted in order to reduce the massive burdens on neighbouring frontline states.”

Researchers say that the health response should do more to address the so-called ‘non-communicable diseases’ which ultimately cause more deaths: slow, silent killers such as diabetes, heart disease and, in particular, mental disorders. This means moving towards the development of universal health care systems in the region and building new public health services.

̽��ֱ��calls for more evidence come on the back of an article published last week in the Journal of the Royal Society of Medicine, in which members of the Syria Public Health Network (SPHN) address the response to mental disorders among displaced Syrians.

Clinics in some camps in Turkey and Lebanon report almost half of occupants suffering from high levels of psychological distress. However, many Syrians in neighbouring countries live outside the camps – up to 80% in Jordan, for example – which means cases are unreported.

In Lebanon, despite political commitment to mental health, there are just 71 psychiatrists, mostly in Beirut.

“ ̽��ֱ��implementation of short-term mental health interventions which often lack culturally relevant or practically feasible assessment tools risk diverting funds away from longer term, evidence based solutions,” said Coutts.

Moreover, a shortage of Syrian mental health professionals – less than 100 prior to the conflict has now fallen to less than 60 – is worsened by some neighbouring countries preventing Syrian doctors of any specialism from practising. Along with Physicians for Human Rights, SPHN members are calling for restrictions to be lifted on practising licenses for displaced Syrian health professionals.

“To date Syrian medical workers in Lebanon and Jordan are a largely untapped workforce who are ready to work and help with the response. However, due to labour laws and the dominance of private health service providers it is very difficult if not impossible for them to work legally,” said SPHN member Dr Aula Abbara.

Emerging evidence from the Syrian crisis, as well as evidence from previous conflicts, is pointing to psychological treatments which show some effectiveness:

Pilot studies with refugees in Turkish camps using ‘telemental’ projects, the delivery of psychiatric care through telecommunications, suggest that such techniques are effective in supporting healthcare professionals on the ground.

̽��ֱ��‘teaching recovery techniques’ method is designed to boost children’s capacity to cope with the psychological aftermath of war. These techniques have been used in communities in the aftermath of major natural disasters and conflicts, and have shown promise.

While SPHN members caution that adequate testing of these interventions is required, they argue that this is precisely the point: more evidence of what works.

Added Coutts: “A more scientific approach is needed so that precious and increasingly scarce financial aid is put to the most effective use possible. At the moment, NGOs and governments are not making sufficient reference to evidence in determining health, education and labour market policies for the largest displacement of people since World War Two.”

̽��ֱ��lack of an evidence base in the donor-funded response to Syrian migrant crisis means funds may be allocated to ineffective interventions, say researchers, who call on funders and policymakers in London for this week’s Syrian Donor Conference to insist on evaluation as a condition of aid.

A focus on health and health services is notably absent in the donor conference agenda yet it is a fundamental determinant on the success of education and livelihoods policies

Adam Coutts

UNHCR Photo Unit

Lebanese Town Opens its Doors to Newly Arrived Syrian Refugees

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Refugee camp entrepreneurship

sc604 — Thu, 17 Sep 2015 08:09:09 +0000

At a time of global focus on refugee issues due to the war in Syria and other displacement, new research from the ̽��ֱ�� of Cambridge calls for policymakers to foster entrepreneurship at refugee camps to help fill an ‘institutional void’ that leads to despair, boredom and crime.

Although most refugee camps are initially set up to provide supposedly “temporary” safety for people uprooted by war, natural disaster or other events, the reality is that many forcibly displaced people spend 20 years or more in exile.

A paper from Cambridge researchers calls on governments and other policymakers to promote refugee-camp entrepreneurship in order to provide an economic and psychological boost to displaced people.

“Refugee camp entrepreneurs reduce aid dependency and in so doing help to give life meaning for, and confer dignity on, the entrepreneurs,” says the paper, by Marlen de la Chaux, a PhD student at the Cambridge Judge Business School, and Helen Haugh, Senior Lecturer in Community Enterprise at Cambridge Judge. Marlen is a Gates Cambridge Scholar.

While such camps are created on the assumption they will be temporary in response to a passing emergency, such displacement is in fact often protracted – so “the rules of the game concerning temporary institutions do not reflect the reality of life in the camp,” the paper says.

̽��ֱ��paper – entitled “Entrepreneurship and Innovation: How Institutional Voids Shape Economic Opportunities in Refugee Camps” – was presented by the authors at this summer’s 75th Annual Meeting of the Academy of Management in Vancouver, Canada.

̽��ֱ��researchers identify three institutional barriers to refugee camp entrepreneurship: a lack of functioning markets, inefficient legal and political systems, and poor infrastructure.

This presents a number of opportunities for policymakers to boost entrepreneurship opportunities, including urban planning techniques to design useful infrastructure because long-term refugee camps tend to resemble small cities rather than transient settlements.

In addition, cash-based aid programmes and partnerships between refugee camp organisers and micro-lending institutions can provide seed capital to refugee camp ventures; innovation hubs such as those recently established in Nairobi, Kenya, can help provide access to business advice and seed capital; and the host country can create employment opportunities within the refugee camp by outsourcing some tasks to refugees.

“As the number of forcibly displaced increases, the urgency to find solutions to redress the negative aspects of life in a refugee camp for those in protracted exile also rises,” the paper says. Enlightened policies to boost refugee-camp entrepreneurship “may also make a positive contribution to the economy of the host country and in so doing help to reduce the local resentment experienced by those living in camps.”

Adapted from an article originally published on the Cambridge Judge Business School website.

Entrepreneurship initiatives can fill the ‘institutional void’ of long-term refugee camps, according to new research.

̽��ֱ��rules of the game concerning temporary institutions do not reflect the reality of life in the camp

Marlen de la Chaux

US State Department photo / Public Domain

Zaatari camp for Syrian refugees in Jordan

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From one extreme to the next?

lw355 — Thu, 05 Feb 2015 10:56:30 +0000

A radical Islamist group has exploited the vacuum created by civil war to capture cities, towns and oil fields across Syria and Iraq – leaving horror and destruction in their wake. Although this might seem unique to a post-9/11 world, religious radicalism exploiting a power vacuum is not new, as research going back 30 years to a different civil war in the same region is showing.

Since April 2013, the Sunni jihadist group Islamic State in Iraq and the Levant, referred to as the ‘Islamic State’ (IS, or Isis), has taken control of vast swathes of Syrian and Iraqi territory, bringing with it an onslaught of appalling atrocities and acts of cruelty. “It will take some time before its full impact is determined… [the threat it poses] is unprecedented in the modern age,” stated a recent report by the Soufan Group, a security intelligence firm in New York.

Meanwhile, Syrian refugees, fleeing IS and the bitter civil war, continue to spill across the borders of neighbouring states, straining their own societies and resources. Lebanon in particular has been greatly affected – almost a quarter of its current population are Syrian refugees.

Yet, while the sudden appearance of reports about the barbarity of IS makes this seem like an unprecedented shock, new research is starting to show that parallels may exist in the recent past.

In the 1980s, Lebanon itself witnessed the ascent of one such precursor Islamic movement, known as ‘Tawheed’, during the country’s civil war. Raphaël Lefèvre, a Gates Cambridge Scholar and PhD candidate working with Professor George Joffe in the Department of Politics and International Studies, and until recently a visiting fellow at the Carnegie Middle East Center, is researching its rise and fall.

His work investigates the ways in which the group seized control of the northern port city of Tripoli and imposed its conservative agenda on locals, before being largely rejected and marginalised by civil society and leftist militants. “While it’s important to keep in mind that history does not necessarily repeat itself, the parallels are great between the history of the rise and fall of Tawheed’s emirate in Tripoli and the current rule of the Islamic State,” he said.

IS may have few obvious antecedents in terms of the way in which its members practise their extremism, but because the pattern of its emergence presents a striking echo of those of earlier radical forces, says researcher Lefèvre, this pattern may provide pointers as to the direction and trajectory of IS.

He also hopes that his research on the events of the 1980s in Lebanon will focus attention on the roots of an increasingly unstable situation in the country. ̽��ֱ��timing of his research is poignant, given that street violence is rising, sectarianism is reaching boiling point and IS has now inaugurated a Lebanese chapter in Tripoli.

Today, references to the failed ‘Tawheed phenomenon’ are common among the citizens of Tripoli. During a year-long visit to Lebanon, where he has now returned, Lefèvre spoke to many who remember the events of the 1980s, and he finds commonalities between Tawheed and IS.

When Tawheed seized control, it imposed its ideological and religious norms on the people, but it also began to fill the socioeconomic gap left by the absence of a Lebanese state during the civil war. “They filled a void – provided security, ran hospitals and even gave education to the kids,” he explained.

Likewise, IS has both imposed a harsh conservative social agenda on the population who live under its sway and used resources such as oil and gas fields to win over locals. “They distribute subsidies and provide state-like services to a population in severe need given the quasi-absence of the Syrian state in remote areas outside of Damascus.”

Just like IS, Tripoli’s Tawheed movement was led by a charismatic figure, the Sunni cleric Said Shaaban. He gathered under his wing three Islamist groups that merged together to form Tawheed. Their aim was to struggle against impurities in society – the warlords and drug dealers – in accordance with Sharia law.

“But, once Tawheed seized control of the city in 1983, all of these grand goals very quickly disappeared. People started realising that there wasn’t much that was Islamic about the group; it was just another political faction trying to rule their city instead of Syria and Israel, and in increasingly corrupt and murky ways.”

After three years, and in the face of pressure from the Syrian regime, internal disagreements over deciding the group’s next steps led to its collapse from within.

IS, too, has been linked with corruption, including suggestions that the organisation has been selling looted antiquities and earning significant amounts from the oil fields it controls in eastern Syria by selling supplies to the Syrian government and across the borders into Turkish and Jordanian underworlds.

Tawheed lost legitimacy when it began to be perceived as a militia using a religious discourse to mobilise people. Lefèvre believes that movements collapse when they try to force society to adapt to their norms: “very often, civil society resists and in the end strikes back.”

In Lebanon today, he sees an increasing feeling of socioeconomic and political marginalisation on the part of Lebanon’s Sunni community – a “highly toxic cocktail”, he calls it, of unemployment, low literacy rates and poverty, leading many to turn away from the state and look for alternative sources of support and protection, including joining Islamic groups. He fears that the current situation may lead back to a situation not dissimilar to that witnessed in the 1980s.

“ ̽��ֱ��influence of the Syrian crisis on Lebanon is very real. Ultimately, whether the country is able to weather the storm, or fall prey to civil war and the rise of extremism, will depend on the ability of Lebanese policymakers to address issues that have long been ignored.”

As for the future of IS, Lefèvre says: “It is unpopular in the cities it is controlling, but we are not yet seeing so much resistance – possibly because of the socioeconomic help they currently provide. While the same collapse may not necessarily happen to IS, the rise and fall of Tawheed shows that internal tensions within a group – whether about the group’s leadership or its priorities – are an important factor that should be taken into account to understand how such movements operate. ̽��ֱ��‘IS phenomenon’ is in fact far from being a new one.”

̽��ֱ��threat to peace posed by the Islamic State group has been described as “unprecedented in the modern age”, yet research on the rise and fall of an extremist group in 1980s Lebanon suggests that we may have seen this all before.

While it’s important to keep in mind that history does not necessarily repeat itself, the parallels are great between the history of the rise and fall of Tawheed’s emirate in Tripoli and the current rule of the Islamic State

Raphael Lefevre

Derek Henry Flood

Lebanon, after the 2006 war

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Migration: Britain’s hospitable past

lw355 — Mon, 10 Feb 2014 08:58:33 +0000

A global trend to legislate for immigration restriction began in the middle decades of the 19th century. It was prompted by two large and sudden global movements – of Irish across the Atlantic during and after the famine of 1845, and of Chinese gold-seekers across the Pacific, to the West Coast of the Americas and to Australasia. California in the US and Victoria in Australia were the first jurisdictions to restrict entry on racial grounds. While the ‘white Australia policy’ became infamous, in fact by 1900 race-based immigration restriction was more ordinary than extraordinary. In most Anglophone jurisdictions – the Canadian provinces, all the Australian colonies, New Zealand, Newfoundland, the US – race-based border control became law and policy with little debate or resistance, sometimes none at all.

Not so in the UK. Pogroms in the 1890s had sparked a great emigration of Jews from Eastern Europe into the UK, mainly en route to the US. It is true and well documented that a freshly visible British anti-Semitism materialised as violently voiced calls for immigration restriction, modelled on US, Australian and New Zealand law. But what was different in Britain was the equally loud objection to closing off borders, indeed to regulating movement at all. In other words, whereas immigration acts were sailing through jurisdictions all over the globe by 1900, in Britain they met fierce, principled and, for a time, successful resistance.

Aliens bills put to Parliament over the 1890s and early 1900s were roundly defeated, argued down mainly by Liberals. By 1904, this included the then-Liberal Winston Churchill.

British politicians opposed immigration restriction on several grounds. For many, free human movement over borders was the necessary corollary of free trade of goods. For others, a moral and political principle of freedom of movement accompanied this more expedient economic rationale. This is where it gets both interesting and strangely unfamiliar to 21st-century political sensibilities.

Not a few parliamentarians proclaimed Great Britain as the last bastion of freedom because it had no immigration restriction policy. Conversely, the US could not, or should not, proclaim itself the land of the free, because it did. British nationalism was thus defined by a commitment to open borders; a stunning reversal of the current situation.

More than this, British liberal opposition to aliens acts and immigration acts rested on a tradition of extending asylum to the politically and religiously persecuted. This had long manifested with respect to European Protestants (religiously) and to those fleeing revolution (politically). A much-treasured hospitable past was mobilised powerfully, and with proud nationalist fervour around 1900, as argument against immigration restriction, setting Britain apart entirely from all other jurisdictions at the time, including all of its own settler colonies. There was simply no comparable discussion.

British opponents of immigration restriction could only hold out so long, however, in the face of this global trend. ̽��ֱ��Aliens Act was passed in 1905 aiming to restrict the entry of European Jews. Historians have long assessed the Aliens Act as a high point (low point) of British anti-Semitism. But the law was more ambiguous than this. For hiding inside the statute itself was an asylum clause that enabled the entry of persons religiously or politically persecuted. It read thus: '[I]n the case of an immigrant who proves that he is seeking admission to this country solely to avoid prosecution or punishment on religious or political grounds or for an offence of a political character, or persecution, involving danger of imprisonment or danger to life or limb, on account of religious belief, leave to land shall not be refused on the ground merely of want of means, or the probability of his becoming a charge on the rates.'

This was a compromise clause, the result of lobbying by Jewish MPs, including Lord Rothschild, and Liberal MPs such as Churchill. ̽��ֱ��job of implementing the new law from 1906 fell to William Gladstone’s son. It was not an easy task, given that Britain had no border control infrastructure to speak of. But one of his earliest instructions to authorities on the ground was that claimants of religious persecution be given the benefit of the doubt, and be permitted to enter without any of the other restrictions applying.

British international lawyers at the time hailed this as the first codification of an individual’s right to asylum (as opposed to asylum being bestowed as the privilege of a state). It also made American legal scholars understand their own federal law as ‘rigid and inelastic’, perhaps requiring relaxation ‘as a concession to humanity.’ In fact, by World War I, both the US and the UK hardened their laws on immigration and aliens, the British repealing the Aliens Act and replacing it with an Enemy Aliens statute.

It is common for historians to view the 1905 Aliens Act as the sinister thin edge of the immigration restriction wedge. But scholars and policy makers might do well to focus on the counterintuitive history of the statute, which codified, albeit for a short time, the right to asylum when in danger of religious or political persecution or prosecution. Of all the global locations where race-based immigration restriction laws proliferated c. 1900, it was in the British parliament, behind the scenes in Whitehall, as well as in the East End, that resistance was strongest and clearest. Is this not the history that should hold current policy makers to task?

Alison Bashford is the recently elected Vere Harmsworth Professor of Imperial and Naval History in Cambridge’s Faculty of History, and is completing a study of the legal history of immigration restriction with Professor Jane McAdam, Director of the Andrew & Renata Kaldor Centre for International Refugee Law at the ̽��ֱ�� of New South Wales, Australia.

In the midst of current controversies over immigration law and policy, Professor Alison Bashford discusses why it's important to recall Britain’s unique place in the international history of modern border control, suggesting that Britain’s principled politico-legal past calls for cautious celebration, rather than the more common critique.

Wikipedia

Jewish refugees from Russia in Liverpool, 1882

For elaboration of the international context of the 1905 Aliens Act, see

Alison Bashford and Jane McAdam, ‘ ̽��ֱ��Right to Asylum: Britain’s 1905 Aliens Act and the Evolution of Refugee Law’, Law and History Review 32, 2 (2014)

Alison Bashford and Catie Gilchrist, ‘ ̽��ֱ��Colonial History of the 1905 Aliens Act’, Journal of Imperial and Commonwealth History, 40 (2012): 409–37

Alison Bashford, ‘Immigration Restriction: Rethinking Period and Place from Settler Colonies to Postcolonial Nations’, Journal of Global History, 9, 1 (2014)

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Unsafe havens? Health risks for refugees

jfp40 — Wed, 05 Feb 2014 09:33:04 +0000

As the humanitarian crisis in Syria continues to unfold, over two million people are thought to have crossed the borders into neighbouring countries. Desperate, empty-handed and facing an uncertain future, most of the refugees will seek aid and support in camps, where they will be exposed to yet another threat: infectious disease.

High population densities, malnutrition, poor sanitation, sexual violence and reduced access to healthcare following forced migration can create a ‘perfect storm’ where communicable diseases become a major cause of mortality and morbidity. And it’s far from a recent problem.

Over 600,000 cases of cholera have been recorded in Haiti since the earthquake of 2010, which displaced up to 2.3 million people. Cholera was also responsible for some 50,000 deaths in 1994 among refugees of the Rwandan genocide. In 1949, the British Red Cross noted that malaria and dysentery were widespread among 30,000 Arab refugees living in huts, caves or ragged tents in Jordan. In 1901, Boer War refugees were exposed to measles, pneumonia, dysentery, diarrhoea, bronchitis and enteric fever in the camps of the Transvaal.

“Since biblical times, mass migrations have followed conflict and crises,” said Professor Andy Cliff. “Today, humanitarian aid organisations perform an incredible job in taking care of refugees but this can take time to come into play, and the conditions that migrants find themselves in raises the spectre of epidemics. Diseases such as cholera, dysentery, measles and meningitis, for instance, have resulted in high mortality rates in relief camps in Africa, Asia and Central America.”

Although the impact of forced migration on health is well known, no study has ever systematically linked the nature of displacement, its geographical location and the particular patterns of disease that occur: a triangulation that, if charted, could help authorities and aid agencies prepare as crises unfold.

"We call this the displacement–disease nexus,” added Cliff. “Understanding it lies at the heart of preparing for future displacements, both for the welfare of the migrants and for the health and economy of the destination.”

For the past year, Cliff from the Department of Geography and Professor Matthew Smallman-Raynor from the ̽��ֱ�� of Nottingham have been leading a project that is assembling the first ever database to link these types of information. And to do so, their team is looking back over 100 years of forced migrations, across the globe.

“ ̽��ֱ��research could scarcely be more timely,” said Smallman-Raynor. “ ̽��ֱ��most recent figures released by the Office of the United Nations High Commissioner for Refugees (UNHCR) estimate up to 45.2 million people in situations of displacement for 2012, which is the highest figure in 20 years.”

Cliff’s colleagues Dr Anna Barford and Heather Hooper have begun the task of hunting through the rich archives held by organisations such as the UNHCR, the International Committee of the Red Cross, the United Nations Office at Geneva and the World Health Organization, as well as searching through scientific journals dating back to 1901. A doctoral student, Anna-Meagan Fairley at the ̽��ֱ�� of Nottingham, is looking specifically at infectious disease among people displaced by natural disasters.

“Because each set of circumstances is unique, we need to look at as many cases of displacement as possible, over a long time period,” said Barford. “Only then can we start to work out whether there are patterns that governments and aid agencies can learn from in preventing epidemics and delivering healthcare.”

Epidemics of communicable diseases not only affect the health of migrants in camps, but also the health of those in areas the migrants pass through during their migration. “Perhaps one of the most significant examples relates to the First World War,” said Cliff. “Chaos ensued in terms of preparedness for the end of the war – several million refugees were swilling around on borders between Russia and eastern Europe, and you could map the spread of typhus and cholera marching with the refugees as they crisscrossed Europe.”

̽��ֱ��results will be used to establish global electronic databases of infectious disease events in relation to mass population movements since the beginning of the 20th century. “It will be a fascinating resource,” said Barford. “Out of this we’ll pick 50 events and look in detail at the short-, medium- and long-term geographical patterns and consequences of displacement-associated epidemics. ̽��ֱ��databases will be available to national and international organisations involved in health promotion and in the delivery of humanitarian assistance.”

̽��ֱ��results will also be published by Oxford ̽��ֱ�� Press as one of a series of atlases; a previous volume in the series Atlas of Epidemic Britain: A Twentieth Century Picture authored by Cliff and Smallman-Raynor won the British Medical Association prize for Best Medical Book of the Year 2013.

̽��ֱ��results of this ambitious project, which is funded by the Leverhulme Trust, will also be of interest to countries such as the UK that eventually become home to refugees after they have left intermediary camps. “This so-called secondary migration has been the cause of much public and political debate, with the UK’s Department of Health launching a consultation into proposals for charging migrants to use the health system,” added Cliff. “By also looking at the long-term health consequences for secondary migrants, we hope to shed light on how best to prepare for their arrival and support their healthcare.”

For further information about this story, please contact Louise Walsh at louise.walsh@admin.cam.ac.uk

Inset image: A Syrian woman near a fire at a refugee camp in Azaz, Syria, on December 17, 2012. Credit: Freedom House

A new study is looking at a century of mass migrations worldwide to understand the public health consequences when people are forced to flee from war, persecution and natural disaster.

Since biblical times, mass migrations have followed conflict and crises

Professor Andy Cliff

MM/JRS

Caption: A group of Sri Lankan refugees arrives in Tamil Nadu after a risky 30-mile boat ride across the Palk Straits

Migration and mental health

Infectious disease is not the only health threat that victims of forced migration face. Their mental health is also at risk.

Forced migrations are often the result of violent events or economic hardship, which can have profound psychological consequences. Migrants may be without their family support network and living in difficult conditions, while their left-behind families might find it equally hard to cope.

̽��ֱ��mental health of individuals after forced migration, as well as after their subsequent return migration, is an area that Dr Tine Van Bortel from the ̽��ֱ��’s Institute of Public Health describes as “one of the least explored areas of health research.”

She has been involved in pilot projects that have looked at the quality of life, well-being and mental health of migrant domestic workers and their left-behind families in Singapore and Sri Lanka, and of Muslims forcibly resettled in 1990 by rebel fighters in Sri Lanka, working in collaboration with Dr Chesmal Siriwardhana and Sabrina Anjara at King’s College London and researchers at the Sri Lankan Institute of Research and Development (IRD).

“In terms of economic forced migration, we find that both labour-receiving countries and labour-sending countries have inadequate measures to provide the information, care and support that’s needed for migrant workers and their left-behind families,” said Van Bortel. “Some labour-receiving countries have health checks in place but these focus mainly on communicable diseases and not on mental health. Hard work, social isolation, abuse and missing their left-behind family members often lead to significant mental strain and sometimes suicide. In turn, the left-behind families often find it difficult to cope too."

“We are now broadening our research to look at possible interventions to raise awareness, psycho-educate and empower people to make more informed decisions about economic migration, to help migrant workers and their left-behind families cope more constructively with often challenging situations, and to address the psycho-social needs of displaced populations,” added Van Bortel.

“Humanitarian agencies are increasingly aware of the psychological consequences of forced migration and have been campaigning for change. We hope that the results might be used by legislators and policy makers in countries affected by forced migration and internal displacement to improve policy and practice for the benefit of individuals, families and communities.”

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