Refugee Crisis
Dr. Raviteja Innamuri M.D.
Psychiatry, CMC-Vellore
“No one leaves home unless home is the mouth of a shark.”
― Warsan Shire, Teaching My Mother How to Give Birth
What’s happening?
New house agreement-check
Travel tickets-check
Packers and movers-check
Transfer and appointment letter-check
Children school-check
And the list goes on…
We spend several months and sometimes even years planning resettlement or shifting to a new home. However, crisis ensues when the equations change overnight and one is forced to leave home, belongings and everything they own for the mere sake of survival. Unfortunately, despite outstanding technological development managed by the human civilization, mankind still struggles to learn its lessons of tolerance, peace and love from its own books of history.
Surprisingly, in this era of ‘global village’, countries and societies are increasingly becoming more exclusive and self-concerned. No better evidence than Br-exit, Trump’s new plans for walls and reservation systems and growing religious intolerance in our own country-India. The worst of this is the refugee crisis not by a natural disaster but created by man upon man majorly covered by the media as Syrian refugee crisis (to escape from war) and Myanmar Rohingya crisis (to escape from persecution).
Why it matters?
Refugee crisis is a vulnerable state to develop not only physical health problems but also several mental health complications. These range from posttraumatic stress disorder, other anxiety disorders, depressive disorders, psychosis and substance use disorders.
Mental health issues
Mental health problems can be present among refugees prior to migration that can worsen during the process of migration, can develop during the process of immigration with exposure to several psychological trauma including grief, poor living conditions, loss of social support, adjustment to new environment and other factors including lack of preparedness, loss of hope and can develop even during resettlement.
Even after resettlement, it often takes several years for the families to find their new home and make choices regarding how much of their original culture they would like to retain, how much of the new culture they would want to assimilate which also largely depends on the place of resettlement. For example, the stark contrast that one can note in a Sikh immigrant from Pakistan settled in Punjabi Bagh in Delhi vs. settled in central Delhi vs. settled in rural Punjab!
Road ahead
Psychiatrists see refugee crisis as a very complex, contemporary phenomenon with consequences more global and long lasting than usually anticipated. The best way to manage refugee crisis like most of the other aspects of life is prevention. However, once they ensue these situations can be better managed with international corporation, agreements, building culture fare support systems and effective application of public health measures and education about mental health problems. Trained interpreters, social support and culture specific interventions often go a long way. Time and again, traditional techniques have been disproved and have re-challenged our understanding of culture and human psychology. For example, mass debriefing is often used to provide psychological support in traumatic and post-traumatic situations. In a recent Cochrane study, Dr. Tharyan and his team found that both community change and cohesion, reinforcing their decision to avoid the mass debriefing of everyone, and focused instead on offering psychological and practical help to those who were most vulnerable. With time, transcultural psychiatry has also been progressive and will continue to provide us valuable lessons to remain a global community living in peace and harmony.
Amen.
