The world has acquired a fairly stereotyped impression of refugees. Unfortunately, these stereotypes also affect those of us who work with refugees and prevent participation by refugees in decisions that affect them and their future.
Firstly, refugees are assumed to be completely helpless and crying out for any assistance that can be given to them. A condition such as this is seen to require direct action and intervention, independent of the participation of, or consultation with, the refugees themselves.
Secondly, refugees are treated as statistics and numbers. The operation of working with them is regarded as a logistical exercise. Refugees are recipients for objects and items. Successful progress in a refugee operation is measured in terms of x houses built, y tons of food provided, z patients treated. There is little consideration of social factors or refugee values because the whole basis of so many refugee relief efforts rests on objects, not on people; on what is available, not on what is needed.
Thirdly, `he who pays the piper, calls the tune'. The donors are usually the ones calling the tune so the agencies serving refugees see themselves as being more accountable to the donors than to the beneficiaries. It is the donors who - to a great extent - dictate the nature of response by consciously or sub-consciously expecting their will to be done. Basic needs may be being met but whose basic needs? The donors, the assisting agencies or those of the recipients?
Fourthly, assisting agencies sometimes develop a highly specialised but rather inflexible approach to the provision of that assistance. Specialisation and models developed in community health care, food distribution, camp layout and services, etc, in one refugee assistance programme become the blueprint for the work of that agency in any and all other refugee settings.
Fifthly, many agencies and donors provide high-tech, high-profile, capital-intensive, photogenic types of assistance such as sophisticated field hospitals, imported machinery and equipment, new technology and `appropriate' housing and sanitation. Many of these appliances and applications are beyond the knowledge and experience of refugees and thus widen the cultural and social gap between the intervenor and the refugee.
Sixthly, the decision-making apparatus in many international organisations or voluntary agencies does not have the provision for a major local input. Overall policy and programming is decided in Geneva, London or Washington and directives are handed down in such a way that questioning them is often difficult or unwise. Policy formulated at these levels may commit an organisation to a course of action that can become outmoded or impractical in the light of subsequent developments.
Seventhly, many agencies have no history of real provision for a participatory approach within their own organisations; power sharing with or participation by those outside the agencies - such as beneficiaries - is consequently unthinkable.
These various constraints to the participation of refugees have led
refugee assistance programmes to be described as:
.. the last bastion of the ultra-paternalistic approach to aid and
development. It is hard to think of another area where the blinkered
nonsense of the `we know what is best for them' approach survives so
unchallenged. (Malloch Brown)(1)
Aengus Finucane, the Executive Director of CONCERN, the Irish NGO, has
said:
Health services, food, shelter, and education can be described as basic
physical needs. But the basic human need of refugees is the restoration of
dignity. Dignity is the vital ingredient missing when basic physical needs
are delivered in a mechanistic and impersonal way. Respect for human
dignity is too often the first casualty of emergency responses to assist
refugees. A less sophisticated level of service may be the only thing that
makes good sense. But there is no excuse for a `frontiersman' approach
which fails to respect the dignity of the refugee. Small technologies may
be beautiful. But a small or lessened place for human dignity is always
and everywhere inappropriate.(2)
The ultra-paternalistic approach described by Malloch Brown means that participatory mechanisms in refugee programmes and camp administrations are often overlooked by the intervenors, whatever their role.
In truth, there are too many barriers, both physical and mental, within the system that preclude effective refugee participation. But the lack of participation by refugees in decisions that affect them and their livelihoods is a fatal error. Why? Because it deprives refugees of the use of their own coping mechanisms which are so important in helping the refugees to re-establish identity, self-esteem and dignity. And what does this type of deprivation cause? Deep down there develops what Tyhurst calls `social displacement syndrome'(3)
. This manifests itself in a mixture of depression, anxiety, apathy and hypochondria, which in the early stages are often considered essentially benign in that they may be slight to the point of not exceeding any limits of normality. These stresses do not require treatment by powerful drugs but rather `the best results are obtained by mobilising the patients socially and inter-personally' (Tyhurst). Left unattended or neglected, these mild disorders can manifest themselves in much stronger psychoses and anti-social behaviour such as severe personality disorders, regression to infantile states and aggression.
It is vitally important for all of us who work with refugees to understand the mental health stresses and strains of being a refugee and take appropriate steps to address them. A refugee suffers from guilt, nostalgia and `living in the past'. A refugee is a survivor. However horrifying the pre-flight conditions and however traumatic the flight, by crossing a border and arriving in a camp the refugee has survived when many of his or her family, relatives, friends and thousands of countrymen and women either did not survive or elected not to flee. After the initial period of euphoria on reaching the safe haven has passed, refugees are often overcome by a sense of guilt that they have survived while others died, or guilt that they abandoned relatives and friends who were unwilling or unable to escape with them. A sense of grieving for home sets in: `home' in the widest sense, meaning community, traditions and culture that have been left behind. This can lead to a nostalgia fixation and then to nervous depression and a failure to adapt, or a willful resistance to adapt to new surroundings. In its severest form it can generate `pronounced, strong withdrawal behaviour; decreased working efficiency or refusal to work' (Zwingmann).(4)
Adaptation difficulties and disorientation - frequent manifestations of being a refugee - are often unwittingly exacerbated by those who seek to help. Refugees are prevented from adapting adequately to new surroundings. The expectations of others - host governments, international organisations, relief officials, donors, the media - condition this adaptation. Prolonged residence in a refugee camp living like a refugee causes a refugee to adopt the role of a refugee. If a refugee is perceived and expected by others to be poor, helpless, ignorant and dependent for long enough, then eventually the refugee will take on that role.
Refugees also suffer from problems of personal identity and inadequacy. The organisation and structure of camp life is authoritarian and impersonal. Every aspect of life is contrived on a mass scale, taking little notice of individual variations. There is an almost total lack of privacy. In this stage, with no clear idea about the future and no sense of social belonging, a refugee can easily lose awareness of himself or herself as a mature social being. People who were self-sufficient before flight now have no source of livelihood, no income, no power and no control over their lives. This hurt sense of pride caused by a sudden fall down the social ladder due to circumstances beyond ones control occurs individually or collectively. Previously independent, self-sufficient and proud people are now entirely dependent on others.
Living in such unnatural social conditions causes in some individuals an impairment of interpersonal and social skills. The failure to maintain social status is felt as a humiliation, giving rise to lack of self-esteem and a sense of shame. The inferiority complexes which arise from this cause some refugees to appear arrogant and sullen, while others boast loudly of the old times when life was good. Relationships in often highly traditional and structured societies break down. Traditional coping mechanisms and methods of dealing with stress and anxiety are no longer effective. Traditional leaders and elders are discredited or powerless or have lost status. The effects of these various stresses are often manifested by the apathy shown by refugees towards attempts to involve them in activities such as public works.
Apathy is a behaviour pattern often found in refugees. The individual and the community become disinterested, passive and dull with a serious deterioration of motivation. Hope has been given up. The only motivation seems to be that of complaining to authorities about the physical living conditions within the camp, in particular singling out problems with food, water and shelter. In fact these physical complaints mask deeper psychological stresses which are, in the main, compounded by camp life. Refugees try to cope with these stresses by following what is essentially a conservative strategy. There is `a profound distrust of innovation, new forms of organizing their lives, since these are challenges to the expressive meaning of both personality and structural traditions'. (DeVoe)(5)
The best way to help overcome the mental health stresses of being a refugee is for all of us in the refugee assistance business to pay more than the cursory lip service to participation. In the refugee relief and development business, the term `participation' is widely used but little understood.
What is `participation'? I am not going to provide a prescriptive list of ideas. Each refugee situation demands its own response and raises its own challenges and opportunities for participation. David Drucker, in an article on community management, provides some interesting observations on the nature of participation:
The fact is that `participation' is fundamentally an act of partnership. Partnerships take time and effort to establish and can only succeed and continue to flourish where there is mutual trust. Trust is not too easy to come by; it has to be solicited, worked for, have exaggerated demands made upon it at first - thus testing its reality and solidarity - and it must be gradually earned and given life... True partnership is what is required, and this demands new directions, new skills, new activities and new roles if the age-old fixed expectations and patterns of interlocking behaviour are not to frustrate the new aspirations of development. (Drucker)(6)
At every stage and at every level of refugee assistance, there has to be a more comprehensive understanding of the refugee experience. Those of us who work with refugees simply have not had the kind of life experiences that refugees have been through. We have to gain a fuller understanding of the refugee experience in order to hope to answer the question: does what we are doing really meet the needs - all the needs - of refugees? Through paying greater attention to refugee participation, we may find that we can begin to answer this question and, at the same time, work towards providing a better quality of life for the many millions of refugees around the world whom, in one capacity or another, we all seek to serve.
This paper was prepared for the Addis Ababa PARinAC conference held in
March 1994 (see page ..) and is based upon research undertaken by Robin
Needham (now Director of CARE-Ethiopia) at the Centre for Development
Studies at Swansea, UK.
1. Malloch Brown, Mark 'Refugees: the African Dimension', paper given at symposium, Assistance to Refugees: Alternative Viewpoints, Queen Elizabeth House, Oxford, UK, March 1984.
2. Feldstein B, Frelick G and Frye E 'Training International Refugee Relief Health Workers', Disasters, Vol 7 (1), pp 26-28, 1983.
3. Tyhurst L 'Psychosocial First Aid for Refugees', Mental Health and Society, Vol 4, pp 319-343, 1977.
4. Zwingmann C A 'The Nostaligic Phenominon and its Exploitation', Uprooting and After, Zwingmann C A and Pfister-Ammende M (ed), Springer Verlag, New York, 1973.
5. DeVoe D M 'Framing Refugees as Clients', International Migration Review, Vol 15 (1), pp 84-88, 1981.
6. Drucker D 'Ask a Silly Question, Get a Silly Answer', Community Management:Asian Experience and Perspectives, Korten David C, Kumarian Press, pp 162-3, 1986.
July 1997