MEDIA STATEMENT FROM HEALTH EQUITY INITIATIVES:
The Realities of Refugees and Asylum Seekers from Burma in Malaysia
Malaysia is currently host to one of the largest refugee and asylum seeker populations in Asia. According to the United Nations High Commissioner for Refugees, there are more than 90,000 registered refugees in the country. Both UNHCR and the refugee communities estimate that the actual number of refugees is much higher, given that thousands have yet to be registered. 92% are Burmese who escaped persecution in Burma, where political turmoil and ruthless military domination have persisted for decades. However, Malaysia has continued to refuse to recognise them as refugees.
Malaysia has not ratified the 1951 Refugee Convention nor the 1967 Protocol. Under the Malaysian Immigration Act 1959/63 (Act 155), refugees and asylum seekers are designated as “illegal migrants” and may be subject to arrest, detention, punishment (including whipping), and deportation. Historically, the focus has been on reducing the number of irregular persons through large-scale (and often violent) ‘crackdowns,' where the aim is to arrest, detain and deport undocumented migrants and refugees. Arrested refugees are often unable to understand the charges read to them and secure appropriate legal assistance.
Life for refugees and asylum seekers in Malaysia is extremely difficult. Unable to work legally in the country, and with limited access to basic services (health care, education or legal services), they are vulnerable to poverty, exploitation and health problems. Refugees and asylum seekers scrape by on earnings from work in low paying, unskilled and often part-time/casual jobs in the plantation, construction, manufacturing, or service sectors. Even amongst those who are employed, poverty and indebtedness are endemic. Many earn far less than the government-determined poverty-line income (PLI) of RM800 per household per month.
Forced labor and human trafficking are serious concerns for this community. Moreover, without the protection that legal status provides, refugees and asylum seekers are afraid to come forward to authorities because they fear arrest and detention. At one time, Malaysian immigration officials were even implicated in such activities: it was found that they had trafficked refugees from Burma up to the Malaysia-Thai border where they were handed over to human smugglers/traffickers who held them for ransom. Those who could not pay were sold to Thai fishermen, brothels or private owners.
Refugees’ and asylum seekers’ dire living circumstances, coupled with aggressive, punitive approaches by the state as well as everyday experiences of discrimination by non-state actors, creates an extremely poor environment for refugees in Malaysia. Furthermore, these adverse life events, combined with the persecution they faced in Burma, increase their vulnerability to a number of health problems, including infectious diseases, psychological problems and under-management of chronic conditions.
Refugee Health
Mental health problems among refugees and asylum seekers in Malaysia are a serious concern. Health Equity Initiatives’ (HEI) analysis of the scores of 578 refugees and asylum seekers who were screened in April and May 2011 using the Depression, Anxiety and Stress Scales 21 (DASS21) indicated that 19.9% experienced either moderate, severe or extremely severe Stress. Almost half (48%) experienced either moderate, severe or extremely severe Anxiety, and 38% experienced either moderate, severe or extremely severe Depression. An earlier analysis of HEI’s mental health clients showed that 22% presented with symptoms that required psychiatric care. A separate study conducted by HEI revealed that, among those with a high level of need for psychosocial services, 77.1% reported they could not afford the services.
In principle, government hospitals in Malaysia are open and available to refugees and asylum seekers, but evidence collected by HEI shows that refugees and asylum seekers experience substantial barriers accessing health care in Malaysia.
The cost of health care is unaffordable for many. This is particularly the case if treatment costs are high and the individual is an asylum seeker (asylum seekers cannot take advantage of the 50% discount off the foreigner rate that registered UNHCR refugees receive). Concerns around arrest and detention are another problem, as refugees and asylum seekers are afraid to travel to seek medical services. Many refugees live outside the city, some in jungle sites, so transportation and security concerns are significant.
Language differences and a lack of information about health services also impact refugees’ ability to access services. Refugees have also cited the poor quality of treatment and discrimination they experience at both public and private health facilities as reasons for not seeking medical treatment when needed. Evidence also showed that refugees delayed seeking medical treatment until the situation became serious, thereby risking their health and increasing their need for hospitalization.
Forced Labor
Forced labor is a situation currently affecting 12.3 million people worldwide. It is defined by the International Labour Organization (ILO) as “all work or service which is exacted from any person under the menace of any penalty and for which the said person has not offered himself voluntarily.” Simply put, there are two elements to forced labor: 1) the work or service must be exacted under menace of a penalty; and 2) it is undertaken involuntarily.
By making the public aware of research on forced labor in Malaysia, HEI wishes to highlight its prevalence. Although almost 9.5 million people are trapped in forced labor in the Asia-Pacific region, the phenomenon of forced labor is not well understood in our societies. Frequently, forced labor operates in a manner closely connected with local context and is therefore less noticeable for most members of that society. In Malaysia, a combination of shortcomings in both immigration and labor laws has created dangerous circumstances, exposing this vulnerable population to forced labor.
HEI’s research on Burmese refugees and asylum seekers in the Klang Valley revealed that one third of the research sample population has experienced forced labor. Playing into their fear of authorities because of the lack of documentation, employers and agents have used the threat of reports to the police and/or immigration as a way to force them into underpaid and exploitative labor. The negative impact on their well-being is demonstrated by more than 60% of the sample population who display symptoms of depression, anxiety and stress. This is more than twice the rate of the general population.
The graveness of the situation cannot be underemphasized. In Malaysia, practices of forced labor can last for years without being detected. Survivors rarely report their experience for a variety of reasons: they don’t know where to go; they are too afraid to speak out; they fear deportation or imprisonment; or they are simply resigned to accept forced labor as a norm rather than a violation of their fundamental human rights. One man HEI interviewed said simply, “I can’t sit around waiting for the good one. I don’t want to wait for the job.” Basic survival - the need for food and shelter for themselves and their families - has left them with little choice but to take up dismal jobs, often entering into situations of forced labor fully aware of the risks and dangers.
Through our campaign we are seeking to shed light on their experience, and to understand their plight as persons - not just as faceless workers. Our ignorance of forced labor situations has undoubtedly contributed to the continuation of these practices. This is why public awareness is essential. We hope that the witness accounts will show that allowing refugees and asylum seekers to work legally will protect them, improve their well-being, and demonstrate that the recognition of their status as refugees will make a whole world of difference.
