The Global Refugee Crisis: A Clarion Call of Conscience

There have always been refugees: people who are forced to flee their respective home countries by armed conflict, persecution or repression. They must find new homes and new lives abroad. But there is something different about the current refugee crisis. This crisis is more severe, pervasive and larger than anything the world has seen in decades. This disaster is of global proportions and the situation is truly desperate for millions. It is the biggest humanitarian emergency of our era and it is still unfolding.

The origin of this crisis is multifactorial and rooted in many different, apparently unrelated conflicts across the globe. The rise of extremist, religiously and ideologically motivated terrorist groups in the Middle East, like ISIS, Bashar Assad’s brutal regime in Syria, Al Qaeda and Western intervention in Iraq have all played a role. These groups use unparalleled violence and brutality to achieve primacy over their rivals.

People are fleeing their homelands in panic, by the millions, in dangerous, overcrowded dinghies, without status and recognition, rather than be killed, taken as prisoners, enslaved or face political and religious persecution. Many of them, including children, have ended up drowned off the coast of countries that have either refused, or prohibited their entry. The luckier ones live in horribly difficult conditions in cramped, unsafe refugee camps with no prospects for jobs or education. The trip they make is so perilous in part because Western governments, wanting to discourage all forms of uncontrolled migration, have let it be that way as a matter of deliberate policy.

The current refugee crisis calls for a global response and all of us must contribute in addressing it. It is a worldwide problem — one whose scale and severity is unmatched since World War 2.

Politics within Europe are unusually hostile to refugees and migrants at the moment given the rise of right wing parties that drum up paranoia against outsiders especially Muslims. This is why the refugees’ plight has become even more acute as most of them have tried to enter the Western world via Europe. This is why they are in crisis, stuck in camps or dying in the Mediterranean rather than resettling safely in Europe.

The US is usually pretty good about resettling refugees — it resettles about 50,000 to 70,000 a year, a number that has been slowly rising since 9/11 — but so far has badly lagged behind in resettling Middle Eastern refugees. Since 2011, the UN refugee agency has referred 17,000 Syrians to the US for resettlement. The US response has been tepid and we have resettled only about 9 percent of those. The US process for applying for resettlement can take up to 24 months for Syrians, due in part to extensive background checks and extraordinary paperwork requirements.

The International Rescue Committee is renewing it’s call for the United States government to resettle 65,000 Syrian refugees before the end of 2016. The recent U.S. commitment to accept around 10,000 Syrian refugees is only a first step toward alleviating their suffering. Much more is needed. It is nothing compared to the more than 800,000 Southeast Asian, mostly Vietnamese, the United States accepted after the end of the Vietnam War.

As citizens of the wealthiest, most powerful and prosperous nation in the history of mankind and by virtue of a shared humanity, it is our responsibility, nay, our duty to open our doors and our hearts and welcome more desperate refugee families to safety and freedom within our communities. Some of our foreign policy decisions have been responsible for increasing instability and, even, the inadvertent rise of extremist groups in the Middle East. We must do our best to help those who are suffering because we cannot remain indifferent and abdicate our moral responsibility.

As psychiatrists, we know that these human beings have been traumatized in unimaginable, horrific ways. They have experienced and survived devastating and profoundly stressful events. It begins with war: the destruction of their homes and communities through the use of extreme and systematic violence, personal threats, attacks, persecutions and killings. This is quickly followed by the trauma of the forced and perilous migration itself which many of them don’t even survive. Those who survive must then face the traumatic loss of their homeland, their aspirations, friends and family, while struggling to cope with squalid conditions in makeshift refugee camps with no hope of an economic or educational future. Sometimes they are subject to racism, dehumanization and depersonalization and forced to endure almost prison like conditions. Desperate conditions in some camps lead to malnutrition and further disease. No human being, ideally, wants to leave their homeland, if they have the chance to live a safe and secure existence. And no mother would put her son on a rickety boat unless she thought the water and what lay beyond was safer than the land.

Therefore, it is our duty firstly, to inform the public about the emotional, psychological, and spiritual impact in addition to the physical cost these refugees have had to pay. We must then tell our representatives in Congress what we think about the refugee crisis and urge them to ease restrictions on refugees. Their applications and security clearances must be prioritized. It’s unacceptable that refugees should wait for years in these camps while their applications are vetted.

In addition, we should also offer our services and expertise to attend to the mental health needs of newly arrived, psychically devastated, physically and emotionally traumatized refugees in our communities in a way that is linguistically and culturally appropriate. We should also advocate for the development of home based, school based, office based and community based programs to attend to the medical and mental health needs of the refugees and help them integrate into society with housing and jobs. This is how we uphold our commitment to justice, equality, humanitarianism, universal human rights, human dignity, and global mental health.

Sadly, the current crisis is unfolding in the context of a strange, culturally paranoid, virulently anti-immigrant moment in American politics. Terrorism and crime are being conflated with and blamed on immigration. Although, even a figure like Donald Trump has expressed his support for resettling refugees, some politicians have warned that ISIS could exploit any Syrian refugee resettlement program to use it as a "a federally funded jihadi pipeline."

This is usual fear mongering. The Obama administration knows this isn't true. These are families stuck in camps we're talking about -- they include torture survivors, war crime victims, victims of sexual assault, people with special medical needs and women who head households. In almost all cases these are people fleeing from terrorism. They are displaced, powerless, and voiceless. However, the administration is unwilling to overcome the political opposition.

Through our representatives in Congress, we must compel our government which appears, at the moment, more concerned with protecting itself politically against the very unlikely risk of letting in potential jihadis than with saving the lives of thousands of Syrian families to respond to this crisis in a way that is consistent with our morality and our values.

The U.S. itself a nation of immigrants fleeing religious persecution has historically been the world leader in recognizing the moral obligation to resettle refugees. We cannot afford to shut our eyes and sit out the biggest refugee crisis since WW2. As the German and Turkish governments calmly take in a million refugees each in 2015, it is vital for the U.S. to step up its response.

As psychiatrists, Americans and citizens of the world, the clarion call of conscience is loud and clear. What morality demands is indisputable. People suffering hunger, illness, pain, anxiety, trauma and other dire conditions should be given every aid available, and those who live relatively comfortably should endure the mere, but often intensely rewarding discomfort of providing it.

Opening our doors and our hearts to people fleeing war, death and poverty, is the right thing to do and our moral responsibility. We must hold true to our obligations in the world and to the values we profess: compassion, empathy, generosity and mercy. It would be unethical for us to stay silent or passive on an issue with such serious, life and death implications for so many people.