Lynette Lee Corporal
BANGKOK, Jun 26 2007 (IPS) – As the United Nations marks International Day of Support for Victims of Torture Wednesday, Burmese refugees who have fled violence in their own country are facing another kind of torture not physical, but mental and psychological.
Depression and stress-related disorders are becoming more common, experts say, in many Burmese refugee camps. Unfortunately, psychosocial services are still lacking in most areas due to shortage in human and material resources.
Mental health patients are increasing in the camps for the last several years. This is due to dismal living conditions in camps, plus the fact that they have been living here for almost two decades facing a bleak, uncertain future, Annabelle Mubi, International Rescue Committee (IRC) psychosocial programme officer in the refugee camp in Mae Hong Son province in north-western Thailand, told IPS in a phone interview.
The IRC is a global network that provides emergency relief, as well as refugee relocation and rehabilitation.
According to Mubi, sufferers are often depressed and stay at home most of the time. Suicide attempts, she adds, are not uncommon especially among teenagers.
There are an estimated 150,000 documented Burmese refugees here in Thailand, many of whom fled the military-run country after the 1998 army crackdown.
The life that they experience day in and day out consist of staying in overcrowded, confined camps for almost two decades, facing a bleak future with almost no opportunities for finding a stable job, and even less hope of returning to their homeland anytime soon.
While international groups like the United Nations High Commissioner for Refugees, Medecins Sans Frontieres, IRC, the Catholic Office Emergency Relief for Refugees provide psychosocial services, experts say that much more assistance is needed.
Not much is happening at all in the psychosocial services level due to a lack of psychiatrists and psychologists in the field, said a representative of the human rights documentation unit of the U.S.-based National Coalition Government of the Union of Burma.
Asking for anonymity, he added that most related services are provided by grassroots groups that are facing drastic fund shortages.
Alcoholism and gender-based violence, including sexual abuse of women and children, have increased over the last four years, laments Mubi.
The IRC staff has been going around the communities, conducting information campaigns about the adverse effects of alcohol and drug use by Burmese youth. They also do home visits for counselling.
Young people, especially the men, have taken to drinking alcohol made from rice wine, which would often lead to domestic violence, said Mubi.
These problems are not only confined to the refugee camps but spills over to the population of Burmese migrant labour in Thailand, estimated at up to one million.
According to Cynthia Maung, who founded the Mae Tao clinic in Mae Sot town on the Thai border with Burma, excessive alcohol consumption is also quite common among migrant workers.
The oppression and violation basic rights of these people have continued even after they left Burma. Life as migrant workers has been very stressful for them because of long working hours, low pay and a still uncertain future. Alcohol is a common form of relaxation, especially for men, said the doctor and former Ramon Magsaysay awardee, known for her humanitarian work among Burmese refugees and migrant workers.
Children are the most vulnerable because as in the refugee camps, a lot of violence happens within families and communities, Maung continues.
One of the most effective ways of giving psychosocial support to these kids is through education. There are now efforts to do that, said Maung. Unfortunately, she adds, the present educational system is not designed to deal with psychosocial issues affecting children.
According to a representative of another NGO working on the Thai-Burma border who did not want to be identified, women and children may bear the brunt of the effects of alcoholism, but the men should not be ignored.
Men, especially those who do not have jobs, need that psychosocial care too to stop them from turning to alcohol out of desperation. But admittedly, there is really a lack of such services, and health agencies need to address this issue in the camps, she added.
In Mae Hong Son, the IRC has so far had 80 mental health cases, most of them involving psychosis, in one camp alone since the service was offered last year. Mubi herself is handling 10 cases.
The figure could be higher because many cases are not being reported. The problem is that there #39s a lot of stigma attached to it and people are often labelled as #39crazy #39 when they seek the help of counsellors, noted Mubi.
Burmese, in general, don #39t feel comfortable opening up to a total stranger. We are very particular about who we trust and choose to open up to, maybe because of what we experienced in the political front and also because of ethnic politics, said Myint Myint San of the Burmese Women #39s Union, a former student activist and refugee.
In Burma, people who have mental problems are sent to asylums and are seen as crazy, so it #39s understandable if people keep their depression and other stresses to themselves. We don #39t have that culture of seeking counselling from outside our own family or peers, she said, adding that she coped with her own trauma of being a refugee in Bangkok by turning to her close friends.
Mubi says things can also become #39too close for comfort #39 for those living in the camps. From what we have observed here, they don #39t easily open up to their friends either, since they think they will see their friends everyday, their confidences will be betrayed and thus, suffer the stigma, she explained.
Refugees would most rather confide in foreign volunteers and visitors, she adds. They tend to look at foreigners as a kind of #39saviour #39 who will perhaps save them from all this misery, she said.
Domestic violence also makes matters worse, because it makes it difficult for refugees or migrants to turn to other family members for help, Mubi points out.
We need the whole community to be involved more in solving the problems and this is why we are conducting training, so that the people themselves will know how to cope, said Mubi. These people are lonely and need someone to talk to and share their feelings and thoughts with another.
