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Health Equity Initiatives (HEI) is concerned about the latest agreement between Malaysia and Australia to send back 800 asylum seekers who will enter Australia by boat to Malaysia, in return for Australia resettling 4,000 additional refugees from Malaysia over the next four years.  

This agreement to send back 800 asylum seekers to Malaysia raises serious concerns. In recent years, Australia has pursued ‘outsourcing’ and ‘offshore’ policies, even investing millions of dollars to intercept and preempt onward movements of asylum seekers to Australia, in blatant violation of its obligations as a state party to the 1951 United Nations convention relating to the status of refugees and its 1967 protocol. The recent deal with Malaysia is yet another example.  

Malaysia, on the other hand, is not a signatory to the 1951 UN convention relating to the status of refugees or its 1967 protocol and has no legislative or administrative provisions in place for refugee protection.

While we welcome the statement by the Malaysian High Commissioner in Canberra, Salman Ahmad that the asylum seekers sent back to Malaysia will not be sent to detention centres; but instead, would be treated with respect and dignity, and would be able to “mingle” in the community (Envoy: No detention centre for asylum seekers, Star , May 9), Malaysia needs to explain how it plans to uphold its commitment to provide international protection to asylum seekers.  

HEI is an organisation that concerns itself with the right to health of marginalised communities, with focus on mental health. Our work with refugees shows that in an urban refugee population such as Malaysia, refugees do indeed mingle in the local community.

However, a major concern that affects their mental health is the lack of safety and security. Their physical safety concerns are due to the lack of recognition of their status by authorities. They are routinely stopped by police and immigration officers, as well as Rela, and experience intense psychological fear related to being sent to prison or detention centres.  

This fear affects their ability to participate fully in the local community. It affects their ability to find work and go to work. It also affects their ability to access health care.  

Another issue of concern with refugee mental health is the lack of certainty about their future. Refugees and asylum seekers often wait for long periods for registration with UNHCR, and then for the resettlement process that would take them to third countries so they can start their lives.

Refugees like the Afghans and the Rohingyas experience inter-generational refugeehood, i.e, they were born as refugees and their children are also born into refugeehood.

In the interim, individuals and families halt different processes in their lives, such as continuing their education, finding meaningful work, and even starting a family, including over a generation.

Our mental health interventions with refugees indicate that refugees and asylum seekers experience clinical depression and anxiety, with many of them entertaining thoughts of suicide in an attempt to end their suffering.  

Added to this is the anxiety and depression that comes from lack of financial security and lack of ‘freedom’. Ultimately, refugees and asylum seekers need financial strength to live in this country. They need to pay for rent, utilities, health care and all the other basic needs.

Many of them end up in dangerous, dirty and demeaning work in informal and unprotected work sectors because they lack the formal right to work. As such, many of them are exposed to risks of forced labour and human trafficking.  

A few studies conducted by HEI with refugees on accessibility to health care show that they avoid and/or delay accessing health care because of lack of affordability, and seek medical care only when their illnesses reach a critical stage.

Results from a 500 respondent survey conducted by HEI indicated that fear of arrest and detention was a major barrier to accessing health care.  

Research in other countries has shown that working is one way for refugees and asylum seekers to cope with their mental health problems and past trauma. Refugees have come to this country because they are fleeing persecution or threat of persecution in their own countries.

Many of them have faced arduous, horrendous and even torturous situations and are left with psychological scars that require safety in order to heal. Also, many hope to regain some sense of normality in their lives and for this crave routine.  

Work will not just offer some form of aid against psychological trauma, but will also afford them the ability to address physical and mental health needs, food, and decent living conditions.  

We call on Australia and Malaysia to call off the proposed deal and act in a manner befitting responsible nations within the international community.  

We call on Malaysia to ratify the 1951 United Nations convention relating to the status of refugees and its 1967 Protocol, recognise the right to work of refugees and asylum seekers, and apply rates paid by Malaysians for public health services to refugees and asylum seekers.

Giving them the right to work would allow them to provide for and pay for their basic needs. For a country like Malaysia, with known labour shortages, recognising refugees and extending refugee protection to them, including granting them the formal right to work, not only makes better economic sense than incurring increased costs of recruiting new foreign labor from overseas; it also validates the country’s efforts to be a key player in the international human rights arena.

Malaysia needs to walk the talk in terms of demonstrating its willingness to provide international protection to asylum seekers.  

We call on Australia to invest the millions of dollars it is spending on deterring asylum seekers from seeking much needed international protection in the expansion of protection space for asylum seekers in Australia and elsewhere, in line with its international obligations.

Vizla Kumaresan is a Clinical Psychologist and a mental health services coordinator for Health Equity Initiatives

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