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Burma (Myanmar) Rohingya Refugee Wellness Country Guide

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Burma (Myanmar) Rohingya Refugee Wellness Country Guide Overview and Context e a d The history of the Rohingya people in Burma (Myanmar) dates i y back to the 15th century. Despite this history in Burma, the u g Rohingya are not viewed as legal citizens or recognized as one of G the 135 official ethnic groups within Burma. The Rohingya primarily n live in the Rakhine (Arakan) state, the poorest state in Burma. In y r i 1982, the Burmese government rescinded the Rohingya’s t citizenship status, severely limiting their ability to vote, travel, or own h n property. Although democratic elections were held in 2012, u Rohingya have faced increased violence perpetrated by the o o government since 2012, including mass rape, torture, and killings. C R Rohingya identity cards were canceled in 2015, further limiting movement, and rendering the Rohingya essentially stateless. s ) s r As a result of this ongoing discrimination, approximately 120,000 Rohingya have been internally displaced, e n 1,000,000 Rohingya have fled to Bangladesh, and 150,000 have fled to Malaysia. The Rohingya are referred to a l by some as the “most persecuted group in the world.” Many believe the atrocities committed against this group l are tantamount to genocide. e m W n Country Info Mental Health Profile e a Population e Research suggests Rohingyan refugees who have g y fled to refugee camps experience high levels of Approximately 1 million live u stress associated with the restrictions of camp life, f in Burma (Myanmar) M such as lack of freedom of movement, safety e concerns, and food scarcity. One study indicated ( R Language high levels of post-traumatic stress disorder (PTSD), depression, and somatic complaints associated with a Rohingya (Bengali dialect) trauma among those living in refugee camps. Many Rohingyan refugees have little to no experience m receiving Western mental health services. As a result, it is important to offer psycho-education to de- r stigmatize accessing mental health services, Religion u normalize common adverse mental health islam (predominantly) symptoms, and ultimately increase client access to B culturally competent healthcare services. Consider Alternative Traditional Interventions Interventions Acknowledging a mental health issue publicly in Alternative therapeutic modalities or Rohingyan culture often carries a heavy stigma. If non-clinical interventions such as someone is experiencing troubling symptoms knitting groups, women’s support associated with depression or anxiety, they may: groups, and art therapy can be useful . A ask an older relative or read religious texts UN research study reported a Rohingya community elder about utilize traditional maternal health group reflected positive their experiences remedies, such as mental health outcomes. The group seek advice of religious herbs, roots, or provided space for the women to leaders massage engage in a non-clinical, social way. See NPCT's Burma (Myanmar) Country Guide for more information e Camps/Countries Hosting Rohingya Refugees a d i y u g G n y r i t h n u o o C R Rakhine State s ) Due to ongoing conflicts, many Rohingya have been forced to flee their homes and seek shelter among Internally s Displaced Persons (IDP) camps within Burma and refugee camps in neighboring countries. Additionally, many live r e in urban dwellings in neighboring countries often because the neighboring country does not host official refugee n a camps or the existing refugee camps and local government restrict the ability to work or go to school. Among l l these temporary shelters, there is generally little access to comprehensive healthcare or mental health services, e employment opportunities, or educational opportunities. Given the breadth of settings and experiences, it is m important to remember that each of your Rohingya clients or patients will have unique experiences that contribute W n to their understanding and approach to health and mental health. Places to which Rohingya have fled can be seen e in the map above. Some of the estimated numbers: a e IDP Camps in Rakhine State (Burma) 120,000 Rohingya Refugees g y Bangladesh Refugee Camps Kutupalong & Nayapara 1,000,000 Rohingya Refugees u Malaysia 150,000 Rohingya Refugees f M Thailand 5,000-15,000 Rohingya Refugees e ( numbers are estimates based on UNHCR and other reports and may reflect refugees registered in camps and unregistered living outside of the camps R a tips for resettlement workers and mental health providers Consider utilizing an available language Foster existing m line system for Rohingya refugee clients. familial The Rohingyan language, a dialect of the Bengali strengths r language, can be difficult to find for in-person through interpretation. Some Rohingyan refugees may understand community social u Bengali, Burmese, Malay, or Thai given the exposure to Learn about the various regions where these languages are spoken. As connections. many Rohingya communities in the U.S. are small in size, history of the B Many Rohingyan phone interpretation may be the client's preference to women take great Rohingyan people. ensure confidentiality. pride in taking care of Some Rohingya their families. This is refugees may feel often a key priority, tension among the Recognize the with some Rohingyan various ethnic groups gender-specific women choosing to from Burma as a result cultural norms care for their home of chronic, historical and preferences. instead of working violence. Through outside of the home. It learning the history, Some Rohingya clients will may be beneficial to communities and not feel comfortable support the design of service providers can shaking the hand of the a women’s group to better address opposite gender, especially engage Rohingyan concerns and foster if the client has not spent women in a culturally healing when much time in urban relevant way. appropriate. settings, where these behaviors are common. Similarly, some Rohingya women may specifically request to be treated by Utilize group work when discussing sensitive issues. women doctors, as is Issues, such as intimate partner violence, are often considered taboo to discuss traditionally seen in the outside of the home. However, it may be helpful to form relationships with domestic Rohingyan culture. violence agencies to provide education and resources as a psycho-educational opportunity that doesn’t require the client to self-identify as a survivor of abuse..
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