World Health • 46th Year, No. 6, November-December 1993 11 The plight of refugees Marie Lobo The International Year of the he concept of "family" differs Family, 1994, offers the new circumstances and often after with country, culture and great privations and hardship. The Ttradition. In situations where United Nations High physical losses of material possessions there are mass movements of may be compounded by losses of life refugees, this concept is further Commissioner for Refugees and limb. However, the emotional and blurred. Individuals establish (UNHCR) an opportunity to mental effects are even worse because relationships for a variety of reasons, they are not perceived; they therefore often mainly to obtain support in a revitalize its concern for the last much longer and are more period of transition, while the violence human dimension of refugee difficult to heal. and trauma associated with the People working with refugees transition from citizen to refugee life, over and above the have to keep in view the dual concept affect people's lives often far into the of mind and body and the context in future. Refugees who are awaiting physical aspect of merely which they live; and programmes for durable solutions to their situation providing food, water and refugees have to be organized in a have to be assisted to find ways and manner which encourages a fuller means of sustaining themselves in a shelter. expression of every aspect of life. reasonable state of well-being. The International Year of the The concept of health adopted by disease - therefore takes on particular Family (IYF) proclaimed by the WHO in 1948 -as a total state of significance for refugees who have United Nations for 1994 has given an well-being physically, mentally and been uprooted from their homes and impetus to this broader concept of socially and not merely the absence of homeland and must adapt to life under health, and has permitted the offices Growth monitoring: refugees everywhere need outside assistance to maintain a reasonable state of health. 12 World Health • 46th Year, No. 6, November-December 1993 of the UNHCR to organize activities for the family's needs, including In this context, UNHCR has tried for refugees which will include men, education of children, medical care to address the planning for the IYF women and children in a process of and a healthy diet. through its branch offices by rediscovering their potential. So far, • Unaccustomed dependency on sensitizing its staff to the special needs 69 countries where the UNHCR has outside assistance. of refugee families. Its programmes offices have organized IYF-related • Inability to participate in consist of a variety of activities which activities. The IYF and what it remunerative work because of host (i) aim to involve refugees themselves represents has particular relevance for government restrictions on in reordering their lives in a manner refugees. employment. that can uphold individual family • Lack of work. structures; (ii) enable them to meet • Idleness in the home. together as communities to resolve Disrupted families • Encountering new diseases, new problems in ways that are culturally systems of health care, and the compatible; and (iii) provide When planning for the International imposition of new foods. opportunities for the local populace to Year, UNHCR has attempted to Associated with all these are very meet with refugees in situations where understand the various factors that real feelings of hopelessness, loss of the latter can present themselves in a characterize refugee family life. purpose in life and motivation, hatred, positive manner. Among these are: revenge, anger and other negative • Separation from family feelings that tend to pervade family members. life with violence. The roots of Children's drawings • Loss of near ones. security, trust and confidence in others • Change of circumstances - are also eroded in the process of Drawing and essay competitions have financial, social, physical, becoming refugees, and this affects been devised for children on the educational. many people's mental health.- theme "My family", with the intention • Loss or change of previous roles: The International Year of the of understanding the concept of family breadwinner, homemaker. Family offers UNHCR an opportunity that refugee children have. What do • Loss of community support. to revitalize its concern for the human they perceive as their family and what • Change of previous norms, e.g., dimension of refugee life, over and are they trying to tell us through their customs, traditions, religious above the physical aspect of merely drawings? It has proved most guidance. providing food, water and shelter. revealing; the children have told • Difficulty in upholding previous Moreover health needs to be viewed stories through their art work about traditions relating to family life, in the truest sense of the term, and the plight of families during flight, and regarding marriage, birth and from a range of physical, social and their life in the camps, or while child-rearing practices. emotional aspects as well as awaiting repatriation after a period in • Loss of financial ability to provide aspirations for the future. exile. Grandparents have figured in Even os refugees, men, women and children can all rediscover their potential through well-organized activities. World Health • 46th Year, No . 6, November-December 1993 13 Distribution of food in o camp in Kenya for Somali and Girls offending school in a refugee village in Pakistan. Ethiopian refugees. these drawings as well as families Women's group activities support Through paintings and posters, with only one parent. Another aspect women in coping with circumstances refugees exorcise the violence of their that has been highlighted is the need of great stress. Health education and recent past and come to terms with the to fmd work for idle fathers who do well-baby clinics as well as baby problems of the present. Health nothing all day while the mothers festivals help to give mothers access messages are also reflected in these work to keep the family alive. The to medical attention, early detection of expressions of art; AIDS, family trauma of violence figures largely in disabilities, and preventive measures plarming, and other family-related those pictures drawn by children from on behalf of their children. health issues have been very war-tom countries. Demonstrations of low-cost, balanced sensitively handled within the relevant Children living under these nutrition are among various other cultural context. circumstances often do not have role ingenious means of coping with life UNHCR in its various offices models they can emulate; their parents under great deprivation and hardship. worldwide strives to obtain the same are under great stress and carmot give Activities for men seek to help privileges for refugees as for the them the time they need. Violence them too to adapt to a change of role citizens of countries where refugees pervades family life. It is very hard for that they perceive as depriving them are to be found. Many offices have a child to accept the humiliation that a of their position as breadwinner, head started innovative programmes like parent must undergo in order to feed of household and decision-maker those described above, taking an the family. Children sometimes have because of their lack of earning integrated approach to embrace all to take part in scavenging for food and capacity. aspects of refugee life. Encouraging other necessities such as water and the refugees themselves to tell us their firewood to keep the family alive. story and what they want in life can Activities for children need to be Group support ensure that whatever is done is targeted at enabling them to express appropriate. • themselves through drawings or play Language classes have proved to be a activities focused on helping them to very good medium for helping develop healthy attitudes to life and friendless and isolated persons to find each other. group support. Family fairs or Their drawings tell the story of festivals where refugees and local trauma and pain as well as the daily people meet to share common goals difficulties to be faced, and assist the and ideas serve to support such Mrs Marie Labo is Senior Social SeNices helpers in understanding the problem activities and relieve the great Officer in the Programme Technical Support better. Section, Office of the UN High Commissioner loneliness that many refugees for Refugees (UNHCR), 154 rue de Lausanne, experience. 1202 Geneva, Switzerland .