Access to health care

After an all day of training on research ethics and interviewing techniques, our refugee research assistants have been sent to the field to identify and recruit families for household interviews in the Chin and Daai Burmese, Iranian, and Sri Lankan refugee communities as well as among the urban poor. Sadly, we could not find a Rohingya research assistant able to write in English. Therefore, instead of conducting household interviews, we will be holding a couple of focus groups with the Rohingya so not all is lost. Fieldwork never goes as planned and always requires thinking on one’s feet!

Avie and I have also started interviewing stakeholders. The topic du jour was access to health care. Since Malaysia is not a signatory of 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, refugees have very few rights. In fact, even refugees registered with UNHCR are treated as illegal and are liable to harassment, detention, fines, corporal punishment in the form of public whipping, and deportation.

The lack of legal recognition of refugees compromises their access to education, legal employment, and health care. With regard to health care, in 2005 the Ministry of Health entered into an agreement with UNHCR to provide UNHCR recognized refugees with a 50 percent discount on fees charged to foreigners seeking health services at government hospitals. The fees refugees are required to pay are equal to payments Malaysian citizens incur when treated at state sponsored hospitals. The Ministry of Health also subsidizes the treatment for HIV and TB.

We haven’t visited any clinics yet, but interviews with IOM and ICMC indicate that health literacy is very limited among refugees living in Kuala Lumpur, preventive care is almost nonexistent, but health care needs are great. Gender-based violence, domestic violence, child abuse, and child marriage are of great concern to service providers and refugee advocates. Resulting physical and emotional health needs are considerable, but few services are available. ICMC, with funding from BPRM, has been providing services to survivors of gender-based violence for the past four years, but like most project-based programming these services are time-limited and long-term sustainability is a challenge.

Stayed tuned for more dispatches from the field…