Protracted Refugee Situations: Parallel Health Systems and Planning for the Integration of Services

The international community typically responds to refugee situationsby establishing ‘care and maintenance’ programmesspecifically for refugees. Limited resources may also be directedto hosting communities, but donors often channel the bulk offunding through UNHCR and its implementing partner NGOs, whoin turn create service delivery structures that are operatedin parallel to local structures. Although there may be causefor this approach in a short-term emergency phase, particularlyif the host country systems are very weak, this eventually becomesfinancially problematic if refugees continue to live in exilefor years at a time. In the short term, it can also engenderan inequitable and inefficient use of scarce resources. Thispaper traces the evolution and impact of implementing refugeehealth services in parallel to local systems using observationsfrom Uganda, and offers Quality Design as a model for planningthe local integration of services.     

More Labels, Fewer Refugees: Remaking the Refugee Label in an Era of Globalization

This paper revisits the concept of refugee labelling I elaboratednearly two decades ago. In radically different conditions, thecontemporary relevance and utility of the concept are re-examinedand re-established. Formulated at a time of regionally contained,mass refugee migration in the south during the late 1970s andearly 1980s, the paper argues that the concept still offersvital insights into the impacts of institutional and bureaucraticpower on the lives of refugees in a globalized era of transnationalsocial transformations, mixed migration flows, and the continuingpresence of large scale refugee migration. The core of the paperargues that the ‘convenient images’ of refugees,labelled within a co-opting humanitarian discourse in the past,have been displaced by a fractioning of the label which is drivenby the need to manage globalized processes and patterns of migrationand forced migration in particular. The paper re-evaluates theconcept using the three original axioms—forming, transformingand politicizing the label ‘refugee’. The core argumentis that in the contemporary era: a) the formation of the refugeelabel reflects causes and patterns of forced migration whichare much more complex than in the past, contrasting with anessentially homogeneous connotation in the past; b) respondingto this complexity, the refugee label is transformed by an institutional‘fractioning’ in order to manage the new migration;c) governments, rather than NGOs as in the past, are the pre-eminentagency in the contemporary processes of transforming the refugeelabel, a process driven by northern interests; d) the refugeelabel has become politicized by the reproduction of institutionalfractioning and by embedding the wider political discourse ofresistance to migrants and refugees.     

难民问题治理上的各相关行为体分析——对缅甸罗兴伽难民的个案研究

本文分析在孟加拉国的缅甸罗兴伽(Rohingya)难民问题的形成,以及在难民保护、援助和难民问题治理过程中各个国家、国际组织、地区组织、国际非政府组织等各相关行为体的角色和作用,并通过进一步探讨认为,罗兴伽难民问题需要东盟组织通过创建新的地区难民问题治理机制来解决。     

Refugees in Russia: the Law on Refugees and its Implementation

Since the adoption of a new Russian Law on Refugees in 1997,the number of recognized refugees has dropped drastically. TheLaw has a definition of the term ‘refugee’ almostidentical to that of the 1951 Convention. But many provisionsof the Law are contradictory to Russia's international obligations.After a short look at the background to the issue, the Law onRefugees is examined. Then the implementation of the Law iscompared with the situation before its entry into force. Thedifficult life conditions of refugees and asylum seekers areconsidered to be partly a result of the legal provisions andtheir realization. The factors that contribute to the presentsituation are discussed. While certain provisions of the existingLaw need to be amended, it has to be implemented in order toprovide international protection to asylum seekers.     

Theoretical and Methodological Challenges of Studying Refugee Children in the Middle East and North Africa: Young Palestinian, Afghan and Sahrawi Refugees

This article aims to address a number of conceptual and methodologicalchallenges facing the study of young refugees. Much of the researchon refugees has, until recently, been focused on adults, andto a lesser degree, on young children. Those studies that doinclude children are largely carried out in the domain of psychologyand psychiatry and tend to pathologize and individualize. Thisarticle is based on observations derived from a six-year, multi-disciplinaryanthropological and participatory research programme that examinedthe impact of forced migration on young people in the MiddleEast and North Africa: Palestinian refugee youth in Lebanon,Syria, Jordan, the West Bank and Gaza, Sahrawi youth in Algeria,and Afghan youth in Iran. It argues that despite the challenges,an anthropological and participatory approach contributes toa greater, more holistic understanding of refugee youth.     

古巴医疗卫生体系再审视:运行机制与经验借鉴

本文从融资体系、服务体系、管理与监督体系及人力资源输送体系四方面对古巴医疗卫生体系进行了再审视,着重分析了系统有效运行的前提和隐含的问题,并对支撑医疗卫生体系建立与发展的社会背景与政治根源进行了反思。最终从扩大医疗卫生资源和控制医疗卫生服务成本两方面总结了可供借鉴的经验:明确政府责任与主导地位,保障投入比例;优化医疗卫生体系层次结构和资源流向;协调四大子系统的互促与对接关系,形成良性循环;从医疗教育入手引导卫生资源均衡配置;切断医务人员收入与服务费用之间的利益链条从而控制费用膨胀。     

Islamism in the Diaspora: Palestinian Refugees in Lebanon

In recent years there has been increasing academic interestin Islamism in the Middle East, not least in Palestinian Islamismchampioned by groups such as Hamas and Islamic Jihad, whichare waging a war of attrition against the Israeli occupationof the West Bank and Gaza. There has been less concern withIslamism among the Palestinian refugees dispersed in MiddleEastern countries such as Syria, Jordan and Lebanon. The articleoutlines the sources of Islamism (‘political Islam’)among Palestinian refugees in Lebanon. The rise of Islamismis a complex mix of contingent factors that is fuelled by socialand political deprivation and shaped by divergent views on Palestiniannationalism (secular vs. Islamist), the Islamist revival inLebanon and ‘strategic localization’ that turnsrefugee camps into battlefields between Palestinian factions.The Islamist groups cater for narrowly defined segments of therefugee population and have been unable to attract wider support.Instead, they cater for minor, camp-based constituencies whichcompete with secular groups for internal control of the campsand, by implication, of the Palestinian nationalist cause itself.     

Settling Like a State: Acehnese Refugees in Vancouver

In Canada, the phenomenon of urban refugees is largely an expressionof state-managed practices, not spontaneous migration and settlement.This study focuses on the distinctly North American, and specificallyCanadian, experiences of pre-meditated, state-planned, government-managedmigration and settlement for urban refugees from the Aceh regionof Indonesia to Vancouver, British Columbia in 2004. It exploreswhy and how these refugees came to Vancouver; the state policydecision that located all of them in one city; and how theyhave fared in acquiring official language proficiency and employment.Whereas many refugees move to urban centres to enhance educationaland employment opportunities, this study illustrates the obstaclesto accessing both in Vancouver. Despite full legal status andaccess to employment sanctioned by the host state, there isno guarantee that refugees will have an easier time creatinglivelihoods under dramatically new conditions. The analysisis based on research conducted between January and August 2005during which a survey of housing, employment, and income issueswas conducted with 70 of the 104 Acehnese refugees who had relocatedto Vancouver since February 2004. In addition, a one-day, three-partseries of focus groups was held during which 47 members of theAcehnese community took part. Discussions centred on three keymoments during their migration: (1) while in Malaysian detentioncamps; (2) upon arrival in Vancouver, British Columbia; and(3) during the first year of settlement in the city, to ascertaincommon settlement experiences, policy implications, and theshort-term ‘success’ of the resettlement.